Identical to H 88, filed 2/13/17.

Enacts new GS 90-171.36B to prohibit an advanced practice registered nurse (APRN) from practicing as such without a license. Defines advanced practice registered nurse or APRN as an individual licensed by the The North Carolina Board of Nursing (Board) as an advanced practice registered nurse within one of the following four roles: (1) nurse practitioner or NP, (2) certified nurse midwife or CNM, (3) clinical nurse specialist or CNS, or (4) certified registered nurse anesthetist or CRNA. Sets out six requirements for licensure, including: holding a current North Carolina registered nurse license, having completed a graduate level APRN program accredited by a nursing or nursing‑related accrediting body that is recognized by the United States Secretary of Education or the Council for Higher Education Accreditation as acceptable to the Board, and being certified by a national certifying body recognized by the Board in the APRN role and population focus appropriate to educational preparation. Eancts GS 90-171.36C, which specifies conditions under which the Board must issue an APRN license to an applicant who does not meet the education or certification requirements. Enacts GS 90-171.36D, which specifies the process for APRN license renewal and reinstatement.  

Amends the definitions of terms used in the Nursing Practice Act. Adds definitions for advanced assessment, advanced practice registered nurse, nurse anesthesia activities, population focus, practice of nursing as an advanced practice registered nurse or APRN, practice of nursing as a certified nurse midwife or CNM, practice of nursing as a certified registered nurse anesthetist or CRNA, practice of nursing as a clinical nurse specialist or CNS, and practice of nursing as a nurse practitioner or NP. Amends the components listed that define the practice of nursing by a registered nurse to include collaborating with other health care providers in determining the appropriate health care for a patient (previously, limited to not prescribing a medical treatment regimen or making a medical diagnosis, except under the supervision of a licensed physician). Makes clarifying, organizational, and technical changes. 

Amends GS 90-18(c) to establish that the practice of nursing by a certified registered anesthetist does not constitute practicing medicine or surgery. Amends GS 90-29(b) to establish that a certified registered anesthetist administering anesthetic in collaboration with a licensed dentist or physician pursuant to GS 90-171.20(6d) does not constitute practicing dentistry.

Amends GS 90-171.21, concerning the Board, as follows. Adds that every registered nurse with an active advanced practice registered nurse license is eligible to vote in the election of the advanced practice registered nurse Board member. Amends the process for handling vacancies. Amends Board membership to require that one member be an APRN. Amends the criteria for Board membership to add requirements related to conduct. No longer requires the public member to be appointed by the Governor and prohibits the member from being a licensed nurse or a licensed health care professional or employed by a health care institution, health care insurer, or health care professional school. Sets out the criteria to be met by the advanced practice registered nurse member. Provides that changes to GS 90-171.21 apply to members newly appointed to the Board after the effective date of the act.

Amends the powers of the Board in GS 90-171.23 to include duties related to APRNs. Requires that the executive officer also hold an active North Carolina license. No longer requires request in order to grant or deny approval of continuing education programs. Includes the power to grant prescribing, ordering, dispensing, and furnishing authority to holders of the advanced practice registered nurse license (deletes duties related to the appointment and maintenance of a subcommittee working to develop rules governing the performance of medical acts by registered nurses). Clarifies the duty of establishing programs for monitoring the treatment, recovery, and the safe practice of nurses experiencing substance use disorders, mental health disorders, or physical conditions impacting the ability to deliver safe care. Gives the Board the power to order or subpoena any patient records, documents, or other material concerning any matter to be heard before or inquired into by the Board. Makes additional clarifying and conforming changes.

Amends GS 90-171.24 to require that the executive director hold an active North Carolina registered nurse license and meet specified criteria. Provides that the director also serves as the Administrator of the Nurse Licensure Compact. 

Amends GS 90-171.27 to set out fees for application for licensure, license renewal, and reinstatement of lapsed licenses for APRNs.

Enacts new GS 90-171.29A to allow the Board to require an applicant or licensee to submit to a mental examination or to a physical examination to determine competence.

Amends GS 90-171.30 to no longer require that the Board administer the licensing exam at least twice a year. 

Amends GS 90-171.33 to delete the the provision allowing the Board to issue a nonrenewable temporary license to persons applying for licensure until the implementation of the computer adaptive licensure exam. 

Amends GS 90-171.36 to provide that if within five years of being placed on inactive status, a person was to change his or her status to active, the person must submit an application and license reinstatement fee.

Amends GS 90-171.36A to no longer allow for the issuance of a special license in recognition of a nurse's retired status.

Amends GS 90-171.37 to provide that the Board has the power to to place on probation with or without conditions, impose limitations and conditions on, accept voluntary surrender, publicly reprimand, issue public letters of concern, require satisfactory completion of treatment programs or remedial or educational training, refuse to issue a certificate of renewal, fine, deny, suspend, or revoke a license or privilege to practice nursing in this state, issued by the Board to any person who has been found by the Board to have committed any of the specified acts, or for any of the specified reasons. Amends and adds to the prohibited acts. Allows the Board to limit, restrict, deny, suspend, or revoke prescriptive or dispensing authority of any APRN who holds prescriptive authority who has been found by the Board to have committed any of the specified acts concerning drugs. Adds that a felony conviction results in the automatic revocation of a license issued by the Board, unless the Board orders otherwise or receives a request for a hearing from the person within 60 days of receiving notice from the Board, after the conviction, of the provisions of this subsection. Provides that the Board and its members and staff are not to be held liable in any civil or criminal proceeding for exercising, in good faith, the powers and duties authorized by law.

Enacts new GS 90-171.37B concerning the Board's duties related to public records. Enacts new GS 90-171.37C concerning service of notice required under GS Chapter 90. 

Amends GS 90-171.40 to require the Board to review all nursing programs in the state at least every 10 (was, 8) years.

Amends GS 90-171.42 to no longer require a request before the Board grants approval to continuing education programs. 

Enacts new GS 90-171.49 to allow the Board to waive the requirements of the Act to permit providing emergency health services to the public during states of emergency.

Repeals GS 90-171.28, Nurses Registered Under Previous Law, and Article 10A of GS Chapter 90, Practice of Midwifery.

Makes additional conforming and clarifying changes.

Effective January 1, 2018.