Plain language analysis:
The emergency rule will allow the Board to grant a waiver from or variance to the following requirements on a case-by-case basis, if a request for a waiver or variance is made due to a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances:
The requirement under s. N 1.08 (5m) (b) that simulation be utilized for no more than 50% of the time designated for meeting clinical learning requirements.
The requirement under s. N 2.31 (3) that an application for a temporary permit include an official transcript of nursing education.
The requirement under s. N 2.33 (1) that the holder of a temporary permit practice only under the direct supervision of a registered nurse.
The requirement under s. N 2.34 that practice under temporary permits, including renewals, may not exceed 6 months total duration.
The requirement under s. N 2.40 (3) (d) that a person renewing a nursing credential after 5 years provide documentation of employment requiring a nursing license within the last 5 years or evidence of completion of a board approved nursing refresher course or education equivalent to a nursing refresher course.The rule will also allow the Board to grant a temporary waiver of the requirement under s. N 8.10 (2) and (7) that an advanced practice nurse prescriber work in a collaborative relationship with at least one physician or dentist and document that relationship. The board may grant a waiver if a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances exist or have occurred that are federally declared or declared by the governor of Wisconsin or the governor’s designee, and granting a waiver is necessary to protect the public health, safety, and welfare. Summary of, and comparison with, existing or proposed federal regulation:
None.
Summary of public comments and feedback on the statement of scope and the Board’s responses:
The Board held a public comment period and conducted a public hearing on April 9, 2020. The Board received testimony in support of the statement of scope from Gina Dennik-Champion on behalf of the Wisconsin Nurses Association. The Board also received written comments in support of the statement of scope from the Wisconsin Association of Nurse Anesthetists.
Comparison with rules in adjacent states:
Illinois:
Rules of the Illinois Department of Financial and Professional Regulation regulate the profession of nursing in Illinois (68 Ill. Adm. Code Part 1300). The Secretary of the Department may grant variances from the rules in individual cases when it is determined that:
the provision from which the variance is granted is not statutorily mandated;
no party will be injured by the granting of the variance; and
the rule from which the variance is granted would, in the particular case, be unreasonable or unnecessarily burdensome.The Secretary is required to notify the Illinois Board of Nursing of the granting of the variance, and the reason for granting the variance, at the next meeting of the Board (68 Ill. Adm. Code s. 1300.60).
Iowa:
Rules of the Iowa Board of Nursing regulate the profession of nursing in Illinois (655 IAC chs. 1 to 20). In response to a petition for waiver, the Board may in its sole discretion issue an order waiving in whole or in part the requirements of a rule if the Board finds, based on clear and convincing evidence, all of the following:
The application of the rule would impose an undue hardship on the person for whom the waiver is requested.
The waiver from the requirements of the rule in the specific case would not prejudice the substantial legal rights of any person.
The provisions of the rule subject to the petition for waiver are not specifically mandated by statute or another provision of law.
Substantially equal protection of public health, safety, and welfare will be afforded by a means other than that prescribed in the particular rule for which the waiver is requested (655 IAC 15.4).Michigan:
Rules of the Michigan Department of Licensing and Regulatory Affairs regulate the profession of nursing in Michigan (Mich Admin Code, R 338.10101 to R 338.10705). The Michigan Board of Nursing may waive the requirement to provide evidence of attendance at educational programs as a condition to license renewal if, upon written application, the Board finds the failure of the licensee to attend was due to the licensee's disability, military service, absence from the continental United States, or a circumstance beyond the control of the licensee which the Board considers good and sufficient (Mich Admin Code, R 338.10601).
Minnesota:
Rules of the Minnesota Board of Nursing regulate the profession of nursing in Minnesota (Minnesota Rules, chs. 6301 to 6321). The Board must waive the requirement for licensure of graduation from an approved nursing program if:
an applicant has been licensed by another jurisdiction based on requirements equivalent to the qualifications required in Minnesota at the time of the applicant’s original licensure; or
an applicant for licensed practical nurse licensure has been licensed by another jurisdiction and passed an acceptable examination as specified in subpart 12 and has had at least 4,000 clock hours of employment as a licensed practical nurse in the five years prior to application for licensure in Minnesota (Minnesota Rules, part 6305.0500, subpart 6).In addition, on presentation of convincing evidence by a registration or reregistration applicant, the Board must grant a variance from the following requirements:
For a receipt deadline, on presentation of convincing evidence of mail delay.
For a fee, on presentation of convincing evidence of financial hardship.
For document submission, on presentation of convincing evidence of loss of records through fire or other disaster.
For the required number of continuing education contact hours, on presentation of convincing evidence of unexpected illness or personal tragedy (Minnesota Rules, part 6310.2800, subpart 9).Summary of factual data and analytical methodologies:
In consultation with staff from the Department of Safety and Professional Services, the Board developed an emergency rule that gives it the ability to provide a waiver from or variance to certain requirements in the event of a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances.
Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:
These emergency rules do not impose any new requirements. The purpose of the rules is to give the Board the ability to provide a waiver from or variance to certain requirements in the event of a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances, including an emergency surge of COVID-19.
Fiscal estimate:
These emergency rules will not have a fiscal impact.
Effect on small business:
These emergency rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at Daniel.Hereth@wisconsin.gov, or by calling (608) 267-2435. Agency contact person:
Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366; telephone 608-261-4472; email at DSPSAdminRules@wisconsin.gov. Place where comments are to be submitted and deadline for submission:
Comments may be submitted to Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366, or by email to DSPSAdminRules@wisconsin.gov. Comments must be submitted by the date and time at which the public hearing on these emergency rules is conducted. Information as to the place, date, and time of the public hearing will be published on the Legislature’s website and in the Wisconsin Administrative Register. ---------------------------------------------------------------------------------------------------------------------
TEXT OF RULE
Section 1. N 1.08 (5m) (b) is amended to read:
N 1.08 (5m) (b) Simulation Except as provided under par. (c), simulation may not be utilized for more than 50% of the time designated for meeting clinical learning requirements.
Section 2. N 1.08 (5m) (c) is created to read:
N 1.08 (5m) (c) If requested by a school of nursing due to a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances, the board may temporarily allow simulation to be utilized for up to 100% of the time designated for meeting clinical learning requirements. The board shall consider each request under this paragraph individually on its merits, and the board may grant additional utilization of simulation for a period of time deemed necessary by the board to address the emergency circumstances.
Section 3. N 2.31 (3) is amended to read:
N 2.31 (3) An official transcript of nursing education submitted by the school of professional nursing or practical nursing directly to the department. If requested by an applicant due to a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances, the board may waive the requirement under this subsection. The board shall consider each request for a waiver individually on its merits, and the board may grant a waiver as deemed appropriate.
Section 4. N 2.33 (1) is amended to read:
N 2.33 (1) Except as provided in sub. under subs. (2) and (3), the holder of a temporary permit shall practice only under the direct supervision of a registered nurse.
Section 5. N 2.33 (3) is created to read:
N 2.33 (3) If requested by an applicant under s. N 2.31 or the holder of a temporary permit and the employer of the applicant or permit holder due to a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances, the board may grant a waiver of the requirement under sub. (1). The board shall consider each request for a waiver individually on its merits, and the board may grant a waiver for a period of time deemed necessary by the board to address the emergency circumstances. Section 6. N 2.34 is renumbered N 2.34 (1) and amended to read:
N 2.34 (1) The temporary permit is valid for a period of 3 months or until the holder receives notification of failing the NCLEX, whichever occurs first. Practice Except as provided under sub. (2), practice under temporary permits, including renewals under s. N 2.35, may not exceed 6 months total duration.
Section 7. N 2.34 (2) is created to read:
N 2.34 (2) The holder of a temporary permit renewed under s. N 2.35 (2) may practice for the duration of the renewal period established by the board. Section 8. N 2.35 (2) is amended to read:
N 2.35 (2) Subsequent renewals may be granted in hardship cases or emergency circumstances including illness, family illness or death, accident, natural disaster, or delay of verification from another state. The board shall consider each application for renewal under this subsection individually on its merits, and the board may grant a renewal as for a renewal period deemed appropriate necessary by the board to address the hardship or emergency circumstances.
Section 9. N 2.40 (3) (d) (intro.) is amended to read:
N 2.40 (3) (d) (intro.) Meet Except as provided under par. (e), meet one of the following requirements:
Section 10. N 2.40 (3) (e) is created to read:
N 2.40 (3) (e) If requested by an applicant due to a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances, the board may waive the requirements under par. (d). The board shall consider each request for a waiver individually on its merits, and may grant a waiver based on satisfactory evidence that granting renewal of the license would adequately protect public health, safety, and welfare.
Section 11. N 8.10 (8) is created to read:
N 8.10 (8) If a public health crisis, natural disaster, critical nursing workforce shortage, or similar emergency circumstances exist or have occurred that are federally declared or declared by the governor of this state or the governor’s designee, the board may grant a temporary waiver of the requirements under subs. (2) and (7) if the board determines that granting a waiver is necessary to protect the public health, safety, or welfare. A waiver granted under this subsection shall be for a stated term not to exceed 90 days, except that the board may extend the waiver if it determines that an extension is necessary to protect the public health, safety, or welfare.
Section 12. Effective date. The rules adopted in this order shall take effect upon publication in the official state newspaper, pursuant to s. 227.22 (2) (c), Stats. ---------------------------------------------------------------------------------------------------------------------
(END OF TEXT OF RULE)
---------------------------------------------------------------------------------------------------------------------
