SB145,45,2524 a. Provides evidence satisfactory to the board that the applicant is currently
25certified by the American Midwifery Certification Board or its successor.
SB145,46,1
1b. Files with the board any plan required under sub. (3m) (f).
SB145,46,32 6. The applicant does not have an arrest or conviction record, subject to ss.
3111.321, 111.322, and 111.335.
SB145,46,64 7. The applicant meets any other criteria established by the board by rule under
5sub. (6) (a) 3. relating to the education, training, or experience required for each
6recognized role.
SB145,46,127 (b) 1. a. Subject to subd. 3. and s. 441.07 (1g), the board shall grant an advanced
8practice registered nurse license to an applicant the board determines meets the
9requirements under par. (a). The board shall also grant a person who is granted a
10license under this subd. 1. a. one or more specialty designations corresponding to the
11recognized roles for which the board determines that the person qualifies based on
12the person's qualifications under par. (a).
SB145,46,1813 b. The board shall grant an advanced practice registered nurse license to each
14individual who, on the day before the effective date of this subd. 1. b. .... [LRB inserts
15date], was certified to issue prescription orders under s. 441.16, 2021 stats. The
16board shall also grant a person who is granted a license under this subd. 1. b. one or
17more specialty designations corresponding to the recognized roles for which the
18board determines that the person qualifies based on the person's qualifications.
SB145,46,2319 c. The board shall grant an advanced practice registered nurse license to each
20individual who, on the day before the effective date of this subd. 1. c. .... [LRB inserts
21date], was licensed as a nurse-midwife under s. 441.15, 2021 stats. The board shall
22also grant a person who is granted a license under this subd. 1. c. a nurse-midwife
23specialty designation.
SB145,46,2524 2. Each specialty designation granted under subd. 1. shall appear on the
25person's advanced practice registered nurse license.
SB145,47,3
13. The board may not grant an advanced practice registered nurse license to
2a person applying concurrently for a license under s. 441.06 (1), (1c), or (1m), unless
3the board also grants the person the license under s. 441.06 (1), (1c), or (1m).
SB145,47,54 4. The board may place specific limitations on a person licensed as an advanced
5practice registered nurse as a condition of licensure.
SB145,47,86 5. If all of the following apply to a person, a notation indicating that the person
7may not issue prescription orders shall appear on the person's advanced practice
8registered nurse license:
SB145,47,119 a. The person is granted an advanced practice registered nurse license under
10subd. 1. a. and satisfies only par. (a) 2. b. but not par. (a) 2. a., or the person is granted
11an advanced practice registered nurse license under subd. 1. c.
SB145,47,1312 b. On January 1, 2024, the person did not hold a certificate under s. 441.16 (2),
132021 stats.
SB145,48,214 (c) On or before the applicable renewal date specified under s. 440.08 (2) (a),
15an advanced practice registered nurse shall submit to the board on a form furnished
16by the board a statement giving his or her name and residence, the nursing workforce
17survey and fee required under s. 441.01 (7), evidence of having satisfied the
18continuing education requirements under sub. (4), evidence of any malpractice
19liability insurance coverage required under sub. (5), any plan required under sub.
20(3m) (f), current evidence that the person satisfies each of the requirements under
21par. (a) 1., 2., 5. a., and 7. that apply with respect to the person, and any other
22information that the board requires by rule, with the applicable renewal fee
23determined by the department under s. 440.03 (9) (a). The board shall grant to a
24person who satisfies the requirements under this paragraph the renewal of his or her
25advanced practice registered nurse license and specialty designations granted under

1par. (b) 1. and shall, if the person holds a license under s. 441.06 (1), (1c), or (1m), also
2grant the renewal of that license.
SB145,48,6 3(2) Prescribing authority. (a) Except as provided in par. (b), an advanced
4practice registered nurse may issue prescription orders, subject to the rules
5promulgated under sub. (6) (a) 1. and 4., and may provide expedited partner therapy
6in the manner described in s. 441.092.
SB145,48,107 (b) An advanced practice registered nurse may not issue prescription orders if
8a notation under sub. (1) (b) 5. indicating that the advanced practice registered nurse
9may not issue prescription orders appears on the advanced practice registered
10nurse's license.
SB145,48,14 11(3) License required; use of titles. (a) 1. The holder of a license issued under
12this section is an “advanced practice registered nurse," may append to his or her
13name the title “A.P.R.N.," and is authorized to practice advanced practice registered
14nursing.
SB145,48,1715 2. The holder of a specialty designation for a recognized role granted under sub.
16(1) (b) 1. may append to his or her name the title and an abbreviation corresponding
17to that recognized role.
SB145,48,2218 (b) 1. Except as provided in sub. (3m) (e) and s. 257.03, no person may practice
19or attempt to practice advanced practice registered nursing, nor use the title
20“advanced practice registered nurse," the title “A.P.R.N.," or anything else to indicate
21that he or she is an advanced practice registered nurse unless he or she is licensed
22under this section.
SB145,48,2323 2. Except as provided in s. 257.03, no person may do any of the following:
SB145,49,3
1a. Use the title “certified nurse-midwife,” the title “C.N.M.,” or anything else
2to indicate that he or she is a certified nurse-midwife unless he or she has been
3granted a certified nurse-midwife specialty designation under sub. (1) (b) 1.
SB145,49,74 b. Use the title “certified registered nurse anesthetist,” the title “C.R.N.A.,” or
5anything else to indicate that he or she is a certified registered nurse anesthetist
6unless he or she has been granted a certified registered nurse anesthetist specialty
7designation under sub. (1) (b) 1.
SB145,49,108 c. Use the title “clinical nurse specialist,” the title “C.N.S.,” or anything else to
9indicate that he or she is a clinical nurse specialist unless he or she has been granted
10a clinical nurse specialist specialty designation under sub. (1) (b) 1.
SB145,49,1311 d. Use the title “nurse practitioner,” the title “N.P.,” or anything else to indicate
12that he or she is a nurse practitioner unless he or she has been granted a nurse
13practitioner specialty designation under sub. (1) (b) 1.
SB145,49,17 14(3m) Practice requirements and limitations. (a) 1. An advanced practice
15registered nurse licensed under this section may, except as provided in subd. 2. and
16par. (b), practice advanced practice registered nursing only in collaboration with a
17physician or dentist.
SB145,49,1918 2. Subdivision 1. does not apply to an advanced practice registered nurse with
19a certified nurse-midwife specialty designation.
SB145,50,420 (b) 1. An advanced practice registered nurse to whom par. (a) 1. applies may,
21except as provided in pars. (bg) 1. and (c), practice advanced practice registered
22nursing in a recognized role without being supervised by or collaborating with, and
23independent of, a physician or dentist if the board verifies, upon application of the
24advanced practice registered nurse, that the advanced practice registered nurse has
25completed 3,840 clinical hours of advanced practice registered nursing practice in

1that recognized role while working with a physician or dentist during those 3,840
2hours of practice. For purposes of this subdivision, during the completion of these
3hours, the advanced practice registered nurse must have continuously satisfied all
4of the following requirements:
SB145,50,65 a. Maintained a mutual, professional relationship with at least one physician
6or dentist.
SB145,50,107 b. Maintained, and provided to the board upon request, documentation
8indicating the relationships the advanced practice registered nurse had with one or
9more physicians or dentists to deal with issues outside of his or her licensed scope
10of practice.
SB145,50,1711 c. Maintained evidence that he or she was subject to a quality assurance
12program, peer review process, or other similar program or process that was
13implemented for and designed to ensure the provision of competent and quality
14patient care and that also included participation by a physician or dentist. Such a
15program or process may include a program or process administered through the
16advanced practice registered nurse's employer, hospital, ambulatory surgery center,
17clinic, or other outpatient facility.
SB145,50,2118 2. For purposes of subd. 1., hours of advanced practice registered nursing
19practice may include the lawful practice of advanced practice registered nursing
20outside this state or the lawful practice of advanced practice registered nursing in
21this state prior to the effective date of this subdivision .... [LRB inserts date].
SB145,50,2522 (bg) 1. An advanced practice registered nurse may provide pain management
23services only while working in a collaborative relationship with a physician. Except
24as provided in subd. 2., this subdivision applies regardless of whether the advanced
25practice registered nurse has qualified for independent practice under par. (b).
SB145,51,4
12. Except as provided in par. (c), subd. 1. does not apply to an advanced practice
2registered nurse who is providing pain management services in a hospital, as defined
3in s. 50.33 (2), or a clinic associated with a hospital, and who has qualified for
4independent practice under par. (b).
SB145,51,105 (bm) For purposes of pars. (a) 1. and (bg) 1., a collaborative relationship is a
6process in which an advanced practice registered nurse is working with a physician
7or dentist, in each other's presence when necessary, to deliver health care services
8within the scope of the advanced practice registered nurse's training, education, and
9experience. The advanced practice registered nurse shall document such a
10collaborative relationship.
SB145,51,1411 (c) Nothing in this section prohibits an entity employing or with a relationship
12with an advanced practice registered nurse from establishing additional
13requirements for an advanced practice registered nurse as a condition of
14employment or relationship.
SB145,51,2015 (d) An advanced practice registered nurse shall adhere to professional
16standards when managing situations that are beyond the advanced practice
17registered nurse's expertise. If a particular patient's needs are beyond the advanced
18practice registered nurse's expertise, the advanced practice registered nurse shall,
19as warranted by the patient's needs, consult or collaborate with or refer the patient
20to at least one of the following:
SB145,51,2121 1. A physician licensed under ch. 448.
SB145,51,2422 2. Another health care provider for whom the advanced practice registered
23nurse has reasonable evidence of having a scope of practice that includes the
24authorization to address the patient's needs.
SB145,52,7
1(e) An advanced practice registered nurse licensed under this section may
2delegate a task or order to another clinically trained health care worker if the task
3or order is within the scope of the advanced practice registered nurse's practice, the
4advanced practice registered nurse is competent to perform the task or issue the
5order, and the advanced practice registered nurse has reasonable evidence that the
6health care worker is minimally competent to perform the task or issue the order
7under the circumstances.
SB145,52,178 (f) An advanced practice registered nurse with a certified nurse-midwife
9specialty designation may not offer to deliver babies outside of a hospital setting
10unless the advanced practice registered nurse files with the board, and the board
11approves, a proactive plan for ensuring appropriate care or care transitions
12conforming with professional standards for patients with higher acuity or emergency
13care needs that exceed the advanced practice registered nurse's scope of practice. An
14advanced practice registered nurse who offers to deliver babies outside of a hospital
15setting shall file a plan under this paragraph when applying for an initial license
16under this section or a renewal of a license under this section, shall keep the plan
17current with the board, and shall follow the plan.
SB145,52,22 18(4) Continuing education. Every advanced practice registered nurse shall
19submit to the board evidence of having completed at least 16 contact hours per
20biennium in clinical pharmacology or therapeutics relevant to the advanced practice
21registered nurse's area of practice. The board may promulgate rules regarding the
22continuing education requirements under this subsection.
SB145,53,6 23(5) Malpractice liability insurance. Except for a person whose employer has
24in effect malpractice liability insurance that provides coverage for the person in the
25amounts specified under s. 655.23 (4), no person may practice advanced practice

1registered nursing unless he or she at all times has in effect malpractice liability
2insurance coverage in the minimum amounts required by the rules of the board. An
3advanced practice registered nurse shall submit evidence of that coverage to the
4board when applying for an initial license under this section or a renewal of a license
5under this section. An advanced practice registered nurse shall also submit such
6evidence to the board upon request of the board.
SB145,53,8 7(6) Rules. (a) The board shall promulgate rules necessary to administer this
8section, including rules for all of the following:
SB145,53,139 1. Further defining the scope of practice of an advanced practice registered
10nurse, practice of a certified nurse-midwife, practice of a certified registered nurse
11anesthetist, practice of a nurse practitioner, and practice of a clinical nurse specialist
12and defining the scope of practice within which an advanced practice registered
13nurse may issue prescription orders under sub. (2).
SB145,53,1514 2. Determining acceptable national certification for purposes of sub. (1) (a) 2.
15a.
SB145,53,1916 3. Establishing the appropriate education, training, or experience
17requirements that a registered nurse must satisfy in order to be an advanced practice
18registered nurse and to obtain each specialty designation corresponding to the
19recognized roles.
SB145,53,2120 4. Specifying the classes of drugs, individual drugs, or devices that may not be
21prescribed by an advanced practice registered nurse under sub. (2).
SB145,53,2222 5. Specifying the conditions to be met for registered nurses to do the following:
SB145,53,2323 a. Administer a drug prescribed by an advanced practice registered nurse.
SB145,53,2424 b. Administer a drug at the direction of an advanced practice registered nurse.
SB145,54,4
16. Establishing the minimum amount of malpractice liability insurance
2coverage that an advanced practice registered nurse must at all times have in effect
3for purposes of sub. (5). The board shall promulgate rules under this subdivision in
4consultation with the commissioner of insurance.
SB145,54,65 7. Establishing standards of professional conduct for advanced practice
6registered nurses generally and for practicing in each recognized role.
SB145,54,77 (am) The board may promulgate rules to implement sub. (3m) (b).
SB145,54,108 (b) The board may not promulgate rules that expand the scope of practice of an
9advanced practice registered nurse beyond the practices within advanced practice
10registered nursing.
SB145,104 11Section 104 . 441.092 of the statutes is created to read:
SB145,54,12 12441.092 Expedited partner therapy. (1) In this section:
SB145,54,1313 (b) “Antimicrobial drug" has the meaning given in s. 448.035 (1) (b).
SB145,54,1414 (c) “Expedited partner therapy" has the meaning given in s. 448.035 (1) (c).
SB145,55,2 15(2) Notwithstanding the requirements of s. 448.9785, an advanced practice
16registered nurse who may issue prescription orders under s. 441.09 (2) may provide
17expedited partner therapy if a patient is diagnosed as infected with a chlamydial
18infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with
19a sexual partner during which the chlamydial infection, gonorrhea, or
20trichomoniasis may have been transmitted to or from the sexual partner. The
21advanced practice registered nurse shall attempt to obtain the name of the patient's
22sexual partner. A prescription order for an antimicrobial drug prepared under this
23subsection shall include the name and address of the patient's sexual partner, if
24known. If the advanced practice registered nurse is unable to obtain the name of the

1patient's sexual partner, the prescription order shall include, in ordinary, bold-faced
2capital letters, the words, “expedited partner therapy" or the letters “EPT."
SB145,55,6 3(3) The advanced practice registered nurse shall provide the patient with a
4copy of the information sheet prepared by the department of health services under
5s. 46.03 (44) and shall request that the patient give the information sheet to the
6person with whom the patient had sexual contact.
SB145,55,11 7(4) (a) Except as provided in par. (b), an advanced practice registered nurse is
8immune from civil liability for injury to or the death of a person who takes any
9antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished
10under this section and if expedited partner therapy is provided as specified under
11this section.
SB145,55,1512 (b) The immunity under par. (a) does not extend to the donation, distribution,
13furnishing, or dispensing of an antimicrobial drug by an advanced practice
14registered nurse whose act or omission involves reckless, wanton, or intentional
15misconduct.
SB145,105 16Section 105 . 441.10 (7) of the statutes is amended to read:
SB145,56,417 441.10 (7) No license is required for practical nursing, but, except as provided
18in s. 257.03, no person without a license may hold himself or herself out as a licensed
19practical nurse or licensed attendant, use the title or letters “Trained Practical
20Nurse" or “T.P.N.", “Licensed Practical Nurse" or “L.P.N.", “ Licensed Attendant" or
21“L.A.", “Trained Attendant" or “T.A.", or otherwise seek to indicate that he or she is
22a licensed practical nurse or licensed attendant. No licensed practical nurse or
23licensed attendant may use the title, or otherwise seek to act as a registered, licensed,
24graduate or professional nurse. Anyone violating this subsection shall be subject to
25the penalties prescribed by s. 441.13. The board shall grant without examination a

1license as a licensed practical nurse to any person who was on July 1, 1949, a licensed
2attendant.
This subsection does not apply to any licensed practical nurse who holds
3a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction, other than
4this state, that has adopted the nurse licensure compact under s. 441.51.
SB145,106 5Section 106 . 441.11 (title) of the statutes is repealed.
SB145,107 6Section 107 . 441.11 (1) of the statutes is repealed.
SB145,108 7Section 108 . 441.11 (2) of the statutes is renumbered 441.09 (5m) and
8amended to read:
SB145,56,149 441.09 (5m) Licensure exemption. The provisions of s. 448.04 (1) (g) 448.03
10(1) (d)
do not apply to a an advanced practice registered nurse licensed under this
11section who possesses a certified registered
nurse anesthetist specialty designation
12under sub. (1) (b) 1.
or to a person who engages in the practice of a nurse anesthetist
13while performing official duties for the armed services or federal health services of
14the United States.
SB145,109 15Section 109 . 441.11 (3) of the statutes is repealed.
SB145,110 16Section 110 . 441.15 of the statutes is repealed.
SB145,111 17Section 111 . 441.16 of the statutes is repealed.
SB145,112 18Section 112 . 441.18 (2) (a) (intro.) of the statutes is amended to read:
SB145,56,2019 441.18 (2) (a) (intro.) An advanced practice registered nurse certified to who
20may
issue prescription orders under s. 441.16 441.09 (2) may do any of the following:
SB145,113 21Section 113 . 441.18 (2) (b) of the statutes is amended to read:
SB145,57,322 441.18 (2) (b) An advanced practice registered nurse who prescribes or delivers
23an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid
24antagonist is prescribed has or has the capacity to provide the knowledge and
25training necessary to safely administer the opioid antagonist to an individual

1undergoing an opioid-related overdose and that the person demonstrates the
2capacity to ensure that any individual to whom the person further delivers the opioid
3antagonist has or receives that knowledge and training.
SB145,114 4Section 114 . 441.18 (3) of the statutes is amended to read:
SB145,57,105 441.18 (3) An advanced practice registered nurse who, acting in good faith,
6prescribes or delivers an opioid antagonist in accordance with sub. (2), or who, acting
7in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall
8be immune from criminal or civil liability and may not be subject to professional
9discipline under s. 441.07 for any outcomes resulting from prescribing, delivering,
10or dispensing the opioid antagonist.
SB145,115 11Section 115 . 441.19 of the statutes is repealed.
SB145,116 12Section 116 . 448.03 (2) (a) of the statutes is amended to read:
SB145,57,2113 448.03 (2) (a) Any person lawfully practicing within the scope of a license,
14permit, registration, certificate, or certification granted to practice midwifery under
15subch. XIII of ch. 440, to practice professional or , practical, or advanced practice
16registered
nursing or nurse-midwifery under ch. 441, to practice chiropractic under
17ch. 446, to practice dentistry or dental hygiene or as an expanded function dental
18auxiliary under ch. 447, to practice optometry under ch. 449, to practice as a
19physician assistant under subch. IX, to practice acupuncture under ch. 451 or under
20any other statutory provision, to practice naturopathic medicine under ch. 466, or as
21otherwise provided by statute.
SB145,117 22Section 117 . 448.035 (1) (a) of the statutes is repealed.
SB145,118 23Section 118 . 448.035 (2) to (4) of the statutes are amended to read:
SB145,58,1124 448.035 (2) Notwithstanding the requirements of s. 448.30, a physician or
25certified advanced practice nurse prescriber
may provide expedited partner therapy

1if the patient is diagnosed as infected with a chlamydial infection, gonorrhea, or
2trichomoniasis and the patient has had sexual contact with a sexual partner during
3which the chlamydial infection, gonorrhea, or trichomoniasis may have been
4transmitted to or from the sexual partner. The physician or certified advanced
5practice nurse prescriber
shall attempt to obtain the name of the patient's sexual
6partner. A prescription order for an antimicrobial drug prepared under this
7subsection shall include the name and address of the patient's sexual partner, if
8known. If the physician or certified advanced practice nurse prescriber is unable to
9obtain the name of the patient's sexual partner, the prescription order shall include,
10in ordinary bold-faced capital letters, the words, “expedited partner therapy" or the
11letters “EPT."
SB145,58,15 12(3) The physician or certified advanced practice nurse prescriber shall provide
13the patient with a copy of the information sheet prepared by the department of health
14services under s. 46.03 (44) and shall request that the patient give the information
15sheet to the person with whom the patient had sexual contact.
SB145,58,20 16(4) (a) Except as provided in par. (b), a physician or certified advanced practice
17nurse prescriber
is immune from civil liability for injury to or the death of a person
18who takes any antimicrobial drug if the antimicrobial drug is prescribed, dispensed,
19or furnished under this section and if expedited partner therapy is provided as
20specified under this section.
SB145,58,2421 (b) The immunity under par. (a) does not extend to the donation, distribution,
22furnishing, or dispensing of an antimicrobial drug by a physician or certified
23advanced practice nurse prescriber
whose act or omission involves reckless, wanton,
24or intentional misconduct.
SB145,119 25Section 119 . 448.56 (1) and (1m) (b) of the statutes are amended to read:
SB145,59,15
1448.56 (1) Written referral. Except as provided in this subsection and s.
2448.52, a person may practice physical therapy only upon the written referral of a
3physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist,
4or advanced practice registered nurse prescriber certified under s. 441.16 (2).
5Written referral is not required if a physical therapist provides services in schools to
6children with disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated
7by the department of public instruction; provides services as part of a home health
8care agency; provides services to a patient in a nursing home pursuant to the
9patient's plan of care; provides services related to athletic activities, conditioning, or
10injury prevention; or provides services to an individual for a previously diagnosed
11medical condition after informing the individual's physician, naturopathic doctor,
12physician assistant, chiropractor, dentist, podiatrist, or advanced practice registered
13nurse prescriber certified under s. 441.16 (2) who made the diagnosis. The
14examining board may promulgate rules establishing additional services that are
15excepted from the written referral requirements of this subsection.
SB145,59,21 16(1m) (b) The examining board shall promulgate rules establishing the
17requirements that a physical therapist must satisfy if a physician, naturopathic
18doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice
19registered nurse prescriber makes a written referral under sub. (1). The purpose of
20the rules shall be to ensure continuity of care between the physical therapist and the
21health care practitioner.
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