State Lawmakers Reach Compromise Regarding Advanced Practice Registered Nurse's License

Thursday, May 8th, 2025 -- 8:00 AM

(Sarah Lehr, Wisconsin Public Radio) For years, Wisconsin lawmakers have proposed creating a new license that would give more independence to nurses with advanced credentials.

According to Sarah Lehr with the Wisconsin Public Radio, previous versions of the proposal have stopped short of becoming law amid opposition from groups representing physicians.

But now, both Democratic and Republican lawmakers say they’ve reached a new compromise. Under the bill, some types of nurses could apply for what’s known as an Advanced Practice Registered Nurse’s License, or APRN.

That includes nurses with certain post-graduate degrees, as well nurse practitioners, certified nurse-midwives, certified registered nurse anesthetists and clinical nurse specialists.

In some circumstances, licensed APRNs would be allowed to set up their own practices after first completing at least 3,840 hours of clinical training under the supervision of a physician or dentist. State Sen. Patrick Testin, an author of the proposal, says expanding the role of APRNs will help counter Wisconsin’s provider shortage.

“By empowering our APRNs to operate at the highest scope of their practice, there is no question that they are going to stand up and deliver top quality health care for the patients in every corner of the state, especially in our rural and underserved areas,” the Stevens Point Republican said at a news conference Tuesday.

Licensure for APRNs has long been supported by the Wisconsin Nurses Association. Twenty-seven other states have a similar legislation in place, according to the association.

“Despite a couple setbacks for the last couple sessions, we’ve had very productive conversations with the various stakeholders, along with Gov. Tony Evers, and we have a deal in place that if and when this bill reaches his desk, it will get signed into law,” Testin said Tuesday.

A spokesperson for Evers’ office confirmed the governor plans to sign the bill if it gets to his desk. The Democratic governor has twice vetoed previous proposals which would have created a new license for APRNs.

In a veto message last year, Evers wrote that he supports creating a new license that would allow APRNs to practice independently. But he said he was opposed to the level of standards laid out in that previous bill.

“I object to new licensure and practice standards for APRNs, especially those APRNs practicing independently, that do not provide adequate experience requirements, titling protections, and safeguards for patients who may be treated for chronic pain management,” the governor wrote.

On Tuesday, Testin and other sponsors of the new legislation said they’ve since addressed previous concerns. That includes changes like increasing the length of supervised time needed under a physician before APRNs can practice on their own, and adding oversight requirements for nurse anesthetists working in pain management, sponsors said.

Additionally, Testin said the latest version gives the Medical Examining Board “a little bit more teeth” when it comes to taking enforcement action against APRNs who use professional titles they don’t hold.

The Wisconsin Medical Society, which represents physicians, has come out against prior versions of the bill. But on Tuesday, Wisconsin Medical Society lobbyist Mark Grapentine, says the society is “gratified” that lawmakers have addressed those concerns in the legislation announced this week.

“We will continue to follow the bill’s process to ensure the important patient protections in the introduced version get to the Governor’s desk”, Grapentine wrote in an email to WPR.

“Physician-led team-based care remains the gold standard for quality care. While this bill allows movement away from that, this compromise helps alleviate some of our specific concerns.”

Last session, the Republican-controlled Legislature rejected an amendment from state Rep. Lisa Subeck, D-Madison, which she said would have allowed a previous version of the bill to secure the governor’s signature.

On Tuesday, Subeck joined Republicans and other Democrats in supporting the new version of the legislation. “Often the devil’s in the details,” Subeck said Tuesday.

“We all agree that we need better access to health care. … This is a bill that, at the end of the day, ensures that we can expand access to health care without compromising quality.”

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