Wisconsin 2025-2026 Regular Session

Wisconsin Assembly Bill AB257 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	2025 - 2026 LEGISLATURE
2	2	LRB-3063/1
3	3	JPC:emw&wlj
4	4	2025 ASSEMBLY BILL 257
5	5	May 12, 2025 - Introduced by Representatives KURTZ, SUBECK, RODRIGUEZ,
6	6	ANDRACA, BEHNKE, BROWN, CRUZ, DESMIDT, EMERSON, GUNDRUM, JOERS,
7	7	KREIBICH, MAXEY, MURPHY, O'CONNOR, ORTIZ-VELEZ, PRADO, SPIROS, STUBBS,
8	8	TUSLER, UDELL and WICHGERS, cosponsored by Senators TESTIN, CABRAL-
9	9	GUEVARA, ROYS, DASSLER-ALFHEIM, HABUSH SINYKIN, HESSELBEIN, KEYESKI,
10	10	LEMAHIEU, MARKLEIN, QUINN, RATCLIFF, SMITH and SPREITZER. Referred to
11	11	Committee on Health, Aging and Long-Term Care.
12	12
13	13	*AUTHORS SUBJECT TO CHANGE*
14	14	AN ACT to repeal 50.01 (1b), 77.54 (14) (f) 3., 118.2925 (1) (b), 118.294 (1) (a),
15	15	146.89 (1) (r) 8., 252.01 (1c), 440.03 (13) (b) 3., 440.03 (13) (b) 42., 440.08 (2) (a)
16	16	4m., 440.08 (2) (a) 50., 441.11 (title), 441.11 (1), 441.11 (3), 441.15, 441.16,
17	17	441.19, 448.035 (1) (a), 450.01 (1m) and 655.001 (9); to renumber 655.001 (1);
18	18	to renumber and amend 146.89 (1) (r) 3., 253.13 (1), 255.06 (1) (d), 441.06
19	19	(7) and 441.11 (2); to amend 29.193 (1m) (a) 2. (intro.), 29.193 (2) (b) 2., 29.193
20	20	(2) (c) 3., 29.193 (2) (cd) 2. b., 29.193 (2) (cd) 2. c., 29.193 (2) (e), 29.193 (3) (a),
21	21	45.40 (1g) (a), 46.03 (44), 50.08 (2), 50.09 (1) (a) (intro.), 50.09 (1) (f) 1., 50.09
22	22	(1) (h), 50.09 (1) (k), 50.49 (1) (b) (intro.), 51.41 (1d) (b) 4., 70.47 (8) (intro.),
23	23	77.54 (14) (f) 4., 97.59, 106.30 (1), 118.15 (3) (a), 118.25 (1) (a), 118.29 (1) (e),
24	24	118.2915 (2) (a), 118.2915 (3) (a), 118.2915 (4) (c), 118.2915 (6) (a) (intro.),
25	25	118.2915 (6) (a) 2., 118.2915 (6) (a) 3., 118.2925 (3), 118.2925 (4) (c), 118.2925
26	26	(5), 118.294 (1) (am), 118.294 (2), 118.294 (4) (a), 146.615 (1) (a), 146.82 (3) (a),
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40	40	ASSEMBLY BILL 257
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42	42	JPC:emw&wlj
43	43	146.89 (1) (r) 1., 146.89 (6), 154.01 (1g), 252.07 (8) (a) 2., 252.07 (9) (c), 252.10
44	44	(7), 252.11 (2), 252.11 (4), 252.11 (5), 252.11 (7), 252.11 (10), 252.15 (3m) (d)
45	45	11. b. and 13., (5g) (c), (5m) (d) 2. and (e) 2. and 3. and (7m) (intro.) and (b),
46	46	252.16 (3) (c) (intro.), 252.17 (3) (c) (intro.), 253.07 (4) (d), 253.115 (4), 253.115
47	47	(7) (a) (intro.), 253.15 (2), 255.06 (2) (d), 255.07 (1) (d), 257.01 (5) (a), 257.01 (5)
48	48	(b), 341.14 (1a), 341.14 (1e) (a), 341.14 (1m), 341.14 (1q), 343.16 (5) (a), 343.51
49	49	(1), 343.62 (4) (a) 4., 440.077 (1) (a), 440.077 (2) (c), 440.094 (1) (c) 1., 440.094
50	50	(2) (a) (intro.), 440.981 (1), 440.982 (1), 440.987 (2), 441.01 (3), 441.01 (4),
51	51	441.01 (7) (a) (intro.), 441.01 (7) (b), 441.06 (3), 441.06 (4), 441.07 (1g) (intro.),
52	52	(a), (c) and (e), 441.07 (2), 441.10 (7), 441.18 (2) (a) (intro.), 441.18 (2) (b),
53	53	441.18 (3), 448.03 (2) (a), 448.035 (2) to (4), 448.56 (1) and (1m) (b), 448.62
54	54	(2m), 448.67 (2), 448.956 (1m), 450.01 (16) (h) 2., 450.01 (16) (hr) 2., 450.03 (1)
55	55	(e), 450.11 (1g) (b), 450.11 (1i) (a) 1., 450.11 (1i) (b) 2. b., 450.11 (7) (b), 450.11
56	56	(8) (e), 450.13 (5) (b), 450.135 (7) (b), 462.04, 655.001 (7t), 655.002 (1) (a),
57	57	655.002 (1) (b), 655.002 (1) (c), 655.002 (1) (d), 655.002 (1) (e), 655.002 (1) (em),
58	58	655.002 (2) (a), 655.002 (2) (b), 655.003 (1), 655.003 (3), 655.005 (2) (a),
59	59	655.005 (2) (b), 655.23 (5m), 655.27 (3) (a) 4., 655.27 (3) (b) 2m., 655.275 (2),
60	60	655.275 (5) (b) 2., 895.478 (3m), 961.01 (19) (a) and 961.395; to repeal and
61	61	recreate 118.2915 (1) (a), 155.01 (1g) (b), 251.01 (1c) and 441.06 (title); to
62	62	create 253.115 (1) (f), 253.13 (1) (a), 253.15 (1) (em), 255.06 (1) (f) 2., 440.03
63	63	(13) (b) 39m., 440.08 (2) (a) 47r., 441.001 (1c), 441.001 (3c), 441.001 (3g),
64	64	441.001 (3n), 441.001 (3r), 441.001 (3w), 441.001 (5), 441.01 (7) (c), 441.065,
65	65	441.07 (1r), 441.09, 441.092 and 655.001 (1g) of the statutes; relating to:
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89	89	ASSEMBLY BILL 257
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92	92	advanced practice registered nurses, extending the time limit for emergency
93	93	rule procedures, providing an exemption from emergency rule procedures, and
94	94	granting rule-making authority.
95	95	Analysis by the Legislative Reference Bureau
96	96	NURSING PRACTICE AND LICENSURE
97	97	This bill makes various changes to practice, licensure, and certification
98	98	requirements for nurses, which are administered by the Board of Nursing.
99	99	Licensure of advanced practice registered nurses
100	100	Under current law, a person who wishes to practice professional nursing must
101	101	be licensed by the Board of Nursing as a registered nurse (RN). This bill creates an
102	102	additional system of licensure for advanced practice registered nurses (APRNs), to
103	103	be administered by the board. Under the bill, in order to apply for an APRN license,
104	104	a person must 1) hold, or concurrently apply for, an RN license; 2) have completed
105	105	an accredited graduate-level or postgraduate-level education program preparing
106	106	the person to practice as an APRN in one of four recognized roles and hold a current
107	107	national certification approved by the board; 3) possess malpractice liability
108	108	insurance as provided in the bill; 4) pay a fee determined by the Department of
109	109	Safety and Professional Services; and 5) satisfy certain other criteria specified in
110	110	the bill. The bill also allows a person who has not completed an accredited
111	111	education program described above to receive an APRN license if the person 1) on
112	112	January 1, 2026, is both licensed as an RN in Wisconsin and practicing in one of the
113	113	four recognized roles and 2) satisfies additional practice or education criteria
114	114	established by the board. The bill also, however, automatically grants licenses to
115	115	certain RNs, as further described below. The four recognized roles, as defined in
116	116	the bill, are 1) certified nurse-midwife; 2) certified registered nurse anesthetist; 3)
117	117	clinical nurse specialist; and 4) nurse practitioner. The bill requires the board,
118	118	upon granting a person an APRN license, to also grant the person one or more
119	119	specialty designations corresponding to the recognized role or roles for which the
120	120	person qualifies.
121	121	Under the bill, all APRNs, except APRNs with a certified nurse-midwife
122	122	specialty designation, must practice in collaboration with a physician or dentist.
123	123	However, under the bill, an APRN may practice without being supervised by a
124	124	physician or dentist if the board verifies that the APRN has completed 3,840 hours
125	125	of professional nursing in a clinical setting and has completed 3,840 clinical hours of
126	126	advanced practice registered nursing practice in their recognized role while
127	127	working with a physician or dentist during those 3,840 hours of practice. APRNs
128	128	may count additional hours practiced as an APRN in collaboration with a physician
129	129	or dentist towards the 3,840 required hours of professional nursing. APRNs with a
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132	132	3 2025 - 2026 Legislature
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136	136	certified nurse-midwife specialty designation are instead required, if they offer to
137	137	deliver babies outside of a hospital setting, to file and keep current with the board a
138	138	proactive plan for involving a hospital or a physician who has admitting privileges
139	139	at a hospital in the treatment of patients with higher acuity or emergency care
140	140	needs, as further described below. Regardless of whether an APRN has qualified to
141	141	practice independently, the bill provides that an APRN may provide treatment of
142	142	pain syndromes through the use of invasive techniques only while working in a
143	143	collaborative relationship with any physician who, through education, training, and
144	144	experience, specializes in pain management. Alternatively, if an APRN has
145	145	qualified to practice independently, the APRN may provide treatment of pain
146	146	syndromes through the use of invasive techniques in a hospital or clinic associated
147	147	with a hospital. Further, an APRN may provide treatment of pain syndromes
148	148	through the use of invasive techniques if the APRN has qualified to practice
149	149	independently and has privileges in a hospital to provide treatment of pain
150	150	syndromes through the use of invasive techniques without a collaborative
151	151	relationship with a physician.
152	152	The holder of an APRN license may append the title XA.P.R.N.Y to his or her
153	153	name, as well as a title corresponding to whichever specialty designations that the
154	154	person possesses. The bill prohibits any person from using the title XA.P.R.N.,Y and
155	155	from otherwise indicating that he or she is an APRN, unless the person is licensed
156	156	by the board as an APRN. The bill also prohibits the use of titles and abbreviations
157	157	corresponding to a recognized role unless the person has a specialty designation for
158	158	that role. The bill further prohibits any person licensed by the board from using,
159	159	assuming, or appending to his or her name any title that is not granted under the
160	160	nursing statutes unless the person holds another credential that entitles the person
161	161	to use, assume, or append to his or her name the title or the person is permitted to
162	162	use, assume, or append to his or her name the title under any other law of the state.
163	163	However, the bill provides that a person who is licensed by the board and holds a
164	164	doctorate degree is not prohibited from using, assuming, or appending to his or her
165	165	name the title XdoctorY or any other words, letters, or abbreviations that represent
166	166	that the person holds that doctorate degree or the field in which the degree was
167	167	received. If a person who is licensed by the board uses, assumes, or appends to his
168	168	or her name the title Xdoctor,Y the bill requires that person to also use, assume, or
169	169	append to his or her name words, letters, or abbreviations that represent the field
170	170	in which the person received the doctorate degree. Further, the bill provides that a
171	171	person who holds a bachelor[s degree or master[s degree is not prohibited from
172	172	using, assuming, or appending to his or her name any words, letters, or
173	173	abbreviations that represent that the person holds that degree or the field in which
174	174	the degree was received.
175	175	The bill allows an APRN to delegate a task or order to another clinically
176	176	trained health care worker if the task or order is within the scope of the APRN[s
177	177	practice, the APRN is competent to perform the task or issue the order, and the
178	178	APRN has reasonable evidence that the health care worker is minimally competent 2025 - 2026 Legislature
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182	182	to perform the task or issue the order under the circumstances. The bill requires an
183	183	APRN to adhere to professional standards when managing situations that are
184	184	beyond the APRN[s expertise.
185	185	Under the bill, when an APRN renews his or her APRN license, the board
186	186	must grant the person the renewal of both the person[s RN license and the person[s
187	187	APRN license. The bill requires all APRNs to complete continuing education
188	188	requirements each biennium in clinical pharmacology or therapeutics relevant to
189	189	the APRN[s area of practice and to satisfy certain other requirements when
190	190	renewing a license.
191	191	Practice of nurse-midwifery
192	192	This bill repeals licensure and practice requirements specific to nurse-
193	193	midwives and the practice of nurse-midwifery, including specific requirements to
194	194	practice with an obstetrician. Under the bill, Xcertified nurse-midwifeY is one of the
195	195	four recognized roles for APRNs, and a person who is licensed as a nurse-midwife
196	196	under current law is automatically granted an APRN license with a certified nurse-
197	197	midwife specialty designation. The bill otherwise allows nurse-midwives to be
198	198	licensed as APRNs if they satisfy the licensure requirements, except that the bill
199	199	also requires that a person applying for a certified nurse-midwife specialty
200	200	designation be certified by the American Midwifery Certification Board. The bill
201	201	also requires an APRN with a specialty designation as a certified nurse-midwife to
202	202	file with the Board of Nursing, and obtain the board[s approval of, a plan for
203	203	ensuring appropriate care or care transitions in treating certain patients if the
204	204	APRN offers to deliver babies outside of a hospital setting.
205	205	Prescribing authority
206	206	Under current law, a person licensed as an RN may apply to the Board of
207	207	Nursing for a certificate to issue prescription orders if the person meets certain
208	208	requirements established by the board. An RN holding a certificate is subject to
209	209	various practice requirements and limitations established by the board and must
210	210	possess malpractice liability insurance in an amount determined by the board.
211	211	The bill eliminates certificates to issue prescription orders and generally
212	212	authorizes APRNs to issue prescription orders. A person who is certified to issue
213	213	prescription orders under current law is automatically granted an APRN license
214	214	with his or her appropriate specialty designation. RNs who are practicing in a
215	215	recognized role on January 1, 2026, but who do not hold a certificate to issue
216	216	prescription orders on that date and who are granted an APRN license under the
217	217	bill may not issue prescription orders. As under current law, an APRN issuing
218	218	prescription orders is subject to various practice requirements and limitations
219	219	established by the board.
220	220	The bill repeals a provision concerning the ability of advanced practice nurses
221	221	who are certified to issue prescription orders and who are required to work in
222	222	collaboration with or under the supervision of a physician to obtain and practice 2025 - 2026 Legislature
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226	226	SECTION 1
227	227	under a federal waiver to dispense narcotic drugs to individuals for addiction
228	228	treatment.
229	229	Malpractice liability insurance
230	230	The bill requires all APRNs to maintain malpractice liability insurance
231	231	coverage evidenced by personal liability coverage in the amounts specified under
232	232	current law for physicians and nurse anesthetists or coverage under a group
233	233	liability policy providing individual coverage for the APRN in the amounts specified
234	234	under current law for physicians and nurse anesthetists. Additionally, the bill
235	235	requires APRNs who have qualified to practice independently and who practice
236	236	outside a collaborative or employment relationship to participate in the Injured
237	237	Patients and Families Compensation Fund. The Injured Patients and Families
238	238	Compensation Fund provides excess medical malpractice coverage for health care
239	239	providers who participate in the fund and meet all other participation
240	240	requirements, which includes maintaining malpractice liability insurance in
241	241	coverage amounts specified under current law.
242	242	OTHER CHANGES
243	243	The bill makes numerous other changes throughout the statutes relating to
244	244	APRNs, including various terminology changes.
245	245	For further information see the state fiscal estimate, which will be printed as
246	246	an appendix to this bill.
247	247	The people of the state of Wisconsin, represented in senate and assembly, do
248	248	enact as follows:
249	249	SECTION 1. 29.193 (1m) (a) 2. (intro.) of the statutes is amended to read:
250	250	29.193 (1m) (a) 2. (intro.) Has a permanent substantial loss of function in one
251	251	or both arms or one or both hands and fails to meet the minimum standards of any
252	252	one of the following standard tests, administered under the direction of a licensed
253	253	physician, a licensed physician assistant, a licensed chiropractor, or a certified
254	254	licensed advanced practice registered nurse prescriber:
255	255	SECTION 2. 29.193 (2) (b) 2. of the statutes is amended to read:
256	256	29.193 (2) (b) 2. An applicant shall submit an application on a form prepared
257	257	and furnished by the department, which shall include a written statement or report
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270	270	SECTION 2
271	271	prepared and signed by a licensed physician, a licensed physician assistant, a
272	272	licensed chiropractor, a licensed podiatrist, or a certified licensed advanced practice
273	273	registered nurse prescriber prepared no more than 6 months preceding the
274	274	application and verifying that the applicant is physically disabled.
275	275	SECTION 3. 29.193 (2) (c) 3. of the statutes is amended to read:
276	276	29.193 (2) (c) 3. The department may issue a Class B permit to an applicant
277	277	who is ineligible for a permit under subd. 1., 2. or 2m. or who is denied a permit
278	278	under subd. 1., 2. or 2m. if, upon review and after considering the physical condition
279	279	of the applicant and the recommendation of a licensed physician, a licensed
280	280	physician assistant, a licensed chiropractor, a licensed podiatrist, or a certified
281	281	licensed advanced practice registered nurse prescriber selected by the applicant
282	282	from a list of licensed physicians, licensed physician assistants, licensed
283	283	chiropractors, licensed podiatrists, and certified licensed advanced practice nurse
284	284	prescribers registered nurses compiled by the department, the department finds
285	285	that issuance of a permit complies with the intent of this subsection. The use of this
286	286	review procedure is discretionary with the department and all costs of the review
287	287	procedure shall be paid by the applicant.
288	288	SECTION 4. 29.193 (2) (cd) 2. b. of the statutes is amended to read:
289	289	29.193 (2) (cd) 2. b. The person has a permanent substantial loss of function
290	290	in one or both arms and fails to meet the minimum standards of the standard upper
291	291	extremity pinch test, the standard grip test, or the standard nine-hole peg test,
292	292	administered under the direction of a licensed physician, a licensed physician
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318	318	SECTION 4
319	319	assistant, a licensed chiropractor, or a certified licensed advanced practice
320	320	registered nurse prescriber.
321	321	SECTION 5. 29.193 (2) (cd) 2. c. of the statutes is amended to read:
322	322	29.193 (2) (cd) 2. c. The person has a permanent substantial loss of function in
323	323	one or both shoulders and fails to meet the minimum standards of the standard
324	324	shoulder strength test, administered under the direction of a licensed physician, a
325	325	licensed physician assistant, a licensed chiropractor, or a certified licensed
326	326	advanced practice registered nurse prescriber.
327	327	SECTION 6. 29.193 (2) (e) of the statutes is amended to read:
328	328	29.193 (2) (e) Review of decisions. An applicant denied a permit under this
329	329	subsection, except a permit under par. (c) 3., may obtain a review of that decision by
330	330	a licensed physician, a licensed physician assistant, a licensed chiropractor, a
331	331	licensed podiatrist, or a certified licensed advanced practice registered nurse
332	332	prescriber designated by the department and with an office located in the
333	333	department district in which the applicant resides. The department shall pay for
334	334	the cost of a review under this paragraph unless the denied application on its face
335	335	fails to meet the standards set forth in par. (c) 1. or 2. A review under this
336	336	paragraph is the only method of review of a decision to deny a permit under this
337	337	subsection and is not subject to further review under ch. 227.
338	338	SECTION 7. 29.193 (3) (a) of the statutes is amended to read:
339	339	29.193 (3) (a) Produces a certificate from a licensed physician, a licensed
340	340	physician assistant, a licensed optometrist, or a certified licensed advanced practice
341	341	registered nurse prescriber stating that his or her sight is impaired to the degree
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368	368	SECTION 7
369	369	that he or she cannot read ordinary newspaper print with or without corrective
370	370	glasses.
371	371	SECTION 8. 45.40 (1g) (a) of the statutes is amended to read:
372	372	45.40 (1g) (a) XHealth care providerY means an advanced practice registered
373	373	nurse prescriber who is certified who may issue prescription orders under s. 441.16
374	374	441.09 (2), an audiologist who is licensed under subch. II of ch. 459 or who holds a
375	375	compact privilege under subch. III of ch. 459, a dentist who is licensed under subch.
376	376	I of ch. 447 or who holds a compact privilege under subch. II of ch. 447, an
377	377	optometrist who is licensed under ch. 449, a physician who is licensed under s.
378	378	448.02, or a podiatrist who is licensed under s. 448.63.
379	379	SECTION 9. 46.03 (44) of the statutes is amended to read:
380	380	46.03 (44) SEXUALLY TRANSMITTED DISEASE TREATMENT INFORMATION.
381	381	Prepare and keep current an information sheet to be distributed to a patient by a
382	382	physician, a physician assistant, or certified an advanced practice registered nurse
383	383	prescriber who may issue prescription orders under s. 441.09 (2) providing
384	384	expedited partner therapy to that patient under s. 441.092, 448.035, or 448.9725.
385	385	The information sheet shall include information about sexually transmitted
386	386	diseases and their treatment and about the risk of drug allergies. The information
387	387	sheet shall also include a statement advising a person with questions about the
388	388	information to contact his or her physician, advanced practice registered nurse,
389	389	pharmacist, or local health department, as defined in s. 250.01 (4).
390	390	SECTION 10. 50.01 (1b) of the statutes is repealed.
391	391	SECTION 11. 50.08 (2) of the statutes is amended to read:
392	392	50.08 (2) A physician, an advanced practice registered nurse prescriber
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420	420	SECTION 11
421	421	certified who may issue prescription orders under s. 441.16 441.09 (2), or a
422	422	physician assistant who prescribes a psychotropic medication to a nursing home
423	423	resident who has degenerative brain disorder shall notify the nursing home if the
424	424	prescribed medication has a boxed warning under 21 CFR 201.57.
425	425	SECTION 12. 50.09 (1) (a) (intro.) of the statutes is amended to read:
426	426	50.09 (1) (a) (intro.) Private and unrestricted communications with the
427	427	resident[s family, physician, physician assistant, advanced practice registered
428	428	nurse prescriber, attorney, and any other person, unless medically contraindicated
429	429	as documented by the resident[s physician, physician assistant, or advanced
430	430	practice registered nurse prescriber in the resident[s medical record, except that
431	431	communications with public officials or with the resident[s attorney shall not be
432	432	restricted in any event. The right to private and unrestricted communications shall
433	433	include, but is not limited to, the right to:
434	434	SECTION 13. 50.09 (1) (f) 1. of the statutes is amended to read:
435	435	50.09 (1) (f) 1. Privacy for visits by spouse or domestic partner. If both
436	436	spouses or both domestic partners under ch. 770 are residents of the same facility,
437	437	the spouses or domestic partners shall be permitted to share a room unless
438	438	medically contraindicated as documented by the resident[s physician, physician
439	439	assistant, or advanced practice registered nurse prescriber in the resident[s
440	440	medical record.
441	441	SECTION 14. 50.09 (1) (h) of the statutes is amended to read:
442	442	50.09 (1) (h) Meet with, and participate in activities of social, religious, and
443	443	community groups at the resident[s discretion, unless medically contraindicated as
444	444	1
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446	446	3
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448	448	5
449	449	6
450	450	7
451	451	8
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457	457	14
458	458	15
459	459	16
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461	461	18
462	462	19
463	463	20
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465	465	22
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470	470	SECTION 14
471	471	documented by the resident[s physician, physician assistant, or advanced practice
472	472	registered nurse prescriber in the resident[s medical record.
473	473	SECTION 15. 50.09 (1) (k) of the statutes is amended to read:
474	474	50.09 (1) (k) Be free from mental and physical abuse, and be free from
475	475	chemical and physical restraints except as authorized in writing by a physician,
476	476	physician assistant, or advanced practice registered nurse prescriber for a specified
477	477	and limited period of time and documented in the resident[s medical record.
478	478	Physical restraints may be used in an emergency when necessary to protect the
479	479	resident from injury to himself or herself or others or to property. However,
480	480	authorization for continuing use of the physical restraints shall be secured from a
481	481	physician, physician assistant, or advanced practice registered nurse prescriber
482	482	within 12 hours. Any use of physical restraints shall be noted in the resident[s
483	483	medical records. XPhysical restraintsY includes, but is not limited to, any article,
484	484	device, or garment that interferes with the free movement of the resident and that
485	485	the resident is unable to remove easily, and confinement in a locked room.
486	486	SECTION 16. 50.49 (1) (b) (intro.) of the statutes is amended to read:
487	487	50.49 (1) (b) (intro.) XHome health servicesY means the following items and
488	488	services that are furnished to an individual, who is under the care of a physician,
489	489	physician assistant, or advanced practice registered nurse prescriber, by a home
490	490	health agency, or by others under arrangements made by the home health agency,
491	491	that are under a plan for furnishing those items and services to the individual that
492	492	is established and periodically reviewed by a physician, physician assistant, or
493	493	advanced practice registered nurse prescriber and that are, except as provided in
494	494	1
495	495	2
496	496	3
497	497	4
498	498	5
499	499	6
500	500	7
501	501	8
502	502	9
503	503	10
504	504	11
505	505	12
506	506	13
507	507	14
508	508	15
509	509	16
510	510	17
511	511	18
512	512	19
513	513	20
514	514	21
515	515	22
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520	520	SECTION 16
521	521	subd. 6., provided on a visiting basis in a place of residence used as the individual[s
522	522	home:
523	523	SECTION 17. 51.41 (1d) (b) 4. of the statutes is amended to read:
524	524	51.41 (1d) (b) 4. A psychiatric mental health advanced practice registered
525	525	nurse who is suggested by the Milwaukee County board of supervisors. The
526	526	Milwaukee County board of supervisors shall solicit suggestions from organizations
527	527	including the Wisconsin Nurses Association for individuals who specialize in a full
528	528	continuum of behavioral health and medical services including emergency
529	529	detention, inpatient, residential, transitional, partial hospitalization, intensive
530	530	outpatient, and wraparound community-based services. The Milwaukee County
531	531	board of supervisors shall suggest to the Milwaukee County executive 4 psychiatric
532	532	mental health advanced practice registered nurses for this board membership
533	533	position.
534	534	SECTION 18. 70.47 (8) (intro.) of the statutes is amended to read:
535	535	70.47 (8) HEARING. (intro.) The board shall hear upon oath all persons who
536	536	appear before it in relation to the assessment. Instead of appearing in person at the
537	537	hearing, the board may allow the property owner, or the property owner [s
538	538	representative, at the request of either person, to appear before the board, under
539	539	oath, by telephone or to submit written statements, under oath, to the board. The
540	540	board shall hear upon oath, by telephone, all ill or disabled persons who present to
541	541	the board a letter from a physician, physician assistant, or advanced practice
542	542	registered nurse prescriber certified under s. 441.16 (2) licensed under ch. 441 that
543	543	confirms their illness or disability. At the request of the property owner or the
544	544	1
545	545	2
546	546	3
547	547	4
548	548	5
549	549	6
550	550	7
551	551	8
552	552	9
553	553	10
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555	555	12
556	556	13
557	557	14
558	558	15
559	559	16
560	560	17
561	561	18
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563	563	20
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565	565	22
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570	570	SECTION 18
571	571	property owner[s representative, the board may postpone and reschedule a hearing
572	572	under this subsection, but may not postpone and reschedule a hearing more than
573	573	once during the same session for the same property. The board at such hearing
574	574	shall proceed as follows:
575	575	SECTION 19. 77.54 (14) (f) 3. of the statutes is repealed.
576	576	SECTION 20. 77.54 (14) (f) 4. of the statutes is amended to read:
577	577	77.54 (14) (f) 4. An advanced practice registered nurse who may issue
578	578	prescription orders under s. 441.09 (2).
579	579	SECTION 21. 97.59 of the statutes is amended to read:
580	580	97.59 Handling foods. No person in charge of any public eating place or
581	581	other establishment where food products to be consumed by others are handled may
582	582	knowingly employ any person handling food products who has a disease in a form
583	583	that is communicable by food handling. If required by the local health officer or any
584	584	officer of the department for the purposes of an investigation, any person who is
585	585	employed in the handling of foods or is suspected of having a disease in a form that
586	586	is communicable by food handling shall submit to an examination by the officer or
587	587	by a physician, physician assistant, or advanced practice registered nurse
588	588	prescriber designated by the officer. The expense of the examination, if any, shall
589	589	be paid by the person examined. Any person knowingly infected with a disease in a
590	590	form that is communicable by food handling who handles food products to be
591	591	consumed by others and any persons knowingly employing or permitting such a
592	592	person to handle food products to be consumed by others shall be punished as
593	593	provided by s. 97.72.
594	594	1
595	595	2
596	596	3
597	597	4
598	598	5
599	599	6
600	600	7
601	601	8
602	602	9
603	603	10
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607	607	14
608	608	15
609	609	16
610	610	17
611	611	18
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613	613	20
614	614	21
615	615	22
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619	619	JPC:emw&wlj
620	620	SECTION 22
621	621	SECTION 22. 106.30 (1) of the statutes is amended to read:
622	622	106.30 (1) DEFINITION. In this section, XnurseY means a registered nurse
623	623	licensed under s. 441.06 or permitted under s. 441.08, a licensed practical nurse
624	624	licensed or permitted under s. 441.10, or an advanced practice registered nurse
625	625	prescriber certified under s. 441.16 (2), or a nurse-midwife licensed under s. 441.15
626	626	441.09.
627	627	SECTION 23. 118.15 (3) (a) of the statutes is amended to read:
628	628	118.15 (3) (a) Any child who is excused by the school board because the child
629	629	is temporarily not in proper physical or mental condition to attend a school program
630	630	but who can be expected to return to a school program upon termination or
631	631	abatement of the illness or condition. The school attendance officer may request
632	632	the parent or guardian of the child to obtain a written statement from a licensed
633	633	physician, naturopathic doctor, dentist, chiropractor, optometrist, psychologist,
634	634	physician assistant, or nurse practitioner, as defined in s. 255.06 (1) (d), or certified
635	635	advanced practice registered nurse prescriber, or registered nurse described under
636	636	s. 255.06 (1) (f) 1. or Christian Science practitioner living and residing in this state,
637	637	who is listed in the Christian Science Journal, as sufficient proof of the physical or
638	638	mental condition of the child. An excuse under this paragraph shall be in writing
639	639	and shall state the time period for which it is valid, not to exceed 30 days.
640	640	SECTION 24. 118.25 (1) (a) of the statutes is amended to read:
641	641	118.25 (1) (a) XPractitionerY means a person licensed as a physician,
642	642	naturopathic doctor, or physician assistant in any state or licensed as an advanced
643	643	practice registered nurse or certified as an advanced practice registered nurse
644	644	1
645	645	2
646	646	3
647	647	4
648	648	5
649	649	6
650	650	7
651	651	8
652	652	9
653	653	10
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655	655	12
656	656	13
657	657	14
658	658	15
659	659	16
660	660	17
661	661	18
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663	663	20
664	664	21
665	665	22
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669	669	JPC:emw&wlj
670	670	SECTION 24
671	671	prescriber in any state. In this paragraph, XphysicianY has the meaning given in s.
672	672	448.01 (5).
673	673	SECTION 25. 118.29 (1) (e) of the statutes is amended to read:
674	674	118.29 (1) (e) XPractitionerY means any physician, naturopathic doctor,
675	675	dentist, optometrist, physician assistant, advanced practice registered nurse
676	676	prescriber with prescribing authority, or podiatrist licensed in any state.
677	677	SECTION 26. 118.2915 (1) (a) of the statutes is repealed and recreated to read:
678	678	118.2915 (1) (a) XAdvanced practice registered nurseY means an individual
679	679	licensed under s. 441.09 who may issue prescription orders under s. 441.09 (2).
680	680	SECTION 27. 118.2915 (2) (a) of the statutes is amended to read:
681	681	118.2915 (2) (a) The governing body of a school may adopt a plan for the
682	682	management of pupils attending the school who have asthma. If the governing body
683	683	of a school adopts a plan under this paragraph, it shall specify in the plan the
684	684	training necessary to perform the activities under sub. (4). The governing body of a
685	685	school may not adopt a plan under this paragraph unless the plan has been
686	686	approved by a physician, an advanced practice registered nurse prescriber, or a
687	687	physician assistant.
688	688	SECTION 28. 118.2915 (3) (a) of the statutes is amended to read:
689	689	118.2915 (3) (a) A physician, an advanced practice registered nurse
690	690	prescriber, or a physician assistant may provide a prescription or standing order for
691	691	a short-acting bronchodilator or components in the name of a school that has
692	692	adopted a plan under sub. (2) (a) to be maintained by the school for use under sub.
693	693	(4).
694	694	SECTION 29. 118.2915 (4) (c) of the statutes is amended to read:
695	695	1
696	696	2
697	697	3
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702	702	8
703	703	9
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707	707	13
708	708	14
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710	710	16
711	711	17
712	712	18
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715	715	21
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722	722	SECTION 29
723	723	118.2915 (4) (c) In accordance with a prescription or standing order from a
724	724	physician, an advanced practice registered nurse prescriber, or a physician
725	725	assistant, administer a short-acting bronchodilator to a pupil or other person who
726	726	the school nurse or designated school personnel believes in good faith is
727	727	experiencing respiratory distress, regardless of whether the pupil or other person
728	728	has a prescription for a short-acting bronchodilator.
729	729	SECTION 30. 118.2915 (6) (a) (intro.) of the statutes is amended to read:
730	730	118.2915 (6) (a) (intro.) None of the following are liable for any injury that
731	731	results from the administration or self-administration of a short-acting
732	732	bronchodilator under this section, regardless of whether authorization was given by
733	733	the pupil[s parent or guardian or by the pupil[s physician, physician assistant, or
734	734	advanced practice registered nurse prescriber, unless the injury is the result of an
735	735	act or omission that constitutes gross negligence or willful or wanton misconduct:
736	736	SECTION 31. 118.2915 (6) (a) 2. of the statutes is amended to read:
737	737	118.2915 (6) (a) 2. A physician, advanced practice registered nurse prescriber,
738	738	or physician assistant who provides a prescription or standing order for a short-
739	739	acting bronchodilator or components to a school under sub. (3) (a).
740	740	SECTION 32. 118.2915 (6) (a) 3. of the statutes is amended to read:
741	741	118.2915 (6) (a) 3. A physician, advanced practice registered nurse prescriber,
742	742	physician assistant, or pharmacist who dispenses a short-acting bronchodilator or
743	743	components to a school in accordance with a prescription or standing order under
744	744	sub. (3) (a).
745	745	SECTION 33. 118.2925 (1) (b) of the statutes is repealed.
746	746	SECTION 34. 118.2925 (3) of the statutes is amended to read:
747	747	1
748	748	2
749	749	3
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753	753	7
754	754	8
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757	757	11
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759	759	13
760	760	14
761	761	15
762	762	16
763	763	17
764	764	18
765	765	19
766	766	20
767	767	21
768	768	22
769	769	23
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774	774	SECTION 34
775	775	118.2925 (3) PRESCRIPTIONS FOR SCHOOLS. A physician, an advanced practice
776	776	registered nurse prescriber who may issue prescription orders under s. 441.09 (2),
777	777	or a physician assistant may prescribe epinephrine delivery systems in the name of
778	778	a school that has adopted a plan under sub. (2) (a), to be maintained by the school
779	779	for use under sub. (4).
780	780	SECTION 35. 118.2925 (4) (c) of the statutes is amended to read:
781	781	118.2925 (4) (c) Administer an epinephrine delivery system to a pupil or other
782	782	person who the school nurse or designated school personnel in good faith believes is
783	783	experiencing anaphylaxis in accordance with a standing protocol from a physician,
784	784	an advanced practice registered nurse prescriber who may issue prescription orders
785	785	under s. 441.09 (2), or a physician assistant, regardless of whether the pupil or
786	786	other person has a prescription for an epinephrine delivery system. If the pupil or
787	787	other person does not have a prescription for an epinephrine delivery system, or the
788	788	person who administers the epinephrine delivery system does not know whether
789	789	the pupil or other person has a prescription for an epinephrine delivery system, the
790	790	person who administers the epinephrine delivery system shall, as soon as
791	791	practicable, report the administration by dialing the telephone number X911Y or, in
792	792	an area in which the telephone number X911Y is not available, the telephone
793	793	number for an emergency medical service provider.
794	794	SECTION 36. 118.2925 (5) of the statutes is amended to read:
795	795	118.2925 (5) IMMUNITY FROM CIVIL LIABILITY; EXEMPTION FROM PRACTICE OF
796	796	MEDICINE. A school and its designated school personnel, and a physician, an
797	797	advanced practice registered nurse prescriber who may issue prescription orders
798	798	under s. 441.09 (2), or a physician assistant who provides a prescription or standing
799	799	1
800	800	2
801	801	3
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803	803	5
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826	826	SECTION 36
827	827	protocol for school epinephrine delivery systems, are not liable for any injury that
828	828	results from the administration or self-administration of an epinephrine delivery
829	829	system under this section, regardless of whether authorization was given by the
830	830	pupil[s parent or guardian or by the pupil[s physician, physician assistant, or
831	831	advanced practice registered nurse prescriber, unless the injury is the result of an
832	832	act or omission that constitutes gross negligence or willful or wanton misconduct.
833	833	The immunity from liability provided under this subsection is in addition to and not
834	834	in lieu of that provided under s. 895.48.
835	835	SECTION 37. 118.294 (1) (a) of the statutes is repealed.
836	836	SECTION 38. 118.294 (1) (am) of the statutes is amended to read:
837	837	118.294 (1) (am) XAdvanced practice registered nurseY has the meaning given
838	838	in s. 154.01 (1g) means an individual licensed under s. 441.09 who may issue
839	839	prescription orders under s. 441.09 (2).
840	840	SECTION 39. 118.294 (2) of the statutes is amended to read:
841	841	118.294 (2) PRESCRIPTIONS FOR SCHOOLS. A physician, an advanced practice
842	842	registered nurse prescriber, or a physician assistant may prescribe undesignated
843	843	glucagon in the name of a school to be maintained by the school for use under sub.
844	844	(3).
845	845	SECTION 40. 118.294 (4) (a) of the statutes is amended to read:
846	846	118.294 (4) (a) A school and its school personnel, and a physician, an
847	847	advanced practice registered nurse prescriber, or a physician assistant who
848	848	provides a prescription or standing order for undesignated glucagon are not liable
849	849	for any injury that results from the administration of undesignated glucagon under
850	850	this section, regardless of whether authorization was given by the pupil[s parent or
851	851	1
852	852	2
853	853	3
854	854	4
855	855	5
856	856	6
857	857	7
858	858	8
859	859	9
860	860	10
861	861	11
862	862	12
863	863	13
864	864	14
865	865	15
866	866	16
867	867	17
868	868	18
869	869	19
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871	871	21
872	872	22
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878	878	SECTION 40
879	879	guardian or by the pupil[s diabetes provider, unless the injury is the result of an act
880	880	or omission that constitutes gross negligence or willful or wanton misconduct. The
881	881	immunity from liability provided under this paragraph is in addition to and not in
882	882	lieu of that provided under s. 895.48.
883	883	SECTION 41. 146.615 (1) (a) of the statutes is amended to read:
884	884	146.615 (1) (a) XAdvanced practice clinicianY means a physician assistant or
885	885	an advanced practice registered nurse, including a nurse practitioner, certified
886	886	nurse-midwife, clinical nurse specialist, or certified registered nurse anesthetist
887	887	licensed under s. 441.09.
888	888	SECTION 42. 146.82 (3) (a) of the statutes is amended to read:
889	889	146.82 (3) (a) Notwithstanding sub. (1), a physician, a naturopathic doctor, a
890	890	limited-scope naturopathic doctor, a physician assistant, or an advanced practice
891	891	registered nurse prescriber certified under s. 441.16 (2) licensed under s. 441.09
892	892	who treats a patient whose physical or mental condition in the physician[s,
893	893	naturopathic doctor[s, limited-scope naturopathic doctor[s, physician assistant[s, or
894	894	advanced practice nurse prescriber[s registered nurse[s judgment affects the
895	895	patient[s ability to exercise reasonable and ordinary control over a motor vehicle
896	896	may report the patient[s name and other information relevant to the condition to
897	897	the department of transportation without the informed consent of the patient.
898	898	SECTION 43. 146.89 (1) (r) 1. of the statutes is amended to read:
899	899	146.89 (1) (r) 1. Licensed as a physician under ch. 448, naturopathic doctor
900	900	under ch. 466, a dentist, dental therapist, or dental hygienist under ch. 447, a
901	901	registered nurse, practical nurse, or nurse-midwife advanced practice registered
902	902	nurse under ch. 441, an optometrist under ch. 449, a physician assistant under
903	903	1
904	904	2
905	905	3
906	906	4
907	907	5
908	908	6
909	909	7
910	910	8
911	911	9
912	912	10
913	913	11
914	914	12
915	915	13
916	916	14
917	917	15
918	918	16
919	919	17
920	920	18
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930	930	SECTION 43
931	931	subch. IX of ch. 448, a pharmacist under ch. 450, a chiropractor under ch. 446, a
932	932	podiatrist under subch. IV of ch. 448, or a physical therapist under subch. III of ch.
933	933	448.
934	934	SECTION 44. 146.89 (1) (r) 3. of the statutes is renumbered 146.89 (1) (r) 5e.
935	935	and amended to read:
936	936	146.89 (1) (r) 5e. A registered nurse practitioner, as defined in s. 255.06 (1) (d)
937	937	who holds a multistate license, as defined in s. 441.51 (2) (h), issued by a party
938	938	state, as defined in s. 441.51 (2) (k), and whose practice of professional nursing
939	939	under s. 441.001 (4) includes performance of delegated medical services under the
940	940	supervision of a physician, dentist, podiatrist, or advanced practice registered
941	941	nurse.
942	942	SECTION 45. 146.89 (1) (r) 8. of the statutes is repealed.
943	943	SECTION 46. 146.89 (6) of the statutes is amended to read:
944	944	146.89 (6) (a) While serving as a volunteer health care provider under this
945	945	section, an advanced practice registered nurse who has a certificate to issue
946	946	prescription orders under s. 441.16 (2) is considered to meet the requirements of s.
947	947	655.23, if required to comply with s. 655.23.
948	948	(b) While serving as a volunteer health care provider under this section, an
949	949	advanced practice registered nurse who has a certificate to issue prescription
950	950	orders under s. 441.16 (2) is not required to maintain in effect malpractice
951	951	insurance.
952	952	SECTION 47. 154.01 (1g) of the statutes is amended to read:
953	953	154.01 (1g) XAdvanced practice registered nurseY means a nurse an
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980	980	SECTION 47
981	981	individual licensed under ch. 441 who is currently certified by a national certifying
982	982	body approved by the board of nursing as a nurse practitioner, certified nurse-
983	983	midwife, certified registered nurse anesthetist, or clinical nurse specialist s. 441.09.
984	984	SECTION 48. 155.01 (1g) (b) of the statutes is repealed and recreated to read:
985	985	155.01 (1g) (b) An individual who is licensed as an advanced practice
986	986	registered nurse and possesses a nurse practitioner specialty designation under s.
987	987	441.09.
988	988	SECTION 49. 251.01 (1c) of the statutes is repealed and recreated to read:
989	989	251.01 (1c) XAdvanced practice registered nurseY means an individual
990	990	licensed under s. 441.09.
991	991	SECTION 50. 252.01 (1c) of the statutes is repealed.
992	992	SECTION 51. 252.07 (8) (a) 2. of the statutes is amended to read:
993	993	252.07 (8) (a) 2. The department or local health officer provides to the court a
994	994	written statement from a physician, physician assistant, or advanced practice
995	995	registered nurse prescriber that the individual has infectious tuberculosis or
996	996	suspect tuberculosis.
997	997	SECTION 52. 252.07 (9) (c) of the statutes is amended to read:
998	998	252.07 (9) (c) If the court orders confinement of an individual under this
999	999	subsection, the individual shall remain confined until the department or local
1000	1000	health officer, with the concurrence of a treating physician, physician assistant, or
1001	1001	advanced practice registered nurse prescriber, determines that treatment is
1002	1002	complete or that the individual is no longer a substantial threat to himself or herself
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1028	1028	SECTION 52
1029	1029	or to the public health. If the individual is to be confined for more than 6 months,
1030	1030	the court shall review the confinement every 6 months.
1031	1031	SECTION 53. 252.10 (7) of the statutes is amended to read:
1032	1032	252.10 (7) Drugs necessary for the treatment of mycobacterium tuberculosis
1033	1033	shall be purchased by the department from the appropriation account under s.
1034	1034	20.435 (1) (e) and dispensed to patients through the public health dispensaries,
1035	1035	local health departments, physicians, or advanced practice nurse prescribers
1036	1036	registered nurses who may issue prescription orders under s. 441.09 (2).
1037	1037	SECTION 54. 252.11 (2) of the statutes is amended to read:
1038	1038	252.11 (2) An officer of the department or a local health officer having
1039	1039	knowledge of any reported or reasonably suspected case or contact of a sexually
1040	1040	transmitted disease for which no appropriate treatment is being administered, or of
1041	1041	an actual contact of a reported case or potential contact of a reasonably suspected
1042	1042	case, shall investigate or cause the case or contact to be investigated as necessary.
1043	1043	If, following a request of an officer of the department or a local health officer, a
1044	1044	person reasonably suspected of being infected with a sexually transmitted disease
1045	1045	refuses or neglects examination by a physician, physician assistant, or advanced
1046	1046	practice registered nurse prescriber or treatment, an officer of the department or a
1047	1047	local health officer may proceed to have the person committed under sub. (5) to an
1048	1048	institution or system of care for examination, treatment, or observation.
1049	1049	SECTION 55. 252.11 (4) of the statutes is amended to read:
1050	1050	252.11 (4) If a person infected with a sexually transmitted disease ceases or
1051	1051	refuses treatment before reaching what in a physician[s, physician assistant[s, or
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1078	1078	SECTION 55
1079	1079	advanced practice nurse prescriber[s registered nurse[s opinion is the
1080	1080	noncommunicable stage, the physician, physician assistant, or advanced practice
1081	1081	registered nurse prescriber shall notify the department. The department shall
1082	1082	without delay take the necessary steps to have the person committed for treatment
1083	1083	or observation under sub. (5), or shall notify the local health officer to take these
1084	1084	steps.
1085	1085	SECTION 56. 252.11 (5) of the statutes is amended to read:
1086	1086	252.11 (5) Any court of record may commit a person infected with a sexually
1087	1087	transmitted disease to any institution or may require the person to undergo a
1088	1088	system of care for examination, treatment, or observation if the person ceases or
1089	1089	refuses examination, treatment, or observation under the supervision of a
1090	1090	physician, physician assistant, or advanced practice registered nurse prescriber.
1091	1091	The court shall summon the person to appear on a date at least 48 hours, but not
1092	1092	more than 96 hours, after service if an officer of the department or a local health
1093	1093	officer petitions the court and states the facts authorizing commitment. If the
1094	1094	person fails to appear or fails to accept commitment without reasonable cause, the
1095	1095	court may cite the person for contempt. The court may issue a warrant and may
1096	1096	direct the sheriff, any constable, or any police officer of the county immediately to
1097	1097	arrest the person and bring the person to court if the court finds that a summons
1098	1098	will be ineffectual. The court shall hear the matter of commitment summarily.
1099	1099	Commitment under this subsection continues until the disease is no longer
1100	1100	communicable or until other provisions are made for treatment that satisfy the
1101	1101	department. The certificate of the petitioning officer is prima facie evidence that
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1128	1128	SECTION 56
1129	1129	the disease is no longer communicable or that satisfactory provisions for treatment
1130	1130	have been made.
1131	1131	SECTION 57. 252.11 (7) of the statutes is amended to read:
1132	1132	252.11 (7) Reports, examinations and inspections, and all records concerning
1133	1133	sexually transmitted diseases are confidential and not open to public inspection,
1134	1134	and may not be divulged except as may be necessary for the preservation of the
1135	1135	public health, in the course of commitment proceedings under sub. (5), or as
1136	1136	provided under s. 938.296 (4) or 968.38 (4). If a physician, physician assistant, or
1137	1137	advanced practice registered nurse prescriber has reported a case of sexually
1138	1138	transmitted disease to the department under sub. (4), information regarding the
1139	1139	presence of the disease and treatment is not privileged when the patient, physician,
1140	1140	physician assistant, or advanced practice registered nurse prescriber is called upon
1141	1141	to testify to the facts before any court of record.
1142	1142	SECTION 58. 252.11 (10) of the statutes is amended to read:
1143	1143	252.11 (10) The state laboratory of hygiene shall examine specimens for the
1144	1144	diagnosis of sexually transmitted diseases for any physician, naturopathic doctor,
1145	1145	physician assistant, advanced practice registered nurse prescriber, or local health
1146	1146	officer in the state, and shall report the positive results of the examinations to the
1147	1147	local health officer and to the department. All laboratories performing tests for
1148	1148	sexually transmitted diseases shall report all positive results to the local health
1149	1149	officer and to the department, with the name of the physician, naturopathic doctor,
1150	1150	physician assistant, or advanced practice registered nurse prescriber to whom
1151	1151	reported.
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1178	1178	SECTION 59
1179	1179	SECTION 59. 252.15 (3m) (d) 11. b. and 13., (5g) (c), (5m) (d) 2. and (e) 2. and
1180	1180	3. and (7m) (intro.) and (b) of the statutes are amended to read:
1181	1181	252.15 (3m) (d) 11. b. The coroner, medical examiner, or appointed assistant
1182	1182	is investigating the cause of death of the subject of the HIV test and has contact
1183	1183	with the body fluid of the subject of the HIV test that constitutes a significant
1184	1184	exposure, if a physician, physician assistant, or advanced practice registered nurse
1185	1185	prescriber, based on information provided to the physician, physician assistant, or
1186	1186	advanced practice registered nurse prescriber, determines and certifies in writing
1187	1187	that the coroner, medical examiner, or appointed assistant has had a contact that
1188	1188	constitutes a significant exposure and if the certification accompanies the request
1189	1189	for disclosure.
1190	1190	13. If the subject of the HIV test has a positive HIV test result and is
1191	1191	deceased, by the subject[s attending physician, physician assistant, or advanced
1192	1192	practice registered nurse prescriber, to persons, if known to the physician,
1193	1193	physician assistant, or advanced practice registered nurse prescriber, with whom
1194	1194	the subject had sexual contact or shared intravenous drug use paraphernalia.
1195	1195	(5g) (c) A physician, physician assistant, or advanced practice registered
1196	1196	nurse prescriber, based on information provided to the physician, physician
1197	1197	assistant, or advanced practice registered nurse prescriber, determines and
1198	1198	certifies in writing that the person has had contact that constitutes a significant
1199	1199	exposure. The certification shall accompany the request for HIV testing and
1200	1200	disclosure. If the person is a physician, physician assistant, or advanced practice
1201	1201	registered nurse prescriber, he or she may not make this determination or
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1228	1228	SECTION 59
1229	1229	certification. The information that is provided to a physician, physician assistant,
1230	1230	or advanced practice registered nurse prescriber to document the occurrence of the
1231	1231	contact that constitutes a significant exposure and the physician[s, physician
1232	1232	assistant[s, or advanced practice nurse prescriber[s registered nurse[s certification
1233	1233	that the person has had contact that constitutes a significant exposure, shall be
1234	1234	provided on a report form that is developed by the department of safety and
1235	1235	professional services under s. 101.02 (19) (a) or on a report form that the
1236	1236	department of safety and professional services determines, under s. 101.02 (19) (b),
1237	1237	is substantially equivalent to the report form that is developed under s. 101.02 (19)
1238	1238	(a).
1239	1239	(5m) (d) 2. A physician, physician assistant, or advanced practice registered
1240	1240	nurse prescriber, based on information provided to the physician, physician
1241	1241	assistant, or advanced practice registered nurse prescriber, determines and
1242	1242	certifies in writing that the contact under subd. 1. constitutes a significant
1243	1243	exposure. A health care provider who has a contact under subd. 1. c. may not make
1244	1244	the certification under this subdivision for himself or herself.
1245	1245	(e) 2. If the contact occurs as provided under par. (d) 1. b., the attending
1246	1246	physician, physician assistant, or advanced practice registered nurse prescriber of
1247	1247	the funeral director, coroner, medical examiner, or appointed assistant.
1248	1248	3. If the contact occurs as provided under par. (d) 1. c., the physician,
1249	1249	physician assistant, or advanced practice registered nurse prescriber who makes
1250	1250	the certification under par. (d) 2.
1251	1251	(7m) REPORTING OF PERSONS SIGNIFICANTLY EXPOSED. (intro.) If a positive,
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1278	1278	SECTION 59
1279	1279	validated HIV test result is obtained from a test subject, the test subject[s
1280	1280	physician, physician assistant, or advanced practice registered nurse prescriber
1281	1281	who maintains a record of the HIV test result under sub. (4) (c) may report to the
1282	1282	state epidemiologist the name of any person known to the physician, physician
1283	1283	assistant, or advanced practice registered nurse prescriber to have had contact with
1284	1284	body fluid of the test subject that constitutes a significant exposure, only after the
1285	1285	physician, physician assistant, or advanced practice registered nurse prescriber has
1286	1286	done all of the following:
1287	1287	(b) Notified the HIV test subject that the name of any person known to the
1288	1288	physician, physician assistant, or advanced practice registered nurse prescriber to
1289	1289	have had contact with body fluid of the test subject that constitutes a significant
1290	1290	exposure will be reported to the state epidemiologist.
1291	1291	SECTION 60. 252.16 (3) (c) (intro.) of the statutes is amended to read:
1292	1292	252.16 (3) (c) (intro.) Has submitted to the department a certification from a
1293	1293	physician, as defined in s. 448.01 (5), physician assistant, or advanced practice
1294	1294	registered nurse prescriber of all of the following:
1295	1295	SECTION 61. 252.17 (3) (c) (intro.) of the statutes is amended to read:
1296	1296	252.17 (3) (c) (intro.) Has submitted to the department a certification from a
1297	1297	physician, as defined in s. 448.01 (5), physician assistant, or advanced practice
1298	1298	registered nurse prescriber of all of the following:
1299	1299	SECTION 62. 253.07 (4) (d) of the statutes is amended to read:
1300	1300	253.07 (4) (d) In each fiscal year, $31,500 as grants for employment in
1301	1301	communities of licensed registered nurses, licensed practical nurses, certified
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1328	1328	SECTION 62
1329	1329	nurse-midwives licensed advanced practice registered nurses, or licensed physician
1330	1330	assistants who are members of a racial minority.
1331	1331	SECTION 63. 253.115 (1) (f) of the statutes is created to read:
1332	1332	253.115 (1) (f) XNurse-midwifeY means an individual who is licensed as an
1333	1333	advanced practice registered nurse and possesses a certified nurse-midwife
1334	1334	specialty designation under s. 441.09.
1335	1335	SECTION 64. 253.115 (4) of the statutes is amended to read:
1336	1336	253.115 (4) SCREENING REQUIRED. Except as provided in sub. (6), the
1337	1337	physician, nurse-midwife licensed under s. 441.15, or certified professional midwife
1338	1338	licensed under s. 440.982 who attended the birth shall ensure that the infant is
1339	1339	screened for hearing loss before being discharged from a hospital, or within 30 days
1340	1340	of birth if the infant was not born in a hospital.
1341	1341	SECTION 65. 253.115 (7) (a) (intro.) of the statutes is amended to read:
1342	1342	253.115 (7) (a) (intro.) The physician, nurse-midwife licensed under s. 441.15,
1343	1343	or certified professional midwife licensed under s. 440.982 who is required to ensure
1344	1344	that the infant is screened for hearing loss under sub. (4) shall do all of the
1345	1345	following:
1346	1346	SECTION 66. 253.13 (1) of the statutes is renumbered 253.13 (1) (b) and
1347	1347	amended to read:
1348	1348	253.13 (1) (b) The attending physician or nurse licensed under s. 441.15
1349	1349	nurse-midwife shall cause every infant born in each hospital or maternity home,
1350	1350	prior to its discharge therefrom, to be subjected to tests for congenital and metabolic
1351	1351	disorders, as specified in rules promulgated by the department. If the infant is born
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1378	1378	SECTION 66
1379	1379	elsewhere than in a hospital or maternity home, the attending physician, nurse
1380	1380	licensed under s. 441.15 nurse-midwife, or birth attendant who attended the birth
1381	1381	shall cause the infant, within one week of birth, to be subjected to these tests.
1382	1382	SECTION 67. 253.13 (1) (a) of the statutes is created to read:
1383	1383	253.13 (1) (a) In this subsection, Xnurse-midwifeY means an individual who is
1384	1384	licensed as an advanced practice registered nurse and possesses a certified nurse-
1385	1385	midwife specialty designation under s. 441.09.
1386	1386	SECTION 68. 253.15 (1) (em) of the statutes is created to read:
1387	1387	253.15 (1) (em) XNurse-midwifeY means an individual who is licensed as an
1388	1388	advanced practice registered nurse and possesses a certified nurse-midwife
1389	1389	specialty designation under s. 441.09.
1390	1390	SECTION 69. 253.15 (2) of the statutes is amended to read:
1391	1391	253.15 (2) INFORMATIONAL MATERIALS. The board shall purchase or prepare
1392	1392	or arrange with a nonprofit organization to prepare printed and audiovisual
1393	1393	materials relating to shaken baby syndrome and impacted babies. The materials
1394	1394	shall include information regarding the identification and prevention of shaken
1395	1395	baby syndrome and impacted babies, the grave effects of shaking or throwing on an
1396	1396	infant or young child, appropriate ways to manage crying, fussing, or other causes
1397	1397	that can lead a person to shake or throw an infant or young child, and a discussion
1398	1398	of ways to reduce the risks that can lead a person to shake or throw an infant or
1399	1399	young child. The materials shall be prepared in English, Spanish, and other
1400	1400	languages spoken by a significant number of state residents, as determined by the
1401	1401	board. The board shall make those written and audiovisual materials available to
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1428	1428	SECTION 69
1429	1429	all hospitals, maternity homes, and nurse-midwives licensed under s. 441.15 that
1430	1430	are required to provide or make available materials to parents under sub. (3) (a) 1.,
1431	1431	to the department and to all county departments and nonprofit organizations that
1432	1432	are required to provide the materials to child care providers under sub. (4) (d), and
1433	1433	to all school boards and nonprofit organizations that are permitted to provide the
1434	1434	materials to pupils in one of grades 5 to 8 and in one of grades 10 to 12 under sub.
1435	1435	(5). The board shall also make those written materials available to all county
1436	1436	departments and Indian tribes that are providing home visitation services under s.
1437	1437	48.983 (4) (b) 1. and to all providers of prenatal, postpartum, and young child care
1438	1438	coordination services under s. 49.45 (44). The board may make available the
1439	1439	materials required under this subsection to be made available by making those
1440	1440	materials available at no charge on the board[s Internet site.
1441	1441	SECTION 70. 255.06 (1) (d) of the statutes is renumbered 255.06 (1) (f) (intro.)
1442	1442	and amended to read:
1443	1443	255.06 (1) (f) (intro.) XNurse practitionerY XWomen[s health nurse clinicianY
1444	1444	means a any of the following:
1445	1445	1. A registered nurse who is licensed under ch. 441 or who holds a multistate
1446	1446	license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.51
1447	1447	(2) (k), and whose practice of professional nursing under s. 441.001 (4) includes
1448	1448	performance of delegated medical services under the supervision of a physician,
1449	1449	naturopathic doctor, dentist, or podiatrist, or advanced practice registered nurse.
1450	1450	SECTION 71. 255.06 (1) (f) 2. of the statutes is created to read:
1451	1451	255.06 (1) (f) 2. An advanced practice registered nurse.
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1478	1478	SECTION 72
1479	1479	SECTION 72. 255.06 (2) (d) of the statutes is amended to read:
1480	1480	255.06 (2) (d) Specialized training for rural colposcopic examinations and
1481	1481	activities. Provide not more than $25,000 in each fiscal year as reimbursement for
1482	1482	the provision of specialized training of nurse practitioners women[s health nurse
1483	1483	clinicians to perform, in rural areas, colposcopic examinations and follow-up
1484	1484	activities for the treatment of cervical cancer.
1485	1485	SECTION 73. 255.07 (1) (d) of the statutes is amended to read:
1486	1486	255.07 (1) (d) XHealth care practitionerY means a physician, a physician
1487	1487	assistant, or an advanced practice registered nurse who is certified to may issue
1488	1488	prescription orders under s. 441.16 441.09 (2).
1489	1489	SECTION 74. 257.01 (5) (a) of the statutes is amended to read:
1490	1490	257.01 (5) (a) An individual who is licensed as a physician, a physician
1491	1491	assistant, or a podiatrist under ch. 448, licensed as a naturopathic doctor under ch.
1492	1492	466, licensed as a registered nurse, licensed practical nurse, or nurse-midwife
1493	1493	advanced practice registered nurse under ch. 441, licensed as a dentist or dental
1494	1494	therapist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a
1495	1495	veterinarian or certified as a veterinary technician under ch. 89, or certified as a
1496	1496	respiratory care practitioner under ch. 448.
1497	1497	SECTION 75. 257.01 (5) (b) of the statutes is amended to read:
1498	1498	257.01 (5) (b) An individual who was at any time within the previous 10 years,
1499	1499	but is not currently, licensed as a physician, a physician assistant, or a podiatrist
1500	1500	under ch. 448, licensed as a naturopathic doctor under ch. 466, licensed as a
1501	1501	registered nurse, licensed practical nurse, or nurse-midwife, advanced practice
1502	1502	registered nurse under ch. 441, licensed as a nurse-midwife under ch. 441, 2023
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1530	1530	SECTION 75
1531	1531	stats., licensed as a dentist or dental therapist under ch. 447, licensed as a
1532	1532	pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary
1533	1533	technician under ch. 89, or certified as a respiratory care practitioner under ch. 448,
1534	1534	if the individual[s license or certification was never revoked, limited, suspended, or
1535	1535	denied renewal.
1536	1536	SECTION 76. 341.14 (1a) of the statutes is amended to read:
1537	1537	341.14 (1a) If any resident of this state, who is registering or has registered
1538	1538	an automobile, or a motor truck, dual purpose motor home or dual purpose farm
1539	1539	truck which has a gross weight of not more than 8,000 pounds, a farm truck which
1540	1540	has a gross weight of not more than 12,000 pounds or a motor home, submits a
1541	1541	statement once every 4 years, as determined by the department, from a physician
1542	1542	licensed to practice medicine in any state, from an advanced practice registered
1543	1543	nurse licensed to practice nursing in any state, from a public health nurse certified
1544	1544	or licensed to practice in any state, from a physician assistant licensed or certified
1545	1545	to practice in any state, from a podiatrist licensed to practice in any state, from a
1546	1546	chiropractor licensed to practice chiropractic in any state, from a physical therapist
1547	1547	licensed to practice in any state, or from a Christian Science practitioner residing in
1548	1548	this state and listed in the Christian Science journal certifying to the department
1549	1549	that the resident is a person with a disability that limits or impairs the ability to
1550	1550	walk, the department shall procure, issue and deliver to the disabled person plates
1551	1551	of a special design in lieu of plates which ordinarily would be issued for the vehicle,
1552	1552	and shall renew the plates. The plates shall be so designed as to readily apprise law
1553	1553	enforcement officers of the fact that the vehicle is owned by a nonveteran disabled
1554	1554	person and is entitled to the parking privileges specified in s. 346.50 (2a). No
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1581	1581	JPC:emw&wlj
1582	1582	SECTION 76
1583	1583	charge in addition to the registration fee shall be made for the issuance or renewal
1584	1584	of such plates.
1585	1585	SECTION 77. 341.14 (1e) (a) of the statutes is amended to read:
1586	1586	341.14 (1e) (a) If any resident of this state, who is registering or has
1587	1587	registered a motorcycle, submits a statement once every 4 years, as determined by
1588	1588	the department, from a physician licensed to practice medicine in any state, from an
1589	1589	advanced practice registered nurse licensed to practice nursing in any state, from a
1590	1590	public health nurse certified or licensed to practice in any state, from a physician
1591	1591	assistant licensed or certified to practice in any state, from a podiatrist licensed to
1592	1592	practice in any state, from a chiropractor licensed to practice chiropractic in any
1593	1593	state, from a physical therapist licensed to practice in any state, from a Christian
1594	1594	Science practitioner residing in this state and listed in the Christian Science
1595	1595	journal, or from the U.S. department of veterans affairs certifying to the
1596	1596	department that the resident is a person with a disability that limits or impairs the
1597	1597	ability to walk, the department shall procure, issue and deliver to the disabled
1598	1598	person a plate of a special design in lieu of the plate which ordinarily would be
1599	1599	issued for the motorcycle, and shall renew the plate. The statement shall state
1600	1600	whether the disability is permanent or temporary and, if temporary, the opinion of
1601	1601	the physician, advanced practice registered nurse, public health nurse, physician
1602	1602	assistant, podiatrist, chiropractor, physical therapist, practitioner, or U.S.
1603	1603	department of veterans affairs as to the duration of the disability. The plate shall
1604	1604	be so designed as to readily apprise law enforcement officers of the fact that the
1605	1605	motorcycle is owned by a disabled person and is entitled to the parking privileges
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1631	1631	JPC:emw&wlj
1632	1632	SECTION 77
1633	1633	specified in s. 346.50 (2a). No charge in addition to the registration fee may be
1634	1634	made for the issuance or renewal of the plate.
1635	1635	SECTION 78. 341.14 (1m) of the statutes is amended to read:
1636	1636	341.14 (1m) If any licensed driver submits to the department a statement
1637	1637	once every 4 years, as determined by the department, from a physician licensed to
1638	1638	practice medicine in any state, from a public health nurse certified or licensed to
1639	1639	practice in any state, from an advanced practice registered nurse licensed to
1640	1640	practice nursing in any state, from a physician assistant licensed or certified to
1641	1641	practice in any state, from a podiatrist licensed to practice in any state, from a
1642	1642	chiropractor licensed to practice chiropractic in any state, from a physical therapist
1643	1643	licensed to practice in any state, or from a Christian Science practitioner residing in
1644	1644	this state and listed in the Christian Science journal certifying that another person
1645	1645	who is regularly dependent on the licensed driver for transportation is a person
1646	1646	with a disability that limits or impairs the ability to walk, the department shall
1647	1647	issue and deliver to the licensed driver plates of a special design in lieu of the plates
1648	1648	which ordinarily would be issued for the automobile or motor truck, dual purpose
1649	1649	motor home or dual purpose farm truck having a gross weight of not more than
1650	1650	8,000 pounds, farm truck having a gross weight of not more than 12,000 pounds or
1651	1651	motor home, and shall renew the plates. The plates shall be so designed as to
1652	1652	readily apprise law enforcement officers of the fact that the vehicle is operated by a
1653	1653	licensed driver on whom a disabled person is regularly dependent and is entitled to
1654	1654	the parking privileges specified in s. 346.50 (2a). No charge in addition to the
1655	1655	registration fee may be made for the issuance or renewal of the plates. The plates
1656	1656	shall conform to the plates required in sub. (1a).
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1684	1684	SECTION 79
1685	1685	SECTION 79. 341.14 (1q) of the statutes is amended to read:
1686	1686	341.14 (1q) If any employer who provides an automobile, or a motor truck,
1687	1687	dual purpose motor home or dual purpose farm truck which has a gross weight of
1688	1688	not more than 8,000 pounds, a farm truck which has a gross weight of not more
1689	1689	than 12,000 pounds or a motor home, for an employee[s use submits to the
1690	1690	department a statement once every 4 years, as determined by the department, from
1691	1691	a physician licensed to practice medicine in any state, from an advanced practice
1692	1692	registered nurse licensed to practice nursing in any state, from a public health
1693	1693	nurse certified or licensed to practice in any state, from a physician assistant
1694	1694	licensed or certified to practice in any state, from a podiatrist licensed to practice in
1695	1695	any state, from a physical therapist licensed to practice in any state, from a
1696	1696	chiropractor licensed to practice chiropractic in any state, or from a Christian
1697	1697	Science practitioner residing in this state and listed in the Christian Science
1698	1698	journal certifying that the employee is a person with a disability that limits or
1699	1699	impairs the ability to walk, the department shall issue and deliver to such employer
1700	1700	plates of a special design in lieu of the plates which ordinarily would be issued for
1701	1701	the vehicle, and shall renew the plates. The plates shall be so designed as to readily
1702	1702	apprise law enforcement officers of the fact that the vehicle is operated by a
1703	1703	disabled person and is entitled to the parking privileges specified in s. 346.50 (2a).
1704	1704	No charge in addition to the registration fee may be made for the issuance or
1705	1705	renewal of the plates. The plates shall conform to the plates required in sub. (1a).
1706	1706	SECTION 80. 343.16 (5) (a) of the statutes is amended to read:
1707	1707	343.16 (5) (a) The secretary may require any applicant for a license or any
1708	1708	licensed operator to submit to a special examination by such persons or agencies as
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1736	1736	SECTION 80
1737	1737	the secretary may direct to determine incompetency, physical or mental disability,
1738	1738	disease, or any other condition that might prevent such applicant or licensed person
1739	1739	from exercising reasonable and ordinary control over a motor vehicle. If the
1740	1740	department requires the applicant to submit to an examination, the applicant shall
1741	1741	pay for the examination. If the department receives an application for a renewal or
1742	1742	duplicate license after voluntary surrender under s. 343.265 or receives a report
1743	1743	from a physician, physician assistant, advanced practice registered nurse
1744	1744	prescriber certified under s. 441.16 (2) licensed under s. 441.09, or optometrist
1745	1745	under s. 146.82 (3), or if the department has a report of 2 or more arrests within a
1746	1746	one-year period for any combination of violations of s. 346.63 (1) or (5) or a local
1747	1747	ordinance in conformity with s. 346.63 (1) or (5) or a law of a federally recognized
1748	1748	American Indian tribe or band in this state in conformity with s. 346.63 (1) or (5), or
1749	1749	s. 346.63 (1m), 1985 stats., or s. 346.63 (2) or (6) or 940.25, or s. 940.09 where the
1750	1750	offense involved the use of a vehicle, the department shall determine, by interview
1751	1751	or otherwise, whether the operator should submit to an examination under this
1752	1752	section. The examination may consist of an assessment. If the examination
1753	1753	indicates that education or treatment for a disability, disease or condition
1754	1754	concerning the use of alcohol, a controlled substance or a controlled substance
1755	1755	analog is appropriate, the department may order a driver safety plan in accordance
1756	1756	with s. 343.30 (1q). If there is noncompliance with assessment or the driver safety
1757	1757	plan, the department shall revoke the person[s operating privilege in the manner
1758	1758	specified in s. 343.30 (1q) (d).
1759	1759	SECTION 81. 343.51 (1) of the statutes is amended to read:
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1786	1786	SECTION 81
1787	1787	343.51 (1) Any person who qualifies for registration plates of a special design
1788	1788	under s. 341.14 (1), (1a), (1m), or (1q) or any other person with a disability that
1789	1789	limits or impairs the ability to walk may request from the department a special
1790	1790	identification card that will entitle any motor vehicle parked by, or under the
1791	1791	direction of, the person, or a motor vehicle operated by or on behalf of the
1792	1792	organization when used to transport such a person, to parking privileges under s.
1793	1793	346.50 (2), (2a), and (3). The department shall issue the card at a fee to be
1794	1794	determined by the department, upon submission by the applicant, if the applicant
1795	1795	is an individual rather than an organization, of a statement from a physician
1796	1796	licensed to practice medicine in any state, from an advanced practice registered
1797	1797	nurse licensed to practice nursing in any state, from a public health nurse certified
1798	1798	or licensed to practice in any state, from a physician assistant licensed or certified
1799	1799	to practice in any state, from a podiatrist licensed to practice in any state, from a
1800	1800	chiropractor licensed to practice chiropractic in any state, from a physical therapist
1801	1801	licensed to practice in any state, or from a Christian Science practitioner residing in
1802	1802	this state and listed in the Christian Science journal that the person is a person
1803	1803	with a disability that limits or impairs the ability to walk. The statement shall
1804	1804	state whether the disability is permanent or temporary and, if temporary, the
1805	1805	opinion of the physician, advanced practice registered nurse, public health nurse,
1806	1806	physician assistant, podiatrist, chiropractor, physical therapist, or practitioner as to
1807	1807	the duration of the disability. The department shall issue the card upon application
1808	1808	by an organization on a form prescribed by the department if the department
1809	1809	believes that the organization meets the requirements under this subsection.
1810	1810	SECTION 82. 343.62 (4) (a) 4. of the statutes is amended to read:
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1838	1838	SECTION 82
1839	1839	343.62 (4) (a) 4. The applicant submits with the application a statement
1840	1840	completed within the immediately preceding 24 months, except as provided by rule,
1841	1841	by a physician licensed to practice medicine in any state, from an advanced practice
1842	1842	registered nurse licensed to practice nursing in any state, from a physician
1843	1843	assistant licensed or certified to practice in any state, from a podiatrist licensed to
1844	1844	practice in any state, from a chiropractor licensed to practice chiropractic in any
1845	1845	state, from a physical therapist licensed to practice in any state, or from a Christian
1846	1846	Science practitioner residing in this state, and listed in the Christian Science
1847	1847	journal certifying that, in the medical care provider[s judgment, the applicant is
1848	1848	physically fit to teach driving.
1849	1849	SECTION 83. 440.03 (13) (b) 3. of the statutes is repealed.
1850	1850	SECTION 84. 440.03 (13) (b) 39m. of the statutes is created to read:
1851	1851	440.03 (13) (b) 39m. Nurse, advanced practice registered.
1852	1852	SECTION 85. 440.03 (13) (b) 42. of the statutes is repealed.
1853	1853	SECTION 86. 440.077 (1) (a) of the statutes is amended to read:
1854	1854	440.077 (1) (a) XAdvanced practice registered nurse prescriberY means an
1855	1855	advanced practice registered nurse prescriber certified licensed under s. 441.16 (2)
1856	1856	441.09.
1857	1857	SECTION 87. 440.077 (2) (c) of the statutes is amended to read:
1858	1858	440.077 (2) (c) Under the program under par. (a), a participating military
1859	1859	medical personnel shall be supervised by a physician, physician assistant,
1860	1860	podiatrist, registered professional nurse, or advanced practice registered nurse
1861	1861	prescriber. The supervising physician, physician assistant, podiatrist, registered
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1888	1888	SECTION 87
1889	1889	professional nurse, or advanced practice registered nurse prescriber shall retain
1890	1890	responsibility for the care of the patient.
1891	1891	SECTION 88. 440.08 (2) (a) 4m. of the statutes is repealed.
1892	1892	SECTION 89. 440.08 (2) (a) 47r. of the statutes is created to read:
1893	1893	440.08 (2) (a) 47r. Nurse, advanced practice registered: March 1 of each even-
1894	1894	numbered year.
1895	1895	SECTION 90. 440.08 (2) (a) 50. of the statutes is repealed.
1896	1896	SECTION 91. 440.094 (1) (c) 1. of the statutes is amended to read:
1897	1897	440.094 (1) (c) 1. A registered nurse, licensed practical nurse, or nurse
1898	1898	midwife licensed under ch. 441, or an advanced practice registered nurse prescriber
1899	1899	certified licensed under ch. 441.
1900	1900	SECTION 92. 440.094 (2) (a) (intro.) of the statutes is amended to read:
1901	1901	440.094 (2) (a) (intro.) Notwithstanding ss. 441.06 (4), 441.15 (2), 441.16,
1902	1902	441.09 (3) (b), 446.02 (1), 447.03 (1) and (2), 448.03 (1) (a), (b), and (c) and (1m),
1903	1903	448.51 (1), 448.61, 448.76, 448.961 (1) and (2), 449.02 (1), 450.03 (1), 451.04 (1),
1904	1904	455.02 (1m), 457.04 (4), (5), (6), and (7), 459.02 (1), 459.24 (1), and 460.02, a health
1905	1905	care provider may provide services within the scope of the credential that the
1906	1906	health care provider holds and the department shall grant the health care provider
1907	1907	a temporary credential to practice under this section if all of the following apply:
1908	1908	SECTION 93. 440.981 (1) of the statutes is amended to read:
1909	1909	440.981 (1) No person may use the title Xlicensed midwife,Y describe or imply
1910	1910	that he or she is a licensed midwife, or represent himself or herself as a licensed
1911	1911	midwife unless the person is granted a license under this subchapter or is licensed
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1924	1924	13
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1932	1932	21
1933	1933	22
1934	1934	23 2025 - 2026 Legislature
1935	1935	ASSEMBLY BILL 257
1936	1936	- 40 - LRB-3063/1
1937	1937	JPC:emw&wlj
1938	1938	SECTION 93
1939	1939	as a nurse-midwife under s. 441.15 an advanced practice registered nurse and
1940	1940	possesses a certified nurse-midwife specialty designation under s. 441.09.
1941	1941	SECTION 94. 440.982 (1) of the statutes is amended to read:
1942	1942	440.982 (1) No person may engage in the practice of midwifery unless the
1943	1943	person is granted a license under this subchapter, is granted a temporary permit
1944	1944	pursuant to a rule promulgated under s. 440.984 (2m), or is licensed as a nurse-
1945	1945	midwife under s. 441.15 an advanced practice registered nurse and possesses a
1946	1946	certified nurse-midwife specialty designation under s. 441.09.
1947	1947	SECTION 95. 440.987 (2) of the statutes is amended to read:
1948	1948	440.987 (2) One member who is licensed as a nurse-midwife under s. 441.15
1949	1949	an advanced practice registered nurse and possesses a certified nurse-midwife
1950	1950	specialty designation under s. 441.09 and who practices in an out-of-hospital
1951	1951	setting.
1952	1952	SECTION 96. 441.001 (1c) of the statutes is created to read:
1953	1953	441.001 (1c) ADVANCED PRACTICE REGISTERED NURSING. XAdvanced practice
1954	1954	registered nursingY means the practice of a certified nurse-midwife, the practice of
1955	1955	a certified registered nurse anesthetist, the practice of a clinical nurse specialist,
1956	1956	and the practice of a nurse practitioner.
1957	1957	SECTION 97. 441.001 (3c) of the statutes is created to read:
1958	1958	441.001 (3c) PRACTICE OF A CERTIFIED NURSE-MIDWIFE. XPractice of a
1959	1959	certified nurse-midwifeY means practice in the management of women[s health
1960	1960	care, pregnancy, childbirth, postpartum care for newborns, family planning, and
1961	1961	1
1962	1962	2
1963	1963	3
1964	1964	4
1965	1965	5
1966	1966	6
1967	1967	7
1968	1968	8
1969	1969	9
1970	1970	10
1971	1971	11
1972	1972	12
1973	1973	13
1974	1974	14
1975	1975	15
1976	1976	16
1977	1977	17
1978	1978	18
1979	1979	19
1980	1980	20
1981	1981	21
1982	1982	22 2025 - 2026 Legislature
1983	1983	ASSEMBLY BILL 257
1984	1984	- 41 - LRB-3063/1
1985	1985	JPC:emw&wlj
1986	1986	SECTION 97
1987	1987	gynecological services consistent with the standards of practice of the American
1988	1988	College of Nurse-Midwives or its successor.
1989	1989	SECTION 98. 441.001 (3g) of the statutes is created to read:
1990	1990	441.001 (3g) PRACTICE OF A CERTIFIED REGISTERED NURSE ANESTHETIST.
1991	1991	XPractice of a certified registered nurse anesthetistY means providing anesthesia
1992	1992	care, pain management care, and care related to anesthesia and pain management
1993	1993	for persons across their lifespan, whose health status may range from healthy
1994	1994	through all levels of acuity, including persons with immediate, severe, or life-
1995	1995	threatening illness or injury, in diverse settings, including hospitals, ambulatory
1996	1996	surgery centers, outpatient clinics, medical offices, and home health care settings.
1997	1997	SECTION 99. 441.001 (3n) of the statutes is created to read:
1998	1998	441.001 (3n) PRACTICE OF A CLINICAL NURSE SPECIALIST. XPractice of a
1999	1999	clinical nurse specialistY means providing advanced nursing care, primarily in
2000	2000	health care facilities, including the diagnosis and treatment of illness for identified
2001	2001	specific populations based on a specialty.
2002	2002	SECTION 100. 441.001 (3r) of the statutes is created to read:
2003	2003	441.001 (3r) PRACTICE OF A NURSE PRACTITIONER. XPractice of a nurse
2004	2004	practitionerY means practice in ambulatory, acute, long-term, or other health care
2005	2005	settings as a primary or specialty care provider who provides health services,
2006	2006	including assessing, diagnosing, treating, or managing acute, episodic, and chronic
2007	2007	illnesses.
2008	2008	SECTION 101. 441.001 (3w) of the statutes is created to read:
2009	2009	1
2010	2010	2
2011	2011	3
2012	2012	4
2013	2013	5
2014	2014	6
2015	2015	7
2016	2016	8
2017	2017	9
2018	2018	10
2019	2019	11
2020	2020	12
2021	2021	13
2022	2022	14
2023	2023	15
2024	2024	16
2025	2025	17
2026	2026	18
2027	2027	19
2028	2028	20
2029	2029	21
2030	2030	22 2025 - 2026 Legislature
2031	2031	ASSEMBLY BILL 257
2032	2032	- 42 - LRB-3063/1
2033	2033	JPC:emw&wlj
2034	2034	SECTION 101
2035	2035	441.001 (3w) PRESCRIPTION ORDER. XPrescription orderY has the meaning
2036	2036	given in s. 450.01 (21).
2037	2037	SECTION 102. 441.001 (5) of the statutes is created to read:
2038	2038	441.001 (5) RECOGNIZED ROLE. XRecognized roleY means one of the following
2039	2039	roles:
2040	2040	(a) Certified nurse-midwife.
2041	2041	(b) Certified registered nurse anesthetist.
2042	2042	(c) Clinical nurse specialist.
2043	2043	(d) Nurse practitioner.
2044	2044	SECTION 103. 441.01 (3) of the statutes is amended to read:
2045	2045	441.01 (3) The board may promulgate rules to establish minimum standards
2046	2046	for schools for professional nurses and, schools for licensed practical nurses, and
2047	2047	schools for advanced practice registered nurses, including all related clinical units
2048	2048	and facilities, and make and provide periodic surveys and consultations to such
2049	2049	schools. It The board may also establish promulgate rules to prevent unauthorized
2050	2050	persons from practicing professional nursing. It shall approve all rules for the
2051	2051	administration of this chapter in accordance with ch. 227.
2052	2052	SECTION 104. 441.01 (4) of the statutes is amended to read:
2053	2053	441.01 (4) The board shall direct that those schools that qualify be placed on
2054	2054	a list of schools the board has approved for professional nurses or, of schools the
2055	2055	board has approved for licensed practical nurses, or of schools the board has
2056	2056	approved for advanced practice registered nurses on application and proof of
2057	2057	1
2058	2058	2
2059	2059	3
2060	2060	4
2061	2061	5
2062	2062	6
2063	2063	7
2064	2064	8
2065	2065	9
2066	2066	10
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2068	2068	12
2069	2069	13
2070	2070	14
2071	2071	15
2072	2072	16
2073	2073	17
2074	2074	18
2075	2075	19
2076	2076	20
2077	2077	21
2078	2078	22 2025 - 2026 Legislature
2079	2079	ASSEMBLY BILL 257
2080	2080	- 43 - LRB-3063/1
2081	2081	JPC:emw&wlj
2082	2082	SECTION 104
2083	2083	qualifications;, and the board shall make a study of nursing education and initiate
2084	2084	promulgate rules and policies to improve it.
2085	2085	SECTION 105. 441.01 (7) (a) (intro.) of the statutes is amended to read:
2086	2086	441.01 (7) (a) (intro.) The board shall require each applicant for the renewal of
2087	2087	a registered nurse or, licensed practical nurse, or advanced practice registered
2088	2088	nurse license issued under this chapter to do all of the following as a condition for
2089	2089	renewing the license:
2090	2090	SECTION 106. 441.01 (7) (b) of the statutes is amended to read:
2091	2091	441.01 (7) (b) The board may not renew a registered nurse or, licensed
2092	2092	practical nurse, or advanced practice registered nurse license under this chapter
2093	2093	unless the renewal applicant has completed the nursing workforce survey to the
2094	2094	satisfaction of the board. The board shall establish standards to determine whether
2095	2095	the survey has been completed. The board shall, by no later than June 30 of each
2096	2096	odd-numbered year, submit all completed nursing workforce survey forms to the
2097	2097	department of workforce development.
2098	2098	SECTION 107. 441.01 (7) (c) of the statutes is created to read:
2099	2099	441.01 (7) (c) An applicant who is renewing both a registered nurse and
2100	2100	advanced practice registered nurse license under s. 441.09 (1) (c) is only required to
2101	2101	pay a single fee under par. (a) 2.
2102	2102	SECTION 108. 441.06 (title) of the statutes is repealed and recreated to read:
2103	2103	441.06 (title) Registered nurses; civil liability exemption.
2104	2104	SECTION 109. 441.06 (3) of the statutes is amended to read:
2105	2105	441.06 (3) A Except as provided in s. 441.09 (1) (c), a registered nurse
2106	2106	1
2107	2107	2
2108	2108	3
2109	2109	4
2110	2110	5
2111	2111	6
2112	2112	7
2113	2113	8
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2118	2118	13
2119	2119	14
2120	2120	15
2121	2121	16
2122	2122	17
2123	2123	18
2124	2124	19
2125	2125	20
2126	2126	21
2127	2127	22
2128	2128	23 2025 - 2026 Legislature
2129	2129	ASSEMBLY BILL 257
2130	2130	- 44 - LRB-3063/1
2131	2131	JPC:emw&wlj
2132	2132	SECTION 109
2133	2133	practicing for compensation shall, on or before the applicable renewal date specified
2134	2134	under s. 440.08 (2) (a), submit to the board on furnished forms a statement giving
2135	2135	name, residence, and other facts that the board requires, with the nursing
2136	2136	workforce survey and fee required under s. 441.01 (7) and the applicable renewal fee
2137	2137	determined by the department under s. 440.03 (9) (a).
2138	2138	SECTION 110. 441.06 (4) of the statutes is amended to read:
2139	2139	441.06 (4) Except as provided in ss. 257.03 and 440.077, no person may
2140	2140	practice or attempt to practice professional nursing, nor use the title, letters, or
2141	2141	anything else to indicate that he or she is a registered or professional nurse unless
2142	2142	he or she is licensed under this section. Except as provided in ss. 257.03 and
2143	2143	440.077, no person not so licensed may use in connection with his or her nursing
2144	2144	employment or vocation any title or anything else to indicate that he or she is a
2145	2145	trained, certified or graduate nurse. This subsection does not apply to any
2146	2146	registered nurse who holds a multistate license, as defined in s. 441.51 (2) (h),
2147	2147	issued by a jurisdiction, other than this state, that has adopted the nurse licensure
2148	2148	compact under s. 441.51.
2149	2149	SECTION 111. 441.06 (7) of the statutes is renumbered 441.09 (7) and
2150	2150	amended to read:
2151	2151	441.09 (7) CIVIL LIABILITY. No person certified licensed as an advanced
2152	2152	practice registered nurse prescriber under s. 441.16 (2) this section is liable for civil
2153	2153	damages for any of the following:
2154	2154	(a) Reporting in good faith to the department of transportation under s.
2155	2155	146.82 (3) a patient[s name and other information relevant to a physical or mental
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2157	2157	2
2158	2158	3
2159	2159	4
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2176	2176	21
2177	2177	22
2178	2178	23 2025 - 2026 Legislature
2179	2179	ASSEMBLY BILL 257
2180	2180	- 45 - LRB-3063/1
2181	2181	JPC:emw&wlj
2182	2182	SECTION 111
2183	2183	condition of the patient that in the advanced practice nurse prescriber[s registered
2184	2184	nurse[s judgment impairs the patient[s ability to exercise reasonable and ordinary
2185	2185	control over a motor vehicle.
2186	2186	(b) In good faith, not reporting to the department of transportation under s.
2187	2187	146.82 (3) a patient[s name and other information relevant to a physical or mental
2188	2188	condition of the patient that in the advanced practice nurse prescriber[s registered
2189	2189	nurse[s judgment does not impair the patient[s ability to exercise reasonable and
2190	2190	ordinary control over a motor vehicle.
2191	2191	SECTION 112. 441.065 of the statutes is created to read:
2192	2192	441.065 Use of titles. (1) Except as provided in sub. (2), no person licensed
2193	2193	under this chapter may use, assume, or append to his or her name any title that is
2194	2194	not granted under this chapter unless the person holds another credential, as
2195	2195	defined in s. 440.01 (2) (a), that entitles the person to use, assume, or append to his
2196	2196	or her name the title or the person is permitted to use, assume, or append to his or
2197	2197	her name the title under any law of this state.
2198	2198	(2) (a) Subsection (1) does not prohibit a person who holds a doctorate degree
2199	2199	from using, assuming, or appending to his or her name the title XdoctorY or any
2200	2200	other words, letters, or abbreviations that represent that the person holds that
2201	2201	doctorate degree or the field in which the degree was received. If a person to whom
2202	2202	this paragraph applies uses, assumes, or appends to his or her name the title
2203	2203	Xdoctor,Y the person shall also use, assume, or append to his or her name words,
2204	2204	letters, or abbreviations that represent the field in which the person received the
2205	2205	doctorate degree.
2206	2206	(b) Subsection (1) does not prohibit a person who holds a bachelor[s degree or
2207	2207	1
2208	2208	2
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2228	2228	22
2229	2229	23
2230	2230	24 2025 - 2026 Legislature
2231	2231	ASSEMBLY BILL 257
2232	2232	- 46 - LRB-3063/1
2233	2233	JPC:emw&wlj
2234	2234	SECTION 112
2235	2235	master[s degree from using, assuming, or appending to his or her name any words,
2236	2236	letters, or abbreviations that represent that the person holds that degree or the
2237	2237	field in which the degree was received.
2238	2238	SECTION 113. 441.07 (1g) (intro.), (a), (c) and (e) of the statutes are amended
2239	2239	to read:
2240	2240	441.07 (1g) (intro.) Subject to the rules promulgated under s. 440.03 (1), the
2241	2241	board may deny an initial license or revoke, limit, suspend, or deny the renewal of a
2242	2242	license of a registered nurse, nurse-midwife advanced practice registered nurse, or
2243	2243	licensed practical nurse; deny an initial certificate or revoke, limit, suspend, or deny
2244	2244	the renewal of a certificate to prescribe drugs or devices granted under s. 441.16; or
2245	2245	reprimand a registered nurse, nurse-midwife advanced practice registered nurse,
2246	2246	or licensed practical nurse, if the board finds that the applicant or licensee
2247	2247	committed any of the following:
2248	2248	(a) Fraud in the procuring or renewal of the certificate or license.
2249	2249	(c) Acts which that show the registered nurse, nurse-midwife advanced
2250	2250	practice registered nurse, or licensed practical nurse to be unfit or incompetent by
2251	2251	reason of negligence, abuse of alcohol or other drugs, or mental incompetency.
2252	2252	(e) A violation of any state or federal law that regulates prescribing or
2253	2253	dispensing drugs or devices, if the person has a certificate to prescribe drugs or
2254	2254	devices under s. 441.16 may issue prescription orders under s. 441.09 (2).
2255	2255	SECTION 114. 441.07 (1r) of the statutes is created to read:
2256	2256	441.07 (1r) If the board finds that a person licensed under this chapter has
2257	2257	violated s. 441.065, the board shall discipline the person as follows:
2258	2258	(a) For a 1st violation, issue a written warning.
2259	2259	1
2260	2260	2
2261	2261	3
2262	2262	4
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2280	2280	22
2281	2281	23
2282	2282	24 2025 - 2026 Legislature
2283	2283	ASSEMBLY BILL 257
2284	2284	- 47 - LRB-3063/1
2285	2285	JPC:emw&wlj
2286	2286	SECTION 114
2287	2287	(b) For a 2nd violation, suspend the license of the person.
2288	2288	(c) For a 3rd violation, revoke the license of the person.
2289	2289	SECTION 115. 441.07 (2) of the statutes is amended to read:
2290	2290	441.07 (2) The board may reinstate a revoked license, no earlier than one year
2291	2291	following revocation, upon receipt of an application for reinstatement. This
2292	2292	subsection does not apply to a license that is revoked under sub. (1r) or s. 440.12.
2293	2293	SECTION 116. 441.09 of the statutes is created to read:
2294	2294	441.09 Advanced practice registered nurses; civil liability exemption.
2295	2295	(1) LICENSE. (a) An applicant who satisfies all of the following requirements may
2296	2296	apply to the board for initial licensure by the board as an advanced practice
2297	2297	registered nurse:
2298	2298	1. The applicant satisfies one of the following criteria:
2299	2299	a. The applicant holds a valid license to practice as a registered nurse issued
2300	2300	under s. 441.06 (1), (1c), or (1m).
2301	2301	b. The applicant applies concurrently for a license under s. 441.06 (1), (1c), or
2302	2302	(1m) with the application for a license under this paragraph.
2303	2303	c. The applicant is a registered nurse who holds a multistate license, as
2304	2304	defined in s. 441.51 (2) (h), issued by a jurisdiction, other than this state, that has
2305	2305	adopted the nurse licensure compact.
2306	2306	2. The applicant provides evidence satisfactory to the board that he or she
2307	2307	satisfies one of the following criteria:
2308	2308	a. The applicant has completed a graduate-level or postgraduate-level
2309	2309	education program that is approved by the board and that prepares the applicant
2310	2310	for the practice of advanced practice registered nursing in one of the 4 recognized
2311	2311	1
2312	2312	2
2313	2313	3
2314	2314	4
2315	2315	5
2316	2316	6
2317	2317	7
2318	2318	8
2319	2319	9
2320	2320	10
2321	2321	11
2322	2322	12
2323	2323	13
2324	2324	14
2325	2325	15
2326	2326	16
2327	2327	17
2328	2328	18
2329	2329	19
2330	2330	20
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2332	2332	22
2333	2333	23
2334	2334	24 2025 - 2026 Legislature
2335	2335	ASSEMBLY BILL 257
2336	2336	- 48 - LRB-3063/1
2337	2337	JPC:emw&wlj
2338	2338	SECTION 116
2339	2339	roles, and the applicant holds a current certification by a national certifying body
2340	2340	approved by the board.
2341	2341	b. On January 1, 2026, the applicant was licensed as a registered nurse in this
2342	2342	state and was practicing in a recognized role, and the applicant satisfies additional
2343	2343	criteria established by the board by rule under sub. (6) (a) 3. relating to practice,
2344	2344	education, or certification.
2345	2345	3. The applicant pays the fee specified under s. 440.05 (1).
2346	2346	4. The applicant provides to the board evidence of any malpractice liability
2347	2347	insurance coverage required under sub. (5).
2348	2348	5. If the applicant is applying to receive a certified nurse-midwife specialty
2349	2349	designation under par. (b) 1., the applicant does all of the following:
2350	2350	a. Provides evidence satisfactory to the board that the applicant is currently
2351	2351	certified by the American Midwifery Certification Board or its successor.
2352	2352	b. Files with the board any plan required under sub. (3m) (f).
2353	2353	6. The applicant does not have an arrest or conviction record, subject to ss.
2354	2354	111.321, 111.322, and 111.335.
2355	2355	7. The applicant meets any other criteria established by the board by rule
2356	2356	under sub. (6) (a) 3. relating to the education, training, or experience required for
2357	2357	each recognized role.
2358	2358	(b) 1. a. Subject to subd. 3. and s. 441.07 (1g), the board shall grant an
2359	2359	advanced practice registered nurse license to an applicant the board determines
2360	2360	meets the requirements under par. (a). The board shall also grant a person who is
2361	2361	granted a license under this subd. 1. a. one or more specialty designations
2362	2362	1
2363	2363	2
2364	2364	3
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2383	2383	22
2384	2384	23 2025 - 2026 Legislature
2385	2385	ASSEMBLY BILL 257
2386	2386	- 49 - LRB-3063/1
2387	2387	JPC:emw&wlj
2388	2388	SECTION 116
2389	2389	corresponding to the recognized roles for which the board determines that the
2390	2390	person qualifies based on the person[s qualifications under par. (a).
2391	2391	b. The board shall grant an advanced practice registered nurse license to each
2392	2392	individual who, on the day before the effective date of this subd. 1. b. .... [LRB
2393	2393	inserts date], was certified to issue prescription orders under s. 441.16, 2023 stats.
2394	2394	The board shall also grant a person who is granted a license under this subd. 1. b.
2395	2395	one or more specialty designations corresponding to the recognized roles for which
2396	2396	the board determines that the person qualifies based on the person[s qualifications.
2397	2397	c. The board shall grant an advanced practice registered nurse license to each
2398	2398	individual who, on the day before the effective date of this subd. 1. c. .... [LRB
2399	2399	inserts date], was licensed as a nurse-midwife under s. 441.15, 2023 stats. The
2400	2400	board shall also grant a person who is granted a license under this subd. 1. c. a
2401	2401	nurse-midwife specialty designation.
2402	2402	2. Each specialty designation granted under subd. 1. shall appear on the
2403	2403	person[s advanced practice registered nurse license.
2404	2404	3. The board may not grant an advanced practice registered nurse license to a
2405	2405	person applying concurrently for a license under s. 441.06 (1), (1c), or (1m), unless
2406	2406	the board also grants the person the license under s. 441.06 (1), (1c), or (1m).
2407	2407	4. The board may place specific limitations on a person licensed as an
2408	2408	advanced practice registered nurse as a condition of licensure.
2409	2409	5. If all of the following apply to a person, a notation indicating that the person
2410	2410	may not issue prescription orders shall appear on the person[s advanced practice
2411	2411	registered nurse license:
2412	2412	1
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2414	2414	3
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2435	2435	ASSEMBLY BILL 257
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2437	2437	JPC:emw&wlj
2438	2438	SECTION 116
2439	2439	a. The person is granted an advanced practice registered nurse license under
2440	2440	subd. 1. a. and satisfies only par. (a) 2. b. but not par. (a) 2. a., or the person is
2441	2441	granted an advanced practice registered nurse license under subd. 1. c.
2442	2442	b. On January 1, 2026, the person did not hold a certificate under s. 441.16
2443	2443	(2), 2023 stats.
2444	2444	(c) On or before the applicable renewal date specified under s. 440.08 (2) (a),
2445	2445	an advanced practice registered nurse shall submit to the board on a form
2446	2446	furnished by the board a statement giving his or her name and residence, the
2447	2447	nursing workforce survey and fee required under s. 441.01 (7), evidence of having
2448	2448	satisfied the continuing education requirements under sub. (4), evidence of any
2449	2449	malpractice liability insurance coverage required under sub. (5), any plan required
2450	2450	under sub. (3m) (f), current evidence that the person satisfies each of the
2451	2451	requirements under par. (a) 1., 2., 5. a., and 7. that apply with respect to the person,
2452	2452	and any other information that the board requires by rule, with the applicable
2453	2453	renewal fee determined by the department under s. 440.03 (9) (a). The board shall
2454	2454	grant to a person who satisfies the requirements under this paragraph the renewal
2455	2455	of his or her advanced practice registered nurse license and specialty designations
2456	2456	granted under par. (b) 1. and shall, if the person holds a license under s. 441.06 (1),
2457	2457	(1c), or (1m), also grant the renewal of that license.
2458	2458	(2) PRESCRIBING AUTHORITY. (a) Except as provided in par. (b), an advanced
2459	2459	practice registered nurse may issue prescription orders, subject to the rules
2460	2460	promulgated under sub. (6) (a) 1. and 4., and may provide expedited partner
2461	2461	therapy in the manner described in s. 441.092.
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2485	2485	ASSEMBLY BILL 257
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2488	2488	SECTION 116
2489	2489	(b) An advanced practice registered nurse may not issue prescription orders if
2490	2490	a notation under sub. (1) (b) 5. indicating that the advanced practice registered
2491	2491	nurse may not issue prescription orders appears on the advanced practice
2492	2492	registered nurse[s license.
2493	2493	(3) LICENSE REQUIRED; USE OF TITLES. (a) 1. The holder of a license issued
2494	2494	under this section is an Xadvanced practice registered nurse,Y may append to his or
2495	2495	her name the title XA.P.R.N.,Y and is authorized to practice advanced practice
2496	2496	registered nursing.
2497	2497	2. The holder of a specialty designation for a recognized role granted under
2498	2498	sub. (1) (b) 1. may append to his or her name the title and an abbreviation
2499	2499	corresponding to that recognized role.
2500	2500	(b) 1. Except as provided in sub. (3m) (e) and s. 257.03, no person may practice
2501	2501	or attempt to practice advanced practice registered nursing, nor use the title
2502	2502	Xadvanced practice registered nurse,Y the title XA.P.R.N.,Y or anything else to
2503	2503	indicate that he or she is an advanced practice registered nurse unless he or she is
2504	2504	licensed under this section.
2505	2505	2. Except as provided in s. 257.03, no person may do any of the following:
2506	2506	a. Use the title Xcertified nurse-midwife,Y the title XC.N.M.,Y or anything else
2507	2507	to indicate that he or she is a certified nurse-midwife unless he or she has been
2508	2508	granted a certified nurse-midwife specialty designation under sub. (1) (b) 1.
2509	2509	b. Use the title Xcertified registered nurse anesthetist,Y the title XC.R.N.A.,Y
2510	2510	or anything else to indicate that he or she is a certified registered nurse anesthetist
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2533	2533	ASSEMBLY BILL 257
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2535	2535	JPC:emw&wlj
2536	2536	SECTION 116
2537	2537	unless he or she has been granted a certified registered nurse anesthetist specialty
2538	2538	designation under sub. (1) (b) 1.
2539	2539	c. Use the title Xclinical nurse specialist,Y the title XC.N.S.,Y or anything else
2540	2540	to indicate that he or she is a clinical nurse specialist unless he or she has been
2541	2541	granted a clinical nurse specialist specialty designation under sub. (1) (b) 1.
2542	2542	d. Use the title Xnurse practitioner,Y the title XN.P.,Y or anything else to
2543	2543	indicate that he or she is a nurse practitioner unless he or she has been granted a
2544	2544	nurse practitioner specialty designation under sub. (1) (b) 1.
2545	2545	(3m) PRACTICE REQUIREMENTS AND LIMITATIONS. (a) 1. An advanced practice
2546	2546	registered nurse licensed under this section may, except as provided in subd. 2. and
2547	2547	par. (b), practice advanced practice registered nursing only in collaboration with a
2548	2548	physician or dentist.
2549	2549	2. Subdivision 1. does not apply to an advanced practice registered nurse with
2550	2550	a certified nurse-midwife specialty designation.
2551	2551	(b) An advanced practice registered nurse to whom par. (a) 1. applies may,
2552	2552	except as provided in pars. (bg) 1. and (c), practice advanced practice registered
2553	2553	nursing in a recognized role without being supervised by or collaborating with, and
2554	2554	independent of, a physician or dentist if the board verifies, upon application of the
2555	2555	advanced practice registered nurse, that the advanced practice registered nurse
2556	2556	satisfies all of the following:
2557	2557	1. The advanced practice registered nurse has completed 3,840 hours of
2558	2558	professional nursing in a clinical setting. Clinical hours completed as a
2559	2559	requirement of a nursing program offered by a qualifying school of nursing under s.
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2586	2586	SECTION 116
2587	2587	441.06 (1) (c) may be used to satisfy the requirement under this subdivision. Hours
2588	2588	completed to satisfy a requirement of an education program described in sub. (1) (a)
2589	2589	2. a. may not be used to satisfy the requirement under this subdivision.
2590	2590	2. At least 24 months have elapsed since the advanced practice registered
2591	2591	nurse first began completing the clinical hours required by a nursing program
2592	2592	described under subd. 1.
2593	2593	3. The advanced practice registered nurse has completed 3,840 clinical hours
2594	2594	of advanced practice registered nursing practice in that recognized role while
2595	2595	working with a physician or dentist who was immediately available for consultation
2596	2596	and accepted responsibility for the actions of the advanced practice registered nurse
2597	2597	during those 3,840 hours of practice. The advanced practice registered nurse may
2598	2598	substitute additional hours of advanced practice registered nursing working with a
2599	2599	physician or dentist described under this subdivision to count toward the
2600	2600	requirement under subd. 1. Each such additional hour shall count toward one hour
2601	2601	of the requirement under subd. 1.
2602	2602	4. At least 24 months have elapsed since the advanced practice registered
2603	2603	nurse first began practicing advanced practice registered nursing in that
2604	2604	recognized role as described under subd. 3.
2605	2605	(bd) For purposes of par. (b) 3., hours of advanced practice registered nursing
2606	2606	practice may include the lawful practice of advanced practice registered nursing
2607	2607	outside this state or the lawful practice of advanced practice registered nursing in
2608	2608	this state prior to the effective date of this paragraph .... [LRB inserts date].
2609	2609	(bg) 1. An advanced practice registered nurse may provide treatment of pain
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2635	2635	JPC:emw&wlj
2636	2636	SECTION 116
2637	2637	syndromes, as defined in s. 50.60 (5), through the use of invasive techniques only
2638	2638	while working in a collaborative relationship with a physician who, through
2639	2639	education, training, and experience, specializes in pain management. Except as
2640	2640	provided in subd. 2., this subdivision applies regardless of whether the advanced
2641	2641	practice registered nurse has qualified for independent practice under par. (b).
2642	2642	2. Except as provided in par. (c), subd. 1. does not apply to an advanced
2643	2643	practice registered nurse who is providing treatment of pain syndromes, as defined
2644	2644	in s. 50.60 (5), through the use of invasive techniques in a hospital, as defined in s.
2645	2645	50.33 (2), or in a clinic associated with a hospital, and who has qualified for
2646	2646	independent practice under par. (b).
2647	2647	3. Except as provided in par. (c), subd. 1. does not apply to an advanced
2648	2648	practice registered nurse who has qualified for independent practice under par. (b)
2649	2649	and has privileges in a hospital, as defined in s. 50.33 (2), to provide treatment of
2650	2650	pain syndromes, as defined in s. 50.60 (5), through the use of invasive techniques
2651	2651	without a collaborative relationship with a physician.
2652	2652	(bm) For purposes of pars. (a) 1. and (bg) 1., a collaborative relationship is a
2653	2653	process in which an advanced practice registered nurse is working with a physician
2654	2654	or dentist, in each other[s presence when necessary, to deliver health care services
2655	2655	within the scope of the advanced practice registered nurse[s training, education,
2656	2656	and experience. The advanced practice registered nurse shall document such a
2657	2657	collaborative relationship.
2658	2658	(c) Nothing in this section prohibits an entity employing or with a relationship
2659	2659	with an advanced practice registered nurse from establishing additional
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2685	2685	JPC:emw&wlj
2686	2686	SECTION 116
2687	2687	requirements for an advanced practice registered nurse as a condition of
2688	2688	employment or relationship.
2689	2689	(d) An advanced practice registered nurse shall adhere to professional
2690	2690	standards when managing situations that are beyond the advanced practice
2691	2691	registered nurse[s expertise. If a particular patient[s needs are beyond the
2692	2692	advanced practice registered nurse[s expertise, the advanced practice registered
2693	2693	nurse shall, as warranted by the patient[s needs, consult or collaborate with or refer
2694	2694	the patient to at least one of the following:
2695	2695	1. A physician licensed under ch. 448.
2696	2696	2. Another health care provider for whom the advanced practice registered
2697	2697	nurse has reasonable evidence of having a scope of practice that includes the
2698	2698	authorization to address the patient[s needs.
2699	2699	(e) An advanced practice registered nurse licensed under this section may
2700	2700	delegate a task or order to another clinically trained health care worker if the task
2701	2701	or order is within the scope of the advanced practice registered nurse[s practice, the
2702	2702	advanced practice registered nurse is competent to perform the task or issue the
2703	2703	order, and the advanced practice registered nurse has reasonable evidence that the
2704	2704	health care worker is minimally competent to perform the task or issue the order
2705	2705	under the circumstances.
2706	2706	(f) An advanced practice registered nurse with a certified nurse-midwife
2707	2707	specialty designation may not offer to deliver babies outside of a hospital setting
2708	2708	unless the advanced practice registered nurse files with the board, and the board
2709	2709	approves, a proactive plan for ensuring appropriate care or care transitions
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2733	2733	ASSEMBLY BILL 257
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2735	2735	JPC:emw&wlj
2736	2736	SECTION 116
2737	2737	conforming with professional standards for patients with higher acuity or
2738	2738	emergency care needs that exceed the advanced practice registered nurse[s scope of
2739	2739	practice. An advanced practice registered nurse who offers to deliver babies outside
2740	2740	of a hospital setting shall file a plan under this paragraph when applying for an
2741	2741	initial license under this section or a renewal of a license under this section, shall
2742	2742	keep the plan current with the board, and shall follow the plan.
2743	2743	(4) CONTINUING EDUCATION. Every advanced practice registered nurse shall
2744	2744	submit to the board evidence of having completed at least 16 contact hours per
2745	2745	biennium in clinical pharmacology or therapeutics relevant to the advanced
2746	2746	practice registered nurse[s area of practice. The board may promulgate rules
2747	2747	regarding the continuing education requirements under this subsection.
2748	2748	(5) MALPRACTICE LIABILITY INSURANCE. No person may practice advanced
2749	2749	practice registered nursing unless he or she at all times has in effect malpractice
2750	2750	liability insurance coverage evidenced by personal liability coverage in the amounts
2751	2751	specified for health care providers under s. 655.23 (4) or coverage under a group
2752	2752	liability policy providing individual coverage for the person in the amounts
2753	2753	specified under s. 655.23 (4). An advanced practice registered nurse shall submit
2754	2754	evidence of that coverage to the board when applying for an initial license under
2755	2755	this section or a renewal of a license under this section. An advanced practice
2756	2756	registered nurse shall also submit such evidence to the board upon request of the
2757	2757	board.
2758	2758	(6) RULES. (a) The board shall promulgate rules necessary to administer this
2759	2759	section, including rules for all of the following:
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2785	2785	JPC:emw&wlj
2786	2786	SECTION 116
2787	2787	1. Further defining the scope of practice of an advanced practice registered
2788	2788	nurse, practice of a certified nurse-midwife, practice of a certified registered nurse
2789	2789	anesthetist, practice of a nurse practitioner, and practice of a clinical nurse
2790	2790	specialist and defining the scope of practice within which an advanced practice
2791	2791	registered nurse may issue prescription orders under sub. (2).
2792	2792	2. Determining acceptable national certification for purposes of sub. (1) (a) 2.
2793	2793	a.
2794	2794	3. Establishing the appropriate education, training, or experience
2795	2795	requirements that a registered nurse must satisfy in order to be an advanced
2796	2796	practice registered nurse and to obtain each specialty designation corresponding to
2797	2797	the recognized roles.
2798	2798	4. Specifying the classes of drugs, individual drugs, or devices that may not be
2799	2799	prescribed by an advanced practice registered nurse under sub. (2).
2800	2800	5. Specifying the conditions to be met for registered nurses to do the following:
2801	2801	a. Administer a drug prescribed by an advanced practice registered nurse.
2802	2802	b. Administer a drug at the direction of an advanced practice registered nurse.
2803	2803	6. Establishing standards of professional conduct for advanced practice
2804	2804	registered nurses generally and for practicing in each recognized role.
2805	2805	(am) The board may promulgate rules to implement sub. (3m) (b).
2806	2806	(b) The board may not promulgate rules that expand the scope of practice of
2807	2807	an advanced practice registered nurse beyond the practices within advanced
2808	2808	practice registered nursing.
2809	2809	SECTION 117. 441.092 of the statutes is created to read:
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2836	2836	SECTION 117
2837	2837	441.092 Expedited partner therapy. (1) In this section:
2838	2838	(b) XAntimicrobial drugY has the meaning given in s. 448.035 (1) (b).
2839	2839	(c) XExpedited partner therapyY has the meaning given in s. 448.035 (1) (c).
2840	2840	(2) Notwithstanding the requirements of s. 448.9785, an advanced practice
2841	2841	registered nurse who may issue prescription orders under s. 441.09 (2) may provide
2842	2842	expedited partner therapy if a patient is diagnosed as infected with a chlamydial
2843	2843	infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with
2844	2844	a sexual partner during which the chlamydial infection, gonorrhea, or
2845	2845	trichomoniasis may have been transmitted to or from the sexual partner. The
2846	2846	advanced practice registered nurse shall attempt to obtain the name of the patient[s
2847	2847	sexual partner. A prescription order for an antimicrobial drug prepared under this
2848	2848	subsection shall include the name and address of the patient[s sexual partner, if
2849	2849	known. If the advanced practice registered nurse is unable to obtain the name of
2850	2850	the patient[s sexual partner, the prescription order shall include, in ordinary, bold-
2851	2851	faced capital letters, the words, Xexpedited partner therapyY or the letters XEPT.Y
2852	2852	(3) The advanced practice registered nurse shall provide the patient with a
2853	2853	copy of the information sheet prepared by the department of health services under
2854	2854	s. 46.03 (44) and shall request that the patient give the information sheet to the
2855	2855	person with whom the patient had sexual contact.
2856	2856	(4) (a) Except as provided in par. (b), an advanced practice registered nurse is
2857	2857	immune from civil liability for injury to or the death of a person who takes any
2858	2858	antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished
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2884	2884	SECTION 117
2885	2885	under this section and if expedited partner therapy is provided as specified under
2886	2886	this section.
2887	2887	(b) The immunity under par. (a) does not extend to the donation, distribution,
2888	2888	furnishing, or dispensing of an antimicrobial drug by an advanced practice
2889	2889	registered nurse whose act or omission involves reckless, wanton, or intentional
2890	2890	misconduct.
2891	2891	SECTION 118. 441.10 (7) of the statutes is amended to read:
2892	2892	441.10 (7) No license is required for practical nursing, but, except as provided
2893	2893	in s. 257.03, no person without a license may hold himself or herself out as a
2894	2894	licensed practical nurse or licensed attendant, use the title or letters XTrained
2895	2895	Practical NurseY or XT.P.N.Y, XLicensed Practical NurseY or XL.P.N.Y, XLicensed
2896	2896	AttendantY or XL.A.Y, XTrained AttendantY or XT.A.Y, or otherwise seek to indicate
2897	2897	that he or she is a licensed practical nurse or licensed attendant. No licensed
2898	2898	practical nurse or licensed attendant may use the title, or otherwise seek to act as a
2899	2899	registered, licensed, graduate or professional nurse. Anyone violating this
2900	2900	subsection shall be subject to the penalties prescribed by s. 441.13. The board shall
2901	2901	grant without examination a license as a licensed practical nurse to any person who
2902	2902	was on July 1, 1949, a licensed attendant. This subsection does not apply to any
2903	2903	licensed practical nurse who holds a multistate license, as defined in s. 441.51 (2)
2904	2904	(h), issued by a jurisdiction, other than this state, that has adopted the nurse
2905	2905	licensure compact under s. 441.51.
2906	2906	SECTION 119. 441.11 (title) of the statutes is repealed.
2907	2907	SECTION 120. 441.11 (1) of the statutes is repealed.
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2934	2934	SECTION 121
2935	2935	SECTION 121. 441.11 (2) of the statutes is renumbered 441.09 (5m) and
2936	2936	amended to read:
2937	2937	441.09 (5m) LICENSURE EXEMPTION. The provisions of s. 448.04 (1) (g) 448.03
2938	2938	(1) (d) do not apply to a an advanced practice registered nurse licensed under this
2939	2939	section who possesses a certified registered nurse anesthetist specialty designation
2940	2940	under sub. (1) (b) 1. or to a person who engages in the practice of a nurse anesthetist
2941	2941	while performing official duties for the armed services or federal health services of
2942	2942	the United States.
2943	2943	SECTION 122. 441.11 (3) of the statutes is repealed.
2944	2944	SECTION 123. 441.15 of the statutes is repealed.
2945	2945	SECTION 124. 441.16 of the statutes is repealed.
2946	2946	SECTION 125. 441.18 (2) (a) (intro.) of the statutes is amended to read:
2947	2947	441.18 (2) (a) (intro.) An advanced practice registered nurse certified to who
2948	2948	may issue prescription orders under s. 441.16 441.09 (2) may do any of the
2949	2949	following:
2950	2950	SECTION 126. 441.18 (2) (b) of the statutes is amended to read:
2951	2951	441.18 (2) (b) An advanced practice registered nurse who prescribes or
2952	2952	delivers an opioid antagonist under par. (a) 1. shall ensure that the person to whom
2953	2953	the opioid antagonist is prescribed has or has the capacity to provide the knowledge
2954	2954	and training necessary to safely administer the opioid antagonist to an individual
2955	2955	undergoing an opioid-related overdose and that the person demonstrates the
2956	2956	capacity to ensure that any individual to whom the person further delivers the
2957	2957	opioid antagonist has or receives that knowledge and training.
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2984	2984	SECTION 127
2985	2985	SECTION 127. 441.18 (3) of the statutes is amended to read:
2986	2986	441.18 (3) An advanced practice registered nurse who, acting in good faith,
2987	2987	prescribes or delivers an opioid antagonist in accordance with sub. (2), or who,
2988	2988	acting in good faith, otherwise lawfully prescribes or dispenses an opioid
2989	2989	antagonist, shall be immune from criminal or civil liability and may not be subject
2990	2990	to professional discipline under s. 441.07 for any outcomes resulting from
2991	2991	prescribing, delivering, or dispensing the opioid antagonist.
2992	2992	SECTION 128. 441.19 of the statutes is repealed.
2993	2993	SECTION 129. 448.03 (2) (a) of the statutes is amended to read:
2994	2994	448.03 (2) (a) Any person lawfully practicing within the scope of a license,
2995	2995	permit, registration, certificate, or certification granted to practice midwifery
2996	2996	under subch. XIII of ch. 440, to practice professional or, practical, or advanced
2997	2997	practice registered nursing or nurse-midwifery under ch. 441, to practice
2998	2998	chiropractic under ch. 446, to practice dentistry, dental therapy, or dental hygiene
2999	2999	or as an expanded function dental auxiliary under ch. 447, to practice optometry
3000	3000	under ch. 449, to practice as a physician assistant under subch. IX, to practice
3001	3001	acupuncture under ch. 451 or under any other statutory provision, to practice
3002	3002	naturopathic medicine under ch. 466, or as otherwise provided by statute.
3003	3003	SECTION 130. 448.035 (1) (a) of the statutes is repealed.
3004	3004	SECTION 131. 448.035 (2) to (4) of the statutes are amended to read:
3005	3005	448.035 (2) Notwithstanding the requirements of s. 448.30, a physician or
3006	3006	certified advanced practice nurse prescriber may provide expedited partner
3007	3007	therapy if the patient is diagnosed as infected with a chlamydial infection,
3008	3008	gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual
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3036	3036	SECTION 131
3037	3037	partner during which the chlamydial infection, gonorrhea, or trichomoniasis may
3038	3038	have been transmitted to or from the sexual partner. The physician or certified
3039	3039	advanced practice nurse prescriber shall attempt to obtain the name of the patient[s
3040	3040	sexual partner. A prescription order for an antimicrobial drug prepared under this
3041	3041	subsection shall include the name and address of the patient[s sexual partner, if
3042	3042	known. If the physician or certified advanced practice nurse prescriber is unable to
3043	3043	obtain the name of the patient[s sexual partner, the prescription order shall
3044	3044	include, in ordinary bold-faced capital letters, the words, Xexpedited partner
3045	3045	therapyY or the letters XEPT.Y
3046	3046	(3) The physician or certified advanced practice nurse prescriber shall
3047	3047	provide the patient with a copy of the information sheet prepared by the
3048	3048	department of health services under s. 46.03 (44) and shall request that the patient
3049	3049	give the information sheet to the person with whom the patient had sexual contact.
3050	3050	(4) (a) Except as provided in par. (b), a physician or certified advanced
3051	3051	practice nurse prescriber is immune from civil liability for injury to or the death of
3052	3052	a person who takes any antimicrobial drug if the antimicrobial drug is prescribed,
3053	3053	dispensed, or furnished under this section and if expedited partner therapy is
3054	3054	provided as specified under this section.
3055	3055	(b) The immunity under par. (a) does not extend to the donation, distribution,
3056	3056	furnishing, or dispensing of an antimicrobial drug by a physician or certified
3057	3057	advanced practice nurse prescriber whose act or omission involves reckless,
3058	3058	wanton, or intentional misconduct.
3059	3059	SECTION 132. 448.56 (1) and (1m) (b) of the statutes are amended to read:
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3086	3086	SECTION 132
3087	3087	448.56 (1) WRITTEN REFERRAL. Except as provided in this subsection and s.
3088	3088	448.52, a person may practice physical therapy only upon the written referral of a
3089	3089	physician, naturopathic doctor, physician assistant, chiropractor, dentist,
3090	3090	podiatrist, or advanced practice registered nurse prescriber certified under s.
3091	3091	441.16 (2). Written referral is not required if a physical therapist provides services
3092	3092	in schools to children with disabilities, as defined in s. 115.76 (5), pursuant to rules
3093	3093	promulgated by the department of public instruction; provides services as part of a
3094	3094	home health care agency; provides services to a patient in a nursing home pursuant
3095	3095	to the patient[s plan of care; provides services related to athletic activities,
3096	3096	conditioning, or injury prevention; or provides services to an individual for a
3097	3097	previously diagnosed medical condition after informing the individual[s physician,
3098	3098	naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or
3099	3099	advanced practice registered nurse prescriber certified under s. 441.16 (2) who
3100	3100	made the diagnosis. The examining board may promulgate rules establishing
3101	3101	additional services that are excepted from the written referral requirements of this
3102	3102	subsection.
3103	3103	(1m) (b) The examining board shall promulgate rules establishing the
3104	3104	requirements that a physical therapist must satisfy if a physician, naturopathic
3105	3105	doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice
3106	3106	registered nurse prescriber makes a written referral under sub. (1). The purpose of
3107	3107	the rules shall be to ensure continuity of care between the physical therapist and
3108	3108	the health care practitioner.
3109	3109	SECTION 133. 448.62 (2m) of the statutes is amended to read:
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3136	3136	SECTION 133
3137	3137	448.62 (2m) An advanced practice registered nurse who is certified to issue
3138	3138	prescription orders under s. 441.16 and who is providing nonsurgical patient
3139	3139	services as directed, supervised, and inspected by a podiatrist who has the power to
3140	3140	direct, decide, and oversee the implementation of the patient services rendered.
3141	3141	SECTION 134. 448.67 (2) of the statutes is amended to read:
3142	3142	448.67 (2) SEPARATE BILLING REQUIRED. Except as provided in sub. (4), a
3143	3143	licensee who renders any podiatric service or assistance, or gives any podiatric
3144	3144	advice or any similar advice or assistance, to any patient, podiatrist, physician,
3145	3145	physician assistant, advanced practice registered nurse prescriber certified under
3146	3146	s. 441.16 (2), partnership, or corporation, or to any other institution or organization,
3147	3147	including a hospital, for which a charge is made to a patient, shall, except as
3148	3148	authorized by Title 18 or Title 19 of the federal Social Security Act, render an
3149	3149	individual statement or account of the charge directly to the patient, distinct and
3150	3150	separate from any statement or account by any other podiatrist, physician,
3151	3151	physician assistant, advanced practice registered nurse prescriber, or other person.
3152	3152	SECTION 135. 448.956 (1m) of the statutes is amended to read:
3153	3153	448.956 (1m) Subject to sub. (1) (a), a licensee may provide athletic training to
3154	3154	an individual without a referral, except that a licensee may not provide athletic
3155	3155	training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation
3156	3156	setting unless the licensee has obtained a written referral for the individual from a
3157	3157	practitioner licensed or certified under subch. II, III, IV, V, or VII of this chapter;
3158	3158	under ch. 446; or under s. 441.16 (2) 441.09 or from a practitioner who holds a
3159	3159	compact privilege under subch. XI or XII of ch. 448.
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3186	3186	SECTION 136
3187	3187	SECTION 136. 450.01 (1m) of the statutes is repealed.
3188	3188	SECTION 137. 450.01 (16) (h) 2. of the statutes is amended to read:
3189	3189	450.01 (16) (h) 2. The patient[s advanced practice registered nurse prescriber,
3190	3190	if the advanced practice registered nurse prescriber has entered into a written
3191	3191	agreement to collaborate with a physician may issue prescription orders under s.
3192	3192	441.09 (2).
3193	3193	SECTION 138. 450.01 (16) (hr) 2. of the statutes is amended to read:
3194	3194	450.01 (16) (hr) 2. An advanced practice registered nurse prescriber who may
3195	3195	issue prescription orders under s. 441.09 (2).
3196	3196	SECTION 139. 450.03 (1) (e) of the statutes is amended to read:
3197	3197	450.03 (1) (e) Any person lawfully practicing within the scope of a license,
3198	3198	permit, registration, certificate, or certification granted to practice as a pharmacy
3199	3199	technician under s. 450.068, to provide home medical oxygen under s. 450.076, to
3200	3200	practice professional or, practical, or advanced practice registered nursing or nurse-
3201	3201	midwifery under ch. 441, to practice dentistry, dental therapy, or dental hygiene or
3202	3202	as an expanded function dental auxiliary under ch. 447, to practice medicine and
3203	3203	surgery under ch. 448, to practice optometry under ch. 449, to practice naturopathic
3204	3204	medicine under ch. 466, or to practice veterinary medicine under ch. 89, or as
3205	3205	otherwise provided by statute.
3206	3206	SECTION 140. 450.11 (1g) (b) of the statutes is amended to read:
3207	3207	450.11 (1g) (b) A pharmacist may, upon the prescription order of a
3208	3208	practitioner providing expedited partner therapy, as specified in s. 441.092,
3209	3209	448.035, or 448.9725, that complies with the requirements of sub. (1), dispense an
3210	3210	antimicrobial drug as a course of therapy for treatment of chlamydial infections,
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3238	3238	SECTION 140
3239	3239	gonorrhea, or trichomoniasis to the practitioner[s patient or a person with whom
3240	3240	the patient has had sexual contact for use by the person with whom the patient has
3241	3241	had sexual contact. The pharmacist shall provide a consultation in accordance with
3242	3242	rules promulgated by the board for the dispensing of a prescription to the person to
3243	3243	whom the antimicrobial drug is dispensed. A pharmacist providing a consultation
3244	3244	under this paragraph shall ask whether the person for whom the antimicrobial
3245	3245	drug has been prescribed is allergic to the antimicrobial drug and advise that the
3246	3246	person for whom the antimicrobial drug has been prescribed must discontinue use
3247	3247	of the antimicrobial drug if the person is allergic to or develops signs of an allergic
3248	3248	reaction to the antimicrobial drug.
3249	3249	SECTION 141. 450.11 (1i) (a) 1. of the statutes is amended to read:
3250	3250	450.11 (1i) (a) 1. A pharmacist may, upon and in accordance with the
3251	3251	prescription order of an advanced practice registered nurse prescriber under s.
3252	3252	441.18 (2) (a) 1., of a physician under s. 448.037 (2) (a) 1., or of a physician assistant
3253	3253	under s. 448.9727 (2) (a) 1. that complies with the requirements of sub. (1), deliver
3254	3254	an opioid antagonist to a person specified in the prescription order and may, upon
3255	3255	and in accordance with the standing order of an advanced practice registered nurse
3256	3256	prescriber under s. 441.18 (2) (a) 2., of a physician under s. 448.037 (2) (a) 2., or of a
3257	3257	physician assistant under s. 448.9727 (2) (a) 2. that complies with the requirements
3258	3258	of sub. (1), deliver an opioid antagonist to an individual in accordance with the
3259	3259	order. The pharmacist shall provide a consultation in accordance with rules
3260	3260	promulgated by the board for the delivery of a prescription to the person to whom
3261	3261	the opioid antagonist is delivered.
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3288	3288	SECTION 142
3289	3289	SECTION 142. 450.11 (1i) (b) 2. b. of the statutes is amended to read:
3290	3290	450.11 (1i) (b) 2. b. An advanced practice registered nurse prescriber may only
3291	3291	deliver or dispense an opioid antagonist in accordance with s. 441.18 (2) or in
3292	3292	accordance with his or her other legal authority to dispense prescription drugs.
3293	3293	SECTION 143. 450.11 (7) (b) of the statutes is amended to read:
3294	3294	450.11 (7) (b) Information communicated to a physician, physician assistant,
3295	3295	or advanced practice registered nurse prescriber in an effort to procure unlawfully
3296	3296	a prescription drug or the administration of a prescription drug is not a privileged
3297	3297	communication.
3298	3298	SECTION 144. 450.11 (8) (e) of the statutes is amended to read:
3299	3299	450.11 (8) (e) The board of nursing, insofar as this section applies to advanced
3300	3300	practice nurse prescribers registered nurses.
3301	3301	SECTION 145. 450.13 (5) (b) of the statutes is amended to read:
3302	3302	450.13 (5) (b) The patient[s advanced practice registered nurse prescriber, if
3303	3303	the advanced practice registered nurse prescriber has entered into a written
3304	3304	agreement to collaborate with a physician may issue prescription orders under s.
3305	3305	441.09 (2).
3306	3306	SECTION 146. 450.135 (7) (b) of the statutes is amended to read:
3307	3307	450.135 (7) (b) The patient[s advanced practice registered nurse prescriber, if
3308	3308	the advanced practice registered nurse prescriber has entered into a written
3309	3309	agreement to collaborate with a physician may issue prescription orders under s.
3310	3310	441.09 (2).
3311	3311	SECTION 147. 462.04 of the statutes is amended to read:
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3338	3338	SECTION 147
3339	3339	462.04 Prescription or order required. A person who holds a license or
3340	3340	limited X-ray machine operator permit under this chapter may not use diagnostic
3341	3341	X-ray equipment on humans for diagnostic purposes unless authorized to do so by
3342	3342	prescription or order of a physician licensed under s. 448.04 (1) (a), a naturopathic
3343	3343	doctor licensed under s. 466.04 (1), a dentist who is licensed under s. 447.04 (1) or
3344	3344	who holds a compact privilege under subch. II of ch. 447, a dental therapist licensed
3345	3345	under s. 447.04 (1m), a podiatrist licensed under s. 448.63, a chiropractor licensed
3346	3346	under s. 446.02, an advanced practice registered nurse certified licensed under s.
3347	3347	441.16 (2) 441.09, a physician assistant who is licensed under s. 448.974 or who
3348	3348	holds a compact privilege under subch. XIII of ch. 448, or, subject to s. 448.56 (7) (a),
3349	3349	a physical therapist who is licensed under s. 448.53 or who holds a compact
3350	3350	privilege under subch. XI of ch. 448.
3351	3351	SECTION 148. 655.001 (1) of the statutes is renumbered 655.001 (1r).
3352	3352	SECTION 149. 655.001 (1g) of the statutes is created to read:
3353	3353	655.001 (1g) XAdvanced practice registered nurseY means an individual who
3354	3354	is licensed under s. 441.09, who has qualified to practice independently in his or her
3355	3355	recognized role under s. 441.09 (3m) (b), and who practices advanced practice
3356	3356	registered nursing, as defined under s. 441.001 (1c), outside of a collaborative
3357	3357	relationship with a physician or dentist, as described under s. 441.09 (3m) (a) 1., or
3358	3358	other employment relationship.
3359	3359	SECTION 150. 655.001 (7t) of the statutes is amended to read:
3360	3360	655.001 (7t) XHealth care practitionerY means a health care professional, as
3361	3361	defined in s. 180.1901 (1m), who is an employee of a health care provider described
3362	3362	in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care
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3390	3390	SECTION 150
3391	3391	services that are not in collaboration with a physician under s. 441.15 (2) (b) or
3392	3392	under the direction and supervision of a physician or nurse anesthetist advanced
3393	3393	practice registered nurse.
3394	3394	SECTION 151. 655.001 (9) of the statutes is repealed.
3395	3395	SECTION 152. 655.002 (1) (a) of the statutes is amended to read:
3396	3396	655.002 (1) (a) A physician or a nurse anesthetist an advanced practice
3397	3397	registered nurse for whom this state is a principal place of practice and who
3398	3398	practices his or her profession in this state more than 240 hours in a fiscal year.
3399	3399	SECTION 153. 655.002 (1) (b) of the statutes is amended to read:
3400	3400	655.002 (1) (b) A physician or a nurse anesthetist an advanced practice
3401	3401	registered nurse for whom Michigan is a principal place of practice, if all of the
3402	3402	following apply:
3403	3403	1. The physician or nurse anesthetist advanced practice registered nurse is a
3404	3404	resident of this state.
3405	3405	2. The physician or nurse anesthetist advanced practice registered nurse
3406	3406	practices his or her profession in this state or in Michigan or a combination of both
3407	3407	more than 240 hours in a fiscal year.
3408	3408	3. The physician or nurse anesthetist advanced practice registered nurse
3409	3409	performs more procedures in a Michigan hospital than in any other hospital. In this
3410	3410	subdivision, XMichigan hospitalY means a hospital located in Michigan that is an
3411	3411	affiliate of a corporation organized under the laws of this state that maintains its
3412	3412	principal office and a hospital in this state.
3413	3413	SECTION 154. 655.002 (1) (c) of the statutes is amended to read:
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3440	3440	SECTION 154
3441	3441	655.002 (1) (c) A physician or nurse anesthetist an advanced practice
3442	3442	registered nurse who is exempt under s. 655.003 (1) or (3), but who practices his or
3443	3443	her profession outside the scope of the exemption and who fulfills the requirements
3444	3444	under par. (a) in relation to that practice outside the scope of the exemption. For a
3445	3445	physician or a nurse anesthetist an advanced practice registered nurse who is
3446	3446	subject to this chapter under this paragraph, this chapter applies only to claims
3447	3447	arising out of practice that is outside the scope of the exemption under s. 655.003 (1)
3448	3448	or (3).
3449	3449	SECTION 155. 655.002 (1) (d) of the statutes is amended to read:
3450	3450	655.002 (1) (d) A partnership comprised of physicians or nurse anesthetists
3451	3451	advanced practice registered nurses and organized and operated in this state for the
3452	3452	primary purpose of providing the medical services of physicians or nurse
3453	3453	anesthetists advanced practice registered nurses.
3454	3454	SECTION 156. 655.002 (1) (e) of the statutes is amended to read:
3455	3455	655.002 (1) (e) A corporation organized and operated in this state for the
3456	3456	primary purpose of providing the medical services of physicians or nurse
3457	3457	anesthetists advanced practice registered nurses.
3458	3458	SECTION 157. 655.002 (1) (em) of the statutes is amended to read:
3459	3459	655.002 (1) (em) Any organization or enterprise not specified under par. (d) or
3460	3460	(e) that is organized and operated in this state for the primary purpose of providing
3461	3461	the medical services of physicians or nurse anesthetists advanced practice
3462	3462	registered nurses.
3463	3463	SECTION 158. 655.002 (2) (a) of the statutes is amended to read:
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3490	3490	SECTION 158
3491	3491	655.002 (2) (a) A physician or nurse anesthetist advanced practice registered
3492	3492	nurse for whom this state is a principal place of practice but who practices his or her
3493	3493	profession fewer than 241 hours in a fiscal year, for a fiscal year, or a portion of a
3494	3494	fiscal year, during which he or she practices his or her profession.
3495	3495	SECTION 159. 655.002 (2) (b) of the statutes is amended to read:
3496	3496	655.002 (2) (b) Except as provided in sub. (1) (b), a physician or nurse
3497	3497	anesthetist advanced practice registered nurse for whom this state is not a
3498	3498	principal place of practice, for a fiscal year, or a portion of a fiscal year, during
3499	3499	which he or she practices his or her profession in this state. For a health care
3500	3500	provider who elects to be subject to this chapter under this paragraph, this chapter
3501	3501	applies only to claims arising out of practice that is in this state and that is outside
3502	3502	the scope of an exemption under s. 655.003 (1) or (3).
3503	3503	SECTION 160. 655.003 (1) of the statutes is amended to read:
3504	3504	655.003 (1) A physician or a nurse anesthetist an advanced practice
3505	3505	registered nurse who is a state, county or municipal employee, or federal employee
3506	3506	or contractor covered under the federal tort claims act, as amended, and who is
3507	3507	acting within the scope of his or her employment or contractual duties.
3508	3508	SECTION 161. 655.003 (3) of the statutes is amended to read:
3509	3509	655.003 (3) Except for a physician or nurse anesthetist advanced practice
3510	3510	registered nurse who meets the criteria under s. 146.89 (5) (a), a physician or a
3511	3511	nurse anesthetist an advanced practice registered nurse who provides professional
3512	3512	services under the conditions described in s. 146.89, with respect to those
3513	3513	professional services provided by the physician or nurse anesthetist advanced
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3540	3540	SECTION 161
3541	3541	practice registered nurse for which he or she is covered by s. 165.25 and considered
3542	3542	an agent of the department, as provided in s. 165.25 (6) (b).
3543	3543	SECTION 162. 655.005 (2) (a) of the statutes is amended to read:
3544	3544	655.005 (2) (a) An employee of a health care provider if the employee is a
3545	3545	physician or a nurse anesthetist an advanced practice registered nurse or is a
3546	3546	health care practitioner who is providing health care services that are not in
3547	3547	collaboration with a physician under s. 441.15 (2) (b) or under the direction and
3548	3548	supervision of a physician or nurse anesthetist advanced practice registered nurse.
3549	3549	SECTION 163. 655.005 (2) (b) of the statutes is amended to read:
3550	3550	655.005 (2) (b) A service corporation organized under s. 180.1903 by health
3551	3551	care professionals, as defined under s. 180.1901 (1m), if the board of governors
3552	3552	determines that it is not the primary purpose of the service corporation to provide
3553	3553	the medical services of physicians or nurse anesthetists advanced practice
3554	3554	registered nurses. The board of governors may not determine under this paragraph
3555	3555	that it is not the primary purpose of a service corporation to provide the medical
3556	3556	services of physicians or nurse anesthetists advanced practice registered nurses
3557	3557	unless more than 50 percent of the shareholders of the service corporation are
3558	3558	neither physicians nor nurse anesthetists advanced practice registered nurses.
3559	3559	SECTION 164. 655.23 (5m) of the statutes is amended to read:
3560	3560	655.23 (5m) The limits set forth in sub. (4) shall apply to any joint liability of
3561	3561	a physician or nurse anesthetist advanced practice registered nurse and his or her
3562	3562	corporation, partnership, or other organization or enterprise under s. 655.002 (1)
3563	3563	(d), (e), or (em).
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3590	3590	SECTION 165
3591	3591	SECTION 165. 655.27 (3) (a) 4. of the statutes is amended to read:
3592	3592	655.27 (3) (a) 4. For a health care provider described in s. 655.002 (1) (d), (e),
3593	3593	(em), or (f), risk factors and past and prospective loss and expense experience
3594	3594	attributable to employees of that health care provider other than employees
3595	3595	licensed as a physician or nurse anesthetist advanced practice registered nurse.
3596	3596	SECTION 166. 655.27 (3) (b) 2m. of the statutes is amended to read:
3597	3597	655.27 (3) (b) 2m. In addition to the fees and payment classifications
3598	3598	described under subds. 1. and 2., the commissioner, after approval by the board of
3599	3599	governors, may establish a separate payment classification for physicians satisfying
3600	3600	s. 655.002 (1) (b) and a separate fee for nurse anesthetists advanced practice
3601	3601	registered nurses satisfying s. 655.002 (1) (b) which take into account the loss
3602	3602	experience of health care providers for whom Michigan is a principal place of
3603	3603	practice.
3604	3604	SECTION 167. 655.275 (2) of the statutes is amended to read:
3605	3605	655.275 (2) APPOINTMENT. The board of governors shall appoint the members
3606	3606	of the council. Section 15.09, except s. 15.09 (4) and (8), does not apply to the
3607	3607	council. The board of governors shall designate the chairperson, who shall be a
3608	3608	physician, the vice chairperson, and the secretary of the council and the terms to be
3609	3609	served by council members. The council shall consist of 5 or 7 persons, not more
3610	3610	than 3 of whom are physicians who are licensed and in good standing to practice
3611	3611	medicine in this state and one of whom is a nurse anesthetist an advanced practice
3612	3612	registered nurse who is licensed and in good standing to practice nursing in this
3613	3613	state. The chairperson or another peer review council member designated by the
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3640	3640	SECTION 167
3641	3641	chairperson shall serve as an ex officio nonvoting member of the medical examining
3642	3642	board and may attend meetings of the medical examining board, as appropriate.
3643	3643	SECTION 168. 655.275 (5) (b) 2. of the statutes is amended to read:
3644	3644	655.275 (5) (b) 2. If a claim was paid for damages arising out of the rendering
3645	3645	of care by a nurse anesthetist an advanced practice registered nurse, with at least
3646	3646	one nurse anesthetist advanced practice registered nurse.
3647	3647	SECTION 169. 895.478 (3m) of the statutes is amended to read:
3648	3648	895.478 (3m) ELEMENTARY AND SECONDARY SCHOOLS. An elementary or
3649	3649	secondary school and its designated school personnel, and a physician, advanced
3650	3650	practice registered nurse prescriber, or physician assistant who provides or
3651	3651	administers an opioid antagonist, are not liable for any injury that results from the
3652	3652	opioid antagonist, regardless of whether authorization was given by the pupil[s
3653	3653	parent or guardian or by the pupil[s physician, advanced practice registered nurse
3654	3654	prescriber, or physician assistant, unless the injury is the result of an act or
3655	3655	omission that constitutes gross negligence or willful or wanton misconduct. The
3656	3656	immunity from liability provided under this subsection is in addition to and not in
3657	3657	lieu of that provided under s. 895.48.
3658	3658	SECTION 170. 961.01 (19) (a) of the statutes is amended to read:
3659	3659	961.01 (19) (a) A physician, advanced practice registered nurse, dentist,
3660	3660	veterinarian, podiatrist, optometrist, scientific investigator or, subject to s. 448.975
3661	3661	(1) (b), a physician assistant, or other person licensed, registered, certified or
3662	3662	otherwise permitted to distribute, dispense, conduct research with respect to,
3663	3663	administer or use in teaching or chemical analysis a controlled substance in the
3664	3664	course of professional practice or research in this state.
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3692	3692	SECTION 171
3693	3693	SECTION 171. 961.395 of the statutes is amended to read:
3694	3694	961.395 Limitation on advanced practice registered nurses. (1) An
3695	3695	advanced practice registered nurse who is certified may issue prescription orders
3696	3696	under s. 441.16 441.09 (2) may prescribe controlled substances only as permitted by
3697	3697	the rules promulgated under s. 441.16 (3) 441.09 (6) (a) 4.
3698	3698	(2) An advanced practice registered nurse certified under s. 441.16 who may
3699	3699	issue prescription orders under s. 441.09 (2) shall include with each prescription
3700	3700	order the advanced practice nurse prescriber certification license number issued to
3701	3701	him or her by the board of nursing.
3702	3702	(3) An advanced practice registered nurse certified under s. 441.16 who may
3703	3703	issue prescription orders under s. 441.09 (2) may dispense a controlled substance
3704	3704	only by prescribing or administering the controlled substance or as otherwise
3705	3705	permitted by the rules promulgated under s. 441.16 (3) 441.09 (6) (a) 4.
3706	3706	SECTION 172. Nonstatutory provisions.
3707	3707	(1) Using the procedure under s. 227.24, the board of nursing may promulgate
3708	3708	rules under ch. 441 that are necessary to implement the changes in this act.
3709	3709	Notwithstanding s. 227.24 (1) (a) and (3), the board is not required to provide
3710	3710	evidence that promulgating a rule under this subsection as an emergency rule is
3711	3711	necessary for the preservation of the public peace, health, safety, or welfare and is
3712	3712	not required to provide a finding of emergency for a rule promulgated under this
3713	3713	subsection. A rule under this subsection may take effect no later than the date
3714	3714	specified in SECTION 173 (intro.) of this act. Notwithstanding s. 227.24 (1) (c) and
3715	3715	(2), a rule promulgated under this subsection is effective for 2 years after its
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3742	3742	SECTION 172
3743	3743	promulgation, or until permanent rules take effect, whichever is sooner, and the
3744	3744	effective period of a rule promulgated under this subsection may not be further
3745	3745	extended under s. 227.24 (2).
3746	3746	(2) (a) In this subsection, the definitions under s. 441.001 apply.
3747	3747	(b) Notwithstanding s. 441.09 (3), an individual who, on January 1, 2026, is
3748	3748	licensed as a registered nurse in this state and is practicing in a recognized role may
3749	3749	continue to practice advanced practice registered nursing and the corresponding
3750	3750	recognized role in which he or she is practicing and may continue to use the titles
3751	3751	corresponding to the recognized roles in which he or she is practicing during the
3752	3752	period before which the board takes final action on the person[s application under s.
3753	3753	441.09. This paragraph does not apply after the first day of the 13th month
3754	3754	beginning after the effective date of this paragraph.
3755	3755	SECTION 173. Effective dates. This act takes effect on the first day of the
3756	3756	13th month beginning after publication, except as follows:
3757	3757	(1) SECTION 172 (1) of this act takes effect on the day after publication.
3758	3758	(END)
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