SB497,39,2323 3. The person pays the fee specified under s. 440.05 (1).
SB497,39,2524 4. The person provides evidence of malpractice liability insurance coverage as
25provided in sub. (7).
SB497,40,3
15. If the person is applying to receive a certified nurse-midwife endorsement
2under par. (b), the person provides evidence satisfactory to the board that the person
3is certified by the American Midwifery Certification Board.
SB497,40,124 (b) The board shall grant an advanced practice registered nurse license to a
5person the board determines meets the requirements under par. (a). The board shall
6also grant a person who receives a license under this paragraph one or more
7endorsements corresponding to the recognized roles for which the board determines
8that the person qualifies based on the person's education and experience under par.
9(a) 2. a. or b. and, if applicable, the person's certification under par. (a) 5. The board
10may not grant a license under this paragraph to a person applying concurrently for
11a license under s. 441.06 (1) or (1m), unless the board also grants the person a license
12to practice as a registered nurse.
SB497,40,2013 (c) The board, upon application, shall also grant authority to issue prescription
14orders to a person who is granted a license under this subsection and who meets the
15education, training, and examination requirements established by the board for
16authority to issue prescription orders. The board shall maintain a register of all
17advanced practice registered nurses authorized to issue prescription orders under
18this paragraph. An advanced practice registered nurse with the authority to issue
19prescription orders under this paragraph may provide expedited partner therapy in
20the manner described in s. 448.035.
SB497,41,6 21(3) License renewal. On or before the applicable renewal date specified under
22s. 440.08 (2) (a), a person issued a license under sub. (2) shall submit to the board on
23a form furnished by the board a statement giving his or her name and residence, the
24nursing workforce survey and fee required under s. 441.01 (7), evidence of having
25satisfied the continuing education requirements under sub. (6), evidence of

1malpractice liability insurance coverage as provided in sub. (7), and other
2information that the board requires by rule, with the applicable renewal fee
3determined by the department under s. 440.03 (9) (a). The board shall grant to a
4person who satisfies the requirements under this subsection the renewal of his or her
5advanced practice registered nurse license and endorsements granted under sub. (2)
6(b) and shall grant the renewal of his or her license to practice as a registered nurse.
SB497,41,9 7(4) Practice; titles. (a) 1. The holder of a license issued under this section is
8an “advanced practice registered nurse" and may append to his or her name the title
9“A.P.R.N." and is authorized to practice advanced practice registered nursing.
SB497,41,1210 2. The holder of an endorsement for a recognized role granted under sub. (2)
11(b) may append to his or her name the title and an abbreviation corresponding to that
12recognized role.
SB497,41,1513 3. The holder of a certified nurse-midwife endorsement granted under sub. (2)
14(b) is a certified nurse-midwife and is authorized to engage in the practice of
15nurse-midwifery.
SB497,41,1916 (b) 1. Except as provided in s. 257.03, no person may practice or attempt to
17practice advanced practice registered nursing, nor use the title “advanced practice
18registered nurse," the title “A.P.R.N.," or anything else to indicate that he or she is
19an advanced practice registered nurse unless he or she is licensed under this section.
SB497,41,2020 2. Except as provided in s. 257.03, no person may do any of the following:
SB497,41,2321 a. Use the title “certified nurse-midwife,” the title “C.N.M.,” or anything else
22to indicate that he or she is a certified nurse-midwife unless he or she has been
23granted a certified nurse-midwife endorsement under sub. (2) (b).
SB497,41,2524 b. Engage in the practice of nurse-midwifery unless he or she has been granted
25a certified nurse-midwife endorsement under sub. (2) (b).
SB497,42,4
1c. Use the title “certified registered nurse anesthetist,” the title “C.R.N.A.,” or
2anything else to indicate that he or she is a certified registered nurse anesthetist
3unless he or she has been granted a certified registered nurse anesthetist
4endorsement under sub. (2) (b).
SB497,42,75 d. Use the title “clinical nurse specialist,” the title “C.N.S.,” or anything else to
6indicate that he or she is a clinical nurse specialist unless he or she has been granted
7a clinical nurse specialist endorsement under sub. (2) (b).
SB497,42,108 e. Use the title “nurse practitioner,” the title “N.P.,” or anything else to indicate
9that he or she is a nurse practitioner unless he or she has been granted a nurse
10practitioner endorsement under sub. (2) (b).
SB497,42,16 11(6) Continuing education. Every advanced practice registered nurse shall
12submit to the board evidence of having completed at least 16 contact hours per
13biennium in clinical pharmacology or therapeutics relevant to the advanced practice
14registered nurse's area of practice. The hours required under this subsection must
15include at least 2 contact hours regarding best practices in prescribing controlled
16substances.
SB497,42,23 17(7) Malpractice liability insurance. Every advanced practice registered
18nurse shall at all times have in effect malpractice liability insurance coverage in the
19minimum amounts required by the rules of the board. An advanced practice
20registered nurse shall submit evidence of that coverage to the board when applying
21for an initial license under this section or a renewal of a license under this section.
22An advanced practice registered nurse shall also submit such evidence to the board
23upon request of the board.
SB497,43,2 24(8) Delegation. An advanced practice registered nurse who has authority to
25issue prescription orders may not delegate the act of issuing a prescription order to

1any nurse who is not authorized to issue prescription orders. Nothing in this section
2prohibits a nurse from issuing a prescription order as an act delegated by a physician.
SB497,43,4 3(9) Rules. The board shall promulgate rules necessary to administer this
4section, including rules for all of the following:
SB497,43,85 (a) Establishing the appropriate education, training, or experience
6requirements that a registered nurse must satisfy to be an advanced practice
7registered nurse and to qualify to be granted the authority to issue prescription
8orders under sub. (2) (c).
SB497,43,119 (b) Specifying the classes of drugs, individual drugs, or devices that may not
10be prescribed by an advanced practice registered nurse authorized to issue
11prescription orders under sub. (2) (c).
SB497,43,1212 (c) Specifying the conditions to be met for registered nurses to do the following:
SB497,43,1313 1. Administer a drug prescribed by an advanced practice registered nurse.
SB497,43,1414 2. Administer a drug at the direction of an advanced practice registered nurse.
SB497,83 15Section 83. 441.11 (title) of the statutes is repealed.
SB497,84 16Section 84. 441.11 (1) of the statutes is repealed.
SB497,85 17Section 85. 441.11 (2) of the statutes is renumbered 441.09 (8m) and amended
18to read:
SB497,43,2119 441.09 (8m) Nurse anesthetists. The provisions of s. 448.04 (1) (g) do not apply
20to a licensed advanced practice registered nurse who possesses a certified registered
21nurse anesthetist endorsement under this section.
SB497,86 22Section 86. 441.11 (3) of the statutes is repealed.
SB497,87 23Section 87. 441.15 of the statutes is repealed.
SB497,88 24Section 88. 441.16 of the statutes is repealed.
SB497,89 25Section 89. 441.18 (2) (a) (intro.) of the statutes is amended to read:
SB497,44,3
1441.18 (2) (a) (intro.) An advanced practice registered nurse certified to issue
2prescription orders under s. 441.16
who has prescribing authority under s. 441.09 (2)
3(c)
may do any of the following:
SB497,90 4Section 90. 441.18 (2) (b) of the statutes is amended to read:
SB497,44,115 441.18 (2) (b) An advanced practice registered nurse who prescribes or delivers
6an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid
7antagonist is prescribed has or has the capacity to provide the knowledge and
8training necessary to safely administer the opioid antagonist to an individual
9undergoing an opioid-related overdose and that the person demonstrates the
10capacity to ensure that any individual to whom the person further delivers the opioid
11antagonist has or receives that knowledge and training.
SB497,91 12Section 91. 441.18 (3) of the statutes is amended to read:
SB497,44,1813 441.18 (3) An advanced practice registered nurse who, acting in good faith,
14prescribes or delivers an opioid antagonist in accordance with sub. (2), or who, acting
15in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall
16be immune from criminal or civil liability and may not be subject to professional
17discipline under s. 441.07 for any outcomes resulting from prescribing, delivering,
18or dispensing the opioid antagonist.
SB497,92 19Section 92. 448.03 (2) (a) of the statutes is amended to read:
SB497,45,220 448.03 (2) (a) Any person lawfully practicing within the scope of a license,
21permit, registration, certificate or certification granted to practice midwifery under
22subch. XIII of ch. 440, to practice professional or , practical, or advanced practice
23registered
nursing or nurse-midwifery under ch. 441, to practice chiropractic under
24ch. 446, to practice dentistry or dental hygiene under ch. 447, to practice optometry

1under ch. 449, to practice acupuncture under ch. 451 or under any other statutory
2provision, or as otherwise provided by statute.
SB497,93 3Section 93. 448.035 (1) (a) of the statutes is repealed.
SB497,94 4Section 94. 448.035 (2), (3) and (4) of the statutes are amended to read:
SB497,45,195 448.035 (2) Notwithstanding the requirements of s. 448.30, a physician,
6physician assistant, or certified advanced practice registered nurse prescriber who
7has prescribing authority under s. 441.09 (2) (c)
may provide expedited partner
8therapy if the patient is diagnosed as infected with a chlamydial infection,
9gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual
10partner during which the chlamydial infection, gonorrhea, or trichomoniasis may
11have been transmitted to or from the sexual partner. The physician, physician
12assistant, or certified advanced practice registered nurse prescriber shall attempt to
13obtain the name of the patient's sexual partner. A prescription order for an
14antimicrobial drug prepared under this subsection shall include the name and
15address of the patient's sexual partner, if known. If the physician, physician
16assistant, or certified advanced practice registered nurse prescriber is unable to
17obtain the name of the patient's sexual partner, the prescription order shall include,
18in ordinary bold-faced capital letters, the words, “expedited partner therapy" or the
19letters “EPT."
SB497,45,24 20(3) The physician, physician assistant, or certified advanced practice
21registered nurse prescriber shall provide the patient with a copy of the information
22sheet prepared by the department of health services under s. 46.03 (44) and shall
23request that the patient give the information sheet to the person with whom the
24patient had sexual contact.
SB497,46,5
1(4) (a) Except as provided in par. (b), a physician, physician assistant, or
2certified advanced practice registered nurse prescriber is immune from civil liability
3for injury to or the death of a person who takes any antimicrobial drug if the
4antimicrobial drug is prescribed, dispensed, or furnished under this section and if
5expedited partner therapy is provided as specified under this section.
SB497,46,96 (b) The immunity under par. (a) does not extend to the donation, distribution,
7furnishing, or dispensing of an antimicrobial drug by a physician, physician
8assistant, or certified advanced practice registered nurse prescriber whose act or
9omission involves reckless, wanton, or intentional misconduct.
SB497,95 10Section 95. 448.56 (1) and (1m) (b) of the statutes are amended to read:
SB497,46,2511 448.56 (1) Written referral. Except as provided in this subsection and s.
12448.52, a person may practice physical therapy only upon the written referral of a
13physician, physician assistant, chiropractor, dentist, podiatrist, or advanced practice
14registered nurse prescriber certified under s. 441.16 (2). Written referral is not
15required if a physical therapist provides services in schools to children with
16disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated by the
17department of public instruction; provides services as part of a home health care
18agency; provides services to a patient in a nursing home pursuant to the patient's
19plan of care; provides services related to athletic activities, conditioning, or injury
20prevention; or provides services to an individual for a previously diagnosed medical
21condition after informing the individual's physician, physician assistant,
22chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber
23certified under s. 441.16 (2)
who made the diagnosis. The examining board may
24promulgate rules establishing additional services that are excepted from the written
25referral requirements of this subsection.
SB497,47,6
1(1m) (b) The examining board shall promulgate rules establishing the
2requirements that a physical therapist must satisfy if a physician, physician
3assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse
4prescriber makes a written referral under sub. (1). The purpose of the rules shall be
5to ensure continuity of care between the physical therapist and the health care
6practitioner.
SB497,96 7Section 96. 448.67 (2) of the statutes is amended to read:
SB497,47,178 448.67 (2) Separate billing required. Except as provided in sub. (4), a licensee
9who renders any podiatric service or assistance, or gives any podiatric advice or any
10similar advice or assistance, to any patient, podiatrist, physician, physician
11assistant, advanced practice registered nurse prescriber certified under s. 441.16 (2),
12partnership, or corporation, or to any other institution or organization, including a
13hospital, for which a charge is made to a patient, shall, except as authorized by
14Title 18 or Title 19 of the federal Social Security Act, render an individual statement
15or account of the charge directly to the patient, distinct and separate from any
16statement or account by any other podiatrist, physician, physician assistant,
17advanced practice registered nurse prescriber, or other person.
SB497,97 18Section 97. 448.956 (1m) of the statutes is amended to read:
SB497,47,2419 448.956 (1m) Subject to sub. (1) (a), a licensee may provide athletic training
20to an individual without a referral, except that a licensee may not provide athletic
21training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation
22setting unless the licensee has obtained a written referral for the individual from a
23practitioner licensed or certified under subch. II, III, IV, V, or VII of this chapter;
24under ch. 446; or under s. 441.16 (2) 441.09.
SB497,98 25Section 98. 450.01 (1m) of the statutes is repealed.
SB497,99
1Section 99. 450.01 (16) (h) 2. of the statutes is amended to read:
SB497,48,52 450.01 (16) (h) 2. The patient's advanced practice registered nurse prescriber,
3if the advanced practice registered nurse prescriber has entered into a written
4agreement to collaborate with a physician
has prescribing authority under s. 441.09
5(2) (c)
.
SB497,100 6Section 100. 450.01 (16) (hr) 2. of the statutes is amended to read:
SB497,48,87 450.01 (16) (hr) 2. An advanced practice registered nurse prescriber who has
8prescribing authority under s. 441.09 (2) (c)
.
SB497,101 9Section 101. 450.03 (1) (e) of the statutes is amended to read:
SB497,48,1610 450.03 (1) (e) Any person lawfully practicing within the scope of a license,
11permit, registration, certificate, or certification granted to provide home medical
12oxygen under s. 450.076, to practice professional or , practical, or advanced practice
13registered
nursing or nurse-midwifery under ch. 441, to practice dentistry or dental
14hygiene under ch. 447, to practice medicine and surgery under ch. 448, to practice
15optometry under ch. 449 or to practice veterinary medicine under ch. 89, or as
16otherwise provided by statute.
SB497,102 17Section 102. 450.11 (1i) (a) 1. of the statutes is amended to read:
SB497,49,318 450.11 (1i) (a) 1. A pharmacist may, upon and in accordance with the
19prescription order of an advanced practice registered nurse prescriber under s.
20441.18 (2) (a) 1., or of a physician or physician assistant under s. 448.037 (2) (a) 1.,
21that complies with the requirements of sub. (1), deliver an opioid antagonist to a
22person specified in the prescription order and may, upon and in accordance with the
23standing order of an advanced practice registered nurse prescriber under s. 441.18
24(2) (a) 2., or of a physician or physician assistant under s. 448.037 (2) (a) 2., that
25complies with the requirements of sub. (1), deliver an opioid antagonist to an

1individual in accordance with the order. The pharmacist shall provide a consultation
2in accordance with rules promulgated by the board for the delivery of a prescription
3to the person to whom the opioid antagonist is delivered.
SB497,103 4Section 103. 450.11 (1i) (b) 2. b. of the statutes is amended to read:
SB497,49,75 450.11 (1i) (b) 2. b. An advanced practice registered nurse prescriber may only
6deliver or dispense an opioid antagonist in accordance with s. 441.18 (2) or in
7accordance with his or her other legal authority to dispense prescription drugs.
SB497,104 8Section 104. 450.11 (7) (b) of the statutes is amended to read:
SB497,49,129 450.11 (7) (b) Information communicated to a physician, physician assistant,
10or advanced practice registered nurse prescriber in an effort to procure unlawfully
11a prescription drug or the administration of a prescription drug is not a privileged
12communication.
SB497,105 13Section 105. 450.11 (8) (e) of the statutes is amended to read:
SB497,49,1514 450.11 (8) (e) The board of nursing, insofar as this section applies to advanced
15practice nurse prescribers registered nurses.
SB497,106 16Section 106. 450.13 (5) (b) of the statutes is amended to read:
SB497,49,1917 450.13 (5) (b) The patient's advanced practice registered nurse prescriber, if the
18advanced practice registered nurse prescriber has entered into a written agreement
19to collaborate with a physician
has prescribing authority under s. 441.09 (2) (c).
SB497,107 20Section 107. 462.04 of the statutes is amended to read:
SB497,50,3 21462.04 Prescription or order required. A person who holds a license or
22limited X-ray machine operator permit under this chapter may not use diagnostic
23X-ray equipment on humans for diagnostic purposes unless authorized to do so by
24prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed
25under s. 447.04 (1), a podiatrist licensed under s. 448.63, a chiropractor licensed

1under s. 446.02, an advanced practice registered nurse certified licensed under s.
2441.16 (2) 441.09, a physician assistant licensed under s. 448.04 (1) (f), or, subject to
3s. 448.56 (7) (a), a physical therapist licensed under s. 448.53.
SB497,108 4Section 108. 655.001 (7t) of the statutes is amended to read:
SB497,50,95 655.001 (7t) “Health care practitioner" means a health care professional, as
6defined in s. 180.1901 (1m), who is an employee of a health care provider described
7in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care
8services that are not in collaboration with a physician under s. 441.15 (2) (b) or under
9the direction and supervision of a physician or nurse anesthetist.
SB497,109 10Section 109. 655.001 (9) of the statutes is amended to read:
SB497,50,1511 655.001 (9) “Nurse anesthetist" means a nurse an individual who is licensed
12under ch. 441 or in a party state, as defined in s. 441.50 (2) (j), who is certified as a
13nurse anesthetist by the American association of nurse anesthetists
as an advanced
14practice registered nurse and possesses a certified registered nurse anesthetist
15endorsement under s. 441.09
.
SB497,110 16Section 110. 655.005 (2) (a) of the statutes is amended to read:
SB497,50,2017 655.005 (2) (a) An employee of a health care provider if the employee is a
18physician or a nurse anesthetist or is a health care practitioner who is providing
19health care services that are not in collaboration with a physician under s. 441.15 (2)
20(b) or
under the direction and supervision of a physician or nurse anesthetist.
SB497,111 21Section 111. 961.01 (19) (a) of the statutes is amended to read:
SB497,51,222 961.01 (19) (a) A physician, advanced practice registered nurse, dentist,
23veterinarian, podiatrist, optometrist, scientific investigator or, subject to s. 448.21
24(3), a physician assistant, or other person licensed, registered, certified or otherwise
25permitted to distribute, dispense, conduct research with respect to, administer or use

1in teaching or chemical analysis a controlled substance in the course of professional
2practice or research in this state.
SB497,112 3Section 112. 961.395 of the statutes is amended to read:
SB497,51,7 4961.395 Limitation on advanced practice registered nurses. (1) An
5advanced practice registered nurse who is certified under s. 441.16 who has
6prescribing authority under s. 441.09 (2) (c)
may prescribe controlled substances only
7as permitted by the rules promulgated under s. 441.16 (3) 441.09 (9).
SB497,51,11 8(2) An advanced practice registered nurse certified under s. 441.16 shall
9include with each prescription order the advanced practice registered nurse
10prescriber certification number identifier issued to him or her by the board of
11nursing.
SB497,51,15 12(3) An advanced practice registered nurse certified under s. 441.16 who has
13prescribing authority under s. 441.09 (2) (c)
may dispense a controlled substance only
14by prescribing or administering the controlled substance or as otherwise permitted
15by the rules promulgated under s. 441.16 (3) 441.09 (9).
SB497,113 16Section 113. Effective date.
SB497,51,1717 (1) This act takes effect on March 1, 2020.
SB497,51,1818 (End)
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