I want to begin by apologizing for the delay in providing this update.  I was hoping that there would be more information available during the days following the November 15 Public Hearing on AB 154 The APRN Modernization Act, but there is nothing more to share. Here is a summary of the hearing.

The Assembly Health, Aging and Long-Term Committee held a public hearing on the APRN Modernization Act, AB 154 that also included Senate Bill 145 that was passed by the Senate on October 17, 2023. The hearing began at 10:00 am with hearings on a variety of other bills. The hearing AB 154 started at around 2:00 pm and ended at 5:00 pm

There were over fifty APRNs, APRN students, and non-nurses in attendance that registered in favor of the bill.  Testimony in favor of the bill was provided by the two bill sponsors, Rep. Gae Magnafici, Details and Senator Patrick Testin Details and Sen. Rachael Cabral-Guevera, last session’s bill sponsor in the Assembly.

Other testifiers represented the Wisconsin Nurses Association, American College of Nurse Midwives, Wisconsin Affiliate, Wisconsin Association of Nurse Anesthetists, Wisconsin Association of Clinical Nurse Specialists, Wisconsin Association for Justice, Medical Economist, Jeff Bauer, https://jeffbauerwords.com/speeches/biographical-sketch/, and others practicing as Psych-Mental Health CNS, Family Practice NP, Tribal clinic NPs and Free Clinics.  They focused on their practice and what they bring to quality care and how full practice authority can be achieved through removal of the mandated APRN and physician collaboration agreement throughout all of the statutes.

Two individuals testified in opposition. One was a physician representing the Wisconsin Chapter of the American College of Emergency Physicians, who requested that the language included in the Governor’s original bill be put back in. The language required all emergency departments to always have a certified emergency physician on staff.

The second individual was the lobbyist for the Wisconsin Medical Society. He shared support for an amendment that would require:

1. New APRN graduates wanting to establish their own independent practice have 2 years of RN experience and 2 years of physician collaboration prior to being a business owner. WNA opposes this concept as it is a restriction of trade and there is no evidence that working two years as a RN contributes to a better APRN. The roles are very different.
2. An independent practicing APRN will need to have a collaborative agreement with a physician with pain management experience in order to provide chronic pain management services.  WNA opposes this on the basis that there is no definition of chronic pain management services and there is a shortage of pain management physicians. This will limit patient access to timely and appropriate care provided by APRNs.  
3. Title protection for physicians that have the suffix “ologist” in their title. This will prevent CRNAs from changing their title to “nurse anesthesiologist”. WNA opposes any form of title protection that does not apply to nurses and needs to stay out of our nurse practice act statute 441.  
4. Independent practicing APRNs will become a part of the Injured Patient and Family Compensation Fund.  WNA supports this as it provides financial remedies related to patient harm. 

The above four proposed “amendments” suggested language was the focus of the questions asked by committee members to those individuals testifying.

WNA would like to thank the fifty (50) APRNs who attended the APRN Legislation Breakfast Briefing, had meetings with their State Assembly Representative, and submitted testimony and support for AB 154.  It was a long day.

Next Steps

It is our understanding that the Assembly Committee will hold a vote on the bill that may include the amendments in some form. The timeline will probably be in January 2024.  WNA continues to work with the Governor’s Office to share our continued concerns regarding the proposed amendments and offer consensus language.

In the meantime, WNA requests your financial support for our advocacy efforts. The WNA Advocacy Fund was established to cover the costs of advocating for the nurses of Wisconsin to advance, support and protect our practice which benefits the care of Wisconsinites. To make a contribution please go to:  https://www.cognitoforms.com/WisconsinNursesAssociation/HelpWNAAdvocateForYou

WNA will keep you posted. Thank you for all you do!

Gina Dennik-Champion, MSN, RN, MSHA

WNA Executive Director