SB 145 — Relating to: advanced practice registered nurses, extending the time limit for emergency rule procedures, providing an exemption from emergency rule procedures, and granting rule-making authority. (FE)

The bill eliminates certificates to issue prescription orders and generally authorizes APRNs to issue prescription orders.

A person who is certified to issue prescription orders under current law is automatically granted an APRN license with his or her appropriate specialty designation.

RNs who are practicing in a recognized role on January 1, 2024, but who do not hold a certificate to issue prescription orders on that date and who are granted an APRN license under the bill may not issue prescription orders.

As under current law, an APRN issuing LRB-0589/1 - 2024 Legislature - 5 - JPC&MED:amn SENATE BILL 145 prescription orders is subject to various practice requirements and limitations established by the board.

The bill repeals a provision concerning the ability of advanced practice nurses who are certified to issue prescription orders and who are required to work in collaboration with or under the supervision of a physician to obtain and practice under a federal waiver to dispense narcotic drugs to individuals for addiction treatment.

Malpractice liability insurance The bill requires all APRNs to maintain malpractice liability insurance in coverage amounts specified under current law for physicians and nurse anesthetists except for APRNs whose employer has in effect malpractice liability insurance that provides the same amount of coverage for the APRN.

Additionally, the bill requires APRNs who have qualified to practice independently and who practice outside a collaborative or employment relationship, but not including those APRNs who only practice as a certified nurse-midwife, to participate in the Injured Patients and Families Compensation Fund.

The Injured Patients and Families Compensation Fund provides excess medical malpractice coverage for health care providers who participate in the fund and meet all other participation requirements, which includes maintaining malpractice liability insurance in coverage amounts specified under current law.

OTHER CHANGES The bill makes numerous other changes throughout the statutes relating to APRNs, including various terminology changes.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

S ECTION 1.

(intro.) of the statutes issenate amendedand toassembly, read:do enact as follows:

29.193is (1m)amended (a)to 2.read:

(intro.)* HasSection a991.11,ISCONSINSTATUTES: permanent substantial loss of function in one or both arms or one or both hands and fails to meet the minimum standards of any one of the following standard tests, administered under the direction of a licensed physician, a licensed physician assistant, a licensed chiropractor, or a certified licensed advanced practice registered nurse prescriber:

SEffective ECTIONdate 2.of acts.

“Every act and every portion of an act enacted by the legislature over the governor’s partial veto which does not expressly prescribe the time when it takes effect shall take effect on the day after its date of publication.” Wisconsin Act − 2 − 2023 Senate Bill 145 29.193(1m) (a) 2.

(intro.) Has a permanent substan- SECTION 6.

29.193 (2) (e) of the statutes is amended tial loss of function in one or both arms or one or both to read:

hands and fails to meet the minimum standards of any one 29.193 (2) (e) Review of decisions.

An applicant of the following standard tests, administered under the denied a permit under this subsection, except a permit direction of a licensed physician, a licensed physician under par.

(c) 3., may obtain a review of that decision by assistant, a licensed chiropractor, or a certifiedicensed a licensed physician, a licensed physician assistant, a advanced practice registered nurse prescriber:

licensed chiropractor, a licensed podiatrist, or a certified SECTION 2.

of the statutes is licensed advanced practice registered nurse prescriber amended to read:

-designated 2024by Legislaturethe -department 6and -with LRB-0589/1an JPC&MED:amnoffice SENATElocated BILL 145 SECTION 2 29.193 (2) (b) 2.

An applicant shall submit an applicationappli- onin athe formdepartment prepareddistrict andin furnished by the department, which shall include a written statement or report prepared and signed by a licensed physician, a licensed physician assistant, a licensed chiropractor, a licensed podiatrist, or a certified licensed advanced practice registerednurse prescriber prepared no more than 6 months preceding the application and verifying that the applicant isresides. physically disabled.

cation on a form prepared and furnished by the depart- The department shall pay for the cost of a review under ment, which shall include a written statement or report this paragraph unless the denied application on its face prepared and signed by a licensed physician, a licensed fails to meet the standards set forth in par.

(c) 1.

or 2.

A physician assistant, a licensed chiropractor, a licensed review under this paragraph is the only method of review podiatrist, or a certifilicensed advanced practice regis- of a decision to deny a permit under this subsection and tered nurse prescriber prepared no more than 6 months is not subject to further review under ch.

227.

preceding the application and verifying that the applicant SECTION 7.

29.193 (3) (a) of the statutes is amended is physically disabled.

to read:

of the statutes is 29.193 (3) (a) Produces a certificate from a licensed amended to read:

29.193physician, (2)a licensed physician assistant, a licensed 29.193(2) (c) 3.

The department may issue a Class B optometrist, or a certified licensed advanced practice reg- permit to an applicant who is ineligible for a permit under istered nurse prescriber stating that his or her sight is subd.

impaired to the degree that he or she cannot read ordinary 1., 2.

if, upon review and after considering the physicalnewspaper conditionprint ofwith the applicant and the recommendation of a licensed physician, a licensed physician assistant, a licensed chiropractor, a licensed podiatrist, or awithout certifieddcorrective advancedglasses. practice registered nurse prescriber selected by the applicant from a list of licensed physicians, licensed physician assistants, licensed chiropractors, licensed podiatrists, and certifiedensed advanced practice nurse prescribers registered nurses compiled by the department, the department finds that issuance of a permit complies with the intent of this subsection.

Thephysical usecondition of this review procedure is discretionary with the departmentapplicant and all costs of the reviewrecommenda- procedureSECTION shall8. be paid by the applicant.

SECTION45.40 4.(1g) (a) of the statutes is amended tion of a licensed physician, a licensed physician assist- to read:

ant, a licensed chiropractor, a licensed podiatrist, or a cer- 45.40 (1g) (a) “Health care provider” means an tified licensed advanced practice registered nurse advanced practice registered nurse prescriber certified prescriber selected by the applicant from a list of licensed who may issue prescription orders under s.

441.16 physicians, licensed physician assistants, licensed chiro- 441.09 (2), an audiologist licensed under ch.

459, a den- practors, licensed podiatrists, and certified licensed tist licensed under ch.

447, an optometrist licensed under advanced practice nurse prescribers registered nurses ch.

449, a physician licensed under s.

448.02, or a podia- compiled by the department, the department finds that trist licensed under s.

448.63.

issuance of a permit complies with the intent of this sub- SECTION 9.

46.03 (44) of the statutes is amended to section.

The use of this review procedure is discretionary read:

with the department and all costs of the review procedure 46.03 (44) S EXUALLY TRANSMITTED DISEASE TREAT - shall be paid by the applicant.

MENT INFORMATION.

Prepare and keep current an infor- SECTION 4.

of the statutes is mation sheet to be distributed to a patient by a physician, amended to read:

29.193a (2)physician assistant, or certified an advanced practice 29.193(2) (cd) 2.

The person has a permanent substantialsub- registered nurse prescriber who may issue prescription stantial loss of function in one or both arms and fails to meetorders the minimum standards of the standard upper extremity pinch test, the standard grip test, or the standard nine-hole peg test, administered under thes. direction of a licensed physician, a licensed physician LRB-0589/1 - 2024 Legislature - 7 - JPC&MED:amn SECTION 4 SENATE BILL 145 assistant, a licensed chiropractor, or a certifiedadvanced practice registered nurse prescriber.

SECTION441.09 5.(2) providing expedited partner meet the minimum standards of the standard upper therapy to that patient under s.

441.092, 448.035, or extremity pinch test, the standard grip test, or the stan- 448.9725.

The information sheet shall include informa- dard nine−hole peg test, administered under the direction tion about sexually transmitted diseases and their treat- of a licensed physician, a licensed physician assistant, a ment and about the risk of drug allergies.

The informa- licensed chiropractor, or a certified licensed advanced tion sheet shall also include a statement advising a person practice registered nurse prescriber.

with questions about the information to contact his or her SECTION 5.

of the statutes is physician, advanced practice registered nurse, pharma- amended to read:

29.193cist, (2)or (cd)local 2.health department, as defined in s.

250.01 29.193(2) (cd) 2.

The person has a permanent substantialsub- loss(4). of function in one or both shoulders and fails to meet the minimum standards of the standard shoulder strength test, administered under the direction of a licensed physician, a licensed physician assistant, a licensed chiropractor, or a certified licensed advanced practice registeredrse prescriber.

stantial loss of function in one or both shoulders and fails SECTION 6.10.

29.193 (2) (e) of the statutes is amended to read:

29.193 (2) (e) Review of decisions.

An applicant denied a permit under this subsection, except a permit under par.

(c) 3., may obtain a review of that decision by a licensed physician, a licensed physician assistant, a licensed chiropractor, a licensed podiatrist, or a certiflicensed advanced practice registered nurse prescriberdesignated by the department and with an office located in the department district in which the applicant resides.

The department shall pay for the cost of a review under this paragraph unless the denied application on its face fails to meet the standards set forth in par.

(c) 1.

or 2.

A review under this paragraph is the only method of review of a decision to deny a permit under this subsection and is not subject to further review under ch.

227.

SECTION 7.

29.193 (3) (a) of the statutes is amended to read:

29.193 (3) (a) Produces a certificate from a licensed physician, a licensed physician assistant, a licensed optometrist, or a certified licensed advanced practice registered nurse prescriber stating that his or her sight is impaired to the degree that he or she cannot read ordinary newspaper print with or without corrective glasses.

SECTION 8.

45.40 (1g) (a) of the statutes is amended to read:

- 2024 Legislature - 8 - LRB-0589/1 JPC&MED:amn SENATE BILL 145 SECTION 8 45.40 (1g) (a) “Health care provider" means an advanced practice registered nurse prescriber certified who may issue prescription orders under s.

441.16 441.09 (2), an audiologist licensed under ch.

459, a dentist licensed under ch.

447, an optometrist licensed under ch.

449, a physician licensed under s.

448.02, or a podiatrist licensed under s.

448.63.

SECTION 9.

46.03 (44) of the statutes is amended to read:

46.03(44) SEXUALLY TRANSMITTED DISEASE TREATMENT INFORMATIOPrepare and keep current an information sheet to be distributed to a patient by a physician, a physician assistant, or certified an advanced practice registered nurse prescriber who may issue prescription orders under s.

441.09 (2) providing expedited partner therapy to that patient under s.

441.092,.035, or 448.9725.

The information sheet shall include information about sexually transmitted diseases and their treatment and about the risk of drug allergies.

The information sheet shall also include a statement advising a person with questions about the information to contact his or her physician, advanced practice registered nurse, pharmacist, or local health department, as defined in s.

250.01 (4).

SECTION 10.

to meet the minimum standards of the standard shoulder SECTION 11.

50.08 (2) of the statutes is amended to strength test, administered under the direction of a read:

licensed physician, a licensed physician assistant, a 50.08 (2) A physician, an advanced practice registeredurseregis- licensed chiropractor, or a certified licensed advanced tered nurse prescriber certified who may issue prescriptionprescrip- orderspractice underregistered s.nurse prescriber.

441.16tion 441.09orders (2), or a physician assistant who prescribes a psychotropic medication to a nursing home resident who has degenerative brain disorder shall notify the nursing home if the prescribed medication has a boxed warning under 21s. CFR 201.57.

SECTION441.16 12.441.09 (2), or a physician Senate Bill 145 − 3 − 2023 Wisconsin Act assistant who prescribes a psychotropic medication to a 50.49 (1) (b) (intro.) “Home health services” means nursing home resident who has degenerative brain disor- the following items and services that are furnished to an der shall notify the nursing home if the prescribed medi- individual, who is under the care of a physician, physi- cation has a boxed warning under 21 CFR 201.57.

50.09cian (1)assistant, (a)or (intro.)advanced ofpractice theregistered statutesnurse ispre- amendedSECTION to12. read:

LRB-0589/1 - 2024 Legislature - 9 - JPC&MED:amn S ECTION 12 SENATE BILL 145 50.09 (1) (a) (intro.)Private(intro.) andof unrestricted communications with the resident'sstatutes family,is physician,scriber, physician assistant, advanced practice registered nurse prescriber, attorney, and any other person, unless medically contraindicated as documented by thea resident'shome physician,health physicianagency, assistant, or advancedby practiceothers registerednurseunder prescriberamended into theread: resident's medical record, except that communications with public officials or with the resident's attorney shall not be restricted in any event.

Thearrangements rightmade toby privatethe home health agency, that are 50.09(1) (a) (intro.) Private and unrestricted communicationscommu- shallunder include,a butplan for furnishing those items and services to the nications with the resident’s family, physician, physician individual that is notestablished limitedand to,periodically reviewed assistant, advanced practice registered nurse prescriber, by a physician, physician assistant, or advanced practice attorney, and any other person, unless medically con- registered nurse prescriber and that are, except as pro- traindicated as documented by the rightresident’s to:physician, vided in subd.

SECTION6., 13.provided on a visiting basis in a place physician assistant, or advanced practice registerednurse of residence used as the individual’s home:

50.09prescriber (1)in (f)the 1.resident’s medical record, except that SECTION 17.

of the statutes is amended to read:

50.09 (1) (f) 1.

Privacy for visits by spouse or domestic partner.

If both spouses or both domestic partners under ch.

770 are residents of the same facility, the spouses or domestic partners shall be permitted to share a room unless medically contraindicated as documented by the resident's physician, physician assistant, or advanced practice registeredrse prescriber in the resident's medical record.

SECTION 14.

50.09 (1) (h) of the statutes is amended to read:

50.09 (1) (h) Meet with, and participate in activities of social, religious, and community groups at the resident's discretion, unless medically contraindicated as documented by the resident's physician, physician assistant, or advanced practice registered nurse prescriber in the resident's medical record.

SECTION 15.

50.09 (1) (k) of the statutes is amended to read:

50.09(1) (k) Be free from mental and physical abuse, and be free from chemical and physical restraints except as authorized in writing by a physician, physician assistant, or advanced practice registered nurse prescriber for a specified and limited period of time and documented in the resident's medical record.

Physical restraints may be used in an emergency when necessary to protect the resident from - 2024 Legislature - 10 - LRB-0589/1 JPC&MED:amn SENATE BILL 145 SECTION 15 injury to himself or herself or others or to property.

However, authorization for continuing use of the physical restraints shall be secured from a physician, physician assistant, or advanced practice regisnurse prescriber within 12 hours.

Any use of physical restraints shall be noted in the resident's medical records.

“Physical restraints" includes, but is not limited to, any article, device, or garment that interferes with the free movement of the resident and that the resident is unable to remove easily, and confinement in a locked room.

SECTION 16.

50.49 (1) (b) (intro.) of the statutes is amended to read:

50.49 (1) (b) (intro.) “Home health services" means the following items and services that are furnished to an individual, who is under the care of a physician, physician assistant, or advanced practice registerede prescriber, by a home health agency, or by others under arrangements made by the home health agency, that are under a plan for furnishing those items and services to the individual that is established and periodically reviewed by a physician, physician assistant, or advanced practice registered nurse prescriber and that are, except as provided in subd.

6., provided on a visiting basis in a place of residence used as the individual's home:

SECTION 17.

of the statutes is communications with public officials or with the resi- amended to read:

51.41dent’s (1d)attorney (b)shall 4.not be restricted in any event.

AThe psychiatric51.41 mental(1d) health(b) advanced4. practice registered nurse who is suggested by the Milwaukee County board of supervisors.

TheA Milwaukeepsychiatric Countymental boardhealth ofright supervisorsto shallprivate solicitand suggestionsunrestricted fromcommunications organizationsshall includingadvanced thepractice Wisconsinregistered Nursesnurse Association for individuals who specializeis insuggested aby fullinclude, continuumbut ofis behavioralnot healthlimited andto, medicalthe servicesright includingto: emergency detention, inpatient, residential, transitional, partial hospitalization, intensive outpatient, and wraparound community-based services.

Thethe Milwaukee County LRB-0589/1 - 2024 Legislature - 11 - JPC&MED:amn S ECTION 17 SENATE BILL 145 board of supervisorssupervisors. shall suggest to the Milwaukee County executive 4 psychiatric mental health advanced practice registerenurses for this board membership position.

The Mil- SECTION 13.

50.09 (1) (f) 1.

of the statutes is amended waukee County board of supervisors shall solicit sugges- to read:

tions from organizations including the Wisconsin Nurses 50.09(1) (f) 1.

Privacy for visits by spouse or domes- Association for individuals who specialize in a full con- tic partner.

If both spouses or both domestic partners tinuum of behavioral health and medical services includ- under ch.

770 are residents of the same facility, the ing emergency detention, inpatient, residential, transi- spouses or domestic partners shall be permitted to share tional, partial hospitalization, intensive outpatient, and a room unless medically contraindicated as documented wraparound community−based services.

The Milwau- by the resident’s physician, physician assistant, or kee County board of supervisors shall suggest to the Mil- advanced practice registered nurse prescriber in the resi- waukee County executive 4 psychiatric mental health dent’s medical record.

advanced practice registered nurses for this board mem- SECTION 14.

50.09 (1) (h) of the statutes is amended bership position.

to read:

70.47 (8) (intro.) of the statutes is 50.09 (1) (h) Meet with, and participate in activities amended to read:

of social, religious, and community groups at the resi- 70.47 (8) HEARING.H EARING.

(intro.) The board shall hear dent’s discretion, unless medically contraindicated as upon oath all persons who appear before it in relation to documented by the resident’s physician, physician assist- the assessment.

Instead of appearing in person at the ant, or advanced practice registered nurse prescriber in hearing, the board may allow the property owner, or the property owner's representative, at the requestresident’s ofmedical eitherrecord. person, to appear before the board, under oath, by telephone or to submit written statements, under oath, to the board.

Theproperty boardowner’s shallrepresentative, hearat upon oath, by telephone, all ill or disabled persons who present to the boardrequest aof lettereither fromSECTION a15. physician, physician assistant, or advanced practice registeredurse prescriber certified under s.

441.1650.09 (2)(1) licensed(k) of the statutes is amended person, to appear before the board, under ch.oath, by tele- to read:

441phone thator confirmsto theirsubmit illnesswritten orstatements, disability.under oath, to the 50.09(1) (k) Be free from mental and physical abuse, board.

AtThe theboard requestshall ofhear theupon propertyoath, ownerby telephone, all and be free from chemical and physical restraints except ill or thedisabled propertypersons owner'swho representative,present to the board maya postponeletter andas rescheduleauthorized ain hearingwriting underby thisa subsection,physician, butphysician mayassist- notfrom postponea andphysician, reschedulephysician aassistant, hearingor moreadvanced thanprac- onceant, duringor theadvanced samepractice sessionregistered nurse prescriber for thetice sameregisterednurse property.prescriber certified under s.

The441.16 boarda atspecified suchand hearinglimited shallperiod proceedof astime follows:and documented in (2) licensed under ch.

SECTION441 19.that confirms their illness or the resident’s medical record.

Physical restraints may be disability.

At the request of the property owner or the used in an emergency when necessary to protect the resi- property owner’s representative, the board may postpone dent from injury to himself or herself or others or to prop- and reschedule a hearing under this subsection, but may erty.

However, authorization for continuing use of the not postpone and reschedule a hearing more than once physical restraints shall be secured from a physician, during the same session for the same property.

The board physician assistant, or advanced practice registerednurse at such hearing shall proceed as follows:

prescriber within 12 hours.

Any use of physical restraints SECTION 19.

of the statutes is repealed.shall be noted in the resident’s medical records.

SECTION“Physical 20.repealed.

restraints” includes, but is not limited to, any article, SECTION 20.

of the statutes is device, or garment that interferes with the free movement amended to read:

of the resident and that the resident is unable to remove 77.54 (14) (f) 4.

An advanced practice registered nurseeasily, whoand mayconfinement issuein prescriptiona orderslocked underroom. s.

441.09nurse (2).who may issue prescription orders under s.

441.09 SECTION 16.

50.49 (1) (b) (intro.) of the statutes is (2).

amended to read:

Wisconsin Act − 4 − 2023 Senate Bill 145 97.59 Handling foods.

No person in charge of any publicpensation eatinginsurer. place or other establishment where food products to be consumed by others are handled may knowingly employ any person handling food products who has a disease in a form - 2024 Legislature - 12 - LRB-0589/1 JPC&MED:amn SENATE BILL 145 SECTION 21 that is communicable by food handling.

IfThe requiredemployee by the local health officer or any officer of the department for the purposes of an investigation, any person who is employedentitled into thehave handlingone ofpublic foodseating place or isother suspectedestablishment ofwhere having a disease in a form that is communicable by food handlingobserver shallprovided submit to an examination by thehimself officer or byherself apresent physician,at physicianthe assistant,products orto advancedbe practiceconsumed rnurseby prescriberothers designatedare byhandled themay officer.examination.

The expenseemployee ofis also entitled to have a knowingly employ any person handling food products translator provided by himself or herself present at the examination,who ifhas any,a shalldisease bein paida form that is communicable by food examination if the personemployee examined.has difficulty speaking or handling.

AnyIf personrequired knowingly infected with a disease in a form that is communicable by foodthe handlinglocal whohealth handlesofficer foodor products to be consumed by others and any personsunderstanding knowinglythe employingEnglish orlanguage. permitting such a person to handle food products to be consumed by others shall be punished as provided by s.

The employer’s or officer of the department for the purposes of an investiga- insurer’s written request for examination shall notify the tion, any person who is employed in the handling of foods employee of all of the following:

or is suspected of having a disease in a form that is com- 1.

The proposed date, time, and place of the examina- municable by food handling shall submit to an examina- tion by the officer or by a physician, physician assistant, tion and the identity and area of specialization of the examining physician, chiropractor, psychologist, dentist, or advanced practice registered nurse prescriber desig- podiatrist, physician assistant, advanced practice regis- nated by the officer.

The expense of the examination, if tered nurse prescriber, or vocational expert.

any, shall be paid by the person examined.

Any person 3.

The employee’s right to have his or her physician, knowingly infected with a disease in a form that is com- chiropractor, psychologist, dentist, physician assistant, municable by food handling who handles food products to be consumed by others and any persons knowingly advanced practice registered nurse prescriber, or podia- trist present at the examination.

employing or permitting such a person to handle food 4.

The employee’s right to receive a copy of all products to be consumed by others shall be punished as reports of the examination that are prepared by the exam- provided by s.

ining physician, chiropractor, psychologist, dentist, SECTION 22.

102.13 (1) (a) of the statutes is amended podiatrist, physician assistant, advanced practice regis- to read:

102.13(1)102.13 (1) (a) Except as provided in sub.

(4), wheneverwhen- compensationtered isnurse claimedprescriber, byor anvocational employee,expert theimmediately employee shall, upon thereceipt writtenof requestthese ofreports by the employee's employer or worker'sworker’s ever compensation insurer,is submitclaimed to reasonable examinations by physicians,an chiropractors,employee, psychologists, dentists, physician assistants, advanced practice nurse prescribersistered nurses, or podiatrists provided and paid for by the employercompensation or insurer.

No employee whoshall, submitsupon tothe anwritten examinationrequest under this paragraph is a patient of the examiningemploy- physician,SECTION chiropractor,24. psychologist, dentist, physician assistant, advanced practice registeredse prescriber, or podiatrist for any purpose other than for the purpose of bringing an action under ch.

655, unless the employee specifically requests treatment from that physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podiatrist.

SECTION 23.

102.13 (1) (b) (intro.), 1., 3.

and 4.

of the statutes are amended to read:

LRB-0589/1 - 2024 Legislature - 13 - JPC&MED:amn SECTION 23 SENATE BILL 145 102.13 (1) (b) (intro.) An employer or insurer who requests that an employee submit to reasonable examination under par.

(a) or (am) shall tender to the employee, before the examination, all necessary expenses including transportation expenses.

The employee is entitled to have a physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podiatrist provided by himself or herself present at the examination and to receive a copy of all reports of the examination that are prepared by the examining physician, chiropractor, psychologist, podiatrist, dentist, physician assistant, advanced practice registered nurse prescriber, or vocational expert immediately upon receipt of those reports by the employer or worker's compensation insurer.

The employee is entitled to have one observer provided by himself or herself present at the examination.

The employee is also entitled to have a translator provided by himself or herself present at the examination if the employee has difficulty speaking or understanding the English language.

The employer's or insurer's written request for examination shall notify the employee of all of the following:

1.

The proposed date, time, and place of the examination and the identity and area of specialization of the examining physician, chiropractor, psychologist, dentist, podiatrist, physician assistant, advanced practice registerede prescriber, or vocational expert.

3.

The employee's right to have his or her physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podiatrist present at the examination.

4.

The employee's right to receive a copy of all reports of the examination that are prepared by the examining physician, chiropractor, psychologist, dentist, podiatrist, physician assistant, advanced practice registered nurse prescriber, or - 2024 Legislature - 14 - LRB-0589/1 JPC&MED:amn SENATE BILL 145 SECTION 23 vocational expert immediately upon receipt of these reports by the employer or worker's compensation insurer.

SECTION 24.

of the ee’s employer or worker’s compensation insurer, submit statutes are amended to read:

to reasonable examinations by physicians, chiropractors, psychologists, dentists, physician assistants, advanced 102.13 (1) (d) 1.

Any physician, chiropractor, psychologist,psy- dentist,practice podiatrist,nurse physicianprescribers assistant,registered advancednurses, practiceor registeredpodia- nursechologist, prescriber,dentist, orpodiatrist, vocationalphysician expertassistant, whotrists isprovided presentand atpaid anyfor examinationby underthe par.employer or insurer.

(a)advanced orpractice (am)registered maynurse beprescriber, requiredor tovoca- testifytional asexpert towho theis resultspresent ofat theany examination.examination under par.

2.No employee who submits to an examination under this (a) or (am) may be required to testify as to the results of paragraph is a patient of the examining physician, chiro- the examination.

Anypractor, physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podiatristpodia- who2. attended a worker's compensation claimant for any condition or complaint reasonably related to the condition for which the claimant claims compensation may be required to testify before the division when the division so directs.

3.Any physician, chiropractor, psychologist, dentist, trist for any purpose other than for the purpose of bring- physician assistant, advanced practice registered nurse ing an action under ch.

Notwithstanding655, unless the employee specifi- prescriber, or podiatrist who attended a worker’s com- pensation claimant for any statutorycondition provisionsor exceptcomplaint par.rea- cally requests treatment from that physician, sonably related to the condition for which the claimant chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podia- claims compensation may be required to testify before trist.

(e), any physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podiatrist attending a worker's compensation claimant for any condition or complaint reasonably related to the conditiondivision forwhen which the claimant claims compensation may furnish to the employee, employer, worker's compensation insurer, department, or division informationso anddirects. reports relative to a compensation claim.

4.SECTION 23.

The102.13 testimony(1) of(b) any(intro.), physician,1., chiropractor,3. psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podiatrist who is licensed to practice where he or she resides or practices in any state and the testimony of any vocational expert may be received in evidence in compensation proceedings.

SECTIONand 25.4.ofthe 3.

102.13Notwithstanding (2)any (a)statutory ofprovisions theexcept statutes isare amended to read:

LRB-0589/1par. - 2024 Legislature - 15 - JPC&MED:amn S ECTION 25 SENATE BILL 145 102.13 (2) (a) An employee who reports an injury alleged to be work-related or files an application for hearing waives any physician-patient, psychologist-patient, or chiropractor-patient privilege with respect to any condition or complaint reasonably related to the condition for which the employee claims compensation.

Notwithstanding(e), ss.any physician, chiropractor, psychologist, den- tist, physician assistant, advanced practice registered 102.13 (1) (b) (intro.) An employer or insurer who nurse prescriber, or podiatrist attending a worker’s com- requests that an employee submit to reasonable examina- tion under par.

51.30(a) and 146.82 and any other law, any physician, chiropractor, psychologist, dentist, podiatrist, physician assistant, advanced practice registerednurse prescriber, hospital, or health(am) careshall providertender shall,to within a reasonable time after written request by the employee, employer,pensation worker'sclaimant compensationfor insurer,any department,condition or division,complaint orrea- itsbefore representative,the provideexamination, thatall personnecessary withexpenses anyincluding informationsonably or written material reasonably related to anythe injurycondition for which the employeeclaimant claimstransportation compensation.expenses.

IfThe theemployee request is byentitled ato representativeclaims of a worker's compensation insurermay forfurnish ato billingthe statement,employee, thehave a physician, chiropractor, psychologist, dentist, podiatrist,employer, worker’s compensation insurer, department, physician assistant, advanced practice registerednurseregistered prescriber,nurse hospital, or healthdivision careinformation providerand shall,reports withinrelative 30to days after receiving the request, provide that person with a completecompen- copyprescriber, ofor anpodiatrist itemizedprovided billingby statementhimself or aherself billingsation statementclaim. in a standard billing format recognized by the federal government.

SECTIONpresent 26.at the examination and to receive a copy of all 4.

102.13The (2)testimony (b)of any physician, chiropractor, psy- reports of the statutesexamination that are prepared by the exam- chologist, dentist, physician assistant, advanced practice ining physician, chiropractor, psychologist, podiatrist, registered nurse prescriber, or podiatrist who is amendedlicensed dentist, physician assistant, advanced practice registered to read:practice where he or she resides or practices inanystate nurse prescriber, or vocational expert immediately upon and the testimony of any vocational expert may be receipt of those reports by the employer or worker’s com- received in evidence in compensation proceedings.

102.13Senate (2)Bill (b)145 A− physician,5 chiropractor,− podiatrist,2023 psychologist,Wisconsin dentist,Act physicianSECTION assistant,25. advanced practice registered nurse prescriber, hospital, or health service provider shall furnish a legible, certified duplicate of the written material requested under par.

(a)102.13 in(2) paper(a) format upon payment of the actualstatutes costsis amended of preparingphysicians, thepodiatrists, certifiedsurgeons, duplicate,dentists, notpsycholo- to exceedread: the greater of 45 cents per page or $7.50 per request, plus the actual costs of postage, or shall furnish a legible, certified duplicate of that material in electronic format upon payment of $26 per request.

Anygists, -physician 2024assistants, Legislatureadvanced -practice 16nurse -pre- LRB-0589/1102.13 JPC&MED:amn(2) SENATE(a) BILLAn 145employee Swho ECTIONreports 26an personinjury whoscribers refusesregistered nurses, and chiropractors, wherever alleged to providebe certifiedwork−related duplicatesor files an application for licensed and practicing, who have examined or treated hearing waives any physician−patient, psychologist− the claimant, and of writtenexperts, materialif inthe practitioner or expert patient, or chiropractor−patient privilege with respect to consents to being subjected to cross−examination, also any condition or complaint reasonably related to the person'scon- custodyconstitute thatprima isfacie requestedevidence underas par.to the matter contained dition for which the employee claims compensation.

(a)in shallthose bereports. liable for reasonable and necessary costs and, notwithstanding s.

814.04Certified (1),reports reasonableof attorneyphysicians, feespodia- incurredNotwithstanding inss. enforcing the requester's right to the duplicates under par.

51.30 and 146.82 and any other law, trists, surgeons, psychologists, and chiropractors are any physician, chiropractor, psychologist, dentist, podia- admissible as evidence of the diagnosis, necessity of the trist, physician assistant, advanced practice registered treatment, and cause and extent of the disability.

Certi- nurse prescriber, hospital, or health care provider shall, fied reports by doctors of dentistry, physician assistants, within a reasonable time after written request by the and advanced practice nurse prescribers registered employee, employer, worker’s compensation insurer, nurses are admissible as evidence of the diagnosis and department, or division, or its representative, provide that necessity of treatment but not of the cause and extent of person with any information or written material reason- disability.

Any physician, podiatrist, surgeon, dentist, ably related to any injury for which the employee claims psychologist, chiropractor, physician assistant, advanced compensation.

If the request is by a representative of a practice registered nurse prescriber, or expert who know- worker’s compensation insurer for a billing statement, ingly makes a false statement of fact or opinion in a certi- the physician, chiropractor, psychologist, dentist, podia- fied report may be fined or imprisoned, or both, under s.

trist, physician assistant, advanced practice registered 943.395.

nurse prescriber, hospital, or health care provider shall, 2.

The record of a hospital or sanatorium in this state within 30 days after receiving the request, provide that that is satisfactory to the division, established by certifi- person with a complete copy of an itemized billing state- cate, affidavit, or testimony of the supervising officer of ment or a billing statement in a standard billing format the hospital or sanatorium, any other person having recognized by the federal government.

charge of the record, or a physician, podiatrist, surgeon, SECTION 26.

102.13 (2) (b) of the statutes is amended dentist, psychologist, physician assistant, advanced prac- to read:

tice registered nurse prescriber, or chiropractor to be the 102.13 (2) (b) A physician, chiropractor, podiatrist, record of the patient in question, and made in the regular psychologist, dentist, physician assistant, advanced prac- course of examination or treatment of the patient, consti- tice registered nurse prescriber, hospital, or health ser- tutes prima facie evidence as to the matter contained in vice provider shall furnish a legible, certified duplicate of the record, to the extent that the record is otherwise com- the written material requested under par.

(a) in paper for- petent and relevant.

mat upon payment of the actual costs of preparing the cer- SECTION 28.

102.29 (3) of the statutes is amended to tified duplicate, not to exceed the greater of 45 cents per read:

page or $7.50 per request, plus the actual costs of postage, 102.29 (3) Nothing in this chapter shall prevent an or shall furnish a legible, certified duplicate of that mate- employee from taking the compensation that the rial in electronic format upon payment of $26 per request.

employee may be entitled to under this chapter and also Any person who refuses to provide certified duplicates of maintaining a civil action against any physician, chiro- written material in the person’s custody that is requested practor, psychologist, dentist, physician assistant, under par.

(a) shall be liable for reasonable and necessary advanced practice registered nurse prescriber, or podia- costs and, notwithstanding s.

814.04 (1), reasonable trist for malpractice.

attorney fees incurred in enforcing the requester’s right SECTION 29.

102.42 (2) (a) of the statutes is amended to the duplicates under par.

Sto ECTIONread: 27.

SECTION 27.

of the statutes 102.42 (2) (a) When the employer has notice of an are amended to read:

injury and its relationship to the employment, the 102.17 (1) (d) 1.

The contents of certified medical employer shall offer to the injured employee his or her and surgical reports by physicians, podiatrists, surgeons, choice of any physician, chiropractor, psychologist, den- dentists, psychologists, physician assistants, advanced tist, physician assistant, advanced practice registered practice nurse prescribers registered nurses, and chiropractorschiro- nurse prescriber, or podiatrist licensed to practice and practors licensed in and practicing in this state, and of certifiedpracticing reportsin bythis expertsstate concerningfor losstreatment of earningthe capacityinjury. under s.

102.44By (2)certified andreports (3), presented by aexperts partyconcerning forloss compensationof constituteearning primamutual facieagreement, evidence as to the matteremployee containedmay inhave thosethe reports,choice subjectof tocapacity anyunder ruless. and limitations the division prescribes.

Certified102.44 reports(2) of physicians, podiatrists, surgeons, dentists, psychologists, physician assistants, advanced practice nurse prescribersgistered nurses, and chiropractors,(3), whereverpresented licensedby anda practicing,party whoany havequalified examined or treated the claimant, and of experts, if the practitioner ornot expertlicensed consents to being subjected to cross-examination, also constitute prima facie evidence as to the matter contained in thosethis reports.state.

CertifiedIn reportsfor ofcompensation physicians,constitute podiatrists,prima surgeons,facie psychologists,evidence and chiropractors are admissible as evidenceto ofcase the diagnosis, necessity of theemergency, treatment, and cause and extent of the disability.Certifiedemployer reportsmay byarrange doctorsfor oftreat- dentistry, physician assistants, and advanced practice nurse prescribers registered nurses are admissible as evidence of the diagnosismatter andcontained necessityin ofthose treatmentreports, butsubject notto ofany therules causement andwithout extenttendering ofa disability.choice.

AnyAfter physician,the podiatrist,emergency surgeon,and dentist,limitations psychologist,the chiropractor,division physicianprescribes. assistant, advanced practice regnurseed LRB-0589/1 - 2024 Legislature - 17 - JPC&MED:amn S ECTION 27 SENATE BILL 145 prescriberor expert who knowingly makes a false statement of fact or opinion in a certified report may be fined or imprisoned, or both, under s.

943.395.Certified reports has passed the employee shall be given his or her choice Wisconsin Act − 6 − 2023 Senate Bill 145 of attending practitioner at the earliest opportunity.

2.The who may issue prescription orders under s.

The441.09 record(2), of a hospital or sanatoriumemployee inhas thisthe stateright that is satisfactory to thea division,2nd establishedchoice by certificate, affidavit, or testimony of theattending supervisingpracti- officer of the hospital or sanatorium, any other person having charge of the record, or a physician, podiatrist, surgeon, dentist, psychologist, physician assistant,assistant advancedmay practiceprescribe registeredepinephrine nursedelivery prescriber,tioner oron chiropractornotice to be the recordemployer of the patient in question, and made in the regular course of examination or treatmentits ofinsurance thecarrier. patient, constitutes prima facie evidence as to the matter contained in the record, to the extent that the record is otherwise competent and relevant.

SECTIONsystems 28.in the name of a school that has adopted a plan Any further choice shall be by mutual agreement.

102.29Part- (3)under ofsub. the statutes is amended to read:

102.29(2) (3)(a), Nothingto inbe thismaintained chapterby shall prevent an employee from taking the compensationschool thatfor theuse employeeners may be entitled to under this chapter and alsoclinics maintainingare aconsidered civilto actionbe againstone anypractitioner. physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered prescriber, or podiatrist for malpractice.

SECTIONunder 29.sub.

102.42(4). (2) (a) of the statutes is amended to read:

102.42Treatment (2)by (a)a Whenpractitioner theon employerreferral hasfrom noticeanother ofprac- anSECTION injury36. and its relationship to the employment, the employer shall offer to the injured employee his or her choice of any physician, chiropractor, psychologist, dentist, physician assistant, advanced practice registered nurse prescriber, or podiatrist licensed to practice and practicing in this state for treatment of the injury.

By118.2925 mutual(4) agreement,(c) theof employee may have the choicestatutes, ofas anytitioner qualifiedis practitionerconsidered notto licensedbe intreatment thisby state.one practitioner.

Inaffected caseby of2023 emergency,Wisconsin theAct employer27, mayis arrangeamended forto treatmentread: without tendering a choice.

After the emergency has passed the employee shall be given his or her choice of - 2024 Legislature - 18 - LRB-0589/1 JPC&MED:amn SENATE BILL 145 SECTION 29 attending practitioner at the earliest opportunity.

The employee has the right to a 2nd choice of attending practitioner on notice to the employer or its insurance carrier.

Any further choice shall be by mutual agreement.

Partners and clinics are considered to be one practitioner.

Treatment by a practitioner on referral from another practitioner is considered to be treatment by one practitioner.

106.30 (1) of the statutes is amended to 118.2925(4) (c) Administer an epinephrine delivery read:

106.30system (1)to Da EFINITION.Inpupil thisor section,other “nurse"person meanswho athe registeredschool nurse licensedor under106.30(1) s.D EFINITION.

441.06Inthissection, or“nurse” permittedmeans designated school personnel in good faith believes is a registered nurse licensed under s.

441.08,441.06 aor licensedpermitted practicalexperiencing nurseanaphylaxis licensedin oraccordance permittedwith a standing under s.

441.10,441.08, a licensed practical nurse licensed or per- protocol from a physician, an advanced practice registeredregis- nursemitted prescriber certified under s.

441.16441.10, (2), or aan nurse-midwifeadvanced licensedpractice regis- tered nurse prescriber who may issue prescription orders tered nurse prescriber certified under s.

441.16 (2), or a under s.

441.09 (2), or a physician assistant, regardless of nurse−midwife licensed under s.

whether the pupil or other person has a prescription for SECTION 31.

118.15 (3) (a) of the statutes is amended toan read:epinephrine delivery system.

118.15If (3) (a) Any child who is excused by the schoolpupil board because the child is temporarily not in proper physical or mentalother conditionper- to attendread: a school program but who can be expected to return to a school program upon termination or abatement of the illness or condition.

Theson schooldoes attendancenot officerhave maya requestprescription for an epinephrine deliv- 118.15(3) (a) Anychild who is excused by the parentschool ery system, or guardianthe ofperson who administers the epineph- board because the child is temporarily not in proper phys- rine delivery system does not know whether the pupil or ical or mental condition to obtainattend a writtenschool statementprogram frombut other person has a licensedprescription physician,for naturopathican doctor,epinephrine dentist,deliv- chiropractor,who optometrist,can psychologist,be physicianexpected assistant,to return to a school program upon ery system, the person who administers the epinephrine termination or nurseabatement practitioner,of asthe definedillness inor s.condition.

255.06The (1)delivery (d),system orshall, certifiedas advancedsoon practiceas registeredpracticable, nursereport prescriber,the school attendance officer may request the parent or registeredadministration nurseby describeddialing underthe s.telephone number “911” or, guardian of the child to obtain a written statement from in an area in which the telephone number “911” is not a licensed physician, naturopathic doctor, dentist, chiro- available, the telephone number for an emergency medi- practor, optometrist, psychologist, physician assistant, or cal service provider.

nurse practitioner, as defined in s.

255.06 (1) (d), or certi- SECTION 37.

118.2925 (5) of the statutes, as affected fied advanced practice registered nurse prescriber,orreg- by 2023 Wisconsin Act 27, is amended to read:

istered nurse described under s.

or ChristianChris- Science118.2925(5) practitionerI livingMMUNITY andFROMCIVIL residingLIABILITY; in this state, who is listed in the Christian Science Journal, as sufficient proof of the physical or mental condition of the child.

AnEXEMP excuse- undertian thisScience paragraphpractitioner shallliving be in writing and shallresiding statein thethis timestate, periodTION forFROM whichPRACTICE itOF isMEDICINE. valid, not to exceed 30 days.

SECTIONA 32.school and its desig- who is listed in the Christian Science Journal, as suffi- nated school personnel, and a physician, an advanced cient proof of the physical or mental condition of the practice registered nurse prescriber who may issue pre- child.

118.25An (1)excuse (a)under ofthis theparagraph statutesshall isbe amendedin towriting read:scription orders under s.

LRB-0589/1441.09 -(2),ora 2024physician Legislatureassist- -and 19shall -state JPC&MED:amnthe Stime ECTIONperiod 32for SENATEwhich BILLit 145is 118.25valid, (1)not (a)to “Practitioner"ant meanswho aprovides person licensed as a physician,prescription naturopathic doctor, or physicianstanding assistantprotocol infor anyexceed state30 ordays. licensed as an advanced practice registered nurse or certified as an advanced practice registered nurse prescriber in any state.

Inschool thisepinephrine paragraph,delivery “physician”systems, hasare thenot meaningliable givenfor inSECTION s.32.

118.25 (1) (a) of the statutes is amended any injury that results from the administration or self− to read:

administration of an epinephrine delivery system under 118.25(1) (a) “Practitioner” means a person licensed this section, regardless of whether authorization was as a physician, naturopathic doctor, or physician assistant given by the pupil’s parent or guardian or by the pupil’s in any state or licensed as an advanced practice registered physician, physician assistant, or advanced practice reg- nurse or certified as an advanced practice registered istered nurse prescriber, unless the injury is the result of nurse prescriber in any state.

In this paragraph, “physi- an act or omission that constitutes gross negligence or cian” has the meaning given in s.

SECTIONwillful 33.orwanton misconduct.

118.29The (1)immunity (e)from ofliabil- theSECTION statutes33. is amended to read:

118.29(1)118.29 (1) (e) “Practitioner"of meansthe anystatutes physician,is naturopathicamended doctor,ity dentist,provided optometrist,under physicianthis assistant,subsection advancedis practicein registeredrescriberaddition withto prescribingandnot authority,to orread: podiatrist licensed in any state.

SECTIONin 34.lieu of that provided under s.

118.2925 (1) (b) of the statutes is repealed.

SECTION 35.

118.2925 (3) of the statutes is amended to read:

118.2925 (3) PRESCRIPTIONS FOR SCHOOLS.A physician, an advanced practice registered nurse prescriber who may issue prescription orders under s.

441.09 (2), or a physician assistant may prescribe epinephrine auto-injectors or prefilled syringes in the name of a school that has adopted a plan under sub.

(2) (a), to be maintained by the school for use under sub.

(4).

SECTION 36.

118.2925 (4) (c) of the statutes is amended to read:

118.2925 (4) (c) Administer an epinephrine auto-injector or prefilled syringe to a pupil or other person who the school nurse or designated school personnel in good faith believes is experiencing anaphylaxis in accordance with a standing protocol from a physician, an advanced practice registerede prescriber who may issue prescription orders under s.

441.09 (2), or a physician assistant, regardless of whether the pupil or other person has a prescription for an epinephrine auto-injector or prefilled syringe.

If the pupil or other person does not have a prescription for an epinephrine auto-injector or prefilled syringe, or the person who administers the - 2024 Legislature - 20 - LRB-0589/1 JPC&MED:amn SENATE BILL 145 SECTION 36 epinephrine auto-injector or prefilled syringe does not know whether the pupil or other person has a prescription for an epinephrine auto-injector or prefilled syringe, the person who administers the epinephrine auto-injector or prefilled syringe shall, as soon as practicable, report the administration by dialing the telephone number “911" or, in an area in which the telephone number “911" is not available, the telephone number for an emergency medical service provider.

SECTION 37.

118.2925 (5) of the statutes is amended to read:

118.2925 (5) IMMUNITY FROM CIVIL LIABILITY;

EXEMPTION FROM PRACTICE OF MEDICINE.A school and its designated school personnel, and a physadvancedn practice registered nurse prescriber who may issue prescription orders under s.

441.09 (2), or a physician assistant who provides a prescription or standing protocol for school epinephrine auto-injectors or prefilled syringes, are not liable for any injury that results from the administration or self-administration of an epinephrine auto-injector or prefilled syringe under this section, regardless of whether authorization was given by the pupil's parent or guardian or by the pupil's physician, physician assistant, or advanced practice registnurse prescriber, unless the injury is the result of an act or omission that constitutes gross negligence or willful or wanton misconduct.

The immunity from liability provided under this subsection is in addition to and not in lieu of that provided under s.

118.29 (1) (e) “Practitioner” means any physician, SECTION 38.

146.615 (1) (a) of the statutes is naturopathic doctor, dentist, optometrist, physician amended to read:

assistant, advanced practice registered nurse prescriber 146.615(1) (a) “Advanced practice clinician"clinician” means awith physicianprescribing assistantauthority, or anpodiatrist advancedlicensed practicein registerednurse,any including a nursephysician practitioner,assistant certifiedor nurse-midwife,an clinicaladvanced nursepractice specialist, or certified registered nursestate. anesthetist licensed under s.

nurse, including a nurse practitioner, certified nurse− SECTION 34.

118.2925 (1) (b) of the statutes is midwife, clinical nurse specialist, or certified registered repealed.

nurse anesthetist licensed under s.

SECTION 39.35.

146.82118.2925 (3) (a) of the statutesstatutes, isas amendedaffected toSECTION read:39.

LRB-0589/1146.82 -(3) 2024(a) Legislatureof -the 21statutes -is JPC&MED:amnamended Sby ECTION2023 39Wisconsin SENATEAct BILL27, 145is 146.82amended (3)to (a)read: Notwithstanding sub.

(1),to aread: physician, a naturopathic doctor, a limited-scope naturopathic doctor, a physician assistant, or an advanced practice registerenurse prescriber certified under s.

441.16118.2925 (2)(3) licensedP underRESCRIPTIONS s.FOR SCHOOLS.

441.09A whophysi- treats146.82(3) a(a) patientNotwithstanding whosesub. physical or mental condition in the physician's, naturopathic doctor's, limited-scope naturopathic doctor's, physician assistant's, or advanced practice nurse prescriber's registered nurse's judgment affects the patient's ability to exercise reasonable and ordinary control over a motor vehicle may report the patient's name and other information relevant to the condition to the department of transportation without the informed consent of the patient.

SECTION(1), 40.a physician, cian, an advanced practice registered nurse prescriber a naturopathic doctor, a limited−scope naturopathic doc- Senate Bill 145 − 7 − 2023 Wisconsin Act tor, a physician assistant, or an advanced practice regis- S ECTION 45.

155.01 (1g) (b) of the statutes is tered nurse prescriber certified under s.

441.16 (2) repealed and recreated to read:

licensed under s.

441.09 who treats a patient whose phys- 155.01 (1g) (b) An individual who is licensed as an ical or mental condition in the physician’s, naturopathic advanced practice registered nurse and possesses a nurse doctor’s, limited−scope naturopathic doctor’s, physician practitioner specialty designation under s.

441.09.

assistant’s, or advanced practice nurse prescriber’sregis- S ECTION 46.

251.01 (1c) of the statutes is repealed tered nurse’s judgment affects the patient’s ability to and recreated to read:

exercise reasonable and ordinary control over a motor 251.01 (1c) “Advanced practice registered nurse” vehicle may report the patient’s name and other informa- means an individual licensed under s.

441.09.

tion relevant to the condition to the department of trans- S ECTION 47.

252.01 (1c) of the statutes is repealed.

portation without the informed consent of the patient.

S ECTION 48.

252.07 (8) (a) 2.

of the statutes is SECTION 40.

146.89amended (1)to (r)read: 1.

252.07(8) (a) 2.

The department or local health offi- 146.89 (1) (r) 1.

cer provides to the court a written statement from a physi- 448, naturopathic doctor under ch.

466, a dentist or dental cian, physician assistant, or advanced practice registered hygienist under ch.

447, a registered nurse, practical nurse prescriber that the individual has infectious tuber- nurse, or nurse-midwifenurse−midwife advanced practice registered nurseculosis underor ch.suspect tuberculosis.

nurse under ch.

449, a physicianS assistantECTION under49. subch.

252.07 (9) (c) of the statutes is amended physician assistant under subch.

448, a pharmacistpharma- underto ch.read:

cist under ch.

446, a podiatristpodia- 252.07 (9) (c) If the court orders confinement of an trist under subch.

448, or a physical therapist individual under this subsection, the individual shall under subch.

remain confined until the department or local health offi- SECTION 41.

of the statutes is renumberedrenum- cer, with the concurrence of a treating physician, physi- bered 146.89 (1) (r) 5e.

cian assistant, or advanced practice registered nurse pre- 146.89 (1) (r) 5e.

A registerederegistered nurse practitioner, as scriber, determines that treatment is complete or that the defined in s.

255.06255.06(1)(d) (1) (d) who holds a multistate license, individual is no longer a substantial threat to himself or as defined in s.

441.51 (2) (h), issued by a party state, as definedherself inor s.to the public health.

441.51If (2)the (k),individual andis whoseto practicebe ofdefined professionalin nursing under s.

441.001441.51 (4)(2) includes(k), performanceand ofwhose delegatedpractice medicalof servicesprofes- underconfined thefor supervisionmore ofthan a6 physician,months, dentist,the podiatrist,court orshall advancedreview practicesional registerednursing nurse.under s.

SECTION441.001 42.(4) includes performance the confinement every 6 months.

of delegated medical services under the supervision of a S ECTION 50.

252.10 (7) of the statutes is amended to physician, dentist, podiatrist, or advanced practice regis- read:

tered nurse.

252.10 (7) Drugs necessary for the treatment of SECTION 42.

of the statutes is mycobacterium tuberculosis shall be purchased by the repealed.

department from the appropriation account under s.

146.89 (6) of the statutes is amended to 20.435 (1) (e) and dispensed to patients through the pub- read:

-lic 2024health Legislaturedispensaries, -local 22health -departments, LRB-0589/1physi- JPC&MED:amn SENATE BILL 145 SECTION 43 146.89 (6) (a) While serving as a volunteer health cians, or advanced practice nurse prescribers registered care provider under this section, an advanced practice registerednurses nurse who hasmay a certificate to issue prescription orders under s.

441.16441.09 (2)registered isnurse consideredwho tohas meeta thecertificate requirementsto ofissue s.prescrip- (2).

tion orders under s.

441.16 (2) is considered to meet the S ECTION 51.

252.11 (2), (4), (5) and (7) of the statutes requirements of s.

are amended to read:

252.11 (2) An officer of the department or a local (b) While serving as a volunteer health care provider health officer having knowledge of any reported or rea- under this section, an advanced practice registered nurse sonably suspected case or contact of a sexually transmit- who has a certificate to issue prescription orders under s.

ted disease for which no appropriate treatment is being 441.16 (2) is not required to maintain in effect malpracticemalprac- administered, or of an actual contact of a reported case or tice insurance.

potential contact of a reasonably suspected case, shall SECTION 44.

154.01 (1g) of the statutes is amended investigate or cause the case or contact to be investigated to read:

154.01(1g)as “Advancednecessary. practice registered nurse” means a nurseindividual licensed under ch.

441If, whofollowing isa currentlyrequest certifiedof byan aofficer nationalof certifyingthe body154.01 approved(1g) by“Advanced thepractice boardregistered ofnurse” nursingdepartment asor a nurselocal practitioner,health certifiedofficer, nurse-midwife,a certifiedperson registeredreasonably nursemeans anesthetist,a ornurse clinicalan nurseindividual specialistlicensed s.under ch.

441 who suspected of being infected with a sexually transmitted is currently certified by a national certifying body disease refuses or neglects examination by a physician, approved by the board of nursing as a nurse practitioner, physician assistant, or advanced practice registered nurse certified nurse−midwife, certified registered nurse anes- prescriber or treatment, an officer of the department or a thetist, or clinical nurse specialist s.

SECTIONlocal 45.health officer may proceed to have the person com- Wisconsin Act − 8 − 2023 Senate Bill 145 mitted under sub.

155.01(5) (1g)to (b)an institution or system of thecare statutesphysician isassistant, repealedadvanced andpractice recreatedregistered tonurse read:for examination, treatment, or observation.

155.01(1g)prescriber, (b)or Anlocal individualhealth whoofficer isin licensedthe asstate, anand advancedshall practice(4) registeredIf nursea andperson possessesinfected with a nursesexually practitionertransmitted specialtyreport designationthe underpositive s.results of the examinations to the local disease ceases or refuses treatment before reaching what health officer and to the department.

441.09.All laboratories per- in a physician’s, physician assistant’s, or advanced prac- forming tests for sexually transmitted diseases shall tice nurse prescriber’s registered nurse’s opinion is the report all positive results to the local health officer and to noncommunicable stage, the physician, physician assist- the department, with the name of the physician, naturo- ant, or advanced practice registered nurse prescriber shall pathic doctor, physician assistant, or advanced practice notify the department.

SECTIONThe 46.department shall without registered nurse prescriber to whom reported.

251.01delay (1c)take ofthe necessary steps to have the statutesperson iscommit- repealedted andfor recreatedtreatment toor read:observation under sub.

251.01(1c)(5), “Advancedor practiceshall registeredS nurse”ECTION means53. an individual licensed under s.

441.09.

SECTION 47.

252.01 (1c) of the statutes is repealed.

SECTION 48.

252.07 (8) (a) 2.

of the statutes is amended to read:

252.07 (8) (a) 2.

The department or local health officer provides to the court a written statement from a physician, physician assistant, or advanced practice registered nurse prescriber that the individual has infectious tuberculosis or suspect tuberculosis.

SECTION 49.

252.07 (9) (c) of the statutes is amended to read:

LRB-0589/1 - 2024 Legislature - 23 - JPC&MED:amn S ECTION 49 SENATE BILL 145 252.07 (9) (c) If the court orders confinement of an individual under this subsection, the individual shall remain confined until the department or local health officer, with the concurrence of a treating physician, physician assistant, or advanced practice registernurse prescriber, determines that treatment is complete or that the individual is no longer a substantial threat to himself or herself or to the public health.

If the individual is to be confined for more than 6 months, the court shall review the confinement every 6 months.

SECTION 50.

252.10 (7) of the statutes is amended to read:

252.10 (7) Drugs necessary for the treatment of mycobacterium tuberculosis shall be purchased by the department from the appropriation account under s.

20.435 (1) (e) and dispensed to patients through the public health dispensaries, local health departments, physicians, advanced practice nurse prescribers registered nurses who may issue prescription orders under s.

441.09 (2).

SECTION 51.

252.11 (2), (4), (5) and (7) of the statutes are amended to read:

252.11 (2) An officer of the department or a local health officer having knowledge of any reported or reasonably suspected case or contact of a sexually transmitted disease for which no appropriate treatment is being administered, or of an actual contact of a reported case or potential contact of a reasonably suspected case, shall investigate or cause the case or contact to be investigated as necessary.

If, following a request of an officer of the department or a local health officer, a person reasonably suspected of being infected with a sexually transmitted disease refuses or neglects examination by a physician, physician assistant, or advanced practice registeredurse prescriber or treatment, an officer of the department or a local health officer may proceed to have the person committed under sub.

(5) to an institution or system of care for examination, treatment, or observation.

- 2024 Legislature - 24 - LRB-0589/1 JPC&MED:amn SENATE BILL 145 S ECTION 51 (4) If a person infected with a sexually transmitted disease ceases or refuses treatment before reaching what in a physician's, physician assistant's, or advanced practice nurse prescriber's registered nurse's opinion is the noncommunicable stage, the physician, physician assistant, or advanced practice registered nurse prescriber shall notify the department.

The department shall without delay take the necessary steps to have the person committed for treatment or observation under sub.

(5), or shall notify the local health officer to take these steps.

(5) Any court of record may commit a person infected with a sexually transmitted disease to any institution or may require the person to undergo a system of care for examination, treatment, or observation if the person ceases or refuses examination, treatment, or observation under the supervision of a physician, physician assistant, or advanced practice registeredse prescriber.

The court shall summon the person to appear on a date at least 48 hours, but not more than 96 hours, after service if an officer of the department or a local health officer petitions the court and states the facts authorizing commitment.

If the person fails to appear or fails to accept commitment without reasonable cause, the court may cite the person for contempt.

The court may issue a warrant and may direct the sheriff, any constable, or any police officer of the county immediately to arrest the person and bring the person to court if the court finds that a summons will be ineffectual.

The court shall hear the matter of commitment summarily.

Commitment under this subsection continues until the disease is no longer communicable or until other provisions are made for treatment that satisfy the department.

The certificate of the petitioning officer is prima facie evidence that the disease is no longer communicable or that satisfactory provisions for treatment have been made.

LRB-0589/1 - 2024 Legislature - 25 - JPC&MED:amn S ECTION 51 SENATE BILL 145 (7) Reports, examinations and inspections, all records concerning sexually transmitted diseases are confidential and not open to public inspection, and may not be divulged except as may be necessary for the preservation of the public health, in the course of commitment proceedings under sub.

(5), or as provided under s.

938.296 (4) or 968.38 (4).

If a physician, physician assistant, or advanced practice registered nurse prescriber has reported a case of sexually transmitted disease to the department under sub.

(4), information regarding the presence of the disease and treatment is not privileged when the patient, physician, physician assistant, or advanced practice registeredrse prescriber is called upon to testify to the facts before any court of record.

SECTION 52.

252.11 (10) of the statutes is amended to read:

252.11 (10) The state laboratory of hygiene shall examine specimens for the diagnosis of sexually transmitted diseases for any physician, naturopathic doctor, physician assistant, advanced practice registerede prescriber, or local health officer in the state, and shall report the positive results of the examinations to the local health officer and to the department.

All laboratories performing tests for sexually transmitted diseases shall report all positive results to the local health officer and to the department, with the name of the physician, naturopathic doctor, physician assistant, or advanced practice registered nurse prescriber to whom reported.

SECTION 53.

and (7m) (intro.) and (b) of notify the statuteslocal arehealth amendedofficer to read:take these steps.

252.15the (3m)statutes (d)are 11.amended to read:

(5) Any court of record may commit a person 252.15 (3m) (d) 11.

The coroner, medical examiner,exam- infected with a sexually transmitted disease to any insti- iner, or appointed assistant is investigating the cause of tution or may require the person to undergo a system of death of the subject of the HIV test and has contact with thecare bodyfor fluidexamination, oftreatment, theor subjectobservation ofif the HIVper- testson thatceases constitutesor arefuses significantexamination, exposure,treatment, -or 2024observa- Legislaturethe -body 26fluid -of LRB-0589/1the JPC&MED:amnsubject SENATEof BILLthe 145HIV SECTIONtest 53that ifconsti- tutes a physician,significant physicianexposure, assistant,if ora advancedphysician, practicephysician registeredrescriber,tion basedunder onthe informationsupervision providedof toa the physician, physician assistant, or advanced practice registered nurse prescriber,pre- determinesassistant, and certifies in writing that the coroner, medical examiner, or appointedadvanced assistantpractice hasregistered hadnurse apre- contactscriber, thatbased constituteson ainformation significantprovided exposureto and if the certificationphysician, accompaniesscriber. the request for disclosure.

13.The court shall summon the person to appear on physician assistant, or advanced practice registered nurse a date at least 48 hours, but not more than 96 hours, after prescriber, determines and certifies in writing that the service if an officer of the department or a local health officer petitions the court and states the facts authorizing coroner, medical examiner, or appointed assistant has had a contact that constitutes a significant exposure and commitment.

If the subjectperson offails theto HIVappear test has a positive HIV test result and is deceased, by the subject's attending physician, physician assistant, or advancedfails practice registerednurse prescriber, to persons, if known to the physician,certification physicianaccompanies assistant, or advanced practice registeredse prescriber, with whom the subjectrequest hadfor sexualdisclo- contactaccept orcommitment sharedwithout intravenousreasonable drugcause, usethe paraphernalia.court sure.

(5g)may (c)cite A physician, physician assistant, or advanced practice registered nurse prescriber, based on information provided to the physician, physician assistant, or advanced practice registerenurse prescriber, determines and certifies in writing that the person has had contact that constitutes a significant exposure.The certification shall accompany the request for HIVcontempt. testing and disclosure.

IfThe thecourt person is a physician, physician assistant, or advanced practice registerede prescribe, he or she may notissue make13. this determination or certification.

TheIf informationthe thatsubject isof providedthe toHIV atest physician,has physiciana assistant,positive orHIV advanceda practicewarrant registerednurseand prescribermay todirect document the occurrencesheriff, ofany theconstable, contactor thatany constitutespolice aofficer significantof exposure and the physician's,county physicianimmediately assistant's,to orarrest advancedthe practiceper- nursetest prescriber'sgisteredresult nurse'sand certificationis thatdeceased, by the personsubject’s hasattending hadson contactand thatbring constitutesthe aperson significantto exposure,court shallif bethe providedcourt onfinds a report form that isa developedphysician, byphysician theassistant, departmentor ofadvanced safetypractice andreg- professionalsummons serviceswill underbe s.ineffectual.

101.02The (19)court (a)shall orhear on a report form that the departmentistered ofnurse safetyprescriber, andto professionalpersons, LRB-0589/1if -known 2024to Legislaturethe -physi- 27cian, -physician JPC&MED:amnassistant, SECTIONor 53advanced SENATEpractice BILLregistered 145matter servicesof determines,commitment undersummarily. s.

101.02Commitment (19)under (b),nurse isprescriber, substantiallywith equivalentwhom to the reportsubject formhad thatsexual con- this subsection continues until the disease is developedno underlonger s.tact or shared intravenous drug use paraphernalia.

communicable or until other provisions are made for treatment that satisfy the department.

The certificate of (5g) (c) A physician, physician assistant, or advanced the petitioning officer is prima facie evidence that the dis- practice registered nurse prescriber, based on informa- ease is no longer communicable or that satisfactory pro- tion provided to the physician, physician assistant, or advanced practice registered nurse prescriber, deter- visions for treatment have been made.

mines and certifies in writing that the person has had con- (7) Reports, examinations and inspections, and all records concerning sexually transmitted diseases are tact that constitutes a significant exposure.

The certifica- confidential and not open to public inspection, and may tion shall accompany the request for HIV testing and not be divulged except as may be necessary for the disclosure.

If the person is a physician, physician assist- preservation of the public health, in the course of com- ant, or advanced practice registered nurse prescriber, he or she may not make this determination or certification.

mitment proceedings under sub.

(5), or as provided under The information that is provided to a physician, physi- s.

938.296 (4) or 968.38 (4).