SF 511 creates a separate license for advanced practice registered nurses (APRN) and permits licensed advanced practice nurses to practice independently without a collaborative agreement.

Section 1 (148.171, subd. 3) makes a conforming change to the definition of an advanced practice registered nurse to specify that the individual is licensed.

Section 2 (148.171, subd. 4a) defines certification.

Section 3 ( 148.171, subd. 5) modifies the definition of clinical nurse specialist practice.

Section 4 (148.171, subd. 6a) defines collaboration.

Section 5 (148.171, subd. 9) makes a technical change.

Section 6 (148.171, subd. 10) modifies the definition of nurse-midwife practice.

Section 7 (148.171, subd. 11) modifies the definition of nurse practitioner practice.  The practice is defined as providing care, including (1) health promotion, disease prevention, health education, and counseling; (2) providing health assessment and screening activities; (3) diagnosing, treating, and facilitating patient management of their acute and chronic illnesses and diseases; (4) ordering, performing, supervising, and interpreting diagnostic studies, excluding interpreting certain scans and mammography; (5) prescribing pharmacologic and nonpharmacologic therapies; and (6) consulting with, collaborating with, or referring to other health care providers as warranted by the needs of the patient.

Section 8 (148.171, subd. 12a) defines population focus.

Section 9 (148.171, subd. 13) modifies the definition of the practice of advanced practice registered nursing to require the performance of an expanded scope of nursing in at least one of the recognized advanced practice registered nurse roles for at least one population focus. The practice also requires the APRN to be accountable (1) to patients for the quality of the care rendered; (2) for recognizing limits of knowledge and experience; and (3) for planning for the management of situations beyond the APRN’s experience.  The practice also includes accepting referrals from, consulting with, collaborating with, or referring to other health care providers as warranted by the needs of the patient.

Section 10 (148.171, subd. 16) modifies the definition of prescribing to state that it does not include the recommending or administering of a drug or therapeutic device for anesthesia by a certified registered nurse anesthetist.

Section 11 (148.171, subd. 17) amends the definition of prescription to clarify that any prescription for a drug must comply with section 151.01, subdivisions 16, 16a, and 16b.

Section 12 (148.171, subd. 17a) adds a definition for primary care provider.

Section 13 (148.171, subd. 21) modifies the definition for registered nurse anesthetist practice.  Paragraph (a) specifies that the practice is defined as providing anesthesia care and services, including:  (1) administering drugs and devices to facilitate diagnostic, therapeutic, and surgical procedures; (2) ordering, performing, supervising, and interpreting diagnostic studies, excluding interpreting certain scans and mammography; (3) prescribing therapies; and (4) consulting with, collaborating with, or referring to other health care providers as warranted by the needs of the patient.

Paragraph (b) specifies that a CRNA may only perform nonsurgical therapies for acute and chronic pain symptoms upon referral and in collaboration with a physician licensed under chapter 147.  Defines the collaborative plan that must be in place for purposes of performing nonsurgical therapies for acute and chronic pain symptoms, and requires the registered nurse anesthetist to perform the nonsurgical therapies at the same licensed facility as the physician.

Paragraph (c) requires the registered nurse anesthetist, for purposes of providing nonsurgical therapies for chronic pain symptoms, to have a written prescribing agreement with a physician licensed under chapter 147 that defines the delegated responsibilities related to prescribing drugs and therapeutic devices.

Section 14 (148.171, subd. 23) defines roles of advanced practice registered nurses as one of the following:  certified registered nurse anesthetist, certified nurse midwife, certified nurse specialist, or certified nurse practitioner.

Section 15 (148.181, subd. 1) makes a conforming change.

Section 16 (148.191, subd. 2) makes a conforming change.

Section 17 (148.211, subd. 1a) specifies that effective January 1, 2016, an APRN must be licensed by the Board of Nursing as an advanced practice registered nurse.  Specifies the requirements for licensure.

Section 18 (148.211, subd. 1b) creates a grandfather clause that requires the board to issue a license to an applicant who does not meet the education requirements for licensure if the applicant is recognized by the board to practice as an APRN in this state on July 1, 2015, submits an application to the board for licensure by January 1, 2016; and meets the other licensure requirements.

Section 19 (148.211, subd. 1c) requires a nurse practitioner or clinical nurse specialist to practice for at least 2,080 hours within a collaborative agreement within a hospital or integrated clinical setting where advanced practice registered nurses and physicians work together to provide patient care.  Defines a collaborative agreement. 

Section 20 (148.211, subd. 2) states that an applicant  for APRN licensure by endorsement  is eligible for licensure if the applicant is licensed or registered as a professional nurse, demonstrates national certification or recertification in the advanced role and population focus area, and complies with the advanced practice nursing educational requirements that were in effect in Minnesota at the time the advanced practice registered nurse completed the advanced practice nursing education program.

Section 21 (148.231, subd. 1) makes conforming changes and specifies that an applicant for registration APRN renewal must provide evidence of current certification or recertification in the appropriate APRN role in at least one population focus by a nationally accredited certifying body recognized by the board.

Section 22 (148.231, subd. 4) makes a conforming change.

Section 23 (148.231, subd. 5) makes a conforming change.

Section 24 (148.233, subd. 2) specifies that only a person who holds a current license to practice advanced practice registered nursing may use the title of advanced practice registered nurse with role designation.  Requires the APRN to use the appropriate designation for personal identification and in documentation of provided services.  Permits an APRN with an earned doctorate to use the term doctor.  Requires an APRN to provide clear identification of the appropriate APRN designation when providing nursing care.

Section 25 (148.234) makes conforming changes.

Section 26 (148.235, subd. 7a) specifies that an APRN is authorized to (1) diagnose, prescribe, and institute therapy or referrals of patients to health care agencies and providers; (2) prescribe, procure, sign for, record, administer, and dispense over the counter, legend and controlled substances including sample drugs; and (3) plan and initiate a therapeutic regimen, including ordering and prescribing durable medical devices and equipment, nutrition, diagnostic, and supportive services.

Section 27 (148.235, subd. 7b) requires APRNs to comply with DEA requirements related to controlled substances and file all of the nurse’s DEA registration and numbers with the board.  The board is required to maintain records of all APRNs with DEA registration and numbers.

Sections 28 to 34 makes conforming changes.

Section 35 (148.281, subd. 3 ) specifies that an APRN who practices advanced practice registered nursing without a current license and certification or recertification shall pay a penalty fee.

Section 36 (148.283) makes a conforming change.

Section 37 (148.2841) creates the Advanced Practice Nursing Advisory Council.

Section 38 (151.01, subd. 23) modifies the definition of practitioner to include a licensed advanced practice registered nurse as the definition applies to chapter 151 (Board of Pharmacy).

Section 39 (152.12) clarifies for purposes of chapter 152 that includes the prescription drug monitoring program that a licensed advanced practice registered nurse may prescribe, administer, and dispense a controlled substance includes in Schedules II through V.

Section 40 establishes initial appointments and the convening of the first meeting of the advisory council.

Section 41 appropriates money to the Board of Nursing.

Section 42 repeals sections 148.235, subd. 1, 2, 2a, 4, 4a, 4b, 6, and 7; and 148.284.

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