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A4052 ACS
ASSEMBLY COMMITTEE SUBSTITUTE FOR
ASSEMBLY, No. 4052
STATE OF NEW JERSEY
222nd LEGISLATURE
�
ADOPTED
MARCH 19, 2026
Sponsored by:
Assemblyman� WILLIAM W. SPEARMAN
District 5 (Camden and Gloucester)
Assemblywoman� KATIE BRENNAN
District 32 (Hudson)
Assemblywoman� ANNETTE QUIJANO
District 20 (Union)
Co-Sponsored by:
Assemblymen Scharfenberger, Kearney, Assemblywomen
Fantasia, Park, Dunn, Reynolds-Jackson, Speight and Assemblyman Onyema
SYNOPSIS
���� Eliminates certain practice restrictions for advanced
practice nurses.
CURRENT VERSION OF TEXT
���� Substitute as adopted by the Assembly Appropriations
Committee.
��
An Act
concerning advanced practice nurses, revising
various parts of the statutory law, and supplementing P.L.1991, c.377
(C.45:11-45 et al.).
����
Be It Enacted
by the Senate and General Assembly of the State of New Jersey:
���� 1.��� (New section) The
Legislature finds and declares that:
���� a.���� Advanced practice
nurses are registered nurses who are certified to provide an advanced level of
health care to patients that exceeds the standard scope of nursing practice.�
���� b.��� Advanced practice nurses
augment the system of care in New Jersey and nationwide by providing treatment
services at a level that can relieve some of the demand on physicians, of whom
there is a chronic shortage, and expedite access to care for patients, including
those in medically underserved areas and among medically underserved
populations.
���� c.���� Studies suggest that
approximately one quarter of the population of the United States lives in an
area with a shortage of primary care professionals.� Limited access to care is
frequently worse among racial and ethnic minorities, people with low incomes,
and individuals for whom a lack of transportation creates logistical barriers
to health care.
���� d.��� One way to reduce gaps
in health care access is to allow full practice authority for advanced practice
nurses, over 75 percent of whom are educated in a primary care specialty and
can directly improve access to both primary care services and specialty care
services.
���� e.���� As of March 2026, 27
states, the District of Columbia, and two U.S. territories have adopted full
practice authority for advanced practice nurses.� The requirement to practice
in collaboration with a physician limits the ability of advanced practice
nurses to provide primary care and specialty care services, and has been
associated with advanced practice nurses leaving New Jersey for other
jurisdictions with fewer practice restrictions.
���� f.���� It has been estimated
that removing practice restrictions for advanced practice nurses has the
potential to reduce health care access disparities by a factor of more than 38
percent.
���� g.��� In response to the
coronavirus disease 2019 (COVID-19) pandemic, Governor Murphy issued Executive
Order No. 112 (2020), which, among other things, directly and through waivers
issued pursuant to its authority, waived existing practice restrictions for
advanced practice nurses, including joint protocol and supervision
requirements.
���� h.��� According to surveys,
over 45 percent of advanced practice nurses in New Jersey reported working
without practice restrictions as authorized under Executive Order No. 112
(2020) and the waivers issued pursuant to the executive order.� No adverse
incidents were reported during the waiver period involving advanced practice
nurses practicing without practice restrictions.
���� i.���� Given the need for
expanded access to care, it is necessary and appropriate to take steps to
remove practice restrictions that serve as a barrier for advanced practice
nurses to practice in New Jersey in certain healthcare settings to the full
extent of their education, clinical training, and national certification.
���� 2.��� Section 1 of P.L.1947,
c.262 (C.45:11-23) is amended to read as follows:
���� 1.��� As used in this act:
���� a.���� The words "the
board" mean the New Jersey Board of Nursing created by this act.
���� b.��� The practice of nursing
as a registered professional nurse is defined as diagnosing and treating human
responses to actual or potential physical and emotional health problems,
through such services as casefinding, health teaching, health counseling, and provision
of care supportive to or restorative of life and well-being, and executing
medical regimens as prescribed by a licensed or otherwise legally authorized
physician or dentist. Diagnosing in the context of nursing practice means the
identification of and discrimination between physical and psychosocial signs
and symptoms essential to effective execution and management of the nursing
regimen within the scope of practice of the registered professional nurse.�
Such diagnostic privilege is distinct from a medical diagnosis.� Treating means
selection and performance of those therapeutic measures essential to the
effective management and execution of the nursing regimen.� Human responses
means those signs, symptoms, and processes which denote the individual's health
need or reaction to an actual or potential health problem.
���� The practice of nursing as a
licensed practical nurse is defined as performing tasks and responsibilities
within the framework of casefinding; reinforcing the patient and family
teaching program through health teaching, health counseling and provision of
supportive and restorative care, under the direction of a registered nurse or
licensed or otherwise legally authorized physician or dentist.
���� The terms "nursing,"
"professional nursing," and "practical nursing" as used in
this act shall not be construed to include nursing by students enrolled in a
school of nursing accredited or approved by the board performed in the
prescribed course of study and training, nor nursing performed in hospitals,
institutions and agencies approved by the board for this purpose by graduates
of such schools pending the results of the first licensing examination
scheduled by the board following completion of a course of study and training
and the attaining of age qualification for examination, or thereafter with the
approval of the board in the case of each individual pending results of
subsequent examinations; nor shall any of said terms be construed to include
nursing performed for a period not exceeding 12 months unless the board shall
approve a longer period, in hospitals, institutions or agencies by a nurse
legally qualified under the laws of another state or country, pending results
of an application for licensing under this act, if such nurse does not
represent or hold himself or herself out as a nurse licensed to practice under
this act; nor shall any of said terms be construed to include the practice of
nursing in this State by any legally qualified nurse of another state whose
engagement made outside of this State requires such nurse to accompany and care
for the patient while in this State during the period of such engagement, not
to exceed six months in this State, if such nurse does not represent or hold himself
or herself out as a nurse licensed to practice in this State; nor shall any of
said terms be construed to include nursing performed by employees or officers
of the United States Government or any agency or service thereof while in the
discharge of his or her official duties; nor shall any of said terms be
construed to include services performed by nurses aides, attendants, orderlies
and ward helpers in hospitals, institutions and agencies or by technicians,
physiotherapists, or medical secretaries, and such duties performed by said
persons aforementioned shall not be subject to rules or regulations which the
board may prescribe concerning nursing; nor shall any of said terms be
construed to include first aid nursing assistance, or gratuitous care by friends
or members of the family of a sick or infirm person, or incidental care of the
sick by a person employed primarily as a domestic or housekeeper,
notwithstanding that the occasion for such employment may be sickness, if such
incidental care does not constitute professional nursing and such person does
not claim or purport to be a licensed nurse; nor shall any of said terms be
construed to include services rendered in accordance with the practice of the
religious tenets of any well-recognized church or denomination which subscribes
to the art of healing by prayer.� A person who is otherwise qualified shall not
be denied licensure as a professional nurse or practical nurse by reason of the
circumstances that such person is in religious life and has taken a vow of
poverty.
���� c.���� "Homemaker-home
health aide" means a person who is employed by a home care services agency
and who is performing delegated nursing regimens or nursing tasks delegated
through the authority of a duly licensed registered professional nurse.� No homemaker-home
health aide shall follow a delegated nursing regimen or perform tasks which are
delegated unless the homemaker-home health aide is under the supervision of a
duly licensed registered professional nurse provided by the home care services
agency that directly employs the homemaker-home health aide. "Home care
services agency" means home health agencies, assisted living residences,
comprehensive personal care homes, assisted living programs or alternate family
care sponsor agencies licensed by the Department of Health pursuant to
P.L.1971, c.136 (C.26:2H-1 et al.), nonprofit homemaker-home health aide
agencies, and health care service firms regulated by the Director of the
Division of Consumer Affairs in the Department of Law and Public Safety and the
Attorney General pursuant to P.L.1989, c.331 (C.34:8-43 et seq.) and P.L.1960,
c.39 (C.56:8-1 et seq.) respectively, which are engaged in the business of
procuring or offering to procure employment for homemaker-home health aides,
where a fee may be exacted, charged or received directly or indirectly for
procuring or offering to procure that employment.�
���� d.��� "Advanced practice
nurse" means a person who holds a certification in accordance with section
8 or 9 of P.L.1991, c.377 (C.45:11-47 or 45:11-48).
���� e.���� "Collaborating
physician" means a person licensed to practice medicine and surgery
pursuant to chapter 9 of Title 45 of the Revised Statutes who agrees to work
with an advanced practice nurse.
����
f.� �Primary health care�
means preventative, diagnostic, treatment, management, or reassessment services
which are provided in a family-centered and community oriented manner to an
individual with acute or chronic illness in the areas of family practice, general
internal medicine, general pediatrics, general obstetrics, gynecology and
reproductive health services, or clinical prevention: (1) at the time of the
individual's initial point of contact with the health care system; or (2) by a
health care practitioner who, regardless of the presence or absence of disease,
has assumed responsibility for the individual and has an ongoing responsibility
to coordinate the individual's medical care. "Primary health care"
includes sick or well care that is provided to any and all age groups, from
perinatal and pediatric care to geriatric care.
����
g.� �Reproductive health
services� means medical, surgical, counseling, or referral services relating to
the human reproductive system.
���� h.� �Behavioral health
care� mean procedures or services rendered by a health care practitioner to a
patient for the treatment of a mental illness, emotional disorder, or drug or
alcohol use disorder.
����
i.� �Higher level of care�
means a clinically appropriate level of behavioral health care treatment that
provides a greater degree of supervision, intensity, structure, or medical
monitoring than the level of care currently being provided to a patient.
���� Nothing in this act shall
confer the authority to a person licensed to practice nursing to practice
another health profession as currently defined in Title 45 of the Revised
Statutes.
(cf: P.L.2019, c.48, s.2)
���� 3.��� Section 10 of P.L.1991,
c.377 (C.45:11-49) is amended to read as follows:
���� 10.� a. In addition to all
other tasks which a registered professional nurse may, by law, perform, an
advanced practice nurse may manage preventive care services
[
and
]
,
diagnose
, monitor,
and manage deviations from wellness and long-term
illnesses, consistent with the needs of the patient and within the
defined
scope of practice of
[
the
]
that
advanced practice nurse, by:
���� (1)�� initiating laboratory
and other diagnostic tests;
���� (2)�� prescribing
,
authorizing,
or ordering medications and devices, as authorized by
subsections
[
b.
and c.
]
b., c., g., or h. of this section
; and
���� (3)�� prescribing or ordering
treatments, including referrals to other licensed health care professionals,
and performing specific procedures in accordance with the provisions of this
[
subsection
]
section
.
���� b.��� An advanced practice
nurse may order medications and devices in the inpatient setting, subject to
the following conditions:
���� (1)�� the collaborating
physician and advanced practice nurse shall address in the joint protocols whether
prior consultation with the collaborating physician is required to initiate an
order for a controlled dangerous substance;
���� (2)�� the order is written in
accordance with standing orders or joint protocols developed in agreement
between a collaborating physician and the advanced practice nurse, or pursuant
to the specific direction of a physician;
���� (3)�� the advanced practice
nurse authorizes the order by signing the nurse's own name, printing the name
and certification number, and printing the collaborating physician's name;
���� (4)�� the physician is present
or readily available through electronic communications;
���� (5)�� the charts and records
of the patients treated by the advanced practice nurse are reviewed by the
collaborating physician and the advanced practice nurse within the period of
time specified by rules adopted by the Commissioner of Health pursuant to
section 13 of P.L.1991, c.377 (C.45:11-52);
���� (6)�� the joint protocols
developed by the collaborating physician and the advanced practice nurse are
reviewed, updated, and signed at least annually by both parties; and
���� (7)�� the advanced practice
nurse has completed six contact hours of continuing professional education in
pharmacology related to controlled substances, including pharmacologic therapy,
addiction prevention and management, and issues concerning prescription opioid
drugs, including responsible prescribing practices, alternatives to opioids for
managing and treating pain, and the risks and signs of opioid abuse, addiction,
and diversion, in accordance with regulations adopted by the New Jersey Board
of Nursing.� The six contact hours shall be in addition to New Jersey Board of
Nursing pharmacology education requirements for advanced practice nurses
related to initial certification and recertification of an advanced practice
nurse as set forth in N.J.A.C.13:37-7.2.
���� c.���� An advanced practice
nurse may prescribe medications and devices in all other medically appropriate
settings, subject to the following conditions:
���� (1)�� the collaborating
physician and advanced practice nurse shall address in the joint protocols
whether prior consultation with the collaborating physician is required to
initiate a prescription for a controlled dangerous substance;
���� (2)�� the prescription is
written in accordance with standing orders or joint protocols developed in
agreement between a collaborating physician and the advanced practice nurse, or
pursuant to the specific direction of a physician;
���� (3)�� the advanced practice
nurse writes the prescription on a New Jersey Prescription Blank pursuant to
P.L.2003, c.280 (C.45:14-40 et seq.), signs the nurse's own name to the
prescription and prints the nurse's name and certification number;
���� (4)�� the prescription is
dated and includes the name of the patient and the name, address, and telephone
number of the collaborating physician;
���� (5)�� the physician is present
or readily available through electronic communications;
���� (6)�� the charts and records
of the patients treated by the advanced practice nurse are periodically
reviewed by the collaborating physician and the advanced practice nurse;
���� (7)�� the joint protocols
developed by the collaborating physician and the advanced practice nurse are
reviewed, updated, and signed at least annually by both parties; and
���� (8)�� the advanced practice
nurse has completed six contact hours of continuing professional education in
pharmacology related to controlled substances, including pharmacologic therapy,
addiction prevention and management, and issues concerning prescription opioid
drugs, including responsible prescribing practices, alternatives to opioids for
managing and treating pain, and the risks and signs of opioid abuse, addiction,
and diversion, in accordance with regulations adopted by the New Jersey Board
of Nursing.� The six contact hours shall be in addition to New Jersey Board of
Nursing pharmacology education requirements for advanced practice nurses
related to initial certification and recertification of an advanced practice
nurse as set forth in N.J.A.C.13:37-7.2.
���� d.��� The joint protocols
employed pursuant to subsections b. and c. of this section shall conform with
standards adopted by the Director of the Division of Consumer Affairs pursuant
to section 12 of P.L.1991, c.377 (C.45:11-51) or section 10 of P.L.1999, c.85
(C.45:11-49.2), as applicable.
���� e.���� (Deleted by amendment,
P.L.2004, c.122.)
���� f.���� An attending advanced
practice nurse may determine and certify the cause of death of the nurse's
patient and execute the death certification pursuant to R.S.26:6-8 if no
[
collaborating
]
physician is
available to do so and the nurse is the patient's primary caregiver.
���� g.���
[
An
]
(1)�
Except as otherwise provided in paragraph (2) of this subsection,
an
advanced practice nurse may authorize qualifying patients for the medical use
of cannabis and issue written instructions for medical cannabis to registered
qualifying patients, subject to the following conditions:
����
[
(1)
]
(a)
���� the collaborating
physician and advanced practice nurse shall address in the joint protocols
whether prior consultation with the collaborating physician is required to
authorize a qualifying patient for the medical use of cannabis or issue written
instructions for medical cannabis;
����
[
(2)
]
(b)
���� the authorization
for the medical use of cannabis or issuance of written instructions for
cannabis is in accordance with standing orders or joint protocols developed in
agreement between a collaborating physician and the advanced practice nurse, or
pursuant to the specific direction of a physician;
����
[
(3)
]
(c)
���� the advanced
practice nurse signs the nurse's own name to the authorization or written
instruction and prints the nurse's name and certification number;
����
[
(4)
]
(d)
���� the authorization
or written instruction is dated and includes the name of the qualifying patient
and the name, address, and telephone number of the collaborating physician;
����
[
(5)
]
(e)
the physician is
present or readily available through electronic communications;
����
[
(6)
]
(f)
���� the charts and
records of qualifying patients treated by the advanced practice nurse are
periodically reviewed by the collaborating physician and the advanced practice
nurse;
����
[
(7)
]
(g)
� the joint protocols
developed by the collaborating physician and the advanced practice nurse are
reviewed, updated, and signed at least annually by both parties; and
����
[
(8)
]
(h)
���� the advanced
practice nurse complies with the requirements for authorizing qualifying
patients for the medical use of cannabis and for issuing written instructions
for medical cannabis established pursuant to P.L.2009, c.307 (C.24:6I-1 et
al.).
����
(2)�
Subject to the
requirements for authorizing qualifying patients for the medical use of
cannabis and for issuing written instructions for medical cannabis established
pursuant to P.L.2009, c.307 (C.24:6I-1 et al.), an advanced practice nurse who
is authorized to practice advanced practice nursing within a population focus
of family or individual across the lifespan, adult gerontology, pediatrics,
women�s health, or behavioral health shall be exempt from subsections b. and c.
of this section and may authorize qualifying patients for the medical use of
cannabis and issue written instructions for medical cannabis to registered
qualifying patients without a joint protocol with a collaborating physician,
provided that:
���� (
a)�� the advanced practice
nurse has more than 5,000 hours of licensed, active, advanced nursing practice
in a role with the applicable population focus;
����
(b) the advanced practice
nurse is providing primary health care or behavioral health care;
����
(c)�� the advanced practice
nurse is not providing health care services in the area of general obstetrics;
����
(d)�� the advanced practice
nurse is not providing elective aesthetic or cosmetic services; and
����
(e)�� the advanced practice
nurse, to the extent the advanced practice nurse is providing behavioral health
care services, takes appropriate action to facilitate the timely referral,
transfer, or admission to a higher level of care in the event the advanced
practice nurse determines, based upon clinical judgment, that a patient
requires such level of care.� The determination shall be based upon a
documented clinical assessment.
����
h.��� (1)� Pursuant to this
subsection, an advanced practice nurse who is authorized to practice advanced
practice nursing within a population focus of family or individual across the
lifespan, adult gerontology, pediatrics, women�s health, or behavioral health
shall be exempt from subsections b. and c. of this section and shall be
authorized to practice without a joint protocol with a collaborating physician,
provided that:
����
(a)�� the advanced practice
nurse has more than 5,000 hours of licensed, active, advanced nursing practice
in a role with the applicable population focus;
����
(b) the advanced practice
nurse is providing primary health care or behavioral health care;
����
(c)�� the advanced practice
nurse is not providing health care services in the area of general obstetrics;
����
(d)�� the advanced practice
nurse is not providing elective aesthetic or cosmetic services; and
����
(e)�� the advanced practice
nurse, to the extent the advanced practice nurse is providing behavioral health
care services, takes appropriate action to facilitate the timely referral,
transfer, or admission to a higher level of care in the event the advanced
practice nurse determines, based upon clinical judgment, that a patient
requires such level of care.� The determination shall be based upon a
documented clinical assessment.
����
(2)� An advanced practice
nurse who meets the exemption criteria provided pursuant to paragraph (1) of
this subsection
may order medications and devices, subject to the
following conditions:
����
(a)�� the advanced practice
nurse shall issue a prescription on a New Jersey Prescription Blank in
accordance with the provisions of P.L.2003, c.280 (C.45:14-40 et seq.), and
include on the prescription blank the advanced practice nurse�s signature,
printed name, certification number, and patient information, and any other
information required pursuant to regulations adopted by the New Jersey Board of
Nursing;
����
(b)�� the advanced practice
nurse shall have completed 14 contact hours of continuing professional
education in pharmacology related to controlled substances, including
pharmacologic therapy and addiction prevention and management.� Of the 14
contact hours, eight hours shall be in addition to New Jersey Board of Nursing controlled
dangerous substance pharmacology education requirements for advanced practice
nurses related to initial certification of an advanced practice nurse as set
forth in regulations adopted by the New Jersey Board of Nursing at the time of
the effective date of
P.L.��� , c.��� (C.������� ) (pending before the
Legislature as this bill)
;
����
(c)�� the advance practice
nurse shall have completed 10 contact hours of continuing professional
education in pharmacology each biennial period;
���� (d)��
the advance practice
nurse, who is practicing independently, shall be held to the same standard of
care as other independent health care practitioners.
����
(e)� the advanced practice
nurse shall be required to be covered by malpractice liability insurance, or if
such liability coverage is not available, by a letter of credit for at least
the minimum amount applicable to a licensed physician.� The advance practice
nurse shall notify the Board of Nursing of the name and address of the
insurance carrier or the institution issuing the letter of credit;
����
(f)� �if the advanced
practice nurse does not provide services to beneficiaries of the Medicare
program established pursuant to section 1801 of the Social Security Act (42
U.S.C. s.1395 et seq.), the advanced practice nurse shall , if applicable, prominently
display in the advanced practice nurse�s office an appropriate notice, and
inform, in writing, the Board of Nursing; and
����
(g)� the advanced practice
nurse shall immediately notify the Board of Nursing if the advanced practice
nurse is:
����
(i)��� is incapable, for
medical or any other good cause, of discharging the functions of the advanced
practice nurse in a manner consistent with the public's health, safety and
welfare;
����
(ii)�� is indicted or
convicted of a crime involving moral turpitude or a crime adversely relating to
the advanced practice nurse�s practice;
����
(iii) is named as a
defendant or respondent in a civil, criminal or administrative investigation,
complaint or judgment involving alleged malpractice, negligence or misconduct
relating to the advanced practice nurse�s practice;
����
(iv)� is the subject of any
voluntary license or certification surrender or any disciplinary action or
order by any state or Federal agency, board or commission, including any order
of limitation or preclusion; or
����
(v)�� fails to maintain or
renew any certification which is required by law as a condition of practice or
as a condition of license or certification renewal.
����
i.� Any provision of State
law or regulation that requires the signature, stamp, verification, affidavit,
or endorsement of a physician shall be deemed to require the signature, stamp,
verification, affidavit, or endorsement of a physician or an advanced practice
nurse, to the extent consistent with the scope of practice of an advanced
practice nurse.
(cf: P.L.2019, c.153, s.47)
���� 4.� Section 10 of P.L.1999,
c.85 (C.45:10-49.2) is amended to read as follows:
���� 10.� No later than the 180th
day after the enactment of P.L.1999, c.85, the Director of the Division of
Consumer Affairs in the Department of Law and Public Safety shall adopt
standards for the joint protocols required by subsection d. of section 10 of P.L.1991,
c.377 (C.45:11-49), which shall apply to the ordering or prescription of
controlled dangerous substances by an advanced practice nurse pursuant to that
section. The standards shall be adopted by regulation in accordance with the
"Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.)
,
provided that such regulation shall not be more restrictive than the provisions
of
P.L.1991, c.377 (C.45:11-45 et al.)
.
(cf: P.L.1999, c.85, s.10)
���� 5.� Section 13 of P.L.2017,
c.341 (C.45:11-49.3) is amended to read as follows:
���� 13.� a. Notwithstanding any
other provision of law
or regulation
to the contrary, an advanced
practice nurse may dispense narcotic drugs for maintenance treatment or
detoxification treatment if the advanced practice nurse has met the training
and registration requirements set forth in subsection (g) of 21 U.S.C. s.823.�
[
An
]
When
applicable, an
advanced practice nurse who is authorized to dispense such
drugs may do so regardless of whether the advanced practice nurse's
collaborating physician has met the training and registration requirements set
forth in subsection (g) of 21 U.S.C. s.823, provided that the joint protocol
established by the advanced practice nurse and the collaborating physician �include
the collaborating physician's written approval for the advanced practice nurse
to dispense the drugs.
���� b.��� Notwithstanding any
other provision of law
or regulation
to the contrary, an advanced
practice nurse, under the joint protocol established by the advanced practice
nurse and the collaborating physician,
may make the determination as to the medical necessity for services
for the treatment of substance use disorder, as provided in P.L.2017, c.28
(C.17:48-6nn et al.), and may prescribe such services.
����
c.���� The provisions of
this section regarding joint protocols shall not apply under the circumstances
outlined in subsections g. and h. of section 10 of P.L.1991, c. 377
(C.45:11-49).
(cf: P.L.2017, c.341, s.13)
���� 6
.
��� Section 11 of P.L.1991, c.377 (C.45:11-50) is amended to
read as follows:
���� 11.� In
addition to such other powers as it may by law possess, the New Jersey Board of
Nursing shall have the following powers and duties
[
;
]
:
���� a.���� To
promulgate, pursuant to the �Administrative Procedure Act,� P.L.1968, c.410
(C.52:14B-1 et seq.), rules and regulations to effectuate the purposes of
[
this act
]
P.L.1991, c.377
(C.45:11-45 et al.)
, except for those
subjects of rule-making authority allocated to the Director of the Division of
Consumer Affairs pursuant to section 12 of P.L.1991, c.377 (C.45:11-51) or
to the Commissioner of Health and Senior Services pursuant to section 13 of P.L.1991,
c.377 (C.45:11-52);
���� b.��� To
evaluate and pass upon the qualifications of candidates
for
certification as advanced practice nurses;
���� c.���� To evaluate and pass
upon national accreditation organizations and the holders of certificates from
those organizations as necessary to award certificates pursuant to section 9 of
P.L.1991, c.377 (C.45:11-48);
���� d.��� To establish specialty
areas of practice for advanced practice nurses;
���� e.���� To take disciplinary
action, in accordance with P.L.1978, c.73 (C.45:1-14 et seq.)
,
against
an advanced practice nurse who violates the provisions of
[
this act
]
P.L.1991, c.377 (C.45:11-45 et al.)
, any
regulation promulgated thereunder, or P.L.1978, c.73 (C.45:1-14 et seq.);
���� f.���� To approve the
examination to be taken by candidates for certification;
���� g.��� To set standards of
professional conduct for advanced practice
nurses;
���� h.��� To set fees for
examinations, certification
,
and other services consistent with section
2 of P.L.1974, c.46 (C.45:1-3.2);
���� i.���� To set standards for
and approve continuing education programs; and
���� j.���� To determine whether
the requirements of another state with respect to certification as an advanced
practice nurse are substantially equivalent to those of this State in
accordance with subsection c. of section 8 of P.L.1991, c.377 (C.45:11-47).
����
k.� To limit, restrict,
deny, suspend or revoke an advanced practice nurse�s licensure, or prescriptive
or dispensing authority. �The board may take disciplinary action for:
���� (
1)�� prescribing,
dispensing, administering, or distributing medications in an unsafe manner;
���� (
2)�� prescribing or
distributing medications outside the advanced practice nurse�s role or
population focus; or
����
(3)�� prescribing,
ordering, procuring, administering, dispensing and furnishing over the counter,
legend and controlled substances outside the applicable state and federal laws
or regulations.
(cf: P.L.1999, c.85, s.8)
���� 7.��� Section 12 of P.L.1991,
c.377 (C.45:11-51) is amended to read as follows:
���� 12.� The Director of the
Division of Consumer Affairs in the Department of Law and Public Safety may
receive and shall give due consideration to advice from the Board of Nursing
and the State Board of Medical Examiners in adopting standards for the joint
protocols required by subsection d. of section 10 of P.L.1991, c.377
(C.45:11-49).� The standards shall be established by rule adopted by the
Director of the Division of Consumer Affairs in accordance with the
"Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.)
,
provided that such rule shall not be more restrictive than the provisions of
P.L.1991, c.377 (C.45:11-45 et al.)
.
(cf: P.L.1991, c.377, s.12)�
���� 8.� Section 13 of P.L.1991,
c.377 (C.45:11-52) is amended to read as follows:
���� 13.� The Commissioner of
Health
[
and
Senior Services
]
shall, by rule adopted in accordance with the "Administrative Procedure
Act," P.L.1968, c.410 (C.52:14B-1 et seq.), establish the periods of time
within which the charts and records of the patients treated by the advanced
practice nurse� in an inpatient setting shall be reviewed by the advanced
practice nurse and the collaborating physician, as required by paragraph (5) of
subsection b. of section 10 of P.L.1991, c.377 (C.45:11-49)
, provided that such
rule shall not be more restrictive than the provisions of
P.L.1991, c.377 (C.45:11-45 et al.)
.
(cf:� P.L.1999, c.85, s.9)
���� 9.� (New section)�
�Notwithstanding the provisions of the �Administrative
Procedure Act,�� P.L.1968, c.410 (C.52:14B-1 et seq.) to the contrary, the
Board of Nursing and the Commissioner of Health
shall
adopt, immediately upon filing proper notice with the Office of Administrative
Law,
regulations
necessary to effectuate the
purposes of this act
, including the process by which the Board shall
verify the number of hours an advanced practice nurse has completed in order
for the advanced practice nurse to practice without a joint protocol pursuant
to subsections g. and h. of section 3 and subsections a. and b. of section 10,�
provided that such rules
shall not be more restrictive than the provisions of
P.L.1991,
c.377 (C.45:11-45 et al.)
. �Such
regulations
shall be effective for a period not to exceed 18 months from the date of the
filing, at which point the
Board of Nursing and the Commissioner of
Health
may thereafter amend, adopt, or readopt the
regulations in accordance with the requirements of P.L.1968, c.410 (C.52:14B-1
et seq.).
���� 10.�
This act shall take effect immediately,
except that notwithstanding any provision of this P.L.��� , c.��� (C.������� )
(pending before the Legislature as this bill) to the contrary, an advanced
practice nurse authorized to prescribe, authorize, or order medications and
devices without a joint protocol pursuant to Executive Order No. 13 (2026)
shall be authorized to:
���� a.� if the advanced practice nurse would have 5,000
hours of licensed, active, advanced nursing practice within 12 months of the
effective date of this P.L.��� , c.��� (C.������� ) (pending before the
Legislature as this bill), continue practicing without a joint protocol; or
���� b.� if the advanced practice nurse would have less
than 5,000 hours of licensed, active, advanced nursing practice within 12
months of the effective date of this P.L.��� , c.��� (C.������� ) (pending
before the Legislature as this bill), continue practicing without a joint
protocol for a period of six months after the effective date of P.L.��� , c.���
(C.������� ) (pending before the Legislature as this bill), after which the
advanced practice nurse shall be required to establish a joint protocol with a
collaborating physician pursuant to the provisions of s
ection 10 of
P.L.1991, c.377 (C.45:11-49) and any hours of licensed, active, advanced
nursing practice without a joint protocol shall be counted towards the
requirements for practice without a joint protocol with a collaborating physician
pursuant to
s
ection
10 of P.L.1991, c.377 (C.45:11-49)
.�