North Carolina 2021-2022 Session Status: In Committee Bipartisan · 23 R · 19 D · 2 I cosponsors

HB 277 — The Safe, Accessible, Value-Directed, and Excellent (SAVE) Act.

Last action — Serial Referral To Insurance Stricken

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2021-2022 Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

366 added · 363 removed

Plain-language change summary

In the revised version of House Bill 277, the definition of "nursing" has been clarified and expanded to include specific aspects of the profession, such as teaching and evaluating nursing practices. Additionally, the description of "nursing programs" has been streamlined to ensure that it clearly refers to educational programs in North Carolina preparing individuals for nursing licensure. These changes matter because they help create a clearer understanding of what constitutes nursing and nursing education, which is important for setting standards in healthcare and ensuring quality training for future nurses.

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GENERAL ASSEMBLY OF NORTH CAROLINA H.B.
GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2021 H 1 HOUSE BILL 277 Short Title:
277 Mar 11, 2021 SESSION 2021 HOUSE PRINCIPAL CLERK H D HOUSE BILL DRH10110-NBf-50 Short Title:
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
A BILL TO BE ENTITLED AN ACT TO DELIVER SAFE, ACCESSIBLE, VALUE-DIRECTED, AND EXCELLENT (SAVE) HEALTH CARE THROUGHOUT NORTH CAROLINA BY MODERNIZING NURSING REGULATIONS.
Health, if favorable, Insurance, if favorable, Rules, Calendar, and Operations of the House March 15, 2021 A BILL TO BE ENTITLED AN ACT TO DELIVER SAFE, ACCESSIBLE, VALUE-DIRECTED, AND EXCELLENT (SAVE) HEALTH CARE THROUGHOUT NORTH CAROLINA BY MODERNIZING NURSING REGULATIONS.
(4) "Nursing" is a Nursing.
*H277-v-1* General Assembly Of North Carolina Session 2021 (4) "Nursing" is a Nursing.
*DRH10110-NBf-50* General Assembly Of North Carolina Session 2021 assisting;
assisting;
and theadministrationofnursingprograms andnursing services.
and theadministrationofnursingprograms andnursingservices.
Ordering,performing,supervising, andinterpretingdiagnosticstudies.
Ordering,performing,supervising,andinterpretingdiagnosticstudies.
(6d) Practice of nursing as a certified registered nurse anesthetist or CRNA.
Page 2 House Bill 277-First Edition General Assembly Of North Carolina Session 2021 (6d) Practice of nursing as a certified registered nurse anesthetist or CRNA.
Page 2 DRH10110-NBf-50 General Assembly Of North Carolina Session 2021 a.
a.
Ordering,performing,supervising, andinterpretingdiagnosticstudies.
Ordering,performing,supervising,andinterpretingdiagnosticstudies.
Ordering,performing,supervising, andinterpretingdiagnosticstudies.
Ordering,performing,supervising,andinterpretingdiagnosticstudies.
Implementing the treatment and pharmaceutical regimen prescribed or ordered by any person authorized by State law to prescribe or order the regimen.
Implementingthe treatment and pharmaceutical regimen prescribed or ordered by any person authorized by State law to prescribe or order the regimen.
g.
House Bill 277-First Edition Page 3 General Assembly Of North Carolina Session 2021 g.
DRH10110-NBf-50 Page 3 General Assembly Of North Carolina Session 2021 i.
i.
Participating in implementing the health care plan developed by the registered nurse and/or prescribed by any person authorized by State lawto prescribesuchaplan,byperforming tasksassignedordelegated by and performed under the supervision or under orders or directions of a registered nurse, physician licensed to practice medicine, dentist, or other person authorized by State law to provide the supervision.
Participating in implementing the health care plan developed by the registered nurse and/or prescribed by any person authorized by State lawto prescribesuchaplan,byperformingtasksassignedordelegated by and performed under the supervision or under orders or directions of a registered nurse, physician licensed to practice medicine, dentist, or other person authorized by State law to provide the supervision.
… (14) The practice of nursing by a an advanced practice registered nurse engaged in the practice of nursing and the performance of acts otherwise constituting medical practice by a registered nurse when performed in accordance with rules and regulations developedby ajoint subcommitteeofthe North Carolina Medical Board and the Board of Nursing and adopted by both boards.as defined in Article 9A of this Chapter.
… (14) The practice of nursing by a an advanced practice registered nurse engaged in the practice of nursing and the performance of acts otherwise constituting medical practice by a registered nurse when performed in accordance with rules and regulations developedbyajoint subcommitteeofthe North Carolina Medical Board and the Board of Nursing and adopted by both boards.as defined in Article 9A of this Chapter.
… d.
… Page 4 House Bill 277-First Edition General Assembly Of North Carolina Session 2021 d.
…." Page 4 DRH10110-NBf-50 General Assembly Of North Carolina Session 2021 SECTION 3.(c) G.S.
…." SECTION 3.(c) G.S.
"(b) A person shall be deemed to be practicing dentistry in this State who does, undertakes or attempts to do, or claims the ability to do any one or more of the following acts or things which, for the purposes of this Article, constitute the practice of dentistry:
"(b) A person shall be deemed to be practicing dentistryin this State who does, undertakes or attempts to do, or claims the ability to do any one or more of the following acts or things which, for the purposes of this Article, constitute the practice of dentistry:
The fees and rules developed by this subcommittee shall govern the performance of medical acts by registered nurses and shall become effective when they have been adopted by both Boards.Grant prescribing, ordering, dispensing, and furnishing authority to holders of the advanced practice registered nurse license pursuant to G.S.
The fees and rules developed by this subcommittee shall govern the performance of medical acts by registered nurses and shall become effective when they have been adopted by both Boards.Grant prescribing, ordering, dispensing, and furnishing authorityto holders of the advanced practice registered nurse license pursuant to G.S.
Application for license as advanced practice registered nurse...............................$100.00 Renewal of license to practice as advanced practice registered nurse (two-year period).............................................................................................100.00 DRH10110-NBf-50 Page 5 General Assembly Of North Carolina Session 2021 Reinstatement of lapsed license to practice as advanced practice registered nurse and renewal fee.....................................................................180.00 Application for examination leading to certificate and license as registered nurse...............................................................................................$75.00 Application for certificate and license as registered nurse by endorsement....................................................................................................150.00 Application for each re-examination leading to certificate and license as registered nurse.................................................................................................75.00 Renewal of license to practice as registered nurse (two-year period)......................100.00 Reinstatement of lapsed license to practice as a registered nurse and renewal fee......................................................................................................180.00 Application forexaminationleading to certificate and licenseas licensed practical nurse by examination .........................................................................75.00 Application for certificate and license as licensed practical nurse by endorsement....................................................................................................150.00 Application for each re-examination leading to certificate and license as licensed practical nurse.....................................................................................75.00 Renewal of license to practice as a licensed practical nurse (two-year period).............................................................................................................100.00 Reinstatement of lapsed license to practice as a licensed practical nurse and renewal fee...............................................................................................180.00 Application fee for retired registered nurse status or retired licensed practical nurse status.........................................................................................50.00 Reinstatement of retired registered nurse to practice as a registered nurse or a retired licensed practical nurse to practice as a licensed practical nurse (two-year period)....................................................................100.00 Reasonable charge for duplication services and materials.
Application for license as advanced practice registered nurse...............................$100.00 House Bill 277-First Edition Page 5 General Assembly Of North Carolina Session 2021 Renewal of license to practice as advanced practice registered nurse (two-year period).............................................................................................100.00 Reinstatement of lapsed license to practice as advanced practice registered nurse and renewal fee.....................................................................180.00 Application for examination leading to certificate and license as registered nurse...............................................................................................$75.00 Application for certificate and license as registered nurse by endorsement....................................................................................................150.00 Application for each re-examination leading to certificate and license as registered nurse.................................................................................................75.00 Renewal of license to practice as registered nurse (two-year period)......................100.00 Reinstatement of lapsed license to practice as a registered nurse and renewal fee......................................................................................................180.00 Application forexaminationleadingto certificate and licenseas licensed practical nurse by examination .........................................................................75.00 Application for certificate and license as licensed practical nurse by endorsement....................................................................................................150.00 Application for each re-examination leading to certificate and license as licensed practical nurse.....................................................................................75.00 Renewal of license to practice as a licensed practical nurse (two-year period).............................................................................................................100.00 Reinstatement of lapsed license to practice as a licensed practical nurse and renewal fee...............................................................................................180.00 Application fee for retired registered nurse status or retired licensed practical nurse status.........................................................................................50.00 Reinstatement of retired registered nurse to practice as a registered nurse or a retired licensed practical nurse to practice as a licensed practical nurse (two-year period)....................................................................100.00 Reasonable charge for duplication services and materials.
(b) Failure to renew the APRN license before the expiration date shall result in automatic forfeiture of the right to practice nursing as an APRN in North Carolina until such time as the license has been reinstated.
Page 6 House Bill 277-First Edition General Assembly Of North Carolina Session 2021 (b) Failure to renew the APRN license before the expiration date shall result in automatic forfeiture of the right to practice nursing as an APRN in North Carolina until such time as the license has been reinstated.
Page 6 DRH10110-NBf-50 General Assembly Of North Carolina Session 2021 (c) An APRN licensee who has allowed his or her license to lapse by failure to renew may apply for reinstatement in a manner prescribed by the Board and pay the required fee.
(c) An APRN licensee who has allowed his or her license to lapse by failure to renew may apply for reinstatement in a manner prescribed by the Board and pay the required fee.
Any person permitted to practice nursing without a license as provided in subdivision [(a)](2) (a)(2) or [(a)](3) (a)(3) of this section shall be held to the same standard of care as any licensed nurse.
Anyperson permitted to practice nursingwithout a license as provided in subdivision [(a)](2) (a)(2) or [(a)](3) (a)(3) of this section shall be held to the same standard of care as any licensed nurse.
(a) Before hiring an advanced practice registered nurse, a registered nurse nurse, or a licensed practical nurse in North Carolina, a health care facility shall verify that the applicant has a current, valid license to practice nursing pursuant to G.S.
(a) Before hiring an advanced practice registered nurse, a registered nurse nurse, or a licensed practical nurse in North Carolina, a health care facilityshall verify that the applicant has a current, valid license to practice nursing pursuant to G.S.
"§ 90-171.44.
House Bill 277-First Edition Page 7 General Assembly Of North Carolina Session 2021 "§ 90-171.44.
DRH10110-NBf-50 Page 7 General Assembly Of North Carolina Session 2021 (1) Sell, fraudulently obtain, or fraudulently furnish any nursing diploma or aid or abet therein.
(1) Sell, fraudulently obtain, or fraudulently furnish any nursing diploma or aid or abet therein.
Page 8 DRH10110-NBf-50
Page 8 House Bill 277-First Edition
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How this bill changes current law

9 changes Share ↗

Compared against the N.C. General Statutes as published AI-generated reading aid — verify against the official bill.

The bill modernizes nursing regulations in North Carolina by redefining terms and updating the scope of practice for advanced practice registered nurses (APRNs).

  • N.C.G.S. § 90-171.20

    § 90-171.20. Definitions.As used in this Article, unless the context requires otherwise: → § 90-171.20. Definitions. As used in this Article, unless the context requires otherwise:

    The section header is updated to include a space after the word 'Definitions.'

  • N.C.G.S. § 90-171.20

    (1) Advanced assessment. – The taking by an advanced practice registered nurse of the history, physical, and psychological assessment of a patient's signs, symptoms, pathophysiologic status, and psychosocial variations in the determination of differential diagnoses and treatment.

    Introduces a new definition for 'Advanced assessment' to clarify the role of APRNs.

  • N.C.G.S. § 90-171.20

    (1a) Advanced practice registered nurse or APRN. – An individual licensed by the Board as an advanced practice registered nurse within one of the following four roles: a. Nurse practitioner or NP. b. Certified nurse midwife or CNM. c. Clinical nurse specialist or CNS. d. Certified registered nurse anesthetist or CRNA.

    Adds a new definition for 'Advanced practice registered nurse' and outlines the specific roles.

  • N.C.G.S. § 90-171.20

    a registered nurse as a registered nurse, or as a licensed practical nurse, including a renewal thereof. → an advanced practice registered nurse, as a registered nurse, or as a licensed practical nurse, including a renewal or reinstatement thereof.

    Expands the definition of 'License' to include advanced practice registered nurses.

  • N.C.G.S. § 90-171.20

    b. Collaborating with other health care providers in determining the appropriate health care for a patient but, subject to the provisions of G.S. 90-18.2, not prescribing a medical treatment regimen or making a medical diagnosis, except under supervision of a licensed physician. → b. Collaborating with other health care providers in determining the appropriate health care for a patient but, subject to the provisions of G.S. 90-18.2, not prescribing a medical treatment regimen or making a medical diagnosis, except under supervision of a licensed physician.patient.

    Clarifies language regarding collaboration with health care providers.

  • N.C.G.S. § 90-171.20

    (6a) Population focus. – With respect to APRN practice, includes one of the following areas of focus: a. The family or the individual across the life span. b. Adult/gerontology. c. Neonatal. d. Pediatrics. e. Women's health or gender-related issues. f. Psychiatric mental health.

    Defines 'Population focus' regarding APRN practice to specify areas of care.

  • N.C.G.S. § 90-171.20

    (6b) Practice of nursing as an advanced practice registered nurse or APRN. – In addition to the RN scope of practice and within the APRN role and population foci, also consists of the following six components: a. Conducting an advanced assessment. b. Delegating and assigning therapeutic measures to assistive personnel. c. Performing other acts that require education and training consistent with professional standards and commensurate with the APRN's education, certification, demonstrated competencies, and experience. d. Complying with the requirements of this Article and rendering quality advanced nursing care. e. Recognizing limits of knowledge and experience. f. Planning for the management of situations beyond the APRN's expertise.

    Details the components of the practice of nursing for APRNs, enhancing their defined roles.

  • N.C.G.S. § 90-18.2

    The section is repealed.

    Eliminates the existing limitations placed on nurse practitioners.

  • N.C.G.S. § 90-18(c)

    practicing medicine or surgery as defined in this Article. → practicing medicine or surgery as defined in this Article: (7) The practice of midwifery as defined in G.S. 90-178.2.

    Updates additional exemptions for what constitutes practicing medicine.

Action History

  1. Serial Referral To Insurance Stricken

  2. Serial Referral To Finance Stricken

  3. Withdrawn From Com

  4. Re-ref Com On Rules, Calendar, and Operations of the House

  5. Serial Referral To Rules, Calendar, and Operations of the House Stricken

  6. Serial Referral To Finance Added

  7. Serial Referral To Rules, Calendar, and Operations of the House Added

  8. Passed 1st Reading

  9. Ref to the Com on Health, if favorable, Insurance, if favorable, Rules, Calendar, and Operations of the House

  10. Filed

Sponsors

Sponsorship breakdown

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3 sponsors · 73 co-sponsors · 103 not signed on

Sponsors (3)

Co-sponsors (73)

Not signed on (103)

103 members have not signed on to this bill.

Show all 103 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Second Reading

Passed 48 Yea · 0 Nay · 2 Other
Party YeaNayPresentNot Voting
Unaffiliated 35000
Democratic 6000
Republican 7002
Total 48002
% of votes cast 96%0%0%4%
How each member voted (50)
Member Party Vote
Apodaca — Yea
Bingham — Yea
Curtis — Yea
Foushee — Yea
Harrington — Yea
D.Davis — Yea
J.Jackson — Yea
Bryant — Yea
Smith — Yea
Smith-Ingram — Yea
VanDuyn — Yea
Brown — Yea
J.Davis — Yea
B.Jackson — Yea
Newton — Yea
Tucker — Yea
Barefoot — Yea
Barringer — Yea
Brock — Yea
Gunn — Yea
Hartsell — Yea
Meredith — Yea
Pate — Yea
Rabin — Yea
Rucho — Yea
Tarte — Yea
Tillman — Yea
Wade — Yea
Wells — Yea
Krawiec — Yea
McKissick — Yea
Randleman — Yea
Soucek — Yea
Stein — Yea
Woodard — Yea
Amanda P. Cook Democratic Yea
Dan Blue Democratic Yea
Gladys A. Robinson Democratic Yea
Joyce Waddell Democratic Yea
Paul A. Lowe, Jr. Democratic Yea
Tracy Clark Democratic Yea
Bill Rabon Republican Not Voting
Carl Ford Republican Yea
Michael V. Lee Republican Yea
Norman W. Sanderson Republican Yea
Phil Berger Republican Yea
Ralph Hise Republican Yea
Tom McInnis Republican Not Voting
W. Ted Alexander Republican Yea
Warren Daniel Republican Yea

Official roll call →

Second Reading

Passed 114 Yea · 0 Nay · 6 Other
Party YeaNayPresentNot Voting
Democratic 10002
Unaffiliated 79004
Republican 23000
U 1000
Total 113006
% of votes cast 95%0%0%5%
How each member voted (119)
Member Party Vote
Avila — Yea
Bishop — Yea
Boles — Yea
Bradford — Yea
Conrad — Yea
Dobson — Yea
Faircloth — Yea
Farmer-Butterfield — Yea
Fisher — Yea
Floyd — Yea
Fraley — Yea
Gill — Yea
Horn — Yea
Jordan — Yea
L.Bell — Yea
C.Graham — Yea
G.Graham — Yea
D.Hall — Yea
L.Hall — Yea
Jackson — Yea
R.Johnson — Yea
G.Martin — Yea
R.Moore — Yea
Queen — Yea
B.Richardson — Yea
B.Turner — Yea
J.Bell — Yea
Brawley — Yea
B.Brown — Yea
R.Brown — Yea
Baskerville — Yea
Bryan — Yea
Bumgardner — Yea
Burr — Yea
Catlin — Yea
Cleveland — Yea
Collins — Yea
Dollar — Yea
Earle — Yea
Elmore — Yea
Glazier — Yea
Goodman — Yea
Hager — Yea
Hamilton — Yea
Hanes — Yea
Hardister — Yea
Holley — Yea
Holloway — Yea
Hunter — Yea
Insko — Yea
Lucas — Yea
Michaux — Yea
Salmon — Yea
Terry — Yea
Wray — Yea
L.Johnson — Yea
Jones — Yea
S.Martin — Yea
T.Moore(Speaker) — Yea
R.Turner — Yea
Malone — Not Voting
Stam(Chair) — Not Voting
Daughtry — Not Voting
Hurley — Yea
Jeter — Yea
Langdon — Yea
Lewis — Not Voting
McElraft — Yea
McNeill — Yea
Pendleton — Yea
Presnell — Yea
Saine — Yea
Speciale — Yea
Szoka — Yea
West — Yea
Yarborough — Yea
Luebke — Yea
McGrady — Yea
Millis — Yea
Schaffer — Yea
Steinburg — Yea
Whitmire — Yea
Zachary — Yea
Becky Carney Democratic Yea
Cecil Brockman Democratic Yea
Dante Pittman Democratic Not Voting
Eric Ager Democratic Yea
Gale Adcock Democratic Yea
Garland E. Pierce Democratic Yea
Gladys A. Robinson Democratic Yea
Graig Meyer Democratic Not Voting
Joyce Waddell Democratic Yea
Pricey Harrison Democratic Yea
Robert T. Reives, II Democratic Yea
Shelly Willingham Democratic Yea
Carl Ford Republican Yea
Dean Arp Republican Yea
Dennis Riddell Republican Yea
Donny Lambeth Republican Yea
Frank Iler Republican Yea
Harry Warren Republican Yea
Hugh Blackwell Republican Yea
Jay Adams Republican Yea
Jimmy Dixon Republican Yea
John A. Torbett Republican Yea
John M. Blust Republican Yea
Julia C. Howard Republican Yea
Kelly E. Hastings Republican Yea
Mark Brody Republican Yea
Mitchell S. Setzer Republican Yea
Phil Shepard Republican Yea
Sam Watford Republican Yea
Sarah Stevens Republican Yea
Stephen M. Ross Republican Yea
Ted Davis, Jr. Republican Yea
Tricia Ann Cotham Republican Yea
W. Ted Alexander Republican Yea
William D. Brisson Republican Yea
Carla D. Cunningham U Yea

Official roll call →

Subjects

healthcare labor
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Frequently asked questions

Who sponsors HB 277?
HB 277 is sponsored by Jake Johnson (Republican), R. Smith, K. Smith, Donna McDowell White (Republican), Adcock, Carla D. Cunningham (U), Diane Wheatley (Republican), Marcia Morey (Democratic), Howard Penny, Jr. (Republican), Ray Pickett (Republican), Garland E. Pierce (Democratic), Mark Pless (Republican), Robert T. Reives, II (Democratic), Richardson, Dennis Riddell (Republican), James Roberson (Democratic), Sasser, Mitchell S. Setzer (Republican), Larry C. Strickland (Republican), Szoka, Terry, Brian Turner (Democratic), Shelly Willingham (Democratic), Wray, Alexander, Autry, Amber M. Baker (Democratic), Mary Belk (Democratic), Hugh Blackwell (Republican), Bradford, Terry M. Brown Jr. (Democratic), Deb Butler (Democratic), Becky Carney (Democratic), Carter, Clemmons, Cleveland, Cooper-Suggs, Allison A. Dahle (Democratic), Elmore, Everitt, Farkas, Fisher, Gailliard, Gill, Edward C. Goodwin (Republican), Graham, Dudley Greene (Republican), Hardister, Harris, Pricey Harrison (Democratic), Julia C. Howard (Republican), Hunt, Hunter, Hurley, Hurtado, Frank Iler (Republican), Insko, Abe Jones (Democratic), Brenden H. Jones (Republican), Keith Kidwell (Republican), Donny Lambeth (Republican), Ted Davis, Jr. (Republican), Mike Clampitt (Republican), Cecil Brockman (Democratic), Julie von Haefen (Democratic), Sarah Stevens (Republican), Dante Pittman (Democratic), Ben T. Moss, Jr. (Republican), Eric Ager (Democratic), Carolyn G. Logan (Democratic), Lucas, Nasif Majeed (U), Jeffrey C. McNeely (Republican), McNeill, Meyer, and Charles W. Miller (Republican).
What is the current status of HB 277?
This bill died with 2021-2022 Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HB 277?
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