SB497: Bill Text

SB497,27,3 253.15 (1) (em) “Nurse-midwife" means an individual who is licensed as an advanced practice registered nurse and possesses a certified nurse-midwife endorsement under s. 441.09.

SB497,58 Section 58. 253.15 (2) of the statutes is amended to read:

SB497,28,2 253.15 (2) Informational materials. The board shall purchase or prepare or arrange with a nonprofit organization to prepare printed and audiovisual materials relating to shaken baby syndrome and impacted babies. The materials shall include information regarding the identification and prevention of shaken baby syndrome and impacted babies, the grave effects of shaking or throwing on an infant or young child, appropriate ways to manage crying, fussing, or other causes that can lead a person to shake or throw an infant or young child, and a discussion of ways to reduce the risks that can lead a person to shake or throw an infant or young child. The materials shall be prepared in English, Spanish, and other languages spoken by a significant number of state residents, as determined by the board. The board shall make those written and audiovisual materials available to all hospitals, maternity homes, and nurse-midwives licensed under s. 441.15 that are required to provide or make available materials to parents under sub. (3) (a) 1., to the department and to all county departments and nonprofit organizations that are required to provide the materials to child care providers under sub. (4) (d), and to all school boards and nonprofit organizations that are permitted to provide the materials to pupils in one of grades 5 to 8 and in one of grades 10 to 12 under sub. (5). The board shall also make those written materials available to all county departments and Indian tribes that are providing home visitation services under s. 48.983 (4) (b) 1. and to all providers of prenatal, postpartum, and young child care coordination services under s. 49.45 (44). The board may make available the materials required under this subsection to be made available by making those materials available at no charge on the board's Internet site.

SB497,59 Section 59. 255.06 (1) (d) of the statutes is renumbered 255.06 (1) (f) (intro.) and amended to read:

SB497,28,6 255.06 (1) (f) (intro.) “Nurse practitioner" “Women's health nurse clinician" means a any of the following:

SB497,28,10 1. A registered nurse licensed under ch. 441 or in a party state, as defined in s. 441.50 (2) (j), whose practice of professional nursing under s. 441.001 (4) includes performance of delegated medical services under the supervision of a physician, dentist, or podiatrist, or advanced practice registered nurse.

SB497,60 Section 60. 255.06 (1) (f) 2. of the statutes is created to read:

SB497,28,12 255.06 (1) (f) 2. An advanced practice registered nurse.

SB497,61 Section 61. 255.06 (2) (d) of the statutes is amended to read:

SB497,28,18 255.06 (2) (d) Specialized training for rural colposcopic examinations and activities. Provide not more than $25,000 in each fiscal year as reimbursement for the provision of specialized training of nurse practitioners women's health nurse clinicians to perform, in rural areas, colposcopic examinations and follow-up activities for the treatment of cervical cancer.

SB497,62 Section 62. 255.07 (1) (d) of the statutes is amended to read:

SB497,28,23 255.07 (1) (d) “Health care practitioner" means a physician, a physician assistant licensed under s. 448.04 (1) (f), or an advanced practice registered nurse who is certified to issue prescription orders under s. 441.16 has prescribing authority under s. 441.09 (2) (c).

SB497,63 Section 63. 257.01 (5) (a) and (b) of the statutes are amended to read:

SB497,29,6 257.01 (5) (a) An individual who is licensed as a physician, a physician assistant, or a podiatrist under ch. 448, licensed as a registered nurse, licensed practical nurse, or nurse-midwife advanced practice registered nurse under ch. 441, licensed as a dentist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary technician under ch. 89, or certified as a respiratory care practitioner under ch. 448.

SB497,29,14 (b) An individual who was at any time within the previous 10 years, but is not currently, licensed as a physician, a physician assistant, or a podiatrist under ch. 448, licensed as a registered nurse, licensed practical nurse, or nurse-midwife, advanced practice registered nurse under ch. 441, licensed as a nurse-midwife under ch. 441, 2015 stats., licensed as a dentist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary technician under ch. 89, or certified as a respiratory care practitioner under ch. 448, if the individual's license or certification was never revoked, limited, suspended, or denied renewal.

SB497,64 Section 64. 341.14 (1a), (1e) (a), (1m) and (1q) of the statutes are amended to read:

SB497,30,10 341.14 (1a) If any resident of this state, who is registering or has registered an automobile, or a motor truck, dual purpose motor home or dual purpose farm truck which has a gross weight of not more than 8,000 pounds, a farm truck which has a gross weight of not more than 12,000 pounds or a motor home, submits a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal certifying to the department that the resident is a person with a disability that limits or impairs the ability to walk, the department shall procure, issue and deliver to the disabled person plates of a special design in lieu of plates which ordinarily would be issued for the vehicle, and shall renew the plates. The plates shall be so designed as to readily apprise law enforcement officers of the fact that the vehicle is owned by a nonveteran disabled person and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee shall be made for the issuance or renewal of such plates.

SB497,31,5 (1e) (a) If any resident of this state, who is registering or has registered a motorcycle, submits a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, from a Christian Science practitioner residing in this state and listed in the Christian Science journal, or from the U.S. department of veterans affairs certifying to the department that the resident is a person with a disability that limits or impairs the ability to walk, the department shall procure, issue and deliver to the disabled person a plate of a special design in lieu of the plate which ordinarily would be issued for the motorcycle, and shall renew the plate. The statement shall state whether the disability is permanent or temporary and, if temporary, the opinion of the physician, advanced practice registered nurse, public health nurse, physician assistant, podiatrist, chiropractor, practitioner, or U.S. department of veterans affairs as to the duration of the disability. The plate shall be so designed as to readily apprise law enforcement officers of the fact that the motorcycle is owned by a disabled person and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee may be made for the issuance or renewal of the plate.

SB497,31,25 (1m) If any licensed driver submits to the department a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from a public health nurse certified or licensed to practice in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal certifying that another person who is regularly dependent on the licensed driver for transportation is a person with a disability that limits or impairs the ability to walk, the department shall issue and deliver to the licensed driver plates of a special design in lieu of the plates which ordinarily would be issued for the automobile or motor truck, dual purpose motor home or dual purpose farm truck having a gross weight of not more than 8,000 pounds, farm truck having a gross weight of not more than 12,000 pounds or motor home, and shall renew the plates. The plates shall be so designed as to readily apprise law enforcement officers of the fact that the vehicle is operated by a licensed driver on whom a disabled person is regularly dependent and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee may be made for the issuance or renewal of the plates. The plates shall conform to the plates required in sub. (1a).

SB497,32,19 (1q) If any employer who provides an automobile, or a motor truck, dual purpose motor home or dual purpose farm truck which has a gross weight of not more than 8,000 pounds, a farm truck which has a gross weight of not more than 12,000 pounds or a motor home, for an employee's use submits to the department a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal certifying that the employee is a person with a disability that limits or impairs the ability to walk, the department shall issue and deliver to such employer plates of a special design in lieu of the plates which ordinarily would be issued for the vehicle, and shall renew the plates. The plates shall be so designed as to readily apprise law enforcement officers of the fact that the vehicle is operated by a disabled person and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee may be made for the issuance or renewal of the plates. The plates shall conform to the plates required in sub. (1a).

SB497,65 Section 65. 343.16 (5) (a) of the statutes is amended to read:

SB497,33,19 343.16 (5) (a) The secretary may require any applicant for a license or any licensed operator to submit to a special examination by such persons or agencies as the secretary may direct to determine incompetency, physical or mental disability, disease, or any other condition that might prevent such applicant or licensed person from exercising reasonable and ordinary control over a motor vehicle. If the department requires the applicant to submit to an examination, the applicant shall pay for the examination. If the department receives an application for a renewal or duplicate license after voluntary surrender under s. 343.265 or receives a report from a physician, physician assistant, as defined in s. 448.01 (6), advanced practice registered nurse prescriber certified under s. 441.16 (2) licensed under s. 441.09, or optometrist under s. 146.82 (3), or if the department has a report of 2 or more arrests within a one-year period for any combination of violations of s. 346.63 (1) or (5) or a local ordinance in conformity with s. 346.63 (1) or (5) or a law of a federally recognized American Indian tribe or band in this state in conformity with s. 346.63 (1) or (5), or s. 346.63 (1m), 1985 stats., or s. 346.63 (2) or (6) or 940.25, or s. 940.09 where the offense involved the use of a vehicle, the department shall determine, by interview or otherwise, whether the operator should submit to an examination under this section. The examination may consist of an assessment. If the examination indicates that education or treatment for a disability, disease or condition concerning the use of alcohol, a controlled substance or a controlled substance analog is appropriate, the department may order a driver safety plan in accordance with s. 343.30 (1q). If there is noncompliance with assessment or the driver safety plan, the department shall revoke the person's operating privilege in the manner specified in s. 343.30 (1q) (d).

SB497,66 Section 66. 343.51 (1) of the statutes is amended to read:

SB497,34,17 343.51 (1) Any person who qualifies for registration plates of a special design under s. 341.14 (1), (1a), (1m), or (1q) or any other person with a disability that limits or impairs the ability to walk may request from the department a special identification card that will entitle any motor vehicle parked by, or under the direction of, the person, or a motor vehicle operated by or on behalf of the organization when used to transport such a person, to parking privileges under s. 346.50 (2), (2a), and (3). The department shall issue the card at a fee to be determined by the department, upon submission by the applicant, if the applicant is an individual rather than an organization, of a statement from a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal that the person is a person with a disability that limits or impairs the ability to walk. The statement shall state whether the disability is permanent or temporary and, if temporary, the opinion of the physician, advanced practice registered nurse, public health nurse, physician assistant, podiatrist, chiropractor, or practitioner as to the duration of the disability. The department shall issue the card upon application by an organization on a form prescribed by the department if the department believes that the organization meets the requirements under this subsection.

SB497,67 Section 67. 343.62 (4) (a) 4. of the statutes is amended to read:

SB497,35,2 343.62 (4) (a) 4. The applicant submits with the application a statement completed within the immediately preceding 24 months, except as provided by rule, by a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state, and listed in the Christian Science journal certifying that, in the medical care provider's judgment, the applicant is physically fit to teach driving.

SB497,68 Section 68. 440.03 (13) (b) 3. of the statutes is repealed.

SB497,69 Section 69. 440.03 (13) (b) 39m. of the statutes is created to read:

SB497,35,5 440.03 (13) (b) 39m. Nurse, advanced practice registered.

SB497,70 Section 70. 440.03 (13) (b) 42. of the statutes is repealed.

SB497,71 Section 71. 440.08 (2) (a) 4m. of the statutes is repealed.

SB497,72 Section 72. 440.08 (2) (a) 47. of the statutes is created to read:

SB497,35,10 440.08 (2) (a) 47. Nurse, advanced practice registered: March 1 of each even-numbered year.

SB497,73 Section 73. 440.08 (2) (a) 50. of the statutes is repealed.

SB497,74 Section 74. 440.981 (1) of the statutes is amended to read:

SB497,35,17 440.981 (1) No person may use the title “licensed midwife," describe or imply that he or she is a licensed midwife, or represent himself or herself as a licensed midwife unless the person is granted a license under this subchapter or is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife endorsement under s. 441.09.

SB497,75 Section 75. 440.982 (1) of the statutes is amended to read:

SB497,35,23 440.982 (1) No person may engage in the practice of midwifery unless the person is granted a license under this subchapter, is granted a temporary permit pursuant to a rule promulgated under s. 440.984 (2m), or is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife endorsement under s. 441.09.

SB497,76 Section 76. 440.987 (2) of the statutes is amended to read:

SB497,36,3 440.987 (2) One member who is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife endorsement under s. 441.09 and who practices in an out-of-hospital setting.

SB497,77 Section 77. 441.01 (7) (a) (intro.) and 1. of the statutes are amended to read:

SB497,36,7 441.01 (7) (a) (intro.) The board shall require each applicant for the renewal of a license, certificate, or permit issued under this chapter to do all of the following as a condition for renewing the license, certificate, or permit:

SB497,36,10 1. Complete and submit to the department with the application for renewal of the license, certificate, or permit a nursing workforce survey developed by the department of workforce development under s. 106.30 (2).

SB497,78 Section 78. 441.01 (7) (b) of the statutes is amended to read:

SB497,36,17 441.01 (7) (b) The board may not renew a license , certificate, or permit under this chapter unless the renewal applicant has completed the nursing workforce survey to the satisfaction of the board. The board shall establish standards to determine whether the survey has been completed. The board shall, by no later than June 30 of each odd-numbered year, submit all completed nursing workforce survey forms to the department of workforce development.

SB497,79 Section 79. 441.06 (3) of the statutes is amended to read:

SB497,36,23 441.06 (3) A Except as provided in s. 441.09 (3), a registered nurse practicing for compensation shall, on or before the applicable renewal date specified under s. 440.08 (2) (a), submit to the board on furnished forms a statement giving name, residence, and other facts that the board requires, with the applicable renewal fee determined by the department under s. 440.03 (9) (a).

SB497,80 Section 80. 441.06 (7) of the statutes is renumbered 441.09 (5) and amended to read:

SB497,37,3 441.09 (5) Civil liability. No person certified licensed as an advanced practice registered nurse prescriber under s. 441.16 (2) this section is liable for civil damages for any of the following:

SB497,37,8 (a) Reporting in good faith to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient that in the advanced practice nurse prescriber's registered nurse's judgment impairs the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB497,37,13 (b) In good faith, not reporting to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient that in the advanced practice nurse prescriber's registered nurse's judgment does not impair the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB497,81 Section 81. 441.07 (1g) (intro.), (a), (c) and (e) of the statutes are amended to read:

SB497,37,23 441.07 (1g) (intro.) Subject to the rules promulgated under s. 440.03 (1), the board may deny an initial license or revoke, limit, suspend, or deny the renewal of a license of a registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse; deny an initial certificate or revoke, limit, suspend, or deny the renewal of a certificate to prescribe drugs or devices granted under s. 441.16; or reprimand a registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse, if the board finds that the applicant or licensee committed any of the following:

SB497,37,24 (a) Fraud in the procuring or renewal of the certificate or license.

SB497,38,3 (c) Acts which show the registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse to be unfit or incompetent by reason of negligence, abuse of alcohol or other drugs, or mental incompetency.

SB497,38,6 (e) A violation of any state or federal law that regulates prescribing or dispensing drugs or devices, if the person has a certificate to prescribe drugs or devices under s. 441.16 is authorized to issue prescription orders under s. 441.09.

SB497,82 Section 82. 441.09 of the statutes is created to read:

SB497,38,9 441.09 Advanced practice registered nurses. (1) Definitions. In this section:

SB497,38,14 (a) “Advanced practice registered nursing” means practicing in one of the 4 recognized roles based on advanced clinical knowledge and skills focusing on direct care of individuals, greater responsibility, autonomy, and accountability for the provision of care, health promotion and maintenance, management of patient conditions, and the use and prescription of pharmacological interventions.

SB497,38,21 (b) “Clinical pharmacology or therapeutics” means the identification of individual and classes of drugs, their indications and contraindications, their efficacy, their side effects and their interactions, as well as, clinical judgment skills and decision-making based on thorough interviewing, history-taking, physical assessment, test selection and interpretation, pathophysiology, epidemiology, diagnostic reasoning, differentiation of conditions, treatment decisions, case evaluation, and nonpharmacological interventions.

SB497,39,2 (c) “Practice of nurse-midwifery" means the management of women's health care, pregnancy, childbirth, postpartum care for newborns, family planning, and gynecological services consistent with the standards of practice of the American College of Nurse-Midwives and the education, training, and experience of the nurse-midwife.

SB497,39,3 (d) “Recognized role” means one of the following roles:

SB497,39,4 1. Certified nurse-midwife.

SB497,39,5 2. Certified registered nurse anesthetist.

SB497,39,6 3. Clinical nurse specialist.

SB497,39,7 4. Nurse practitioner.

SB497,39,10 (2) Initial license. (a) Any person who satisfies all of the following requirements may apply to the department for initial licensure by the board as an advanced practice registered nurse:

SB497,39,13 1. The person holds a valid license to practice as a registered nurse issued under s. 441.06 (1) or (1m) or applies concurrently for a license under s. 441.06 (1) or (1m) with the application for a license under this paragraph.

SB497,39,15 2. The person provides evidence satisfactory to the board that he or she satisfies one of the following criteria:

SB497,39,18 a. The person has completed an accredited graduate-level or postgraduate-level education program that prepares the person for the practice of advanced practice registered nursing.

SB497,39,22 b. On January 1, 2017, the person was licensed as a registered nurse in this state and was practicing in a recognized role, and the person satisfies additional criteria established by the board by rule under this subd. 2. b. relating to practice or education.

SB497,39,23 3. The person pays the fee specified under s. 440.05 (1).

SB497,39,25 4. The person provides evidence of malpractice liability insurance coverage as provided in sub. (7).

SB497,40,3 5. If the person is applying to receive a certified nurse-midwife endorsement under par. (b), the person provides evidence satisfactory to the board that the person is certified by the American Midwifery Certification Board.

SB497,40,12 (b) The board shall grant an advanced practice registered nurse license to a person the board determines meets the requirements under par. (a). The board shall also grant a person who receives a license under this paragraph one or more endorsements corresponding to the recognized roles for which the board determines that the person qualifies based on the person's education and experience under par. (a) 2. a. or b. and, if applicable, the person's certification under par. (a) 5. The board may not grant a license under this paragraph to a person applying concurrently for a license under s. 441.06 (1) or (1m), unless the board also grants the person a license to practice as a registered nurse.

SB497,40,20 (c) The board, upon application, shall also grant authority to issue prescription orders to a person who is granted a license under this subsection and who meets the education, training, and examination requirements established by the board for authority to issue prescription orders. The board shall maintain a register of all advanced practice registered nurses authorized to issue prescription orders under this paragraph. An advanced practice registered nurse with the authority to issue prescription orders under this paragraph may provide expedited partner therapy in the manner described in s. 448.035.

SB497,41,6 (3) License renewal. On or before the applicable renewal date specified under s. 440.08 (2) (a), a person issued a license under sub. (2) shall submit to the board on a form furnished by the board a statement giving his or her name and residence, the nursing workforce survey and fee required under s. 441.01 (7), evidence of having satisfied the continuing education requirements under sub. (6), evidence of malpractice liability insurance coverage as provided in sub. (7), and other information that the board requires by rule, with the applicable renewal fee determined by the department under s. 440.03 (9) (a). The board shall grant to a person who satisfies the requirements under this subsection the renewal of his or her advanced practice registered nurse license and endorsements granted under sub. (2) (b) and shall grant the renewal of his or her license to practice as a registered nurse.

SB497,41,9 (4) Practice; titles. (a) 1. The holder of a license issued under this section is an “advanced practice registered nurse" and may append to his or her name the title “A.P.R.N." and is authorized to practice advanced practice registered nursing.

SB497,41,12 2. The holder of an endorsement for a recognized role granted under sub. (2) (b) may append to his or her name the title and an abbreviation corresponding to that recognized role.

SB497,41,15 3. The holder of a certified nurse-midwife endorsement granted under sub. (2) (b) is a certified nurse-midwife and is authorized to engage in the practice of nurse-midwifery.

SB497,41,19 (b) 1. Except as provided in s. 257.03, no person may practice or attempt to practice advanced practice registered nursing, nor use the title “advanced practice registered nurse," the title “A.P.R.N.," or anything else to indicate that he or she is an advanced practice registered nurse unless he or she is licensed under this section.

SB497,41,20 2. Except as provided in s. 257.03, no person may do any of the following:

SB497,41,23 a. Use the title “certified nurse-midwife,” the title “C.N.M.,” or anything else to indicate that he or she is a certified nurse-midwife unless he or she has been granted a certified nurse-midwife endorsement under sub. (2) (b).

SB497,41,25 b. Engage in the practice of nurse-midwifery unless he or she has been granted a certified nurse-midwife endorsement under sub. (2) (b).

SB497,42,4 c. Use the title “certified registered nurse anesthetist,” the title “C.R.N.A.,” or anything else to indicate that he or she is a certified registered nurse anesthetist unless he or she has been granted a certified registered nurse anesthetist endorsement under sub. (2) (b).

SB497,42,7 d. Use the title “clinical nurse specialist,” the title “C.N.S.,” or anything else to indicate that he or she is a clinical nurse specialist unless he or she has been granted a clinical nurse specialist endorsement under sub. (2) (b).

SB497,42,10 e. Use the title “nurse practitioner,” the title “N.P.,” or anything else to indicate that he or she is a nurse practitioner unless he or she has been granted a nurse practitioner endorsement under sub. (2) (b).

SB497,42,16 (6) Continuing education. Every advanced practice registered nurse shall submit to the board evidence of having completed at least 16 contact hours per biennium in clinical pharmacology or therapeutics relevant to the advanced practice registered nurse's area of practice. The hours required under this subsection must include at least 2 contact hours regarding best practices in prescribing controlled substances.

SB497,42,23 (7) Malpractice liability insurance. Every advanced practice registered nurse shall at all times have in effect malpractice liability insurance coverage in the minimum amounts required by the rules of the board. An advanced practice registered nurse shall submit evidence of that coverage to the board when applying for an initial license under this section or a renewal of a license under this section. An advanced practice registered nurse shall also submit such evidence to the board upon request of the board.