HB 1067 2023
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hb1067-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to autonomous practice by an advanced 2
practice registered nurse; amending s. 395.0191, F.S.; 3
revising staff membership and clinical privileges for 4
certain advanced practice registered nurses; amending 5
s. 464.0123, F.S.; revising practice requirements for 6
an autonomous advanced practice registered nurse; 7
revising practice requirements for certified nurse 8
midwives; authorizing an autonomous advance d practice 9
registered nurse to perform certain acts; providing 10
for expiration of the Council on Advanced Practice 11
Registered Nurse Autonomous Practice; providing an 12
effective date. 13
14
Be It Enacted by the Legislature of the State of Florida: 15
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Section 1. Paragraph (b) of subsection (2) of section 17
395.0191, Florida Statutes, is amended to read: 18
395.0191 Staff membership and clinical privileges. — 19
(2) 20
(b) An advanced practice registered nurse who is certified 21
as a registered nurse anesthetist license d under part I of 22
chapter 464 shall administer anesthesia under the onsite medical 23
direction of a professional licensed under chapter 458, chapter 24
459, or chapter 466, and in accordance with an established 25
HB 1067 2023
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
protocol approved by the medical staff. The medica l direction 26
shall specifically address the needs of the individual patient. 27
This paragraph does not apply to an advanced practice registered 28
nurse registered as an autonomous advanced practice registered 29
nurse under s. 464.0123 who is a certified registere d nurse 30
anesthetist under part 1 of chapter 464. 31
Section 2. Paragraphs (a) and (b) of subsection (3) of 32
section 464.0123, Florida Statutes, are amended and paragraph 33
(e) is added to subsection (4) of that section, to read: 34
464.0123 Autonomous practic e by an advanced practice 35
registered nurse.— 36
(3) PRACTICE REQUIREMENTS. — 37
(a) An advanced practice registered nurse who is 38
registered under this section may: 39
1. Engage in autonomous practice only in primary care 40
practice, including family medicine, ge neral pediatrics, and 41
general internal medicine, as defined by board rule . 42
2. For certified nurse midwives, engage in autonomous 43
practice in the performance of the acts listed in s. 44
464.012(4)(c). 45
2.3. Perform the general functions of an advanced pract ice 46
registered nurse under s. 464.012(3) and the acts within his or 47
her specialty under s. 464.012(4) related to primary care . 48
3.4. For a patient who requires the services of a health 49
care facility, as defined in s. 408.032(8): 50
HB 1067 2023
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
a. Admit the patient to the facility. 51
b. Manage the care received by the patient in the 52
facility. 53
c. Discharge the patient from the facility, unless 54
prohibited by federal law or rule. 55
4.5. Provide a signature, certification, stamp, 56
verification, affidavit, or endorsement that is otherwise 57
required by law to be provided by a physician, except an 58
advanced practice registered nurse registered under this section 59
may not issue a physician certi fication under s. 381.986. 60
(b) A certified nurse midwife providing out-of-hospital 61
birth services must have a written plan for the appropriate 62
delivery of emergency care. A copy of the plan must be 63
maintained on file and must include all of the following : 64
1. The name and address of the closest hospital. 65
2. Reasons for which an emergency transfer may be 66
required. 67
3. Emergency medical services to be used in the event of 68
an emergency patient transfer agreement with a hospital and a 69
written referral agreement with a physician licensed under 70
chapter 458 or chapter 459 to engage in nurse midwifery . 71
(4) COUNCIL ON ADVANCED PRACTICE REGISTERED NURSE 72
AUTONOMOUS PRACTICE. — 73
(e) The council shall expire on July 1, 2024. 74
Section 3. This act shall take e ffect July 1, 2023. 75