S 2996 — Eliminates certain practice restrictions for advanced practice nurses.

2026, c.006 (S2996CHAPTER SCS)6 §1  C.45:11-48.1An §§9,10Act C.45:11-52.1concerning advanced practice nurses, revising various parts of the statutory law, and 45:11-52.2supplementing  P.L.1991, P.L.c.377 (C.45:11-45 et al.).

2026, CHAPTER 6, approved March 30, 2026 Senate Committee Substitute for Senate, No.

2996     An Act concerning advanced practice nurses, revising various parts of the statutory law, and supplementing P.L.1991, c.377 (C.45:11-45 et al.).

      C.45:11-48.1  1.   Findings, (Newdeclarations. section) The Legislature finds and declares that:

     1.    The Legislature finds and declares that:

territories have adopted full practice authority for advanced practice nurses.  The requirement to practice in collaboration with a physician limits the ability of advanced practice nurses to provide primary care and specialty care services,services and has been associated with advanced practice nurses leaving New Jersey for other jurisdictions with fewer practice restrictions.

  C.45:11-23  Definitions.

     a.     The words "the board" mean the New Jersey Board of Nursing created by this act.

     b.    The practice of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential physical and emotional health problems,problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens as prescribed by a licensed or otherwise legally authorized physician or dentist.

Diagnosing Diagnosing in the context of nursing practice means the identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen within the scope of practice of the registered professional nurse.  Such diagnostic privilege is distinct from a medical diagnosis.  Treating means selection and performance of those therapeutic measures essential to the effective management and execution of the nursing regimen.  Human responses means those signs, symptoms, and processes which denote the individual's health need or reaction to an actual or potential health problem.

     The practice of nursing as a licensed practical nurse is defined as performing tasks and responsibilities within the framework of casefinding;casefinding, reinforcing the patient and family teaching program through health teaching, health counseling, and provision of supportive and restorative care, under the direction of a registered nurse or licensed or otherwise legally authorized physician or dentist.

reinforcing     theThe patientterms "nursing," "professional nursing," and family"practical teachingnursing" programas throughused healthin teaching,this healthact counselingshall andnot provisionbe construed to include nursing by students enrolled in a school of supportivenursing accredited or approved by the board performed in the prescribed course of study and restorativetraining, care,nor undernursing performed in hospitals, institutions, and agencies approved by the directionboard for this purpose by graduates of such schools pending the results of the first licensing examination scheduled by the board following completion of a registeredcourse nurseof orstudy licensedand ortraining otherwiseand legallythe authorizedattaining physicianof age qualification for examination, or dentist.thereafter with the approval of the board in the case of each individual pending results of subsequent examinations;

    nor Theshall termsany "nursing,"of "professionalsaid nursing,"terms and "practical nursing" as used in this act shall not be construed to include nursing byperformed studentsfor enrolled in a schoolperiod ofnot nursingexceeding accredited12 ormonths approvedunless by the board performedshall inapprove thea prescribedlonger courseperiod, of study and training, nor nursing performed in hospitals, institutionsinstitutions, andor agencies approved by thea boardnurse forlegally thisqualified purposeunder by graduates of such schools pending the resultslaws of theanother firststate licensingor examinationcountry, scheduledpending byresults the board following completion of aan courseapplication offor studylicensing andunder trainingthis andact, theif attainingsuch ofnurse agedoes qualificationnot forrepresent examination, or thereafterhold withhimself theor approvalherself ofout theas boarda innurse thelicensed caseto ofpractice eachunder individualthis pendingact; results of subsequent examinations;

nor shall any of said terms be construed to include nursing performed for a period not exceeding 12 months unless the board shall approve a longer period, in hospitals, institutions or agencies by a nurse legally qualified under the laws of another state or country, pending results of an application for licensing under this act, if such nurse does not represent or hold himself or herself out as a nurse licensed to practice under this act;

nor shall any of said terms be construed to include services performed by nursesnurse aides, attendants, orderliesorderlies, and ward helpers in hospitals, institutionsinstitutions, and agencies or by technicians, physiotherapists, or medical secretaries, and such duties performed by said persons aforementioned shall not be subject to rules or regulations which the board may prescribe concerning nursing;

nor shall any of said terms be construed to include first aid nursing assistance, or gratuitous care by friends or members of the family of a sick or infirm person, or incidental care of the sick by a person employed primarily as a domestic or housekeeper, notwithstanding that the occasion for such employment may be sickness, if such incidental care does not constitute professional nursing and such person does not claim or purport to be a licensed nurse;

     c.     "Homemaker-home health aide" means a person who is employed by a home care services agency and who is performing delegated nursing regimens or nursing tasks delegated through the authority of a duly licensed registered professional nurse.  No homemaker-home health aide shall follow a delegated nursing regimen or perform tasks which are delegated unless the homemaker-home health aide is under the supervision of a duly licensed registered professional nurse provided by the home care services agency that directly employs the homemaker-home health aide.

"Home care services agency" means home health agencies, assisted living residences, comprehensive personal care homes, assisted living programs or alternate family care sponsor agencies licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et al.), nonprofit homemaker-home health aide agencies, and health care service firms regulated by the Director of the Division of Consumer Affairs in the Department of Law and Public Safety and the Attorney GeneralGeneral, pursuant to P.L.1989, c.331 (C.34:8-43 et seq.) and P.L.1960, c.39 (C.56:8-1 et seq.) respectively, which are engaged in the business of procuring or offering to procure employment for homemaker-home health aides,aides where a fee may be exacted, chargedcharged, or received directly or indirectly for procuring or offering to procure that employment.       d.    "Advanced practice nurse" means a person who holds a certification in accordance with section 8 or 9 of P.L.1991, c.377 (C.45:11-47 or 45:11-48).C.45:11-48).

     e.     "Collaborating physician" means a person licensed to practice medicine and surgery pursuant to chapter 9 of Title 45 of the Revised Statutes who agrees to work with an advanced practice nurse.

     f.“Primary health care” means preventative, diagnostic, treatment, management, or reassessment services which are provided in a family-centered and community-oriented manner to an individual with acute or chronic illness in the areas of family practice, general internal medicine, general pediatrics, general obstetrics, gynecology and reproductive health services, or clinical prevention:

“Primary health care” means preventative, diagnostic, treatment, management, or reassessment services which are provided in a family-centered and community oriented manner to an individual with acute or chronic illness in the areas of family practice, general internal medicine, general pediatrics, general obstetrics, gynecology and reproductive health services, or clinical prevention:

"Primary health care" includes sick or well care that is provided to any and all age groups,groups from perinatal and pediatric care to geriatric care.

     g.  “Reproductive “Reproductive health services” means medical, surgical, counseling, or referral services relating to the human reproductive system.

     h. “Behavioral health care” mean procedures or services rendered by a health care practitioner to a patient for the treatment of a mental illness, emotional disorder, or drug or alcohol use disorder.

“Behavioral     health “Higher level of care” meanmeans proceduresa orclinically servicesappropriate renderedlevel byof abehavioral health care practitionertreatment tothat provides a patientgreater fordegree theof treatmentsupervision, ofintensity, astructure, mentalor illness,medical emotionalmonitoring disorder,than orthe druglevel orof alcoholcare usecurrently disorder.being provided to a patient.

     i.  “Higher level of care” means a clinically appropriate level of behavioral health care treatment that provides a greater degree of supervision, intensity, structure, or medical monitoring than the level of care currently being provided to a patient.

(cf:       3.    Section 10 of P.L.1991, c.377 (C.45:11-49) is amended to read as follows:

P.L.2019, c.48, s.2)       C.45:11-49  3.   Permitted Sectionduties 10 of P.L.1991,advanced c.377practice (C.45:11-49)nurse. is amended to read as follows:

In addition to all other tasks which a registered professional nurse may, by law, perform, an advanced practice nurse may manage preventive care servicesservices, [and] , diagnose, monitor, and manage deviations from wellness and long-term illnesses, consistent with the needs of the patient and within the defined scope of practice of [the] that advanced practice nurse, by:

     (2)   prescribing, authorizing, or ordering medications and devices, as authorized by subsections [b.b., c., g., or h.

and c.] b., c., g., or h.

and      (3)   prescribing or ordering treatments, including referrals to other licensed health care professionals, and performing specific procedures in accordance with the provisions of this [subsection] section.

     (3)   the advanced practice nurse writes the prescription on a New Jersey Prescription Blank pursuant to P.L.2003, c.280 (C.45:14-40 et seq.), signs the nurse's own name to the prescriptionprescription, and prints the nurse's name and certification number;

     e.     (Deleted by amendment, P.L.2004, c.122.)      f.     An attending advanced practice nurse may determine and certify the cause of death of the nurse's patient and execute the death certification pursuant to R.S.26:6-8 if no [collaborating] physician is available to do so and the nurse is the patient's primary caregiver.

     g.   g. [An] (1)  Except as otherwise provided in paragraph (2) of this subsection, an advanced practice nurse may authorize qualifying patients for the medical use of cannabis and issue written instructions for medical cannabis to registered qualifying patients, subject to the following conditions:

    (1) [(1)]Except (a)    as theotherwise collaboratingprovided physician and advanced practice nurse shall address in theparagraph joint(2) protocolsof whetherthis priorsubsection, consultationan withadvanced thepractice collaboratingnurse physicianmay is required to authorize a qualifying patientpatients for the medical use of cannabis orand issue written instructions for medical cannabis;cannabis to registered qualifying patients, subject to the following conditions:

     [(2)](a)   (b)     the authorizationcollaborating forphysician theand medicaladvanced usepractice ofnurse cannabisshall oraddress issuancein ofthe writtenjoint instructionsprotocols forwhether cannabisprior isconsultation in accordance with standingthe orderscollaborating orphysician jointis protocolsrequired developedto inauthorize agreement between a collaboratingqualifying physicianpatient andfor the advancedmedical practiceuse nurse,of cannabis or pursuantissue towritten theinstructions specificfor directionmedical ofcannabis; a physician;

     [(3)](b)   (c)    the authorization for the advancedmedical practiceuse nurseof signscannabis theor nurse'sissuance ownof namewritten toinstructions thefor authorizationcannabis is in accordance with standing orders or writtenjoint instructionprotocols developed in agreement between a collaborating physician and printsthe advanced practice nurse, or pursuant to the nurse'sspecific namedirection andof certificationa number;physician;

     [(4)](c)   (d)     the authorizationadvanced orpractice writtennurse instructionsigns isthe datednurse's andown includes the name ofto the qualifyingauthorization patientor andwritten theinstruction name, address, and telephoneprints numberthe ofnurse's thename collaboratingand physician;certification number;

     [(5)](d)   (e) the physicianauthorization or written instruction is presentdated orand readilyincludes availablethe throughname electronicof communications;the qualifying patient and the name, address, and telephone number of the collaborating physician;