441.16(2)
(2) The board shall grant a certificate to issue prescription orders to an advanced practice nurse who meets the education, training and examination requirements established by the board for a certificate to issue prescription orders, and who pays the fee specified under
s. 440.05 (1).
441.16(3)
(3) The board shall promulgate rules necessary to administer this section, including rules for all of the following:
441.16(3)(a)
(a) Establishing the education, training or experience requirements that a registered nurse must satisfy to be an advanced practice nurse. The rules promulgated under this paragraph shall require a registered nurse to have education, training or experience that is in addition to the education, training or experience required for licensure as a registered nurse.
441.16(3)(am)
(am) Establishing the appropriate education, training and examination requirements that an advanced practice nurse must satisfy to qualify for a certificate to issue prescription orders.
441.16(3)(b)
(b) Defining the scope of practice within which an advanced practice nurse may issue prescription orders.
441.16(3)(c)
(c) Specifying the classes of drugs, individual drugs or devices that may not be prescribed by an advanced practice nurse.
441.16(3)(cm)
(cm) Specifying the conditions to be met for a registered nurse to do the following:
441.16(3)(cm)1.
1. Administer a drug prescribed by an advanced practice nurse who is certified to issue prescription orders.
441.16(3)(cm)2.
2. Administer a drug at the direction of an advanced practice nurse who is certified to issue prescription orders.
441.16(3)(d)
(d) Establishing procedures for maintaining a certificate to issue prescription orders, including requirements for continuing education.
441.16(3)(e)
(e) Establishing the minimum amount of malpractice liability insurance coverage that an advanced practice nurse shall have if he or she is certified to issue prescription orders. The board shall promulgate rules under this paragraph in consultation with the commissioner of insurance.
441.16(4)
(4) Every advanced practice nurse who is certified to issue prescription orders shall annually submit to the board evidence satisfactory to the board that he or she has in effect malpractice liability insurance coverage in the minimum amounts required by the rules of the board.
441.16(5)
(5) An advanced practice nurse who is certified to issue prescription orders may not delegate the act of issuing a prescription order to any nurse who is not certified to issue prescription orders.
441.16(6)
(6) Nothing in this section prohibits a nurse from issuing a prescription order as an act delegated by a physician.
441.16 History
History: 1993 a. 138;
1995 a. 448.
441.16 Cross-reference
Cross Reference: See also ch.
N 8, Wis. adm. code.
NURSE LICENSURE COMPACT
441.50
441.50
Nurse licensure compact. 441.50(1)
(1)
Article I - Findings and Declaration of Purpose. 441.50(1)(a)1.
1. That the health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws.
441.50(1)(a)2.
2. That violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public.
441.50(1)(a)3.
3. That the expanded mobility of nurses and the use of advanced communication technologies as part of our nation's health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation.
441.50(1)(a)4.
4. That new practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex.
441.50(1)(a)5.
5. That the current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant to both nurses and states.
441.50(1)(b)
(b) The general purposes of this compact are as follows:
441.50(1)(b)1.
1. To facilitate the states' responsibility to protect the public's health and safety.
441.50(1)(b)2.
2. To ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation.
441.50(1)(b)3.
3. To facilitate the exchange of information between party states in the areas of nurse regulation, investigation and adverse actions.
441.50(1)(b)4.
4. To promote compliance with the laws governing the practice of nursing in each jurisdiction.
441.50(1)(b)5.
5. To invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses.
441.50(2)
(2) Article II - Definitions. As used in this compact:
441.50(2)(a)
(a) "Adverse action" means a home or remote state action.
441.50(2)(b)
(b) "Alternative program" means a voluntary, nondisciplinary monitoring program approved by a nurse licensing board.
441.50(2)(c)
(c) "Coordinated licensure information system" means an integrated process for collecting, storing and sharing information on nurse licensure and enforcement activities related to nurse licensure laws, which is administered by a nonprofit organization composed of and controlled by state nurse licensing boards.
441.50(2)(d)
(d) "Current significant investigative information" means any of the following:
441.50(2)(d)1.
1. Investigative information that a licensing board, after a preliminary inquiry that includes notification and an opportunity for the nurse to respond if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction.
441.50(2)(d)2.
2. Investigative information that indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and had an opportunity to respond.
441.50(2)(e)
(e) "Home state" means the party state that is the nurse's primary state of residence.
441.50(2)(f)
(f) "Home state action" means any administrative, civil, equitable or criminal action permitted by the home state's laws that are imposed on a nurse by the home state's licensing board or other authority including actions against an individual's license, such as revocation, suspension, probation or any other action that affects a nurse's authorization to practice.
441.50(2)(g)
(g) "Licensing board" means a party state's regulatory body responsible for issuing nurse licenses.
441.50(2)(h)
(h) "Multistate licensure privilege" means current, official authority from a remote state permitting the practice of nursing as either a registered nurse or a licensed practical/vocational nurse in such party state. All party states have the authority, in accordance with existing state due process law, to take actions against the nurse's privilege, such as revocation, suspension, probation or any other action that affects a nurse's authorization to practice.
441.50(2)(i)
(i) "Nurse" means a registered nurse or licensed practical/vocational nurse, as those terms are defined by each party's state practice laws.
441.50(2)(j)
(j) "Party state" means any state that has adopted this compact.
441.50(2)(k)
(k) "Remote state" means a party state, other than the home state, where the patient is located at the time nursing care is provided, or, in the case of the practice of nursing not involving a patient, in such party state where the recipient of nursing practice is located.
441.50(2)(L)
(L) "Remote state action" means any of the following:
441.50(2)(L)1.
1. Any administrative, civil, equitable or criminal action permitted by a remote state's laws that are imposed on a nurse by the remote state's licensing board or other authority including actions against an individual's multistate licensure privilege to practice in the remote state.
441.50(2)(L)2.
2. Cease and desist and other injunctive or equitable orders issued by remote states or the licensing boards thereof.
441.50(2)(m)
(m) "State" means a state, territory, or possession of the United States, the District of Columbia or the Commonwealth of Puerto Rico.
441.50(2)(n)
(n) "State practice laws" means those individual party state's laws and regulations that govern the practice of nursing, define the scope of nursing practice, and create the methods and grounds for imposing discipline. "State practice laws" does not include the initial qualifications for licensure or requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.
441.50(3)
(3) Article III - General Provisions and Jurisdiction. 441.50(3)(a)(a) A license to practice registered nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a multistate licensure privilege to practice as a registered nurse in such party state. A license to practice licensed practical/vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a multistate licensure privilege to practice as a licensed practical/vocational nurse in such party state. In order to obtain or retain a license, an applicant must meet the home state's qualifications for licensure and license renewal as well as all other applicable state laws.
441.50(3)(b)
(b) Party states may, in accordance with state due process laws, limit or revoke the multistate licensure privilege of any nurse to practice in their state and may take any other actions under their applicable state laws necessary to protect the health and safety of their citizens. If a party state takes such action, it shall promptly notify the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states.
441.50(3)(c)
(c) Every nurse practicing in a party state must comply with the state practice laws of the state in which the patient is located at the time care is rendered. In addition, the practice of nursing is not limited to patient care, but shall include all nursing practice as defined by the state practice laws of a party state. The practice of nursing will subject a nurse to the jurisdiction of the nurse licensing board and the courts, as well as the laws, in that party state.
441.50(3)(d)
(d) This compact does not affect additional requirements imposed by states for advanced practice registered nursing. However, a multistate licensure privilege to practice registered nursing granted by a party state shall be recognized by other party states as a license to practice registered nursing if one is required by state law as a precondition for qualifying for advanced practice registered nurse authorization.
441.50(3)(e)
(e) Individuals not residing in a party state shall continue to be able to apply for nurse licensure as provided for under the laws of each party state. However, the license granted to these individuals will not be recognized as granting the privilege to practice nursing in any other party state unless explicitly agreed to by that party state.
441.50(4)
(4) Article IV - Applications for Licensure in a Party State. 441.50(4)(a)(a) Upon application for a license, the licensing board in a party state shall ascertain, through the coordinated licensure information system, whether the applicant has ever held, or is the holder of, a license issued by any other state, whether there are any restrictions on the multistate licensure privilege, and whether any other adverse action by any state has been taken against the license.
441.50(4)(b)
(b) A nurse in a party state shall hold licensure in only one party state at a time, issued by the home state.
441.50(4)(c)
(c) A nurse who intends to change his or her primary state of residence may apply for licensure in the new home state in advance of such change. However, new licenses will not be issued by a party state until after a nurse provides evidence of the change in his or her primary state of residence satisfactory to the new home state's licensing board.
441.50(4)(d)1.1. When a nurse changes his or her primary state of residence by moving between two party states, and obtains a license from the new home state, the license from the former home state is no longer valid.
441.50(4)(d)2.
2. When a nurse changes his or her primary state of residence by moving from a nonparty state to a party state, and obtains a license from the new home state, the individual state license issued by the nonparty state is not affected and will remain in full force if so provided by the laws of the nonparty state.
441.50(4)(d)3.
3. When a nurse changes his or her primary state of residence by moving from a party state to a nonparty state, the license issued by the prior home state converts to an individual state license, valid only in the former home state, without the multistate licensure privilege to practice in other party states.
441.50(5)
(5) Article V - Adverse Actions. In addition to the general provisions described in
sub. (3), the following provisions apply:
441.50(5)(a)
(a) The licensing board of a remote state shall promptly report to the administrator of the coordinated licensure information system any remote state actions including the factual and legal basis for such action, if known. The licensing board of a remote state shall also promptly report any significant current investigative information yet to result in a remote state action. The administrator of the coordinated licensure information system shall promptly notify the home state of any such reports.
441.50(5)(b)
(b) The licensing board of a party state shall have the authority to complete any pending investigations for a nurse who changes his or her primary state of residence during the course of such investigations. It shall also have the authority to take appropriate actions, and shall promptly report the conclusions of such investigations to the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the new home state of any such actions.
441.50(5)(c)
(c) A remote state may take adverse action affecting the multistate licensure privilege to practice within that party state. However, only the home state shall have the power to impose adverse action against the license issued by the home state.
441.50(5)(d)
(d) For purposes of imposing adverse action, the licensing board of the home state shall give the same priority and effect to reported conduct received from a remote state as it would if such conduct had occurred within the home state. In so doing, it shall apply its own state laws to determine appropriate action.
441.50(5)(e)
(e) The home state may take adverse action based on the factual findings of the remote state, so long as each state follows its own procedures for imposing such adverse action.
441.50(5)(f)
(f) Nothing in this compact shall override a party state's decision that participation in an alternative program may be used in lieu of licensure action and that such participation shall remain nonpublic if required by the party state's laws. Party states must require nurses who enter any alternative programs to agree not to practice in any other party state during the term of the alternative program without prior authorization from such other party state.
441.50(6)
(6) Article VI - Additional Authorities Invested in Party State Nurse Licensing Boards. Notwithstanding any other powers, party state nurse licensing boards shall have the authority to do any of the following:
441.50(6)(a)
(a) If otherwise permitted by state law, recover from the affected nurse the costs of investigations and disposition of cases resulting from any adverse action taken against that nurse.
441.50(6)(b)
(b) Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse licensing board in a party state for the attendance and testimony of witnesses, or the production of evidence from another party state, or both, shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state where the witnesses or evidence, or both, are located.
441.50(6)(c)
(c) Issue cease and desist orders to limit or revoke a nurse's authority to practice in their state.
441.50(7)
(7) Article VII - Coordinated Licensure Information System. 441.50(7)(a)(a) All party states shall participate in a cooperative effort to create a coordinated database of all licensed registered nurses and licensed practical/vocational nurses. This system will include information on the licensure and disciplinary history of each nurse, as contributed by party states, to assist in the coordination of nurse licensure and enforcement efforts.
441.50(7)(b)
(b) Notwithstanding any other provision of law, all party states' licensing boards shall promptly report adverse actions, actions against multistate licensure privileges, any current significant investigative information yet to result in adverse action, denials of applications, and the reasons for such denials, to the coordinated licensure information system.
441.50(7)(c)
(c) Current significant investigative information shall be transmitted through the coordinated licensure information system only to party state licensing boards.
441.50(7)(d)
(d) Notwithstanding any other provision of law, all party states' licensing boards contributing information to the coordinated licensure information system may designate information that may not be shared with nonparty states or disclosed to other entities or individuals without the express permission of the contributing state.
441.50(7)(e)
(e) Any personally identifiable information obtained by a party state's licensing board from the coordinated licensure information system may not be shared with nonparty states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information.
