Certified nurse midwives; not required to have written collaborative agreement with physician to practice as.

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To: Public Health and Human
Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representative Eubanks

HOUSE BILL NO. 418

AN ACT TO AMEND SECTIONS 73-15-5 AND 73-15-20, MISSISSIPPI 1
CODE OF 1972, TO AUTHORIZE CERTIFIED NURSE MIDWIVES TO PRACTICE AS 2
AN ADVANCED PRACTICE REGISTERED NURSE WITHOUT HAVING A WRITTEN 3
COLLABORATIVE/CONSULTATIVE RELATIONSHIP AGREEMENT WITH A PHYSICIAN 4
OR HAVING AN AGREEMENT WITH A PHYSICIAN REGARDING THE PROTOCOL OR 5
PRACTICE GUIDELINES OF THE CERTIFIED NURSE MIDWIFE; AND FOR 6
RELATED PURPOSES. 7
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 8
SECTION 1. Section 73-15-5, Mississippi Code of 1972, is 9
amended as follows: 10
73-15-5. (1) "Board" means the Mississippi Board of 11
Nursing. 12
(2) The "practice of nursing" by a registered nurse means 13
the performance for compensation of services which requires 14
substantial knowledge of the biological, physical, behavioral, 15
psychological and sociological sciences and of nursing theory as 16
the basis for assessment, diagnosis, planning, intervention and 17
evaluation in the promotion and maintenance of health; management 18
of individuals' responses to illness, injury or infirmity; the 19
restoration of optimum function; or the achievement of a dignified 20
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death. "Nursing practice" includes, but is not limited to, 21
administration, teaching, counseling, delegation and supervision 22
of nursing, and execution of the medical regimen, including the 23
administration of medications and treatments prescribed by any 24
licensed or legally authorized physician or dentist. The 25
foregoing shall not be deemed to include acts of medical diagnosis 26
or prescriptions of medical, therapeutic or corrective measures, 27
except as may be set forth by rules and regulations promulgated 28
and implemented by the Mississippi Board of Nursing. 29
(3) "Clinical nurse specialist practice" by a certified 30
clinical nurse specialist means the delivery of advanced practice 31
nursing care to individuals or groups using advanced diagnostic 32
and assessment skills to manage and improve the health status of 33
individuals and families; diagnose human responses to actual or 34
potential health problems; plan for health promotion, disease 35
prevention, and therapeutic intervention in collaboration with the 36
patient or client; implement therapeutic interventions based on 37
the nurse specialist's area of expertise and within the scope of 38
advanced nursing practice, including, but not limited to, direct 39
patient care, counseling, teaching, collaboration with other 40
licensed health care providers; and, coordination of health care 41
as necessary and appropriate and evaluation of the effectiveness 42
of care. 43
(4) "Advanced nursing practice" means, in addition to the 44
practice of professional nursing, the performance of 45
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advanced-level nursing approved by the board which, by virtue of 46
graduate education and experience are appropriately performed by 47
an advanced practice registered nurse. The advanced practice 48
registered nurse may diagnose, treat and manage medical 49
conditions. This may include prescriptive authority as identified 50
by the board. Advanced practice registered nurses must practice 51
in a collaborative/consultative relationship with a physician or 52
dentist with an unrestricted license to practice in the State of 53
Mississippi, except as otherwise authorized in Section 54
73-15-20(3), and advanced nursing must be performed within the 55
framework of a standing protocol or practice guidelines, as 56
appropriate. 57
(5) The "practice of nursing" by a licensed practical nurse 58
means the performance for compensation of services requiring basic 59
knowledge of the biological, physical, behavioral, psychological 60
and sociological sciences and of nursing procedures which do not 61
require the substantial skill, judgment and knowledge required of 62
a registered nurse. These services are performed under the 63
direction of a registered nurse or a licensed physician or 64
licensed dentist and utilize standardized procedures in the 65
observation and care of the ill, injured and infirm; in the 66
maintenance of health; in action to safeguard life and health; and 67
in the administration of medications and treatments prescribed by 68
any licensed physician or licensed dentist authorized by state law 69
to prescribe. On a selected basis, and within safe limits, the 70
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role of the licensed practical nurse shall be expanded by the 71
board under its rule-making authority to more complex procedures 72
and settings commensurate with additional preparation and 73
experience. 74
(6) A "license" means an authorization to practice nursing 75
as a registered nurse or a licensed practical nurse designated 76
herein. 77
(7) A "registered nurse" is a person who is licensed or 78
holds the privilege to practice under the provisions of this 79
article and who practices nursing as defined herein. "RN" is the 80
abbreviation for the title of Registered Nurse. 81
(8) A "licensed practical nurse" is a person who is licensed 82
or holds the privilege to practice under this article and who 83
practices practical nursing as defined herein. "LPN" is the 84
abbreviation for the title of Licensed Practical Nurse. 85
(9) A "registered nurse in clinical practice" is one who 86
functions in any health care delivery system which provides 87
nursing services. 88
(10) A "clinical nurse specialist" is a person who is 89
licensed or holds the privilege to practice under this article in 90
this state to practice professional nursing and who in this state 91
practices advanced nursing as defined herein. "CNS" is the 92
abbreviation for the title of Clinical Nurse Specialist. 93
(11) An "advanced practice registered nurse" is a person who 94
is licensed or holds the privilege to practice under this article 95
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and who is certified in advanced practice registered nurse or 96
specialized nursing practice and includes certified registered 97
nurse midwives, certified registered nurse anesthetists and 98
certified nurse practitioners. "CNM" is the abbreviation for the 99
title of Certified Nurse Midwife, "CRNA" is the abbreviation for 100
the title of Certified Registered Nurse Anesthetist. "CNP" is the 101
abbreviation for the title of Certified Nurse Practitioner. 102
(12) A "nurse educator" is a registered nurse who meets the 103
criteria for faculty as set forth in a state-accredited program of 104
nursing for registered nurses, or a state-approved program of 105
nursing for licensed practical nurses, and who functions as a 106
faculty member. 107
(13) A "consumer representative" is a person representing 108
the interests of the general public, who may use services of a 109
health agency or health professional organization or its members 110
but who is neither a provider of health services, nor employed in 111
the health services field, nor holds a vested interest in the 112
provision of health services at any level, nor has an immediate 113
family member who holds vested interests in the provision of 114
health services at any level. 115
(14) "Privilege to practice" means the multistate licensure 116
privilege to practice nursing in the state as described in the 117
Nurse Licensure Compact provided for in Section 73-15-201. 118
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(15) "Licensee" is a person who has been issued a license to 119
practice nursing in the state or who holds the privilege to 120
practice nursing in the state. 121
SECTION 2. Section 73-15-20, Mississippi Code of 1972, is 122
amended as follows: 123
73-15-20. (1) Advanced practice registered nurses. Any 124
nurse desiring to be certified as an advanced practice registered 125
nurse shall apply to the board and submit proof that he or she 126
holds a current license to practice professional nursing and that 127
he or she meets one or more of the following requirements: 128
(a) Satisfactory completion of a formal post-basic 129
educational program of at least one (1) academic year, the primary 130
purpose of which is to prepare nurses for advanced or specialized 131
practice. 132
(b) Certification by a board-approved certifying body. 133
Such certification shall be required for initial state 134
certification and any recertification as a registered nurse 135
anesthetist, nurse practitioner or nurse midwife. The board may 136
by rule provide for provisional or temporary state certification 137
of graduate nurse practitioners for a period of time determined to 138
be appropriate for preparing and passing the National 139
Certification Examination. Those with provisional or temporary 140
certifications must practice under the direct supervision of a 141
licensed physician or a certified nurse practitioner or certified 142
nurse midwife with at least five (5) years of experience. 143
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(c) Graduation from a program leading to a master's or 144
post-master's degree in a nursing clinical specialty area with 145
preparation in specialized practitioner skills. 146
(2) Rulemaking. The board shall provide by rule the 147
appropriate requirements for advanced practice registered nurses 148
in the categories of certified registered nurse anesthetist, 149
certified nurse midwife and advanced practice registered nurse. 150
(3) Collaboration. Except as otherwise authorized in this 151
subsection (3), an advanced practice registered nurse shall 152
perform those functions authorized in this section within a 153
collaborative/consultative relationship with a dentist or 154
physician with an unrestricted license to practice dentistry or 155
medicine in this state and within an established protocol or 156
practice guidelines, as appropriate, that is filed with the board 157
upon license application, license renewal, after entering into a 158
new collaborative/consultative relationship or making changes to 159
the protocol or practice guidelines or practice site. The board 160
shall review and approve the protocol to ensure compliance with 161
applicable regulatory standards. The advanced practice registered 162
nurse may not practice as an * * * advance practice registered 163
nurse if there is no collaborative/consultative relationship with 164
a physician or dentist and a board-approved protocol or practice 165
guidelines. However, a certified nurse midwife is not required to 166
have a written collaborative/consultative relationship agreement 167
with a physician or have an agreement with a physician regarding 168
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the protocol or practice guidelines of the certified nurse midwife 169
in order to practice as an advance practice registered nurse. 170
(4) Renewal. The board shall renew a license for an 171
advanced practice registered nurse upon receipt of the renewal 172
application, fees and protocol or practice guidelines. The board 173
shall adopt rules establishing procedures for license renewals. 174
The board shall by rule prescribe continuing education 175
requirements for advanced practice nurses not to exceed forty (40) 176
hours biennially as a condition for renewal of a license or 177
certificate. 178
(5) Reinstatement. Advanced practice registered nurses may 179
reinstate a lapsed privilege to practice upon submitting 180
documentation of a current active license to practice professional 181
nursing, a reinstatement application and fee, a protocol or 182
practice guidelines, documentation of current certification as an 183
advanced practice nurse in a designated area of practice by a 184
national certification organization recognized by the board and 185
documentation of at least forty (40) hours of continuing education 186
related to the advanced clinical practice of the nurse 187
practitioner within the previous two-year period. The board shall 188
adopt rules establishing the procedure for reinstatement. 189
(6) Changes in status. The advanced practice registered 190
nurse shall notify the board immediately regarding changes in the 191
collaborative/consultative relationship with a licensed physician 192
or dentist. If changes leave the advanced practice registered 193
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nurse without a board-approved collaborative/consultative 194
relationship with a physician or dentist, the advanced practice 195
registered nurse may not practice as an advanced practice 196
registered nurse. 197
(7) Practice requirements. The advanced practice registered 198
nurse shall practice: 199
(a) According to standards and guidelines of the 200
National Certification Organization. 201
(b) In a collaborative/consultative relationship with a 202
licensed physician whose practice is compatible with that of the 203
nurse practitioner, except as otherwise authorized in Section 204
73-15-20(3). Certified registered nurse anesthetists may 205
collaborate/consult with licensed dentists. The advanced practice 206
nurse must be able to communicate reliably with a 207
collaborating/consulting physician or dentist while practicing. 208
(c) According to a board-approved protocol or practice 209
guidelines. 210
(d) Advanced practice registered nurses practicing as 211
nurse anesthetists must practice according to board-approved 212
practice guidelines that address pre-anesthesia preparation and 213
evaluation; anesthesia induction, maintenance, and emergence; 214
post-anesthesia care; peri-anesthetic and clinical support 215
functions. 216
(e) Except as otherwise authorized in Section 217
73-15-20(3), advanced practice registered nurses practicing in 218
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other specialty areas must practice according to a board-approved 219
protocol that has been mutually agreed upon by the nurse 220
practitioner and a Mississippi licensed physician or dentist whose 221
practice or prescriptive authority is not limited as a result of 222
voluntary surrender or legal/regulatory order. 223
(f) Each collaborative/consultative relationship shall 224
include and implement a formal quality assurance/quality 225
improvement program which shall be maintained on site and shall be 226
available for inspection by representatives of the board. This 227
quality assurance/quality improvement program must be sufficient 228
to provide a valid evaluation of the practice and be a valid basis 229
for change, if any. 230
(g) Nurse practitioners may not write prescriptions 231
for, dispense or order the use of or administration of any 232
schedule of controlled substances except as contained in this 233
chapter. 234
(8) Prescribing controlled substances and medications. 235
Certified nurse midwives and certified nurse practitioners may 236
apply for controlled substance prescriptive authority after 237
completing a board-approved educational program. Certified nurse 238
midwives and certified nurse practitioners who have completed the 239
program and received prescription authority from the board may 240
prescribe Schedules II-V. The words "administer," "controlled 241
substances" and "ultimate user," shall have the same meaning as 242
set forth in Section 41-29-105, unless the context otherwise 243
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ST: Certified nurse midwives; not required to
have written collaborative agreement with
physician to practice as.
requires. The board shall promulgate rules governing prescribing 244
of controlled substances, including distribution, record keeping, 245
drug maintenance, labeling and distribution requirements and 246
prescription guidelines for controlled substances and all 247
medications. Prescribing any controlled substance in violation of 248
the rules promulgated by the board shall constitute a violation of 249
Section 73-15-29(1)(f), (k) and (l) and shall be grounds for 250
disciplinary action. The prescribing, administering or 251
distributing of any legend drug or other medication in violation 252
of the rules promulgated by the board shall constitute a violation 253
of Section 73-15-29(1)(f), (k) and (l) and shall be grounds for 254
disciplinary action. 255
SECTION 3. This act shall take effect and be in force from 256
and after July 1, 2026. 257