SLS 16RS-517 REENGROSSED
2016 Regular Session
SENATE BILL NO. 187
BY SENATOR BARROW
NURSES. Provides relative to advanced practice registered nursing. (gov sig)
1 AN ACT
2 To amend and reenact R.S. 37:913(3)(a)(vii) and (ix), (8), and the introductory paragraph
3 of (9), and to enact Part V of Chapter 11 of Title 37 of the Louisiana Revised
4 Statutes of 1950, to be comprised of R.S. 37:1018.1, relative to advanced practice
5 registered nursing; to provide relative to collaborative practice agreement
6 requirements for advanced practice registered nurses; to establish an exemption to
7 such requirements for certain nurses; to provide for qualifications for the exemption;
8 to provide for certification and grounds for revocation of the exemption; to provide
9 for duties and powers of the Louisiana State Board of Nursing; to provide for
10 definitions; to provide for administrative rulemaking; to provide for an effective
11 date; and to provide for related matters.
12 Be it enacted by the Legislature of Louisiana:
13 Section 1. R.S. 37:913(3)(a)(vii) and (ix), (8), and the introductory paragraph of (9)
14 are hereby amended and reenacted and Part V of Chapter 11 of Title 37 of the Louisiana
15 Revised Statutes of 1950, comprised of R.S. 37:1018.1, is hereby enacted to read as follows:
16 §913. Definitions
17 As used in this Part:
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1 * * *
2 (3)(a) "Advanced practice registered nursing" means nursing by a certified
3 registered nurse anesthetist, certified nurse midwife, clinical nurse specialist, or
4 nurse practitioner which is based on knowledge and skills acquired in a basic nursing
5 education program, licensure as a registered nurse, and a minimum of a master's
6 degree with a concentration in the respective advanced practice nursing specialty
7 which includes both didactic and clinical components, advanced knowledge in
8 nursing theory, physical and psychosocial assessment, nursing interventions, and
9 management of health care. Advanced practice registered nursing includes:
10 * * *
11 (vii) Analyzing multiple sources of data and identifying and performing
12 certain acts of medical diagnosis in accordance with the a collaborative practice
13 agreement, unless the advanced practice registered nurse is exempted from the
14 requirement to enter into a collaborative practice agreement by the provisions
15 of R.S. 37:1018.1.
16 * * *
17 (ix) Consulting with or referring patients to licensed physicians, dentists, and
18 other health care healthcare providers in accordance with a collaborative practice
19 agreement, unless the advanced practice registered nurse is exempted from the
20 requirement to enter into a collaborative practice agreement by the provisions
21 of R.S. 37:1018.1.
22 * * *
23 (8) "Collaborative practice" means the joint management of the health care
24 of a patient by an advanced practice registered nurse who is not exempted from the
25 requirement to enter into a collaborative practice agreement pursuant to R.S.
26 37:1018.1 and is performing advanced practice registered nursing and one or more
27 consulting physicians or dentists. Except as otherwise provided in R.S. 37:930 and
28 1018.1, acts of medical diagnosis and prescription by an advanced practice registered
29 nurse shall be in accordance with a collaborative practice agreement.
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1 (9) "Collaborative practice agreement" means a formal written statement
2 addressing the parameters of the a collaborative practice which are mutually agreed
3 upon by the an advanced practice registered nurse who is not exempted from the
4 requirement to enter into a collaborative practice agreement pursuant to R.S.
5 37:1018.1 and one or more licensed physicians or dentists which. A collaborative
6 practice agreement shall include but not be limited to the following provisions:
7 * * *
8 PART V. COLLABORATIVE P RACTICE AGREEMENTS
9 §1018.1. Collaborative practice agreements; exemptions
10 A. As used in this Part, "board" means the Louisiana State Board of
11 Nursing.
12 B. Each nurse practitioner, clinical nurse specialist, and certified nurse
13 midwife who meets all of the following qualifications shall be exempt from any
14 requirement set forth in this Chapter to enter into a collaborative practice
15 agreement in order to perform advanced practice registered nursing:
16 (1) Currently holds unencumbered, unrestricted, and valid registered
17 nurse and advanced practice registered nurse licenses in this state and is not
18 subject to disciplinary proceedings for any of the grounds provided in R.S.
19 37:921.
20 (2) Has experience as recognized by the board to be no less than two
21 thousand hours in collaborative practice.
22 (3) Has successfully completed academic coursework in physical
23 assessment, advanced pharmacology, and advanced pathophysiology.
24 C.(1) The board shall have the exclusive and final authority to determine
25 whether a nurse practitioner, clinical nurse specialist, or certified nurse midwife
26 has met the qualifications required by Subsection B of this Section.
27 (2) Upon application of a nurse practitioner, clinical nurse specialist, or
28 certified nurse midwife, if the board determines that all qualifications required
29 by Subsection B of this Section have been met, the nurse practitioner, clinical
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1 nurse specialist, or certified nurse midwife shall not be required to enter into a
2 collaborative practice agreement in order to perform advanced practice
3 registered nursing.
4 (3)(a) The board shall issue to each nurse practitioner, clinical nurse
5 specialist, and certified nurse midwife it deems to be qualified for the exemption
6 provided for in this Section a certificate which bears all of the following:
7 (i) The name of the applicant.
8 (ii) The date of approval for the exemption.
9 (iii) A statement of reliance verifying the exemption.
10 (iv) The signature of a designee of the board, under the seal of the board.
11 (b) Each certificate issued in accordance with the provisions of this
12 Paragraph shall be admissible as evidence in all state courts as verification of
13 the exemption provided for in this Section without the necessity of a personal
14 court appearance by any member of the board.
15 D. The board may revoke an exemption granted pursuant to this Section
16 at any time if it determines that an advanced practice registered nurse no longer
17 meets the qualifications required by this Section.
18 E. The board shall promulgate all rules in accordance with the
19 Administrative Procedure Act as are necessary to implement the provisions of
20 this Part.
21 F. The board shall retain all necessary information regarding the
22 number of nurse practitioners, clinical nurse specialists, and certified nurse
23 midwives who meet the qualifications for exemptions in this Part. Three years
24 after implementation of this Part, the board shall submit a written report
25 providing a status update and review of implementation including information
26 on complaints and any disciplinary action taken by the board to the Senate and
27 House committees on health and welfare. The committees may convene for an
28 oversight hearing of this report jointly or separately.
29 G. The provisions of this Part shall only apply to nurse practitioners,
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1 clinical nurse specialists, and certified nurse midwives who practice in a parish
2 designated wholly or in part as a primary care health shortage area as set forth
3 under Section 332 of the Public Health Services Act, as determined by the
4 United States Department of Health and Human Services, Health Resources and
5 Services Administration.
6 Section 2. This Act shall become effective upon signature by the governor or, if not
7 signed by the governor, upon expiration of the time for bills to become law without signature
8 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
9 vetoed by the governor and subsequently approved by the legislature, this Act shall become
10 effective on the day following such approval.
The original instrument was prepared by Christine Arbo Peck. The following
digest, which does not constitute a part of the legislative instrument, was
prepared by Linda Nugent.
DIGEST
SB 187 Reengrossed 2016 Regular Session Barrow
Present law provides a definition for advanced practice registered nurse (APRN) including
performing acts under a collaborative practice agreement. Proposed law provides exceptions
from the collaborative practice agreement under proposed law.
Proposed law establishes a new Part regarding collaborative practice agreements which
allows the board of nursing to promulgate rules to cover circumstances in which an
exemption from the collaborative practice agreement is permitted. Further, provides for
minimum qualifications for exemption from the collaborative practice agreement mandate,
including at least 2,000 hours of experience in a collaborative practice. Provides for
application, issuance of a certificate, and revocation authority for the board.
Proposed law provides that the exemption shall only be applicable in a parish designated by
federal law to be wholly or in part a primary care health shortage area.
Three years after implementation of proposed law, the La. State Nursing Board shall submit
to the House and Senate committees on health and welfare a written report providing a status
update and review of implementation.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Amends R.S. 37:913(3)(a)(vii) and (ix), (8), and (9)(intro para); adds R.S. 37:1018.1)
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Summary of Amendments Adopted by Senate
Senate Floor Amendments to engrossed bill
1. Increases the number of hours of experience required from 250 to 2,000.
2. Limits the exemption to a parish that is designated by federal law to be a
primary care health shortage area.
3. Requires a written report by the La. State Nursing Board providing a status
update and review of implementation after three years.
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