Florida Senate - 2023                                    SB 1058
       By Senator Rodriguez
       40-00461A-23                                          20231058__
    1                        A bill to be entitled                      
    2         An act relating to autonomous practice by advanced
    3         practice registered nurses; amending s. 395.0191,
    4         F.S.; exempting certain advanced practice registered
    5         nurses from specified medical direction requirements
    6         for clinical privileges in hospitals; amending s.
    7         464.0123, F.S.; revising the scope of autonomous
    8         practice for certain advanced practice registered
    9         nurses; revising requirements for certified nurse
   10         midwives registered to engage in autonomous practice;
   11         providing for the future expiration of the Council on
   12         Advanced Practice Registered Nurse Autonomous
   13         Practice; providing an effective date.
   15  Be It Enacted by the Legislature of the State of Florida:
   17         Section 1. Paragraph (b) of subsection (2) of section
   18  395.0191, Florida Statutes, is amended to read:
   19         395.0191 Staff membership and clinical privileges.—
   20         (2)
   21         (b) An advanced practice registered nurse who is certified
   22  as a registered nurse anesthetist licensed under part I of
   23  chapter 464 shall administer anesthesia under the onsite medical
   24  direction of a professional licensed under chapter 458, chapter
   25  459, or chapter 466, and in accordance with an established
   26  protocol approved by the medical staff. The medical direction
   27  shall specifically address the needs of the individual patient.
   28  This paragraph does not apply to an advanced practice registered
   29  nurse registered as an autonomous advanced practice registered
   30  nurse under s. 464.0123 who is a certified registered nurse
   31  anesthetist under part I of chapter 464.
   32         Section 2. Paragraphs (a) and (b) of subsection (3) of
   33  section 464.0123, Florida Statutes, are amended, and paragraph
   34  (e) is added to subsection (4) of that section, to read:
   35         464.0123 Autonomous practice by an advanced practice
   36  registered nurse.—
   37         (3) PRACTICE REQUIREMENTS.—
   38         (a) An advanced practice registered nurse who is registered
   39  under this section may:
   40         1. Engage in autonomous practice only in primary care
   41  practice, including family medicine, general pediatrics, and
   42  general internal medicine, as defined by board rule.
   43         2. For certified nurse midwives, engage in autonomous
   44  practice in the performance of the acts listed in s.
   45  464.012(4)(c).
   46         3. Perform the general functions of an advanced practice
   47  registered nurse under s. 464.012(3) and the acts within his or
   48  her specialty under s. 464.012(4) related to primary care.
   49         3.4. For a patient who requires the services of a health
   50  care facility, as defined in s. 408.032(8):
   51         a. Admit the patient to the facility.
   52         b. Manage the care received by the patient in the facility.
   53         c. Discharge the patient from the facility, unless
   54  prohibited by federal law or rule.
   55         4.5. Provide a signature, certification, stamp,
   56  verification, affidavit, or endorsement that is otherwise
   57  required by law to be provided by a physician, except an
   58  advanced practice registered nurse registered under this section
   59  may not issue a physician certification under s. 381.986.
   60         (b) A certified nurse midwife providing out-of-hospital
   61  birth services must have a written plan for the appropriate
   62  delivery of emergency care. A copy of the plan must be
   63  maintained on file and must include all of the following:
   64         1.The name and address of the closest hospital.
   65         2.Reasons for which an emergency transfer may be required.
   66         3.Emergency medical services to be used in the event of an
   67  emergency patient transfer agreement with a hospital and a
   68  written referral agreement with a physician licensed under
   69  chapter 458 or chapter 459 to engage in nurse midwifery.
   72         (e)The council shall dissolve, and this subsection
   73  expires, on July 1, 2024.
   74         Section 3. This act shall take effect July 1, 2023.