New Law Will Allow Experienced Nurse Practitioners to Practice Independently

On March 11, 2020, Governor Ron DeSantis approved HB 607, which will permit advanced nurse practitioners (ARNP) to practice autonomously — that is, without consultation or supervision by a physician — if certain criteria are met.  Specifically, section 464.0123(1), Florida Statutes, allows ARNPs to apply to practice independently if they meet the following criteria:

1. Have an active, unencumbered license to practice;
2. Lack any disciplinary action as dictated by sections 456.072 or 464.018, Florida Statutes, or comparable disciplinary action from another state, territory, or jurisdiction within the past five (5) years from the date of the application;
3. Have a minimum of 3,000 clinical practice hours for the five (5) years preceding the application – which may have been completed in any state, jurisdiction, or territory of the United States, and include activities such as “clinical instructional hours” (defined as educational hours “provided by faculty in a clinical setting in a graduate program leading to a master’s or doctoral degree in a clinical nursing specialty area”);
4. Have completed three graduate-level semester hours in differential diagnosis and three graduate-level semester hours in pharmacology; and
5. Complete any further registration requirements dictated by the Board of Nursing.

§ 464.0123(1), Fla. Stat.

Autonomous practice by ARNP, however, is limited to primary care – including family medical, general pediatrics, and general internal medicine.  § 464.0123(3), Fla. Stat.  Certified nurse midwives who meet the requisite criteria may also practice autonomously, as limited by section 464.012(4)(c), Florida Statutes, and so long as a written transfer agreement and a written physician referral agreement is in place.  Id.

Notably, the new law allows ARNPs to not only admit patients to a facility, but also participate in and manage the care of their patient at a facility and discharge the patient as they deem medically fit.  § 464.0123(3)(a)(4), Fla. Stat.  It would, of course, be at the discretion of individual hospitals to allow ARNPs to practice in this manner; however, the legal basis to do so is now in place.

Additional rules to further clarify the scope and standards of practice of this law are anticipated from the Board of Nursing in conjunction with the newly created Council on Advanced Practice Registered Nurse Autonomous Practice.  The law is to take effect on July 1, 2020.