Date of enactment:
2023 Senate Bill 145 Date of publication*:
2023 WISCONSIN ACT
AN ACT to repeal 50.01 (1b), 77.54 (14) (f) 3., 118.2925 (1) (b), 146.89 (1) (r) 8., 252.01 (1c), 440.03 (13) (b) 3.,
440.03 (13) (b) 42., 440.08 (2) (a) 4m., 440.08 (2) (a) 50., 441.11 (title), 441.11 (1), 441.11 (3), 441.15, 441.16,
441.19, 448.035 (1) (a), 450.01 (1m) and 655.001 (9); to renumber 655.001 (1); to renumber and amend 146.89
(1) (r) 3., 253.13 (1), 255.06 (1) (d), 441.06 (7) and 441.11 (2); to amend 29.193 (1m) (a) 2. (intro.), 29.193 (2) (b)
2., 29.193 (2) (c) 3., 29.193 (2) (cd) 2. b., 29.193 (2) (cd) 2. c., 29.193 (2) (e), 29.193 (3) (a), 45.40 (1g) (a), 46.03
(44), 50.08 (2), 50.09 (1) (a) (intro.), 50.09 (1) (f) 1., 50.09 (1) (h), 50.09 (1) (k), 50.49 (1) (b) (intro.), 51.41 (1d)
(b) 4., 70.47 (8) (intro.), 77.54 (14) (f) 4., 97.59, 102.13 (1) (a), 102.13 (1) (b) (intro.), 1., 3. and 4., 102.13 (1) (d)
1., 2., 3. and 4., 102.13 (2) (a), 102.13 (2) (b), 102.17 (1) (d) 1. and 2., 102.29 (3), 102.42 (2) (a), 106.30 (1), 118.15
(3) (a), 118.25 (1) (a), 118.29 (1) (e), 118.2925 (3), 118.2925 (4) (c), 118.2925 (5), 146.615 (1) (a), 146.82 (3) (a),
146.89 (1) (r) 1., 146.89 (6), 154.01 (1g), 252.07 (8) (a) 2., 252.07 (9) (c), 252.10 (7), 252.11 (2), (4), (5) and (7),
252.11 (10), 252.15 (3m) (d) 11. b. and 13., (5g) (c), (5m) (d) 2. and (e) 2. and 3. and (7m) (intro.) and (b), 252.16
(3) (c) (intro.), 252.17 (3) (c) (intro.), 253.07 (4) (d), 253.115 (4), 253.115 (7) (a) (intro.), 253.15 (2), 255.06 (2) (d),
255.07 (1) (d), 257.01 (5) (a) and (b), 341.14 (1a), (1e) (a), (1m) and (1q), 343.16 (5) (a), 343.51 (1), 343.62 (4) (a)
4., 440.077 (1) (a), 440.077 (2) (c), 440.094 (1) (c) 1., 440.094 (2) (a) (intro.), 440.981 (1), 440.982 (1), 440.987 (2),
441.01 (3), 441.01 (4), 441.01 (7) (a) (intro.), 441.01 (7) (b), 441.06 (3), 441.06 (4), 441.07 (1g) (intro.), (a), (c) and
(e), 441.10 (7), 441.18 (2) (a) (intro.), 441.18 (2) (b), 441.18 (3), 448.03 (2) (a), 448.035 (2) to (4), 448.56 (1) and
(1m) (b), 448.62 (2m), 448.67 (2), 448.956 (1m), 450.01 (16) (h) 2., 450.01 (16) (hr) 2., 450.03 (1) (e), 450.11 (1g)
(b), 450.11 (1i) (a) 1., 450.11 (1i) (b) 2. b., 450.11 (7) (b), 450.11 (8) (e), 450.13 (5) (b), 450.135 (7) (b), 462.04,
655.001 (7t), 655.002 (1) (a), 655.002 (1) (b), 655.002 (1) (c), 655.002 (1) (d), 655.002 (1) (e), 655.002 (1) (em),
655.002 (2) (a), 655.002 (2) (b), 655.003 (1), 655.003 (3), 655.005 (2) (a), 655.005 (2) (b), 655.23 (5m), 655.27 (3)
(a) 4., 655.27 (3) (b) 2m., 655.275 (2), 655.275 (5) (b) 2., 961.01 (19) (a) and 961.395; to repeal and recreate 155.01
(1g) (b), 251.01 (1c) and 441.06 (title); and to create 253.115 (1) (f), 253.13 (1) (a), 253.15 (1) (em), 255.06 (1) (f)
2., 440.03 (13) (b) 39m., 440.08 (2) (a) 47r., 441.001 (1c), 441.001 (3c), 441.001 (3g), 441.001 (3n), 441.001 (3r),
441.001 (3w), 441.001 (5), 441.01 (7) (c), 441.09, 441.092 and 655.001 (1g) of the statutes; relating to: advanced
practice registered nurses, extending the time limit for emergency rule procedures, providing an exemption from
emergency rule procedures, and granting rule−making authority.
The people of the state of Wisconsin, represented in
senate and assembly, do enact as follows:
SECTION 1. 29.193 (1m) (a) 2. (intro.) of the statutes
is amended to read:
* Section 991.11, WISCONSIN STATUTES: Effective date of acts. “Every act and every portion of an act enacted by the legislature over the governor’s
partial veto which does not expressly prescribe the time when it takes effect shall take effect on the day after its date of publication.” − 2 −2023 Wisconsin Act 2023 Senate Bill 145
29.193 (1m) (a) 2. (intro.) Has a permanent substan-
tial loss of function in one or both arms or one or both
hands and fails to meet the minimum standards of any one
of the following standard tests, administered under the
direction of a licensed physician, a licensed physician
assistant, a licensed chiropractor, or a certified licensed
advanced practice registered nurse prescriber:
SECTION 2. 29.193 (2) (b) 2. of the statutes is
amended to read:
29.193 (2) (b) 2. An applicant shall submit an appli-
cation on a form prepared and furnished by the depart-
ment, which shall include a written statement or report
prepared and signed by a licensed physician, a licensed
physician assistant, a licensed chiropractor, a licensed
podiatrist, or a certified licensed advanced practice regis-
tered nurse prescriber prepared no more than 6 months
preceding the application and verifying that the applicant
is physically disabled.
SECTION 3. 29.193 (2) (c) 3. of the statutes is
amended to read:
29.193 (2) (c) 3. The department may issue a Class B
permit to an applicant who is ineligible for a permit under
subd. 1., 2. or 2m. or who is denied a permit under subd.
1., 2. or 2m. if, upon review and after considering the
physical condition of the applicant and the recommenda-
tion of a licensed physician, a licensed physician assist-
ant, a licensed chiropractor, a licensed podiatrist, or a cer-
tified licensed advanced practice registered nurse
prescriber selected by the applicant from a list of licensed
physicians, licensed physician assistants, licensed chiro-
practors, licensed podiatrists, and certified licensed
advanced practice nurse prescribers registered nurses
compiled by the department, the department finds that
issuance of a permit complies with the intent of this sub-
section. The use of this review procedure is discretionary
with the department and all costs of the review procedure
shall be paid by the applicant.
SECTION 4. 29.193 (2) (cd) 2. b. of the statutes is
amended to read:
29.193 (2) (cd) 2. b. The person has a permanent sub-
stantial loss of function in one or both arms and fails to
meet the minimum standards of the standard upper
extremity pinch test, the standard grip test, or the stan-
dard nine−hole peg test, administered under the direction
of a licensed physician, a licensed physician assistant, a
licensed chiropractor, or a certified licensed advanced
practice registered nurse prescriber.
SECTION 5. 29.193 (2) (cd) 2. c. of the statutes is
amended to read:
29.193 (2) (cd) 2. c. The person has a permanent sub-
stantial loss of function in one or both shoulders and fails
to meet the minimum standards of the standard shoulder
strength test, administered under the direction of a
licensed physician, a licensed physician assistant, a
licensed chiropractor, or a certified licensed advanced
practice registered nurse prescriber.
SECTION 6. 29.193 (2) (e) of the statutes is amended
to read:
29.193 (2) (e) Review of decisions. An applicant
denied a permit under this subsection, except a permit
under par. (c) 3., may obtain a review of that decision by
a licensed physician, a licensed physician assistant, a
licensed chiropractor, a licensed podiatrist, or a certified
licensed advanced practice registered nurse prescriber
designated by the department and with an office located
in the department district in which the applicant resides.
The department shall pay for the cost of a review under
this paragraph unless the denied application on its face
fails to meet the standards set forth in par. (c) 1. or 2. A
review under this paragraph is the only method of review
of a decision to deny a permit under this subsection and
is not subject to further review under ch. 227.
SECTION 7. 29.193 (3) (a) of the statutes is amended
to read:
29.193 (3) (a) Produces a certificate from a licensed
physician, a licensed physician assistant, a licensed
optometrist, or a certified licensed advanced practice reg-
istered nurse prescriber stating that his or her sight is
impaired to the degree that he or she cannot read ordinary
newspaper print with or without corrective glasses.
SECTION 8. 45.40 (1g) (a) of the statutes is amended
to read:
45.40 (1g) (a) “Health care provider” means an
advanced practice registered nurse prescriber certified
who may issue prescription orders under s. 441.16
441.09 (2), an audiologist licensed under ch. 459, a den-
tist licensed under ch. 447, an optometrist licensed under
ch. 449, a physician licensed under s. 448.02, or a podia-
trist licensed under s. 448.63.
SECTION 9. 46.03 (44) of the statutes is amended to
read:
46.03 (44) SEXUALLY TRANSMITTED DISEASE TREAT-
MENT INFORMATION. Prepare and keep current an infor-
mation sheet to be distributed to a patient by a physician,
a physician assistant, or certified an advanced practice
registered nurse prescriber who may issue prescription
orders under s. 441.09 (2) providing expedited partner
therapy to that patient under s. 441.092, 448.035, or
448.9725. The information sheet shall include informa-
tion about sexually transmitted diseases and their treat-
ment and about the risk of drug allergies. The informa-
tion sheet shall also include a statement advising a person
with questions about the information to contact his or her
physician, advanced practice registered nurse, pharma-
cist, or local health department, as defined in s. 250.01
(4).
SECTION 10. 50.01 (1b) of the statutes is repealed.
SECTION 11. 50.08 (2) of the statutes is amended to
read:
50.08 (2) A physician, an advanced practice regis-
tered nurse prescriber certified who may issue prescrip-
tion orders under s. 441.16 441.09 (2), or a physician − 3 − 2023 Wisconsin Act 2023 Senate Bill 145
assistant who prescribes a psychotropic medication to a
nursing home resident who has degenerative brain disor-
der shall notify the nursing home if the prescribed medi-
cation has a boxed warning under 21 CFR 201.57.
SECTION 12. 50.09 (1) (a) (intro.) of the statutes is
amended to read:
50.09 (1) (a) (intro.) Private and unrestricted commu-
nications with the resident’s family, physician, physician
assistant, advanced practice registered nurse prescriber,
attorney, and any other person, unless medically con-
traindicated as documented by the resident’s physician,
physician assistant, or advanced practice registered nurse
prescriber in the resident’s medical record, except that
communications with public officials or with the resi-
dent’s attorney shall not be restricted in any event. The
right to private and unrestricted communications shall
include, but is not limited to, the right to:
SECTION 13. 50.09 (1) (f) 1. of the statutes is amended
to read:
50.09 (1) (f) 1. Privacy for visits by spouse or domes-
tic partner. If both spouses or both domestic partners
under ch. 770 are residents of the same facility, the
spouses or domestic partners shall be permitted to share
a room unless medically contraindicated as documented
by the resident’s physician, physician assistant, or
advanced practice registered nurse prescriber in the resi-
dent’s medical record.
SECTION 14. 50.09 (1) (h) of the statutes is amended
to read:
50.09 (1) (h) Meet with, and participate in activities
of social, religious, and community groups at the resi-
dent’s discretion, unless medically contraindicated as
documented by the resident’s physician, physician assist-
ant, or advanced practice registered nurse prescriber in
the resident’s medical record.
SECTION 15. 50.09 (1) (k) of the statutes is amended
to read:
50.09 (1) (k) Be free from mental and physical abuse,
and be free from chemical and physical restraints except
as authorized in writing by a physician, physician assist-
ant, or advanced practice registered nurse prescriber for
a specified and limited period of time and documented in
the resident’s medical record. Physical restraints may be
used in an emergency when necessary to protect the resi-
dent from injury to himself or herself or others or to prop-
erty. However, authorization for continuing use of the
physical restraints shall be secured from a physician,
physician assistant, or advanced practice registered nurse
prescriber within 12 hours. Any use of physical restraints
shall be noted in the resident’s medical records. “Physical
restraints” includes, but is not limited to, any article,
device, or garment that interferes with the free movement
of the resident and that the resident is unable to remove
easily, and confinement in a locked room.
SECTION 16. 50.49 (1) (b) (intro.) of the statutes is
amended to read:
50.49 (1) (b) (intro.) “Home health services” means
the following items and services that are furnished to an
individual, who is under the care of a physician, physi-
cian assistant, or advanced practice registered nurse pre-
scriber, by a home health agency, or by others under
arrangements made by the home health agency, that are
under a plan for furnishing those items and services to the
individual that is established and periodically reviewed
by a physician, physician assistant, or advanced practice
registered nurse prescriber and that are, except as pro-
vided in subd. 6., provided on a visiting basis in a place
of residence used as the individual’s home:
SECTION 17. 51.41 (1d) (b) 4. of the statutes is
amended to read:
51.41 (1d) (b) 4. A psychiatric mental health
advanced practice registered nurse who is suggested by
the Milwaukee County board of supervisors. The Mil-
waukee County board of supervisors shall solicit sugges-
tions from organizations including the Wisconsin Nurses
Association for individuals who specialize in a full con-
tinuum of behavioral health and medical services includ-
ing emergency detention, inpatient, residential, transi-
tional, partial hospitalization, intensive outpatient, and
wraparound community−based services. The Milwau-
kee County board of supervisors shall suggest to the Mil-
waukee County executive 4 psychiatric mental health
advanced practice registered nurses for this board mem-
bership position.
SECTION 18. 70.47 (8) (intro.) of the statutes is
amended to read:
70.47 (8) HEARING. (intro.) The board shall hear
upon oath all persons who appear before it in relation to
the assessment. Instead of appearing in person at the
hearing, the board may allow the property owner, or the
property owner’s representative, at the request of either
person, to appear before the board, under oath, by tele-
phone or to submit written statements, under oath, to the
board. The board shall hear upon oath, by telephone, all
ill or disabled persons who present to the board a letter
from a physician, physician assistant, or advanced prac-
tice registered nurse prescriber certified under s. 441.16
(2) licensed under ch. 441 that confirms their illness or
disability. At the request of the property owner or the
property owner’s representative, the board may postpone
and reschedule a hearing under this subsection, but may
not postpone and reschedule a hearing more than once
during the same session for the same property. The board
at such hearing shall proceed as follows:
SECTION 19. 77.54 (14) (f) 3. of the statutes is
repealed.
SECTION 20. 77.54 (14) (f) 4. of the statutes is
amended to read:
77.54 (14) (f) 4. An advanced practice registered
nurse who may issue prescription orders under s. 441.09
(2).
SECTION 21. 97.59 of the statutes is amended to read: − 4 −2023 Wisconsin Act 2023 Senate Bill 145
97.59 Handling foods. No person in charge of any
public eating place or other establishment where food
products to be consumed by others are handled may
knowingly employ any person handling food products
who has a disease in a form that is communicable by food
handling. If required by the local health officer or any
officer of the department for the purposes of an investiga-
tion, any person who is employed in the handling of foods
or is suspected of having a disease in a form that is com-
municable by food handling shall submit to an examina-
tion by the officer or by a physician, physician assistant,
or advanced practice registered nurse prescriber desig-
nated by the officer. The expense of the examination, if
any, shall be paid by the person examined. Any person
knowingly infected with a disease in a form that is com-
municable by food handling who handles food products
to be consumed by others and any persons knowingly
employing or permitting such a person to handle food
products to be consumed by others shall be punished as
provided by s. 97.72.
SECTION 22. 102.13 (1) (a) of the statutes is amended
to read:
102.13 (1) (a) Except as provided in sub. (4), when-
ever compensation is claimed by an employee, the
employee shall, upon the written request of the employ-
ee’s employer or worker’s compensation insurer, submit
to reasonable examinations by physicians, chiropractors,
psychologists, dentists, physician assistants, advanced
practice nurse prescribers registered nurses, or podia-
trists provided and paid for by the employer or insurer.
No employee who submits to an examination under this
paragraph is a patient of the examining physician, chiro-
practor, psychologist, dentist, physician assistant,
advanced practice registered nurse prescriber, or podia-
trist for any purpose other than for the purpose of bring-
ing an action under ch. 655, unless the employee specifi-
cally requests treatment from that physician,
chiropractor, psychologist, dentist, physician assistant,
advanced practice registered nurse prescriber, or podia-
trist.
SECTION 23. 102.13 (1) (b) (intro.), 1., 3. and 4. of the
statutes are amended to read:
102.13 (1) (b) (intro.) An employer or insurer who
requests that an employee submit to reasonable examina-
tion under par. (a) or (am) shall tender to the employee,
before the examination, all necessary expenses including
transportation expenses. The employee is entitled to
have a physician, chiropractor, psychologist, dentist,
physician assistant, advanced practice registered nurse
prescriber, or podiatrist provided by himself or herself
present at the examination and to receive a copy of all
reports of the examination that are prepared by the exam-
ining physician, chiropractor, psychologist, podiatrist,
dentist, physician assistant, advanced practice registered
nurse prescriber, or vocational expert immediately upon
receipt of those reports by the employer or worker’s com-
pensation insurer. The employee is entitled to have one
observer provided by himself or herself present at the
examination. The employee is also entitled to have a
translator provided by himself or herself present at the
examination if the employee has difficulty speaking or
understanding the English language. The employer’s or
insurer’s written request for examination shall notify the
employee of all of the following:
1. The proposed date, time, and place of the examina-
tion and the identity and area of specialization of the
examining physician, chiropractor, psychologist, dentist,
podiatrist, physician assistant, advanced practice regis-
tered nurse prescriber, or vocational expert.
3. The employee’s right to have his or her physician,
chiropractor, psychologist, dentist, physician assistant,
advanced practice registered nurse prescriber, or podia-
trist present at the examination.
4. The employee’s right to receive a copy of all
reports of the examination that are prepared by the exam-
ining physician, chiropractor, psychologist, dentist,
podiatrist, physician assistant, advanced practice regis-
tered nurse prescriber, or vocational expert immediately
upon receipt of these reports by the employer or worker’s
compensation insurer.
SECTION 24. 102.13 (1) (d) 1., 2., 3. and 4. of the
statutes are amended to read:
102.13 (1) (d) 1. Any physician, chiropractor, psy-
chologist, dentist, podiatrist, physician assistant,
advanced practice registered nurse prescriber, or voca-
tional expert who is present at any examination under par.
(a) or (am) may be required to testify as to the results of
the examination.
2. Any physician, chiropractor, psychologist, dentist,
physician assistant, advanced practice registered nurse
prescriber, or podiatrist who attended a worker’s com-
pensation claimant for any condition or complaint rea-
sonably related to the condition for which the claimant
claims compensation may be required to testify before
the division when the division so directs.
3. Notwithstanding any statutory provisions except
par. (e), any physician, chiropractor, psychologist, den-
tist, physician assistant, advanced practice registered
nurse prescriber, or podiatrist attending a worker’s com-
pensation claimant for any condition or complaint rea-
sonably related to the condition for which the claimant
claims compensation may furnish to the employee,
employer, worker’s compensation insurer, department,
or division information and reports relative to a compen-
sation claim.
4. The testimony of any physician, chiropractor, psy-
chologist, dentist, physician assistant, advanced practice
registered nurse prescriber, or podiatrist who is licensed
to practice where he or she resides or practices in any state
and the testimony of any vocational expert may be
received in evidence in compensation proceedings. − 5 − 2023 Wisconsin Act 2023 Senate Bill 145
SECTION 25. 102.13 (2) (a) of the statutes is amended
to read:
102.13 (2) (a) An employee who reports an injury
alleged to be work−related or files an application for
hearing waives any physician−patient, psychologist−
patient, or chiropractor−patient privilege with respect to
any condition or complaint reasonably related to the con-
dition for which the employee claims compensation.
Notwithstanding ss. 51.30 and 146.82 and any other law,
any physician, chiropractor, psychologist, dentist, podia-
trist, physician assistant, advanced practice registered
nurse prescriber, hospital, or health care provider shall,
within a reasonable time after written request by the
employee, employer, worker’s compensation insurer,
department, or division, or its representative, provide that
person with any information or written material reason-
ably related to any injury for which the employee claims
compensation. If the request is by a representative of a
worker’s compensation insurer for a billing statement,
the physician, chiropractor, psychologist, dentist, podia-
trist, physician assistant, advanced practice registered
nurse prescriber, hospital, or health care provider shall,
within 30 days after receiving the request, provide that
person with a complete copy of an itemized billing state-
ment or a billing statement in a standard billing format
recognized by the federal government.
SECTION 26. 102.13 (2) (b) of the statutes is amended
to read:
102.13 (2) (b) A physician, chiropractor, podiatrist,
psychologist, dentist, physician assistant, advanced prac-
tice registered nurse prescriber, hospital, or health ser-
vice provider shall furnish a legible, certified duplicate of
the written material requested under par. (a) in paper for-
mat upon payment of the actual costs of preparing the cer-
tified duplicate, not to exceed the greater of 45 cents per
page or $7.50 per request, plus the actual costs of postage,
or shall furnish a legible, certified duplicate of that mate-
rial in electronic format upon payment of $26 per request.
Any person who refuses to provide certified duplicates of
written material in the person’s custody that is requested
under par. (a) shall be liable for reasonable and necessary
costs and, notwithstanding s. 814.04 (1), reasonable
attorney fees incurred in enforcing the requester’s right
to the duplicates under par. (a).
SECTION 27. 102.17 (1) (d) 1. and 2. of the statutes
are amended to read:
102.17 (1) (d) 1. The contents of certified medical
and surgical reports by physicians, podiatrists, surgeons,
dentists, psychologists, physician assistants, advanced
practice nurse prescribers registered nurses, and chiro-
practors licensed in and practicing in this state, and of
certified reports by experts concerning loss of earning
capacity under s. 102.44 (2) and (3), presented by a party
for compensation constitute prima facie evidence as to
the matter contained in those reports, subject to any rules
and limitations the division prescribes. Certified reports
of physicians, podiatrists, surgeons, dentists, psycholo-
gists, physician assistants, advanced practice nurse pre-
scribers registered nurses, and chiropractors, wherever
licensed and practicing, who have examined or treated
the claimant, and of experts, if the practitioner or expert
consents to being subjected to cross−examination, also
constitute prima facie evidence as to the matter contained
in those reports. Certified reports of physicians, podia-
trists, surgeons, psychologists, and chiropractors are
admissible as evidence of the diagnosis, necessity of the
treatment, and cause and extent of the disability. Certi-
fied reports by doctors of dentistry, physician assistants,
and advanced practice nurse prescribers registered
nurses are admissible as evidence of the diagnosis and
necessity of treatment but not of the cause and extent of
disability. Any physician, podiatrist, surgeon, dentist,
psychologist, chiropractor, physician assistant, advanced
practice registered nurse prescriber, or expert who know-
ingly makes a false statement of fact or opinion in a certi-
fied report may be fined or imprisoned, or both, under s.
943.395.
2. The record of a hospital or sanatorium in this state
that is satisfactory to the division, established by certifi-
cate, affidavit, or testimony of the supervising officer of
the hospital or sanatorium, any other person having
charge of the record, or a physician, podiatrist, surgeon,
dentist, psychologist, physician assistant, advanced prac-
tice registered nurse prescriber, or chiropractor to be the
record of the patient in question, and made in the regular
course of examination or treatment of the patient, consti-
tutes prima facie evidence as to the matter contained in
the record, to the extent that the record is otherwise com-
petent and relevant.
SECTION 28. 102.29 (3) of the statutes is amended to
read:
102.29 (3) Nothing in this chapter shall prevent an
employee from taking the compensation that the
employee may be entitled to under this chapter and also
maintaining a civil action against any physician, chiro-
practor, psychologist, dentist, physician assistant,
advanced practice registered nurse prescriber, or podia-
trist for malpractice.
SECTION 29. 102.42 (2) (a) of the statutes is amended
to read:
102.42 (2) (a) When the employer has notice of an
injury and its relationship to the employment, the
employer shall offer to the injured employee his or her
choice of any physician, chiropractor, psychologist, den-
tist, physician assistant, advanced practice registered
nurse prescriber, or podiatrist licensed to practice and
practicing in this state for treatment of the injury. By
mutual agreement, the employee may have the choice of
any qualified practitioner not licensed in this state. In
case of emergency, the employer may arrange for treat-
ment without tendering a choice. After the emergency
has passed the employee shall be given his or her choice − 6 −2023 Wisconsin Act 2023 Senate Bill 145
of attending practitioner at the earliest opportunity. The
employee has the right to a 2nd choice of attending practi-
tioner on notice to the employer or its insurance carrier.
Any further choice shall be by mutual agreement. Part-
ners and clinics are considered to be one practitioner.
Treatment by a practitioner on referral from another prac-
titioner is considered to be treatment by one practitioner.
SECTION 30. 106.30 (1) of the statutes is amended to
read:
106.30 (1) DEFINITION. In this section, “nurse” means
a registered nurse licensed under s. 441.06 or permitted
under s. 441.08, a licensed practical nurse licensed or per-
mitted under s. 441.10, or an advanced practice regis-
tered nurse prescriber certified under s. 441.16 (2), or a
nurse−midwife licensed under s. 441.15 441.09.
SECTION 31. 118.15 (3) (a) of the statutes is amended
to read:
118.15 (3) (a) Any child who is excused by the school
board because the child is temporarily not in proper phys-
ical or mental condition to attend a school program but
who can be expected to return to a school program upon
termination or abatement of the illness or condition. The
school attendance officer may request the parent or
guardian of the child to obtain a written statement from
a licensed physician, naturopathic doctor, dentist, chiro-
practor, optometrist, psychologist, physician assistant, or
nurse practitioner, as defined in s. 255.06 (1) (d), or certi-
fied advanced practice registered nurse prescriber, or reg-
istered nurse described under s. 255.06 (1) (f) 1. or Chris-
tian Science practitioner living and residing in this state,
who is listed in the Christian Science Journal, as suffi-
cient proof of the physical or mental condition of the
child. An excuse under this paragraph shall be in writing
and shall state the time period for which it is valid, not to
exceed 30 days.
SECTION 32. 118.25 (1) (a) of the statutes is amended
to read:
118.25 (1) (a) “Practitioner” means a person licensed
as a physician, naturopathic doctor, or physician assistant
in any state or licensed as an advanced practice registered
nurse or certified as an advanced practice registered
nurse prescriber in any state. In this paragraph, “physi-
cian” has the meaning given in s. 448.01 (5).
SECTION 33. 118.29 (1) (e) of the statutes is amended
to read:
118.29 (1) (e) “Practitioner” means any physician,
naturopathic doctor, dentist, optometrist, physician
assistant, advanced practice registered nurse prescriber
with prescribing authority, or podiatrist licensed in any
state.
SECTION 34. 118.2925 (1) (b) of the statutes is
repealed.
SECTION 35. 118.2925 (3) of the statutes, as affected
by 2023 Wisconsin Act 27, is amended to read:
118.2925 (3) PRESCRIPTIONS FOR SCHOOLS. A physi-
cian, an advanced practice registered nurse prescriber
who may issue prescription orders under s. 441.09 (2), or
a physician assistant may prescribe epinephrine delivery
systems in the name of a school that has adopted a plan
under sub. (2) (a), to be maintained by the school for use
under sub. (4).
SECTION 36. 118.2925 (4) (c) of the statutes, as
affected by 2023 Wisconsin Act 27, is amended to read:
118.2925 (4) (c) Administer an epinephrine delivery
system to a pupil or other person who the school nurse or
designated school personnel in good faith believes is
experiencing anaphylaxis in accordance with a standing
protocol from a physician, an advanced practice regis-
tered nurse prescriber who may issue prescription orders
under s. 441.09 (2), or a physician assistant, regardless of
whether the pupil or other person has a prescription for
an epinephrine delivery system. If the pupil or other per-
son does not have a prescription for an epinephrine deliv-
ery system, or the person who administers the epineph-
rine delivery system does not know whether the pupil or
other person has a prescription for an epinephrine deliv-
ery system, the person who administers the epinephrine
delivery system shall, as soon as practicable, report the
administration by dialing the telephone number “911” or,
in an area in which the telephone number “911” is not
available, the telephone number for an emergency medi-
cal service provider.
SECTION 37. 118.2925 (5) of the statutes, as affected
by 2023 Wisconsin Act 27, is amended to read:
118.2925 (5) IMMUNITY FROM CIVIL LIABILITY; EXEMP-
TION FROM PRACTICE OF MEDICINE. A school and its desig-
nated school personnel, and a physician, an advanced
practice registered nurse prescriber who may issue pre-
scription orders under s. 441.09 (2), or a physician assist-
ant who provides a prescription or standing protocol for
school epinephrine delivery systems, are not liable for
any injury that results from the administration or self−
administration of an epinephrine delivery system under
this section, regardless of whether authorization was
given by the pupil’s parent or guardian or by the pupil’s
physician, physician assistant, or advanced practice reg-
istered nurse prescriber, unless the injury is the result of
an act or omission that constitutes gross negligence or
willful or wanton misconduct. The immunity from liabil-
ity provided under this subsection is in addition to and not
in lieu of that provided under s. 895.48.
SECTION 38. 146.615 (1) (a) of the statutes is
amended to read:
146.615 (1) (a) “Advanced practice clinician” means
a physician assistant or an advanced practice registered
nurse, including a nurse practitioner, certified nurse−
midwife, clinical nurse specialist, or certified registered
nurse anesthetist licensed under s. 441.09.
SECTION 39. 146.82 (3) (a) of the statutes is amended
to read:
146.82 (3) (a) Notwithstanding sub. (1), a physician,
a naturopathic doctor, a limited−scope naturopathic doc- − 7 − 2023 Wisconsin Act 2023 Senate Bill 145
tor, a physician assistant, or an advanced practice regis-
tered nurse prescriber certified under s. 441.16 (2)
licensed under s. 441.09 who treats a patient whose phys-
ical or mental condition in the physician’s, naturopathic
doctor’s, limited−scope naturopathic doctor’s, physician
assistant’s, or advanced practice nurse prescriber’s regis-
tered nurse’s judgment affects the patient’s ability to
exercise reasonable and ordinary control over a motor
vehicle may report the patient’s name and other informa-
tion relevant to the condition to the department of trans-
portation without the informed consent of the patient.
SECTION 40. 146.89 (1) (r) 1. of the statutes is
amended to read:
146.89 (1) (r) 1. Licensed as a physician under ch.
448, naturopathic doctor under ch. 466, a dentist or dental
hygienist under ch. 447, a registered nurse, practical
nurse, or nurse−midwife advanced practice registered
nurse under ch. 441, an optometrist under ch. 449, a
physician assistant under subch. IX of ch. 448, a pharma-
cist under ch. 450, a chiropractor under ch. 446, a podia-
trist under subch. IV of ch. 448, or a physical therapist
under subch. III of ch. 448.
SECTION 41. 146.89 (1) (r) 3. of the statutes is renum-
bered 146.89 (1) (r) 5e. and amended to read:
146.89 (1) (r) 5e. A registered nurse practitioner, as
defined in s. 255.06 (1) (d) who holds a multistate license,
as defined in s. 441.51 (2) (h), issued by a party state, as
defined in s. 441.51 (2) (k), and whose practice of profes-
sional nursing under s. 441.001 (4) includes performance
of delegated medical services under the supervision of a
physician, dentist, podiatrist, or advanced practice regis-
tered nurse.
SECTION 42. 146.89 (1) (r) 8. of the statutes is
repealed.
SECTION 43. 146.89 (6) of the statutes is amended to
read:
146.89 (6) (a) While serving as a volunteer health
care provider under this section, an advanced practice
registered nurse who has a certificate to issue prescrip-
tion orders under s. 441.16 (2) is considered to meet the
requirements of s. 655.23, if required to comply with s.
655.23.
(b) While serving as a volunteer health care provider
under this section, an advanced practice registered nurse
who has a certificate to issue prescription orders under s.
441.16 (2) is not required to maintain in effect malprac-
tice insurance.
SECTION 44. 154.01 (1g) of the statutes is amended
to read:
154.01 (1g) “Advanced practice registered nurse”
means a nurse an individual licensed under ch. 441 who
is currently certified by a national certifying body
approved by the board of nursing as a nurse practitioner,
certified nurse−midwife, certified registered nurse anes-
thetist, or clinical nurse specialist s. 441.09.
SECTION 45. 155.01 (1g) (b) of the statutes is
repealed and recreated to read:
155.01 (1g) (b) An individual who is licensed as an
advanced practice registered nurse and possesses a nurse
practitioner specialty designation under s. 441.09.
SECTION 46. 251.01 (1c) of the statutes is repealed
and recreated to read:
251.01 (1c) “Advanced practice registered nurse”
means an individual licensed under s. 441.09.
SECTION 47. 252.01 (1c) of the statutes is repealed.
SECTION 48. 252.07 (8) (a) 2. of the statutes is
amended to read:
252.07 (8) (a) 2. The department or local health offi-
cer provides to the court a written statement from a physi-
cian, physician assistant, or advanced practice registered
nurse prescriber that the individual has infectious tuber-
culosis or suspect tuberculosis.
SECTION 49. 252.07 (9) (c) of the statutes is amended
to read:
252.07 (9) (c) If the court orders confinement of an
individual under this subsection, the individual shall
remain confined until the department or local health offi-
cer, with the concurrence of a treating physician, physi-
cian assistant, or advanced practice registered nurse pre-
scriber, determines that treatment is complete or that the
individual is no longer a substantial threat to himself or
herself or to the public health. If the individual is to be
confined for more than 6 months, the court shall review
the confinement every 6 months.
SECTION 50. 252.10 (7) of the statutes is amended to
read:
252.10 (7) Drugs necessary for the treatment of
mycobacterium tuberculosis shall be purchased by the
department from the appropriation account under s.
20.435 (1) (e) and dispensed to patients through the pub-
lic health dispensaries, local health departments, physi-
cians, or advanced practice nurse prescribers registered
nurses who may issue prescription orders under s. 441.09
(2).
SECTION 51. 252.11 (2), (4), (5) and (7) of the statutes
are amended to read:
252.11 (2) An officer of the department or a local
health officer having knowledge of any reported or rea-
sonably suspected case or contact of a sexually transmit-
ted disease for which no appropriate treatment is being
administered, or of an actual contact of a reported case or
potential contact of a reasonably suspected case, shall
investigate or cause the case or contact to be investigated
as necessary. If, following a request of an officer of the
department or a local health officer, a person reasonably
suspected of being infected with a sexually transmitted
disease refuses or neglects examination by a physician,
physician assistant, or advanced practice registered nurse
prescriber or treatment, an officer of the department or a
local health officer may proceed to have the person com- − 8 −2023 Wisconsin Act 2023 Senate Bill 145
mitted under sub. (5) to an institution or system of care
for examination, treatment, or observation.
(4) If a person infected with a sexually transmitted
disease ceases or refuses treatment before reaching what
in a physician’s, physician assistant’s, or advanced prac-
tice nurse prescriber’s registered nurse’s opinion is the
noncommunicable stage, the physician, physician assist-
ant, or advanced practice registered nurse prescriber shall
notify the department. The department shall without
delay take the necessary steps to have the person commit-
ted for treatment or observation under sub. (5), or shall
notify the local health officer to take these steps.
(5) Any court of record may commit a person
infected with a sexually transmitted disease to any insti-
tution or may require the person to undergo a system of
care for examination, treatment, or observation if the per-
son ceases or refuses examination, treatment, or observa-
tion under the supervision of a physician, physician
assistant, or advanced practice registered nurse pre-
scriber. The court shall summon the person to appear on
a date at least 48 hours, but not more than 96 hours, after
service if an officer of the department or a local health
officer petitions the court and states the facts authorizing
commitment. If the person fails to appear or fails to
accept commitment without reasonable cause, the court
may cite the person for contempt. The court may issue
a warrant and may direct the sheriff, any constable, or any
police officer of the county immediately to arrest the per-
son and bring the person to court if the court finds that a
summons will be ineffectual. The court shall hear the
matter of commitment summarily. Commitment under
this subsection continues until the disease is no longer
communicable or until other provisions are made for
treatment that satisfy the department. The certificate of
the petitioning officer is prima facie evidence that the dis-
ease is no longer communicable or that satisfactory pro-
visions for treatment have been made.
(7) Reports, examinations and inspections, and all
records concerning sexually transmitted diseases are
confidential and not open to public inspection, and may
not be divulged except as may be necessary for the
preservation of the public health, in the course of com-
mitment proceedings under sub. (5), or as provided under
s. 938.296 (4) or 968.38 (4). If a physician, physician
assistant, or advanced practice registered nurse pre-
scriber has reported a case of sexually transmitted disease
to the department under sub. (4), information regarding
the presence of the disease and treatment is not privileged
when the patient, physician, physician assistant, or
advanced practice registered nurse prescriber is called
upon to testify to the facts before any court of record.
SECTION 52. 252.11 (10) of the statutes is amended
to read:
252.11 (10) The state laboratory of hygiene shall
examine specimens for the diagnosis of sexually trans-
mitted diseases for any physician, naturopathic doctor,
physician assistant, advanced practice registered nurse
prescriber, or local health officer in the state, and shall
report the positive results of the examinations to the local
health officer and to the department. All laboratories per-
forming tests for sexually transmitted diseases shall
report all positive results to the local health officer and to
the department, with the name of the physician, naturo-
pathic doctor, physician assistant, or advanced practice
registered nurse prescriber to whom reported.
SECTION 53. 252.15 (3m) (d) 11. b. and 13., (5g) (c),
(5m) (d) 2. and (e) 2. and 3. and (7m) (intro.) and (b) of
the statutes are amended to read:
252.15 (3m) (d) 11. b. The coroner, medical exam-
iner, or appointed assistant is investigating the cause of
death of the subject of the HIV test and has contact with
the body fluid of the subject of the HIV test that consti-
tutes a significant exposure, if a physician, physician
assistant, or advanced practice registered nurse pre-
scriber, based on information provided to the physician,
physician assistant, or advanced practice registered nurse
prescriber, determines and certifies in writing that the
coroner, medical examiner, or appointed assistant has
had a contact that constitutes a significant exposure and
if the certification accompanies the request for disclo-
sure.
13. If the subject of the HIV test has a positive HIV
test result and is deceased, by the subject’s attending
physician, physician assistant, or advanced practice reg-
istered nurse prescriber, to persons, if known to the physi-
cian, physician assistant, or advanced practice registered
nurse prescriber, with whom the subject had sexual con-
tact or shared intravenous drug use paraphernalia.
(5g) (c) A physician, physician assistant, or advanced
practice registered nurse prescriber, based on informa-
tion provided to the physician, physician assistant, or
advanced practice registered nurse prescriber, deter-
mines and certifies in writing that the person has had con-
tact that constitutes a significant exposure. The certifica-
tion shall accompany the request for HIV testing and
disclosure. If the person is a physician, physician assist-
ant, or advanced practice registered nurse prescriber, he
or she may not make this determination or certification.
The information that is provided to a physician, physi-
cian assistant, or advanced practice registered nurse pre-
scriber to document the occurrence of the contact that
constitutes a significant exposure and the physician’s,
physician assistant’s, or advanced practice nurse pre-
scriber’s registered nurse’s certification that the person
has had contact that constitutes a significant exposure,
shall be provided on a report form that is developed by the
department of safety and professional services under s.
101.02 (19) (a) or on a report form that the department of
safety and professional services determines, under s.
101.02 (19) (b), is substantially equivalent to the report
form that is developed under s. 101.02 (19) (a). − 9 − 2023 Wisconsin Act 2023 Senate Bill 145
(5m) (d) 2. A physician, physician assistant, or
advanced practice registered nurse prescriber, based on
information provided to the physician, physician assist-
ant, or advanced practice registered nurse prescriber,
determines and certifies in writing that the contact under
subd. 1. constitutes a significant exposure. A health care
provider who has a contact under subd. 1. c. may not
make the certification under this subdivision for himself
or herself.
(e) 2. If the contact occurs as provided under par. (d)
1. b., the attending physician, physician assistant, or
advanced practice registered nurse prescriber of the
funeral director, coroner, medical examiner, or appointed
assistant.
3. If the contact occurs as provided under par. (d) 1.
c., the physician, physician assistant, or advanced prac-
tice registered nurse prescriber who makes the certifica-
tion under par. (d) 2.
(7m) REPORTING OF PERSONS SIGNIFICANTLY EXPOSED.
(intro.) If a positive, validated HIV test result is obtained
from a test subject, the test subject’s physician, physician
assistant, or advanced practice registered nurse pre-
scriber who maintains a record of the HIV test result
under sub. (4) (c) may report to the state epidemiologist
the name of any person known to the physician, physician
assistant, or advanced practice registered nurse pre-
scriber to have had contact with body fluid of the test sub-
ject that constitutes a significant exposure, only after the
physician, physician assistant, or advanced practice reg-
istered nurse prescriber has done all of the following:
(b) Notified the HIV test subject that the name of any
person known to the physician, physician assistant, or
advanced practice registered nurse prescriber to have had
contact with body fluid of the test subject that constitutes
a significant exposure will be reported to the state epide-
miologist.
SECTION 54. 252.16 (3) (c) (intro.) of the statutes is
amended to read:
252.16 (3) (c) (intro.) Has submitted to the depart-
ment a certification from a physician, as defined in s.
448.01 (5), physician assistant, or advanced practice reg-
istered nurse prescriber of all of the following:
SECTION 55. 252.17 (3) (c) (intro.) of the statutes is
amended to read:
252.17 (3) (c) (intro.) Has submitted to the depart-
ment a certification from a physician, as defined in s.
448.01 (5), physician assistant, or advanced practice reg-
istered nurse prescriber of all of the following:
SECTION 56. 253.07 (4) (d) of the statutes is amended
to read:
253.07 (4) (d) In each fiscal year, $31,500 as grants
for employment in communities of licensed registered
nurses, licensed practical nurses, certified nurse−mid-
wives licensed advanced practice registered nurses, or
licensed physician assistants who are members of a racial
minority.
SECTION 57. 253.115 (1) (f) of the statutes is created
to read:
253.115 (1) (f) “Nurse−midwife” means an individ-
ual who is licensed as an advanced practice registered
nurse and possesses a certified nurse−midwife specialty
designation under s. 441.09.
SECTION 58. 253.115 (4) of the statutes is amended
to read:
253.115 (4) SCREENING REQUIRED. Except as pro-
vided in sub. (6), the physician, nurse−midwife licensed
under s. 441.15, or certified professional midwife
licensed under s. 440.982 who attended the birth shall
ensure that the infant is screened for hearing loss before
being discharged from a hospital, or within 30 days of
birth if the infant was not born in a hospital.
SECTION 59. 253.115 (7) (a) (intro.) of the statutes is
amended to read:
253.115 (7) (a) (intro.) The physician, nurse−mid-
wife licensed under s. 441.15, or certified professional
midwife licensed under s. 440.982 who is required to
ensure that the infant is screened for hearing loss under
sub. (4) shall do all of the following:
SECTION 60. 253.13 (1) of the statutes is renumbered
253.13 (1) (b) and amended to read:
253.13 (1) (b) The attending physician or nurse
licensed under s. 441.15 nurse−midwife shall cause every
infant born in each hospital or maternity home, prior to
its discharge therefrom, to be subjected to tests for con-
genital and metabolic disorders, as specified in rules pro-
mulgated by the department. If the infant is born else-
where than in a hospital or maternity home, the attending
physician, nurse licensed under s. 441.15 nurse−mid-
wife, or birth attendant who attended the birth shall cause
the infant, within one week of birth, to be subjected to
these tests.
SECTION 61. 253.13 (1) (a) of the statutes is created
to read:
253.13 (1) (a) In this subsection, “nurse−midwife”
means an individual who is licensed as an advanced prac-
tice registered nurse and possesses a certified nurse−mid-
wife specialty designation under s. 441.09.
SECTION 62. 253.15 (1) (em) of the statutes is created
to read:
253.15 (1) (em) “Nurse−midwife” means an individ-
ual who is licensed as an advanced practice registered
nurse and possesses a certified nurse−midwife specialty
designation under s. 441.09.
SECTION 63. 253.15 (2) of the statutes is amended to
read:
253.15 (2) INFORMATIONAL MATERIALS. The board
shall purchase or prepare or arrange with a nonprofit
organization to prepare printed and audiovisual materials
relating to shaken baby syndrome and impacted babies.
The materials shall include information regarding the
identification and prevention of shaken baby syndrome
and impacted babies, the grave effects of shaking or − 10 −2023 Wisconsin Act 2023 Senate Bill 145
throwing on an infant or young child, appropriate ways
to manage crying, fussing, or other causes that can lead
a person to shake or throw an infant or young child, and
a discussion of ways to reduce the risks that can lead a
person to shake or throw an infant or young child. The
materials shall be prepared in English, Spanish, and other
languages spoken by a significant number of state resi-
dents, as determined by the board. The board shall make
those written and audiovisual materials available to all
hospitals, maternity homes, and nurse−midwives
licensed under s. 441.15 that are required to provide or
make available materials to parents under sub. (3) (a) 1.,
to the department and to all county departments and non-
profit organizations that are required to provide the mate-
rials to child care providers under sub. (4) (d), and to all
school boards and nonprofit organizations that are per-
mitted to provide the materials to pupils in one of grades
5 to 8 and in one of grades 10 to 12 under sub. (5). The
board shall also make those written materials available to
all county departments and Indian tribes that are provid-
ing home visitation services under s. 48.983 (4) (b) 1. and
to all providers of prenatal, postpartum, and young child
care coordination services under s. 49.45 (44). The board
may make available the materials required under this
subsection to be made available by making those materi-
als available at no charge on the board’s Internet site.
SECTION 64. 255.06 (1) (d) of the statutes is renum-
bered 255.06 (1) (f) (intro.) and amended to read:
255.06 (1) (f) (intro.) “Nurse practitioner” “Women’s
health nurse clinician” means a any of the following:
1. A registered nurse who is licensed under ch. 441
or who holds a multistate license, as defined in s. 441.51
(2) (h), issued in a party state, as defined in s. 441.51 (2)
(k), and whose practice of professional nursing under s.
441.001 (4) includes performance of delegated medical
services under the supervision of a physician, naturo-
pathic doctor, dentist, or podiatrist, or advanced practice
registered nurse.
SECTION 65. 255.06 (1) (f) 2. of the statutes is created
to read:
255.06 (1) (f) 2. An advanced practice registered
nurse.
SECTION 66. 255.06 (2) (d) of the statutes is amended
to read:
255.06 (2) (d) Specialized training for rural colpo-
scopic examinations and activities. Provide not more
than $25,000 in each fiscal year as reimbursement for the
provision of specialized training of nurse practitioners
women’s health nurse clinicians to perform, in rural
areas, colposcopic examinations and follow−up activi-
ties for the treatment of cervical cancer.
SECTION 67. 255.07 (1) (d) of the statutes is amended
to read:
255.07 (1) (d) “Health care practitioner” means a
physician, a physician assistant, or an advanced practice
registered nurse who is certified to may issue prescription
orders under s. 441.16 441.09 (2).
SECTION 68. 257.01 (5) (a) and (b) of the statutes are
amended to read:
257.01 (5) (a) An individual who is licensed as a
physician, a physician assistant, or a podiatrist under ch.
448, licensed as a naturopathic doctor under ch. 466,
licensed as a registered nurse, licensed practical nurse, or
nurse−midwife advanced practice registered nurse under
ch. 441, licensed as a dentist under ch. 447, licensed as a
pharmacist under ch. 450, licensed as a veterinarian or
certified as a veterinary technician under ch. 89, or certi-
fied as a respiratory care practitioner under ch. 448.
(b) An individual who was at any time within the pre-
vious 10 years, but is not currently, licensed as a physi-
cian, a physician assistant, or a podiatrist under ch. 448,
licensed as a naturopathic doctor under ch. 466, licensed
as a registered nurse, licensed practical nurse, or nurse−
midwife, advanced practice registered nurse under ch.
441, licensed as a nurse−midwife under ch. 441, 2021
stats., licensed as a dentist under ch. 447, licensed as a
pharmacist under ch. 450, licensed as a veterinarian or
certified as a veterinary technician under ch. 89, or certi-
fied as a respiratory care practitioner under ch. 448, if the
individual’s license or certification was never revoked,
limited, suspended, or denied renewal.
SECTION 69. 341.14 (1a), (1e) (a), (1m) and (1q) of
the statutes are amended to read:
341.14 (1a) If any resident of this state, who is regis-
tering or has registered an automobile, or a motor truck,
dual purpose motor home or dual purpose farm truck
which has a gross weight of not more than 8,000 pounds,
a farm truck which has a gross weight of not more than
12,000 pounds or a motor home, submits a statement
once every 4 years, as determined by the department,
from a physician licensed to practice medicine in any
state, from an advanced practice registered nurse
licensed to practice nursing in any state, from a public
health nurse certified or licensed to practice in any state,
from a physician assistant licensed or certified to practice
in any state, from a podiatrist licensed to practice in any
state, from a chiropractor licensed to practice chiroprac-
tic in any state, or from a Christian Science practitioner
residing in this state and listed in the Christian Science
journal certifying to the department that the resident is a
person with a disability that limits or impairs the ability
to walk, the department shall procure, issue and deliver
to the disabled person plates of a special design in lieu of
plates which ordinarily would be issued for the vehicle,
and shall renew the plates. The plates shall be so
designed as to readily apprise law enforcement officers
of the fact that the vehicle is owned by a nonveteran dis-
abled person and is entitled to the parking privileges
specified in s. 346.50 (2a). No charge in addition to the − 11 − 2023 Wisconsin Act 2023 Senate Bill 145
registration fee shall be made for the issuance or renewal
of such plates.
(1e) (a) If any resident of this state, who is registering
or has registered a motorcycle, submits a statement once
every 4 years, as determined by the department, from a
physician licensed to practice medicine in any state, from
an advanced practice registered nurse licensed to practice
nursing in any state, from a public health nurse certified
or licensed to practice in any state, from a physician
assistant licensed or certified to practice in any state,
from a podiatrist licensed to practice in any state, from a
chiropractor licensed to practice chiropractic in any state,
from a Christian Science practitioner residing in this state
and listed in the Christian Science journal, or from the
U.S. department of veterans affairs certifying to the
department that the resident is a person with a disability
that limits or impairs the ability to walk, the department
shall procure, issue and deliver to the disabled person a
plate of a special design in lieu of the plate which ordinar-
ily would be issued for the motorcycle, and shall renew
the plate. The statement shall state whether the disability
is permanent or temporary and, if temporary, the opinion
of the physician, advanced practice registered nurse, pub-
lic health nurse, physician assistant, podiatrist, chiro-
practor, practitioner, or U.S. department of veterans
affairs as to the duration of the disability. The plate shall
be so designed as to readily apprise law enforcement offi-
cers of the fact that the motorcycle is owned by a disabled
person and is entitled to the parking privileges specified
in s. 346.50 (2a). No charge in addition to the registration
fee may be made for the issuance or renewal of the plate.
(1m) If any licensed driver submits to the department
a statement once every 4 years, as determined by the
department, from a physician licensed to practice
medicine in any state, from a public health nurse certified
or licensed to practice in any state, from an advanced
practice registered nurse licensed to practice nursing in
any state, from a physician assistant licensed or certified
to practice in any state, from a podiatrist licensed to prac-
tice in any state, from a chiropractor licensed to practice
chiropractic in any state, or from a Christian Science
practitioner residing in this state and listed in the Chris-
tian Science journal certifying that another person who is
regularly dependent on the licensed driver for transporta-
tion is a person with a disability that limits or impairs the
ability to walk, the department shall issue and deliver to
the licensed driver plates of a special design in lieu of the
plates which ordinarily would be issued for the automo-
bile or motor truck, dual purpose motor home or dual pur-
pose farm truck having a gross weight of not more than
8,000 pounds, farm truck having a gross weight of not
more than 12,000 pounds or motor home, and shall renew
the plates. The plates shall be so designed as to readily
apprise law enforcement officers of the fact that the vehi-
cle is operated by a licensed driver on whom a disabled
person is regularly dependent and is entitled to the park-
ing privileges specified in s. 346.50 (2a). No charge in
addition to the registration fee may be made for the
issuance or renewal of the plates. The plates shall con-
form to the plates required in sub. (1a).
(1q) If any employer who provides an automobile, or
a motor truck, dual purpose motor home or dual purpose
farm truck which has a gross weight of not more than
8,000 pounds, a farm truck which has a gross weight of
not more than 12,000 pounds or a motor home, for an
employee’s use submits to the department a statement
once every 4 years, as determined by the department,
from a physician licensed to practice medicine in any
state, from an advanced practice registered nurse
licensed to practice nursing in any state, from a public
health nurse certified or licensed to practice in any state,
from a physician assistant licensed or certified to practice
in any state, from a podiatrist licensed to practice in any
state, from a chiropractor licensed to practice chiroprac-
tic in any state, or from a Christian Science practitioner
residing in this state and listed in the Christian Science
journal certifying that the employee is a person with a dis-
ability that limits or impairs the ability to walk, the
department shall issue and deliver to such employer
plates of a special design in lieu of the plates which ordi-
narily would be issued for the vehicle, and shall renew the
plates. The plates shall be so designed as to readily
apprise law enforcement officers of the fact that the vehi-
cle is operated by a disabled person and is entitled to the
parking privileges specified in s. 346.50 (2a). No charge
in addition to the registration fee may be made for the
issuance or renewal of the plates. The plates shall con-
form to the plates required in sub. (1a).
SECTION 70. 343.16 (5) (a) of the statutes is amended
to read:
343.16 (5) (a) The secretary may require any appli-
cant for a license or any licensed operator to submit to a
special examination by such persons or agencies as the
secretary may direct to determine incompetency, physi-
cal or mental disability, disease, or any other condition
that might prevent such applicant or licensed person from
exercising reasonable and ordinary control over a motor
vehicle. If the department requires the applicant to sub-
mit to an examination, the applicant shall pay for the
examination. If the department receives an application
for a renewal or duplicate license after voluntary surren-
der under s. 343.265 or receives a report from a physi-
cian, physician assistant, advanced practice registered
nurse prescriber certified under s. 441.16 (2) licensed
under s. 441.09, or optometrist under s. 146.82 (3), or if
the department has a report of 2 or more arrests within a
one−year period for any combination of violations of s.
346.63 (1) or (5) or a local ordinance in conformity with
s. 346.63 (1) or (5) or a law of a federally recognized
American Indian tribe or band in this state in conformity
with s. 346.63 (1) or (5), or s. 346.63 (1m), 1985 stats.,
or s. 346.63 (2) or (6) or 940.25, or s. 940.09 where the − 12 −2023 Wisconsin Act 2023 Senate Bill 145
offense involved the use of a vehicle, the department
shall determine, by interview or otherwise, whether the
operator should submit to an examination under this sec-
tion. The examination may consist of an assessment. If
the examination indicates that education or treatment for
a disability, disease or condition concerning the use of
alcohol, a controlled substance or a controlled substance
analog is appropriate, the department may order a driver
safety plan in accordance with s. 343.30 (1q). If there is
noncompliance with assessment or the driver safety plan,
the department shall revoke the person’s operating privi-
lege in the manner specified in s. 343.30 (1q) (d).
SECTION 71. 343.51 (1) of the statutes is amended to
read:
343.51 (1) Any person who qualifies for registration
plates of a special design under s. 341.14 (1), (1a), (1m),
or (1q) or any other person with a disability that limits or
impairs the ability to walk may request from the depart-
ment a special identification card that will entitle any
motor vehicle parked by, or under the direction of, the
person, or a motor vehicle operated by or on behalf of the
organization when used to transport such a person, to
parking privileges under s. 346.50 (2), (2a), and (3). The
department shall issue the card at a fee to be determined
by the department, upon submission by the applicant, if
the applicant is an individual rather than an organization,
of a statement from a physician licensed to practice
medicine in any state, from an advanced practice regis-
tered nurse licensed to practice nursing in any state, from
a public health nurse certified or licensed to practice in
any state, from a physician assistant licensed or certified
to practice in any state, from a podiatrist licensed to prac-
tice in any state, from a chiropractor licensed to practice
chiropractic in any state, or from a Christian Science
practitioner residing in this state and listed in the Chris-
tian Science journal that the person is a person with a dis-
ability that limits or impairs the ability to walk. The state-
ment shall state whether the disability is permanent or
temporary and, if temporary, the opinion of the physi-
cian, advanced practice registered nurse, public health
nurse, physician assistant, podiatrist, chiropractor, or
practitioner as to the duration of the disability. The
department shall issue the card upon application by an
organization on a form prescribed by the department if
the department believes that the organization meets the
requirements under this subsection.
SECTION 72. 343.62 (4) (a) 4. of the statutes is
amended to read:
343.62 (4) (a) 4. The applicant submits with the
application a statement completed within the immedi-
ately preceding 24 months, except as provided by rule, by
a physician licensed to practice medicine in any state,
from an advanced practice registered nurse licensed to
practice nursing in any state, from a physician assistant
licensed or certified to practice in any state, from a podia-
trist licensed to practice in any state, from a chiropractor
licensed to practice chiropractic in any state, or from a
Christian Science practitioner residing in this state, and
listed in the Christian Science journal certifying that, in
the medical care provider’s judgment, the applicant is
physically fit to teach driving.
SECTION 73. 440.03 (13) (b) 3. of the statutes is
repealed.
SECTION 74. 440.03 (13) (b) 39m. of the statutes is
created to read:
440.03 (13) (b) 39m. Nurse, advanced practice regis-
tered.
SECTION 75. 440.03 (13) (b) 42. of the statutes is
repealed.
SECTION 76. 440.077 (1) (a) of the statutes is
amended to read:
440.077 (1) (a) “Advanced practice registered nurse
prescriber” means an advanced practice registered nurse
prescriber certified licensed under s. 441.16 (2) 441.09.
SECTION 77. 440.077 (2) (c) of the statutes is
amended to read:
440.077 (2) (c) Under the program under par. (a), a
participating military medical personnel shall be super-
vised by a physician, physician assistant, podiatrist, reg-
istered professional nurse, or advanced practice regis-
tered nurse prescriber. The supervising physician,
physician assistant, podiatrist, registered professional
nurse, or advanced practice registered nurse prescriber
shall retain responsibility for the care of the patient.
SECTION 78. 440.08 (2) (a) 4m. of the statutes is
repealed.
SECTION 79. 440.08 (2) (a) 47r. of the statutes is cre-
ated to read:
440.08 (2) (a) 47r. Nurse, advanced practice regis-
tered: March 1 of each even−numbered year.
SECTION 80. 440.08 (2) (a) 50. of the statutes is
repealed.
SECTION 81. 440.094 (1) (c) 1. of the statutes is
amended to read:
440.094 (1) (c) 1. A registered nurse, licensed practi-
cal nurse, or nurse midwife licensed under ch. 441, or an
advanced practice registered nurse prescriber certified
licensed under ch. 441.
SECTION 82. 440.094 (2) (a) (intro.) of the statutes is
amended to read:
440.094 (2) (a) (intro.) Notwithstanding ss. 441.06
(4), 441.15 (2), 441.16, 441.09 (3) (b), 446.02 (1), 447.03
(1) and (2), 448.03 (1) (a), (b), and (c) and (1m), 448.51
(1), 448.61, 448.76, 448.961 (1) and (2), 449.02 (1),
450.03 (1), 451.04 (1), 455.02 (1m), 457.04 (4), (5), (6),
and (7), 459.02 (1), 459.24 (1), and 460.02, a health care
provider may provide services within the scope of the
credential that the health care provider holds and the
department shall grant the health care provider a tempo-
rary credential to practice under this section if all of the
following apply: − 13 − 2023 Wisconsin Act 2023 Senate Bill 145
SECTION 83. 440.981 (1) of the statutes is amended
to read:
440.981 (1) No person may use the title “licensed
midwife,” describe or imply that he or she is a licensed
midwife, or represent himself or herself as a licensed
midwife unless the person is granted a license under this
subchapter or is licensed as a nurse−midwife under s.
441.15 an advanced practice registered nurse and pos-
sesses a certified nurse−midwife specialty designation
under s. 441.09.
SECTION 84. 440.982 (1) of the statutes is amended
to read:
440.982 (1) No person may engage in the practice of
midwifery unless the person is granted a license under
this subchapter, is granted a temporary permit pursuant
to a rule promulgated under s. 440.984 (2m), or is
licensed as a nurse−midwife under s. 441.15 an advanced
practice registered nurse and possesses a certified nurse−
midwife specialty designation under s. 441.09.
SECTION 85. 440.987 (2) of the statutes is amended
to read:
440.987 (2) One member who is licensed as a nurse−
midwife under s. 441.15 an advanced practice registered
nurse and possesses a certified nurse−midwife specialty
designation under s. 441.09 and who practices in an out−
of−hospital setting.
SECTION 86. 441.001 (1c) of the statutes is created to
read:
441.001 (1c) ADVANCED PRACTICE REGISTERED NURS-
ING. “Advanced practice registered nursing” means the
practice of a certified nurse−midwife, the practice of a
certified registered nurse anesthetist, the practice of a
clinical nurse specialist, and the practice of a nurse practi-
tioner.
SECTION 87. 441.001 (3c) of the statutes is created to
read:
441.001 (3c) PRACTICE OF A CERTIFIED NURSE−MID-
WIFE. “Practice of a certified nurse−midwife” means
practice in the management of women’s health care,
pregnancy, childbirth, postpartum care for newborns,
family planning, and gynecological services consistent
with the standards of practice of the American College of
Nurse−Midwives or its successor.
SECTION 88. 441.001 (3g) of the statutes is created to
read:
441.001 (3g) PRACTICE OF A CERTIFIED REGISTERED
NURSE ANESTHETIST. “Practice of a certified registered
nurse anesthetist” means providing anesthesia care, pain
management care, and care related to anesthesia and pain
management for persons across their lifespan, whose
health status may range from healthy through all levels of
acuity, including persons with immediate, severe, or life−
threatening illness or injury, in diverse settings, including
hospitals, ambulatory surgery centers, outpatient clinics,
medical offices, and home health care settings.
SECTION 89. 441.001 (3n) of the statutes is created to
read:
441.001 (3n) PRACTICE OF A CLINICAL NURSE SPECIAL-
IST. “Practice of a clinical nurse specialist” means provid-
ing advanced nursing care, primarily in health care facili-
ties, including the diagnosis and treatment of illness for
identified specific populations based on a specialty.
SECTION 90. 441.001 (3r) of the statutes is created to
read:
441.001 (3r) PRACTICE OF A NURSE PRACTITIONER.
“Practice of a nurse practitioner” means practice in
ambulatory, acute, long−term, or other health care set-
tings as a primary or specialty care provider who pro-
vides health services, including assessing, diagnosing,
treating, or managing acute, episodic, and chronic ill-
nesses.
SECTION 91. 441.001 (3w) of the statutes is created
to read:
441.001 (3w) PRESCRIPTION ORDER. “Prescription
order” has the meaning given in s. 450.01 (21).
SECTION 92. 441.001 (5) of the statutes is created to
read:
441.001 (5) RECOGNIZED ROLE. “Recognized role”
means one of the following roles:
(a) Certified nurse−midwife.
(b) Certified registered nurse anesthetist.
(c) Clinical nurse specialist.
(d) Nurse practitioner.
SECTION 93. 441.01 (3) of the statutes is amended to
read:
441.01 (3) The board may promulgate rules to estab-
lish minimum standards for schools for professional
nurses and, schools for licensed practical nurses, and
schools for advanced practice registered nurses, includ-
ing all related clinical units and facilities, and make and
provide periodic surveys and consultations to such
schools. It The board may also establish promulgate
rules to prevent unauthorized persons from practicing
professional nursing. It shall approve all rules for the
administration of this chapter in accordance with ch. 227.
SECTION 94. 441.01 (4) of the statutes is amended to
read:
441.01 (4) The board shall direct that those schools
that qualify be placed on a list of schools the board has
approved for professional nurses or, of schools the board
has approved for licensed practical nurses, or of schools
the board has approved for advanced practice registered
nurses on application and proof of qualifications;, and the
board shall make a study of nursing education and initiate
promulgate rules and policies to improve it.
SECTION 95. 441.01 (7) (a) (intro.) of the statutes is
amended to read:
441.01 (7) (a) (intro.) The board shall require each
applicant for the renewal of a registered nurse or, licensed
practical nurse, or advanced practice registered nurse − 14 −2023 Wisconsin Act 2023 Senate Bill 145
license issued under this chapter to do all of the following
as a condition for renewing the license:
SECTION 96. 441.01 (7) (b) of the statutes is amended
to read:
441.01 (7) (b) The board may not renew a registered
nurse or, licensed practical nurse, or advanced practice
registered nurse license under this chapter unless the
renewal applicant has completed the nursing workforce
survey to the satisfaction of the board. The board shall
establish standards to determine whether the survey has
been completed. The board shall, by no later than June
30 of each odd−numbered year, submit all completed
nursing workforce survey forms to the department of
workforce development.
SECTION 97. 441.01 (7) (c) of the statutes is created
to read:
441.01 (7) (c) An applicant who is renewing both a
registered nurse and advanced practice registered nurse
license under s. 441.09 (1) (c) is only required to pay a
single fee under par. (a) 2.
SECTION 98. 441.06 (title) of the statutes is repealed
and recreated to read:
441.06 (title) Registered nurses; civil liability
exemption.
SECTION 99. 441.06 (3) of the statutes is amended to
read:
441.06 (3) A Except as provided in s. 441.09 (1) (c),
a registered nurse practicing for compensation shall, on
or before the applicable renewal date specified under s.
440.08 (2) (a), submit to the board on furnished forms a
statement giving name, residence, and other facts that the
board requires, with the nursing workforce survey and
fee required under s. 441.01 (7) and the applicable
renewal fee determined by the department under s.
440.03 (9) (a).
SECTION 100. 441.06 (4) of the statutes is amended
to read:
441.06 (4) Except as provided in ss. 257.03 and
440.077, no person may practice or attempt to practice
professional nursing, nor use the title, letters, or anything
else to indicate that he or she is a registered or profes-
sional nurse unless he or she is licensed under this sec-
tion. Except as provided in ss. 257.03 and 440.077, no
person not so licensed may use in connection with his or
her nursing employment or vocation any title or anything
else to indicate that he or she is a trained, certified or grad-
uate nurse. This subsection does not apply to any regis-
tered nurse who holds a multistate license, as defined in
s. 441.51 (2) (h), issued by a jurisdiction, other than this
state, that has adopted the nurse licensure compact under
s. 441.51.
SECTION 101. 441.06 (7) of the statutes is renum-
bered 441.09 (7) and amended to read:
441.09 (7) CIVIL LIABILITY. No person certified
licensed as an advanced practice registered nurse pre-
scriber under s. 441.16 (2) this section is liable for civil
damages for any of the following:
(a) Reporting in good faith to the department of trans-
portation under s. 146.82 (3) a patient’s name and other
information relevant to a physical or mental condition of
the patient that in the advanced practice nurse pre-
scriber’s registered nurse’s judgment impairs the
patient’s ability to exercise reasonable and ordinary con-
trol over a motor vehicle.
(b) In good faith, not reporting to the department of
transportation under s. 146.82 (3) a patient’s name and
other information relevant to a physical or mental condi-
tion of the patient that in the advanced practice nurse pre-
scriber’s registered nurse’s judgment does not impair the
patient’s ability to exercise reasonable and ordinary con-
trol over a motor vehicle.
SECTION 102. 441.07 (1g) (intro.), (a), (c) and (e) of
the statutes are amended to read:
441.07 (1g) (intro.) Subject to the rules promulgated
under s. 440.03 (1), the board may deny an initial license
or revoke, limit, suspend, or deny the renewal of a license
of a registered nurse, nurse−midwife advanced practice
registered nurse, or licensed practical nurse; deny an ini-
tial certificate or revoke, limit, suspend, or deny the
renewal of a certificate to prescribe drugs or devices
granted under s. 441.16; or reprimand a registered nurse,
nurse−midwife advanced practice registered nurse, or
licensed practical nurse, if the board finds that the appli-
cant or licensee committed any of the following:
(a) Fraud in the procuring or renewal of the certificate
or license.
(c) Acts which that show the registered nurse, nurse−
midwife advanced practice registered nurse, or licensed
practical nurse to be unfit or incompetent by reason of
negligence, abuse of alcohol or other drugs, or mental
incompetency.
(e) A violation of any state or federal law that regu-
lates prescribing or dispensing drugs or devices, if the
person has a certificate to prescribe drugs or devices
under s. 441.16 may issue prescription orders under s.
441.09 (2).
SECTION 103. 441.09 of the statutes is created to read:
441.09 Advanced practice registered nurses; civil
liability exemption. (1) LICENSE. (a) An applicant who
satisfies all of the following requirements may apply to
the board for initial licensure by the board as an advanced
practice registered nurse:
1. The applicant satisfies one of the following crite-
ria:
a. The applicant holds a valid license to practice as
a registered nurse issued under s. 441.06 (1), (1c), or
(1m).
b. The applicant applies concurrently for a license
under s. 441.06 (1), (1c), or (1m) with the application for
a license under this paragraph. − 15 − 2023 Wisconsin Act 2023 Senate Bill 145
c. The applicant is a registered nurse who holds a
multistate license, as defined in s. 441.51 (2) (h), issued
by a jurisdiction, other than this state, that has adopted the
nurse licensure compact.
2. The applicant provides evidence satisfactory to the
board that he or she satisfies one of the following criteria:
a. The applicant has completed a graduate−level or
postgraduate−level education program that is approved
by the board and that prepares the applicant for the prac-
tice of advanced practice registered nursing in one of the
4 recognized roles, and the applicant holds a current certi-
fication by a national certifying body approved by the
board.
b. On January 1, 2024, the applicant was licensed as
a registered nurse in this state and was practicing in a rec-
ognized role, and the applicant satisfies additional crite-
ria established by the board by rule under sub. (6) (a) 3.
relating to practice, education, or certification.
3. The applicant pays the fee specified under s.
440.05 (1).
4. The applicant provides to the board evidence of
any malpractice liability insurance coverage required
under sub. (5).
5. If the applicant is applying to receive a certified
nurse−midwife specialty designation under par. (b) 1.,
the applicant does all of the following:
a. Provides evidence satisfactory to the board that the
applicant is currently certified by the American Mid-
wifery Certification Board or its successor.
b. Files with the board any plan required under sub.
(3m) (f).
6. The applicant does not have an arrest or conviction
record, subject to ss. 111.321, 111.322, and 111.335.
7. The applicant meets any other criteria established
by the board by rule under sub. (6) (a) 3. relating to the
education, training, or experience required for each rec-
ognized role.
(b) 1. a. Subject to subd. 3. and s. 441.07 (1g), the
board shall grant an advanced practice registered nurse
license to an applicant the board determines meets the
requirements under par. (a). The board shall also grant a
person who is granted a license under this subd. 1. a. one
or more specialty designations corresponding to the rec-
ognized roles for which the board determines that the per-
son qualifies based on the person’s qualifications under
par. (a).
b. The board shall grant an advanced practice regis-
tered nurse license to each individual who, on the day
before the effective date of this subd. 1. b. .... [LRB
inserts date], was certified to issue prescription orders
under s. 441.16, 2021 stats. The board shall also grant a
person who is granted a license under this subd. 1. b. one
or more specialty designations corresponding to the rec-
ognized roles for which the board determines that the per-
son qualifies based on the person’s qualifications.
c. The board shall grant an advanced practice regis-
tered nurse license to each individual who, on the day
before the effective date of this subd. 1. c. .... [LRB inserts
date], was licensed as a nurse−midwife under s. 441.15,
2021 stats. The board shall also grant a person who is
granted a license under this subd. 1. c. a nurse−midwife
specialty designation.
2. Each specialty designation granted under subd. 1.
shall appear on the person’s advanced practice registered
nurse license.
3. The board may not grant an advanced practice reg-
istered nurse license to a person applying concurrently
for a license under s. 441.06 (1), (1c), or (1m), unless the
board also grants the person the license under s. 441.06
(1), (1c), or (1m).
4. The board may place specific limitations on a per-
son licensed as an advanced practice registered nurse as
a condition of licensure.
5. If all of the following apply to a person, a notation
indicating that the person may not issue prescription
orders shall appear on the person’s advanced practice
registered nurse license:
a. The person is granted an advanced practice regis-
tered nurse license under subd. 1. a. and satisfies only par.
(a) 2. b. but not par. (a) 2. a., or the person is granted an
advanced practice registered nurse license under subd. 1.
c.
b. On January 1, 2024, the person did not hold a cer-
tificate under s. 441.16 (2), 2021 stats.
(c) On or before the applicable renewal date specified
under s. 440.08 (2) (a), an advanced practice registered
nurse shall submit to the board on a form furnished by the
board a statement giving his or her name and residence,
the nursing workforce survey and fee required under s.
441.01 (7), evidence of having satisfied the continuing
education requirements under sub. (4), evidence of any
malpractice liability insurance coverage required under
sub. (5), any plan required under sub. (3m) (f), current
evidence that the person satisfies each of the require-
ments under par. (a) 1., 2., 5. a., and 7. that apply with
respect to the person, and any other information that the
board requires by rule, with the applicable renewal fee
determined by the department under s. 440.03 (9) (a).
The board shall grant to a person who satisfies the
requirements under this paragraph the renewal of his or
her advanced practice registered nurse license and spe-
cialty designations granted under par. (b) 1. and shall, if
the person holds a license under s. 441.06 (1), (1c), or
(1m), also grant the renewal of that license.
(2) PRESCRIBING AUTHORITY. (a) Except as provided
in par. (b), an advanced practice registered nurse may
issue prescription orders, subject to the rules promul-
gated under sub. (6) (a) 1. and 4., and may provide expe-
dited partner therapy in the manner described in s.
441.092. − 16 −2023 Wisconsin Act 2023 Senate Bill 145
(b) An advanced practice registered nurse may not
issue prescription orders if a notation under sub. (1) (b)
5. indicating that the advanced practice registered nurse
may not issue prescription orders appears on the
advanced practice registered nurse’s license.
(3) LICENSE REQUIRED; USE OF TITLES. (a) 1. The
holder of a license issued under this section is an
“advanced practice registered nurse,” may append to his
or her name the title “A.P.R.N.,” and is authorized to
practice advanced practice registered nursing.
2. The holder of a specialty designation for a recog-
nized role granted under sub. (1) (b) 1. may append to his
or her name the title and an abbreviation corresponding
to that recognized role.
(b) 1. Except as provided in sub. (3m) (e) and s.
257.03, no person may practice or attempt to practice
advanced practice registered nursing, nor use the title
“advanced practice registered nurse,” the title
“A.P.R.N.,” or anything else to indicate that he or she is
an advanced practice registered nurse unless he or she is
licensed under this section.
2. Except as provided in s. 257.03, no person may do
any of the following:
a. Use the title “certified nurse−midwife,” the title
“C.N.M.,” or anything else to indicate that he or she is a
certified nurse−midwife unless he or she has been
granted a certified nurse−midwife specialty designation
under sub. (1) (b) 1.
b. Use the title “certified registered nurse anesthe-
tist,” the title “C.R.N.A.,” or anything else to indicate that
he or she is a certified registered nurse anesthetist unless
he or she has been granted a certified registered nurse
anesthetist specialty designation under sub. (1) (b) 1.
c. Use the title “clinical nurse specialist,” the title
“C.N.S.,” or anything else to indicate that he or she is a
clinical nurse specialist unless he or she has been granted
a clinical nurse specialist specialty designation under
sub. (1) (b) 1.
d. Use the title “nurse practitioner,” the title “N.P.,”
or anything else to indicate that he or she is a nurse practi-
tioner unless he or she has been granted a nurse practi-
tioner specialty designation under sub. (1) (b) 1.
(3m) PRACTICE REQUIREMENTS AND LIMITATIONS. (a)
1. An advanced practice registered nurse licensed under
this section may, except as provided in subd. 2. and par.
(b), practice advanced practice registered nursing only in
collaboration with a physician or dentist.
2. Subdivision 1. does not apply to an advanced prac-
tice registered nurse with a certified nurse−midwife spe-
cialty designation.
(b) 1. An advanced practice registered nurse to whom
par. (a) 1. applies may, except as provided in pars. (bg) 1.
and (c), practice advanced practice registered nursing in
a recognized role without being supervised by or collabo-
rating with, and independent of, a physician or dentist if
the board verifies, upon application of the advanced prac-
tice registered nurse, that the advanced practice regis-
tered nurse has completed 5,760 clinical hours of
advanced practice registered nursing practice in that rec-
ognized role while working with a physician or dentist
during those 5,760 hours of practice. For purposes of this
subdivision, during the completion of these hours, the
advanced practice registered nurse must have continu-
ously satisfied all of the following requirements:
a. Maintained a mutual, professional relationship
with at least one physician or dentist.
b. Maintained, and provided to the board upon
request, documentation indicating the relationships the
advanced practice registered nurse had with one or more
physicians or dentists to deal with issues outside of his or
her licensed scope of practice.
c. Maintained evidence that he or she was subject to
a quality assurance program, peer review process, or
other similar program or process that was implemented
for and designed to ensure the provision of competent
and quality patient care and that also included participa-
tion by a physician or dentist. Such a program or process
may include a program or process administered through
the advanced practice registered nurse’s employer, hos-
pital, ambulatory surgery center, clinic, or other outpa-
tient facility.
2. For purposes of subd. 1., hours of advanced prac-
tice registered nursing practice may include the lawful
practice of advanced practice registered nursing outside
this state or the lawful practice of advanced practice reg-
istered nursing in this state prior to the effective date of
this subdivision .... [LRB inserts date].
(bg) 1. An advanced practice registered nurse may
provide pain management services only while working in
a collaborative relationship with a physician. Except as
provided in subd. 2., this subdivision applies regardless
of whether the advanced practice registered nurse has
qualified for independent practice under par. (b).
2. Except as provided in par. (c), subd. 1. does not
apply to an advanced practice registered nurse who is
providing pain management services in a hospital, as
defined in s. 50.33 (2), or a clinic associated with a hospi-
tal, and who has qualified for independent practice under
par. (b).
(bm) For purposes of pars. (a) 1. and (bg) 1., a collab-
orative relationship is a process in which an advanced
practice registered nurse is working with a physician or
dentist, in each other’s presence when necessary, to
deliver health care services within the scope of the
advanced practice registered nurse’s training, education,
and experience. The advanced practice registered nurse
shall document such a collaborative relationship.
(c) Nothing in this section prohibits an entity
employing or with a relationship with an advanced prac-
tice registered nurse from establishing additional
requirements for an advanced practice registered nurse as
a condition of employment or relationship. − 17 − 2023 Wisconsin Act 2023 Senate Bill 145
(d) An advanced practice registered nurse shall
adhere to professional standards when managing situa-
tions that are beyond the advanced practice registered
nurse’s expertise. If a particular patient’s needs are
beyond the advanced practice registered nurse’s exper-
tise, the advanced practice registered nurse shall, as war-
ranted by the patient’s needs, consult or collaborate with
or refer the patient to at least one of the following:
1. A physician licensed under ch. 448.
2. Another health care provider for whom the
advanced practice registered nurse has reasonable evi-
dence of having a scope of practice that includes the
authorization to address the patient’s needs.
(e) An advanced practice registered nurse licensed
under this section may delegate a task or order to another
clinically trained health care worker if the task or order
is within the scope of the advanced practice registered
nurse’s practice, the advanced practice registered nurse
is competent to perform the task or issue the order, and the
advanced practice registered nurse has reasonable evi-
dence that the health care worker is minimally competent
to perform the task or issue the order under the circum-
stances.
(f) An advanced practice registered nurse with a cer-
tified nurse−midwife specialty designation may not offer
to deliver babies outside of a hospital setting unless the
advanced practice registered nurse files with the board,
and the board approves, a proactive plan for ensuring
appropriate care or care transitions conforming with pro-
fessional standards for patients with higher acuity or
emergency care needs that exceed the advanced practice
registered nurse’s scope of practice. An advanced prac-
tice registered nurse who offers to deliver babies outside
of a hospital setting shall file a plan under this paragraph
when applying for an initial license under this section or
a renewal of a license under this section, shall keep the
plan current with the board, and shall follow the plan.
(4) CONTINUING EDUCATION. Every advanced prac-
tice registered nurse shall submit to the board evidence of
having completed at least 16 contact hours per biennium
in clinical pharmacology or therapeutics relevant to the
advanced practice registered nurse’s area of practice.
The board may promulgate rules regarding the continu-
ing education requirements under this subsection.
(5) MALPRACTICE LIABILITY INSURANCE. Except for
a person whose employer has in effect malpractice liabil-
ity insurance that provides coverage for the person in the
amounts specified under s. 655.23 (4), no person may
practice advanced practice registered nursing unless he
or she at all times has in effect malpractice liability insur-
ance coverage in the minimum amounts required by the
rules of the board. An advanced practice registered nurse
shall submit evidence of that coverage to the board when
applying for an initial license under this section or a
renewal of a license under this section. An advanced
practice registered nurse shall also submit such evidence
to the board upon request of the board.
(6) RULES. (a) The board shall promulgate rules nec-
essary to administer this section, including rules for all of
the following:
1. Further defining the scope of practice of an
advanced practice registered nurse, practice of a certified
nurse−midwife, practice of a certified registered nurse
anesthetist, practice of a nurse practitioner, and practice
of a clinical nurse specialist and defining the scope of
practice within which an advanced practice registered
nurse may issue prescription orders under sub. (2).
2. Determining acceptable national certification for
purposes of sub. (1) (a) 2. a.
3. Establishing the appropriate education, training, or
experience requirements that a registered nurse must sat-
isfy in order to be an advanced practice registered nurse
and to obtain each specialty designation corresponding to
the recognized roles.
4. Specifying the classes of drugs, individual drugs,
or devices that may not be prescribed by an advanced
practice registered nurse under sub. (2).
5. Specifying the conditions to be met for registered
nurses to do the following:
a. Administer a drug prescribed by an advanced prac-
tice registered nurse.
b. Administer a drug at the direction of an advanced
practice registered nurse.
6. Establishing the minimum amount of malpractice
liability insurance coverage that an advanced practice
registered nurse must at all times have in effect for pur-
poses of sub. (5). The board shall promulgate rules under
this subdivision in consultation with the commissioner of
insurance.
7. Establishing standards of professional conduct for
advanced practice registered nurses generally and for
practicing in each recognized role.
(am) The board may promulgate rules to implement
sub. (3m) (b).
(b) The board may not promulgate rules that expand
the scope of practice of an advanced practice registered
nurse beyond the practices within advanced practice reg-
istered nursing.
SECTION 104. 441.092 of the statutes is created to
read:
441.092 Expedited partner therapy. (1) In this
section:
(b) “Antimicrobial drug” has the meaning given in s.
448.035 (1) (b).
(c) “Expedited partner therapy” has the meaning
given in s. 448.035 (1) (c).
(2) Notwithstanding the requirements of s. 448.9785,
an advanced practice registered nurse who may issue pre-
scription orders under s. 441.09 (2) may provide expe-
dited partner therapy if a patient is diagnosed as infected − 18 −2023 Wisconsin Act 2023 Senate Bill 145
with a chlamydial infection, gonorrhea, or trichomonia-
sis and the patient has had sexual contact with a sexual
partner during which the chlamydial infection, gonor-
rhea, or trichomoniasis may have been transmitted to or
from the sexual partner. The advanced practice regis-
tered nurse shall attempt to obtain the name of the
patient’s sexual partner. A prescription order for an anti-
microbial drug prepared under this subsection shall
include the name and address of the patient’s sexual part-
ner, if known. If the advanced practice registered nurse
is unable to obtain the name of the patient’s sexual part-
ner, the prescription order shall include, in ordinary,
bold−faced capital letters, the words, “expedited partner
therapy” or the letters “EPT.”
(3) The advanced practice registered nurse shall pro-
vide the patient with a copy of the information sheet pre-
pared by the department of health services under s. 46.03
(44) and shall request that the patient give the informa-
tion sheet to the person with whom the patient had sexual
contact.
(4) (a) Except as provided in par. (b), an advanced
practice registered nurse is immune from civil liability
for injury to or the death of a person who takes any anti-
microbial drug if the antimicrobial drug is prescribed,
dispensed, or furnished under this section and if expe-
dited partner therapy is provided as specified under this
section.
(b) The immunity under par. (a) does not extend to the
donation, distribution, furnishing, or dispensing of an
antimicrobial drug by an advanced practice registered
nurse whose act or omission involves reckless, wanton,
or intentional misconduct.
SECTION 105. 441.10 (7) of the statutes is amended
to read:
441.10 (7) No license is required for practical nurs-
ing, but, except as provided in s. 257.03, no person with-
out a license may hold himself or herself out as a licensed
practical nurse or licensed attendant, use the title or let-
ters “Trained Practical Nurse” or “T.P.N.”, “Licensed
Practical Nurse” or “L.P.N.”, “Licensed Attendant” or
“L.A.”, “Trained Attendant” or “T.A.”, or otherwise seek
to indicate that he or she is a licensed practical nurse or
licensed attendant. No licensed practical nurse or
licensed attendant may use the title, or otherwise seek to
act as a registered, licensed, graduate or professional
nurse. Anyone violating this subsection shall be subject
to the penalties prescribed by s. 441.13. The board shall
grant without examination a license as a licensed practi-
cal nurse to any person who was on July 1, 1949, a
licensed attendant. This subsection does not apply to any
licensed practical nurse who holds a multistate license, as
defined in s. 441.51 (2) (h), issued by a jurisdiction, other
than this state, that has adopted the nurse licensure com-
pact under s. 441.51.
SECTION 106. 441.11 (title) of the statutes is
repealed.
SECTION 107. 441.11 (1) of the statutes is repealed.
SECTION 108. 441.11 (2) of the statutes is renum-
bered 441.09 (5m) and amended to read:
441.09 (5m) LICENSURE EXEMPTION. The provisions
of s. 448.04 (1) (g) 448.03 (1) (d) do not apply to a an
advanced practice registered nurse licensed under this
section who possesses a certified registered nurse anes-
thetist specialty designation under sub. (1) (b) 1. or to a
person who engages in the practice of a nurse anesthetist
while performing official duties for the armed services or
federal health services of the United States.
SECTION 109. 441.11 (3) of the statutes is repealed.
SECTION 110. 441.15 of the statutes is repealed.
SECTION 111. 441.16 of the statutes is repealed.
SECTION 112. 441.18 (2) (a) (intro.) of the statutes is
amended to read:
441.18 (2) (a) (intro.) An advanced practice regis-
tered nurse certified to who may issue prescription orders
under s. 441.16 441.09 (2) may do any of the following:
SECTION 113. 441.18 (2) (b) of the statutes is
amended to read:
441.18 (2) (b) An advanced practice registered nurse
who prescribes or delivers an opioid antagonist under
par. (a) 1. shall ensure that the person to whom the opioid
antagonist is prescribed has or has the capacity to provide
the knowledge and training necessary to safely adminis-
ter the opioid antagonist to an individual undergoing an
opioid−related overdose and that the person demon-
strates the capacity to ensure that any individual to whom
the person further delivers the opioid antagonist has or
receives that knowledge and training.
SECTION 114. 441.18 (3) of the statutes is amended
to read:
441.18 (3) An advanced practice registered nurse
who, acting in good faith, prescribes or delivers an opioid
antagonist in accordance with sub. (2), or who, acting in
good faith, otherwise lawfully prescribes or dispenses an
opioid antagonist, shall be immune from criminal or civil
liability and may not be subject to professional discipline
under s. 441.07 for any outcomes resulting from prescrib-
ing, delivering, or dispensing the opioid antagonist.
SECTION 115. 441.19 of the statutes is repealed.
SECTION 116. 448.03 (2) (a) of the statutes is
amended to read:
448.03 (2) (a) Any person lawfully practicing within
the scope of a license, permit, registration, certificate, or
certification granted to practice midwifery under subch.
XIII of ch. 440, to practice professional or, practical, or
advanced practice registered nursing or nurse−mid-
wifery under ch. 441, to practice chiropractic under ch.
446, to practice dentistry or dental hygiene or as an
expanded function dental auxiliary under ch. 447, to
practice optometry under ch. 449, to practice as a physi-
cian assistant under subch. IX, to practice acupuncture
under ch. 451 or under any other statutory provision, to − 19 − 2023 Wisconsin Act 2023 Senate Bill 145
practice naturopathic medicine under ch. 466, or as other-
wise provided by statute.
SECTION 117. 448.035 (1) (a) of the statutes is
repealed.
SECTION 118. 448.035 (2) to (4) of the statutes are
amended to read:
448.035 (2) Notwithstanding the requirements of s.
448.30, a physician or certified advanced practice nurse
prescriber may provide expedited partner therapy if the
patient is diagnosed as infected with a chlamydial infec-
tion, gonorrhea, or trichomoniasis and the patient has had
sexual contact with a sexual partner during which the
chlamydial infection, gonorrhea, or trichomoniasis may
have been transmitted to or from the sexual partner. The
physician or certified advanced practice nurse prescriber
shall attempt to obtain the name of the patient’s sexual
partner. A prescription order for an antimicrobial drug
prepared under this subsection shall include the name and
address of the patient’s sexual partner, if known. If the
physician or certified advanced practice nurse prescriber
is unable to obtain the name of the patient’s sexual part-
ner, the prescription order shall include, in ordinary
bold−faced capital letters, the words, “expedited partner
therapy” or the letters “EPT.”
(3) The physician or certified advanced practice
nurse prescriber shall provide the patient with a copy of
the information sheet prepared by the department of
health services under s. 46.03 (44) and shall request that
the patient give the information sheet to the person with
whom the patient had sexual contact.
(4) (a) Except as provided in par. (b), a physician or
certified advanced practice nurse prescriber is immune
from civil liability for injury to or the death of a person
who takes any antimicrobial drug if the antimicrobial
drug is prescribed, dispensed, or furnished under this sec-
tion and if expedited partner therapy is provided as speci-
fied under this section.
(b) The immunity under par. (a) does not extend to the
donation, distribution, furnishing, or dispensing of an
antimicrobial drug by a physician or certified advanced
practice nurse prescriber whose act or omission involves
reckless, wanton, or intentional misconduct.
SECTION 119. 448.56 (1) and (1m) (b) of the statutes
are amended to read:
448.56 (1) WRITTEN REFERRAL. Except as provided
in this subsection and s. 448.52, a person may practice
physical therapy only upon the written referral of a physi-
cian, naturopathic doctor, physician assistant, chiroprac-
tor, dentist, podiatrist, or advanced practice registered
nurse prescriber certified under s. 441.16 (2). Written
referral is not required if a physical therapist provides
services in schools to children with disabilities, as
defined in s. 115.76 (5), pursuant to rules promulgated by
the department of public instruction; provides services as
part of a home health care agency; provides services to a
patient in a nursing home pursuant to the patient’s plan of
care; provides services related to athletic activities, con-
ditioning, or injury prevention; or provides services to an
individual for a previously diagnosed medical condition
after informing the individual’s physician, naturopathic
doctor, physician assistant, chiropractor, dentist, podia-
trist, or advanced practice registered nurse prescriber cer-
tified under s. 441.16 (2) who made the diagnosis. The
examining board may promulgate rules establishing
additional services that are excepted from the written
referral requirements of this subsection.
(1m) (b) The examining board shall promulgate rules
establishing the requirements that a physical therapist
must satisfy if a physician, naturopathic doctor, physi-
cian assistant, chiropractor, dentist, podiatrist, or
advanced practice registered nurse prescriber makes a
written referral under sub. (1). The purpose of the rules
shall be to ensure continuity of care between the physical
therapist and the health care practitioner.
SECTION 120. 448.62 (2m) of the statutes is amended
to read:
448.62 (2m) An advanced practice registered nurse
who is certified to issue prescription orders under s.
441.16 and who is providing nonsurgical patient services
as directed, supervised, and inspected by a podiatrist who
has the power to direct, decide, and oversee the imple-
mentation of the patient services rendered.
SECTION 121. 448.67 (2) of the statutes is amended
to read:
448.67 (2) SEPARATE BILLING REQUIRED. Except as
provided in sub. (4), a licensee who renders any podiatric
service or assistance, or gives any podiatric advice or any
similar advice or assistance, to any patient, podiatrist,
physician, physician assistant, advanced practice regis-
tered nurse prescriber certified under s. 441.16 (2), part-
nership, or corporation, or to any other institution or
organization, including a hospital, for which a charge is
made to a patient, shall, except as authorized by Title 18
or Title 19 of the federal Social Security Act, render an
individual statement or account of the charge directly to
the patient, distinct and separate from any statement or
account by any other podiatrist, physician, physician
assistant, advanced practice registered nurse prescriber,
or other person.
SECTION 122. 448.956 (1m) of the statutes, as
affected by 2021 Wisconsin Act 251, is amended to read:
448.956 (1m) Subject to sub. (1) (a), a licensee may
provide athletic training to an individual without a refer-
ral, except that a licensee may not provide athletic train-
ing as described under s. 448.95 (5) (d) or (e) in an outpa-
tient rehabilitation setting unless the licensee has
obtained a written referral for the individual from a prac-
titioner licensed or certified under subch. II, III, IV, V, or
VII of this chapter; under ch. 446; or under s. 441.16 (2)
441.09 or from a practitioner who holds a compact privi-
lege under subch. XI or XII of ch. 448.
SECTION 123. 450.01 (1m) of the statutes is repealed. − 20 −2023 Wisconsin Act 2023 Senate Bill 145
SECTION 124. 450.01 (16) (h) 2. of the statutes is
amended to read:
450.01 (16) (h) 2. The patient’s advanced practice
registered nurse prescriber, if the advanced practice reg-
istered nurse prescriber has entered into a written agree-
ment to collaborate with a physician may issue prescrip-
tion orders under s. 441.09 (2).
SECTION 125. 450.01 (16) (hr) 2. of the statutes is
amended to read:
450.01 (16) (hr) 2. An advanced practice registered
nurse prescriber who may issue prescription orders under
s. 441.09 (2).
SECTION 126. 450.03 (1) (e) of the statutes is
amended to read:
450.03 (1) (e) Any person lawfully practicing within
the scope of a license, permit, registration, certificate, or
certification granted to practice as a pharmacy technician
under s. 450.068, to provide home medical oxygen under
s. 450.076, to practice professional or, practical, or
advanced practice registered nursing or nurse−mid-
wifery under ch. 441, to practice dentistry or dental
hygiene or as an expanded function dental auxiliary
under ch. 447, to practice medicine and surgery under ch.
448, to practice optometry under ch. 449, to practice
naturopathic medicine under ch. 466, or to practice vet-
erinary medicine under ch. 89, or as otherwise provided
by statute.
SECTION 127. 450.11 (1g) (b) of the statutes is
amended to read:
450.11 (1g) (b) A pharmacist may, upon the prescrip-
tion order of a practitioner providing expedited partner
therapy, as specified in s. 441.092, 448.035, or 448.9725,
that complies with the requirements of sub. (1), dispense
an antimicrobial drug as a course of therapy for treatment
of chlamydial infections, gonorrhea, or trichomoniasis to
the practitioner’s patient or a person with whom the
patient has had sexual contact for use by the person with
whom the patient has had sexual contact. The pharmacist
shall provide a consultation in accordance with rules pro-
mulgated by the board for the dispensing of a prescription
to the person to whom the antimicrobial drug is dis-
pensed. A pharmacist providing a consultation under this
paragraph shall ask whether the person for whom the
antimicrobial drug has been prescribed is allergic to the
antimicrobial drug and advise that the person for whom
the antimicrobial drug has been prescribed must discon-
tinue use of the antimicrobial drug if the person is allergic
to or develops signs of an allergic reaction to the antimi-
crobial drug.
SECTION 128. 450.11 (1i) (a) 1. of the statutes is
amended to read:
450.11 (1i) (a) 1. A pharmacist may, upon and in
accordance with the prescription order of an advanced
practice registered nurse prescriber under s. 441.18 (2)
(a) 1., of a physician under s. 448.037 (2) (a) 1., or of a
physician assistant under s. 448.9727 (2) (a) 1. that com-
plies with the requirements of sub. (1), deliver an opioid
antagonist to a person specified in the prescription order
and may, upon and in accordance with the standing order
of an advanced practice registered nurse prescriber under
s. 441.18 (2) (a) 2., of a physician under s. 448.037 (2) (a)
2., or of a physician assistant under s. 448.9727 (2) (a) 2.
that complies with the requirements of sub. (1), deliver an
opioid antagonist to an individual in accordance with the
order. The pharmacist shall provide a consultation in
accordance with rules promulgated by the board for the
delivery of a prescription to the person to whom the opi-
oid antagonist is delivered.
SECTION 129. 450.11 (1i) (b) 2. b. of the statutes is
amended to read:
450.11 (1i) (b) 2. b. An advanced practice registered
nurse prescriber may only deliver or dispense an opioid
antagonist in accordance with s. 441.18 (2) or in accord-
ance with his or her other legal authority to dispense pre-
scription drugs.
SECTION 130. 450.11 (7) (b) of the statutes is
amended to read:
450.11 (7) (b) Information communicated to a physi-
cian, physician assistant, or advanced practice registered
nurse prescriber in an effort to procure unlawfully a pre-
scription drug or the administration of a prescription drug
is not a privileged communication.
SECTION 131. 450.11 (8) (e) of the statutes is
amended to read:
450.11 (8) (e) The board of nursing, insofar as this
section applies to advanced practice nurse prescribers
registered nurses.
SECTION 132. 450.13 (5) (b) of the statutes is
amended to read:
450.13 (5) (b) The patient’s advanced practice regis-
tered nurse prescriber, if the advanced practice registered
nurse prescriber has entered into a written agreement to
collaborate with a physician may issue prescription
orders under s. 441.09 (2).
SECTION 133. 450.135 (7) (b) of the statutes is
amended to read:
450.135 (7) (b) The patient’s advanced practice reg-
istered nurse prescriber, if the advanced practice regis-
tered nurse prescriber has entered into a written agree-
ment to collaborate with a physician may issue
prescription orders under s. 441.09 (2).
SECTION 134. 462.04 of the statutes, as affected by
2021 Wisconsin Act 251, is amended to read:
462.04 Prescription or order required. A person
who holds a license or limited X−ray machine operator
permit under this chapter may not use diagnostic X−ray
equipment on humans for diagnostic purposes unless
authorized to do so by prescription or order of a physician
licensed under s. 448.04 (1) (a), a naturopathic doctor
licensed under s. 466.04 (1), a dentist licensed under s.
447.04 (1), a podiatrist licensed under s. 448.63, a chiro-
practor licensed under s. 446.02, an advanced practice − 21 − 2023 Wisconsin Act 2023 Senate Bill 145
registered nurse certified licensed under s. 441.16 (2)
441.09, a physician assistant licensed under s. 448.974,
or, subject to s. 448.56 (7) (a), a physical therapist who
is licensed under s. 448.53 or who holds a compact privi-
lege under subch. XI of ch. 448.
SECTION 135. 655.001 (1) of the statutes is renum-
bered 655.001 (1r).
SECTION 136. 655.001 (1g) of the statutes is created
to read:
655.001 (1g) “Advanced practice registered nurse”
means an individual who is licensed under s. 441.09, who
has qualified to practice independently in his or her rec-
ognized role under s. 441.09 (3m) (b), and who practices
advanced practice registered nursing, as defined under s.
441.001 (1c), outside of a collaborative relationship with
a physician or dentist, as described under s. 441.09 (3m)
(a) 1., or other employment relationship.
SECTION 137. 655.001 (7t) of the statutes is amended
to read:
655.001 (7t) “Health care practitioner” means a
health care professional, as defined in s. 180.1901 (1m),
who is an employee of a health care provider described
in s. 655.002 (1) (d), (e), (em), or (f) and who has the
authority to provide health care services that are not in
collaboration with a physician under s. 441.15 (2) (b) or
under the direction and supervision of a physician or
nurse anesthetist advanced practice registered nurse.
SECTION 138. 655.001 (9) of the statutes is repealed.
SECTION 139. 655.002 (1) (a) of the statutes is
amended to read:
655.002 (1) (a) A physician or a nurse anesthetist an
advanced practice registered nurse for whom this state is
a principal place of practice and who practices his or her
profession in this state more than 240 hours in a fiscal
year.
SECTION 140. 655.002 (1) (b) of the statutes is
amended to read:
655.002 (1) (b) A physician or a nurse anesthetist an
advanced practice registered nurse for whom Michigan
is a principal place of practice, if all of the following
apply:
1. The physician or nurse anesthetist advanced prac-
tice registered nurse is a resident of this state.
2. The physician or nurse anesthetist advanced prac-
tice registered nurse practices his or her profession in this
state or in Michigan or a combination of both more than
240 hours in a fiscal year.
3. The physician or nurse anesthetist advanced prac-
tice registered nurse performs more procedures in a
Michigan hospital than in any other hospital. In this sub-
division, “Michigan hospital” means a hospital located in
Michigan that is an affiliate of a corporation organized
under the laws of this state that maintains its principal
office and a hospital in this state.
SECTION 141. 655.002 (1) (c) of the statutes is
amended to read:
655.002 (1) (c) A physician or nurse anesthetist an
advanced practice registered nurse who is exempt under
s. 655.003 (1) or (3), but who practices his or her profes-
sion outside the scope of the exemption and who fulfills
the requirements under par. (a) in relation to that practice
outside the scope of the exemption. For a physician or
a nurse anesthetist an advanced practice registered nurse
who is subject to this chapter under this paragraph, this
chapter applies only to claims arising out of practice that
is outside the scope of the exemption under s. 655.003 (1)
or (3).
SECTION 142. 655.002 (1) (d) of the statutes is
amended to read:
655.002 (1) (d) A partnership comprised of physi-
cians or nurse anesthetists advanced practice registered
nurses and organized and operated in this state for the pri-
mary purpose of providing the medical services of physi-
cians or nurse anesthetists advanced practice registered
nurses.
SECTION 143. 655.002 (1) (e) of the statutes is
amended to read:
655.002 (1) (e) A corporation organized and operated
in this state for the primary purpose of providing the med-
ical services of physicians or nurse anesthetists advanced
practice registered nurses.
SECTION 144. 655.002 (1) (em) of the statutes is
amended to read:
655.002 (1) (em) Any organization or enterprise not
specified under par. (d) or (e) that is organized and oper-
ated in this state for the primary purpose of providing the
medical services of physicians or nurse anesthetists
advanced practice registered nurses.
SECTION 145. 655.002 (2) (a) of the statutes is
amended to read:
655.002 (2) (a) A physician or nurse anesthetist
advanced practice registered nurse for whom this state is
a principal place of practice but who practices his or her
profession fewer than 241 hours in a fiscal year, for a fis-
cal year, or a portion of a fiscal year, during which he or
she practices his or her profession.
SECTION 146. 655.002 (2) (b) of the statutes is
amended to read:
655.002 (2) (b) Except as provided in sub. (1) (b), a
physician or nurse anesthetist advanced practice regis-
tered nurse for whom this state is not a principal place of
practice, for a fiscal year, or a portion of a fiscal year, dur-
ing which he or she practices his or her profession in this
state. For a health care provider who elects to be subject
to this chapter under this paragraph, this chapter applies
only to claims arising out of practice that is in this state
and that is outside the scope of an exemption under s.
655.003 (1) or (3).
SECTION 147. 655.003 (1) of the statutes is amended
to read:
655.003 (1) A physician or a nurse anesthetist an
advanced practice registered nurse who is a state, county − 22 −2023 Wisconsin Act 2023 Senate Bill 145
or municipal employee, or federal employee or contrac-
tor covered under the federal tort claims act, as amended,
and who is acting within the scope of his or her employ-
ment or contractual duties.
SECTION 148. 655.003 (3) of the statutes is amended
to read:
655.003 (3) Except for a physician or nurse anesthe-
tist advanced practice registered nurse who meets the cri-
teria under s. 146.89 (5) (a), a physician or a nurse anes-
thetist an advanced practice registered nurse who
provides professional services under the conditions
described in s. 146.89, with respect to those professional
services provided by the physician or nurse anesthetist
advanced practice registered nurse for which he or she is
covered by s. 165.25 and considered an agent of the
department, as provided in s. 165.25 (6) (b).
SECTION 149. 655.005 (2) (a) of the statutes is
amended to read:
655.005 (2) (a) An employee of a health care
provider if the employee is a physician or a nurse anes-
thetist an advanced practice registered nurse or is a health
care practitioner who is providing health care services
that are not in collaboration with a physician under s.
441.15 (2) (b) or under the direction and supervision of
a physician or nurse anesthetist advanced practice regis-
tered nurse.
SECTION 150. 655.005 (2) (b) of the statutes is
amended to read:
655.005 (2) (b) A service corporation organized
under s. 180.1903 by health care professionals, as defined
under s. 180.1901 (1m), if the board of governors deter-
mines that it is not the primary purpose of the service cor-
poration to provide the medical services of physicians or
nurse anesthetists advanced practice registered nurses.
The board of governors may not determine under this
paragraph that it is not the primary purpose of a service
corporation to provide the medical services of physicians
or nurse anesthetists advanced practice registered nurses
unless more than 50 percent of the shareholders of the
service corporation are neither physicians nor nurse anes-
thetists advanced practice registered nurses.
SECTION 151. 655.23 (5m) of the statutes is amended
to read:
655.23 (5m) The limits set forth in sub. (4) shall
apply to any joint liability of a physician or nurse anesthe-
tist advanced practice registered nurse and his or her cor-
poration, partnership, or other organization or enterprise
under s. 655.002 (1) (d), (e), or (em).
SECTION 152. 655.27 (3) (a) 4. of the statutes is
amended to read:
655.27 (3) (a) 4. For a health care provider described
in s. 655.002 (1) (d), (e), (em), or (f), risk factors and past
and prospective loss and expense experience attributable
to employees of that health care provider other than
employees licensed as a physician or nurse anesthetist
advanced practice registered nurse.
SECTION 153. 655.27 (3) (b) 2m. of the statutes is
amended to read:
655.27 (3) (b) 2m. In addition to the fees and payment
classifications described under subds. 1. and 2., the com-
missioner, after approval by the board of governors, may
establish a separate payment classification for physicians
satisfying s. 655.002 (1) (b) and a separate fee for nurse
anesthetists advanced practice registered nurses satisfy-
ing s. 655.002 (1) (b) which take into account the loss
experience of health care providers for whom Michigan
is a principal place of practice.
SECTION 154. 655.275 (2) of the statutes is amended
to read:
655.275 (2) APPOINTMENT. The board of governors
shall appoint the members of the council. Section 15.09,
except s. 15.09 (4) and (8), does not apply to the council.
The board of governors shall designate the chairperson,
who shall be a physician, the vice chairperson, and the
secretary of the council and the terms to be served by
council members. The council shall consist of 5 or 7 per-
sons, not more than 3 of whom are physicians who are
licensed and in good standing to practice medicine in this
state and one of whom is a nurse anesthetist an advanced
practice registered nurse who is licensed and in good
standing to practice nursing in this state. The chairperson
or another peer review council member designated by the
chairperson shall serve as an ex officio nonvoting mem-
ber of the medical examining board and may attend meet-
ings of the medical examining board, as appropriate.
SECTION 155. 655.275 (5) (b) 2. of the statutes is
amended to read:
655.275 (5) (b) 2. If a claim was paid for damages
arising out of the rendering of care by a nurse anesthetist
an advanced practice registered nurse, with at least one
nurse anesthetist advanced practice registered nurse.
SECTION 156. 961.01 (19) (a) of the statutes is
amended to read:
961.01 (19) (a) A physician, advanced practice regis-
tered nurse, dentist, veterinarian, podiatrist, optometrist,
scientific investigator or, subject to s. 448.975 (1) (b), a
physician assistant, or other person licensed, registered,
certified or otherwise permitted to distribute, dispense,
conduct research with respect to, administer or use in
teaching or chemical analysis a controlled substance in
the course of professional practice or research in this
state.
SECTION 157. 961.395 of the statutes is amended to
read:
961.395 Limitation on advanced practice regis-
tered nurses. (1) An advanced practice registered nurse
who is certified may issue prescription orders under s.
441.16 441.09 (2) may prescribe controlled substances
only as permitted by the rules promulgated under s.
441.16 (3) 441.09 (6) (a) 4.
(2) An advanced practice registered nurse certified
under s. 441.16 who may issue prescription orders under − 23 − 2023 Wisconsin Act 2023 Senate Bill 145
s. 441.09 (2) shall include with each prescription order
the advanced practice nurse prescriber certification
license number issued to him or her by the board of nurs-
ing.
(3) An advanced practice registered nurse certified
under s. 441.16 who may issue prescription orders under
s. 441.09 (2) may dispense a controlled substance only by
prescribing or administering the controlled substance or
as otherwise permitted by the rules promulgated under s.
441.16 (3) 441.09 (6) (a) 4.
SECTION 158.0Nonstatutory provisions.
(1) Using the procedure under s. 227.24, the board of
nursing may promulgate rules under ch. 441 that are nec-
essary to implement the changes in this act. Notwith-
standing s. 227.24 (1) (a) and (3), the board is not required
to provide evidence that promulgating a rule under this
subsection as an emergency rule is necessary for the
preservation of the public peace, health, safety, or welfare
and is not required to provide a finding of emergency for
a rule promulgated under this subsection. A rule under
this subsection may take effect no later than the date spec-
ified in SECTION 159 (intro.) of this act. Notwithstanding
s. 227.24 (1) (c) and (2), a rule promulgated under this
subsection is effective for 2 years after its promulgation,
or until permanent rules take effect, whichever is sooner,
and the effective period of a rule promulgated under this
subsection may not be further extended under s. 227.24
(2).
(2) (a) In this subsection, the definitions under s.
441.001 apply.
(b) Notwithstanding s. 441.09 (3), an individual who,
on January 1, 2024, is licensed as a registered nurse in this
state and is practicing in a recognized role may continue
to practice advanced practice registered nursing and the
corresponding recognized role in which he or she is prac-
ticing and may continue to use the titles corresponding to
the recognized roles in which he or she is practicing dur-
ing the period before which the board takes final action
on the person’s application under s. 441.09. This para-
graph does not apply after the first day of the 13th month
beginning after the effective date of this paragraph.
SECTION 159.0Effective dates. This act takes effect
on the first day of the 13th month beginning after publica-
tion, except as follows:
(1) SECTION 158 (1) of this act takes effect on the day
after publication.