Florida Senate - 2023 SB 1058 By Senator Rodriguez 40-00461A-23 20231058__ 1 A bill to be entitled 2 An act relating to autonomous practice by advanced 3 practice registered nurses; amending s. 395.0191, 4 F.S.; exempting certain advanced practice registered 5 nurses from specified medical direction requirements 6 for clinical privileges in hospitals; amending s. 7 464.0123, F.S.; revising the scope of autonomous 8 practice for certain advanced practice registered 9 nurses; revising requirements for certified nurse 10 midwives registered to engage in autonomous practice; 11 providing for the future expiration of the Council on 12 Advanced Practice Registered Nurse Autonomous 13 Practice; providing an effective date. 14 15 Be It Enacted by the Legislature of the State of Florida: 16 17 Section 1.Paragraph (b) of subsection (2) of section 18 395.0191, Florida Statutes, is amended to read: 19 395.0191Staff membership and clinical privileges. 20 (2) 21 (b)An advanced practice registered nurse who is certified 22 as a registered nurse anesthetist licensed under part I of 23 chapter 464 shall administer anesthesia under the onsite medical 24 direction of a professional licensed under chapter 458, chapter 25 459, or chapter 466, and in accordance with an established 26 protocol approved by the medical staff. The medical direction 27 shall specifically address the needs of the individual patient. 28 This paragraph does not apply to an advanced practice registered 29 nurse registered as an autonomous advanced practice registered 30 nurse under s. 464.0123 who is a certified registered nurse 31 anesthetist under part I of chapter 464. 32 Section 2.Paragraphs (a) and (b) of subsection (3) of 33 section 464.0123, Florida Statutes, are amended, and paragraph 34 (e) is added to subsection (4) of that section, to read: 35 464.0123Autonomous practice by an advanced practice 36 registered nurse. 37 (3)PRACTICE REQUIREMENTS. 38 (a)An advanced practice registered nurse who is registered 39 under this section may: 40 1.Engage in autonomous practice only in primary care 41 practice, including family medicine, general pediatrics, and 42 general internal medicine, as defined by board rule. 43 2.For certified nurse midwives, engage in autonomous 44 practice in the performance of the acts listed in s. 45 464.012(4)(c). 46 3.Perform the general functions of an advanced practice 47 registered nurse under s. 464.012(3) and the acts within his or 48 her specialty under s. 464.012(4) related to primary care. 49 3.4.For a patient who requires the services of a health 50 care facility, as defined in s. 408.032(8): 51 a.Admit the patient to the facility. 52 b.Manage the care received by the patient in the 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 certification 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 required. 66 3.Emergency medical services to be used in the event of an 67 emergency patient transfer agreement with a hospital and a 68 written referral agreement with a physician licensed under 69 chapter 458 or chapter 459 to engage in nurse midwifery. 70 (4)COUNCIL ON ADVANCED PRACTICE REGISTERED NURSE 71 AUTONOMOUS PRACTICE. 72 (e)The council shall dissolve, and this subsection 73 expires, on July 1, 2024. 74 Section 3.This act shall take effect July 1, 2023.