(5) "Autonomous practice" means advanced nursing practice by an advanced practice registered nurse who is registered under s. 464.0123 and who is not subject to supervision by a physician or a supervisory protocol.

•  3000 supervised clinical practice hours within the past 5 years. 
• Within the past 5 years completed:

              - 3 graduate-level semester hours, or the equivalent in differential diagnosis

              - 3 graduate-level semester hours, or the equivalent in pharmacology.

• Professional liability insurance not less than $100,000 per claim, with a minimum annual aggregate of not less than $300.000. OR letter of credit.  The requirements do not apply to:

                - Exclusively as an officer, employee or agent of the Federal Government or of the state or its agencies                     or its subdivisions

                - Practices only in conjunction with his or her teaching duties at an accredited school or its main                               teaching hospitals.

• Primary care practice only:  family medicine, general pediatrics and general internal medicine, as defined by board rule.
• Includes CNMs, but no CRNAs or specialty NPs
• Line 1076-1084:  Perform the general functions of an APRN related to primary care

                - For pt who requires the services of a health care facility as defined in s. 408.032(8):

• Admit, manage in the facility and discharge the pt from the facility, unless prohibited by federal law or rule.
• Global signature authority except physician certification under s. 381.986 (medical marijuana)
• No surgical procedure other than a SQ procedure
• Establish Council on Advanced Practice Registered Nurse Autonomous Practice within the Dept of Health (lines 1101-1140) with 2 MD, 2 DO, 4 APRN, and State Surgeon General or designee as chair of the council.

                 - Council shall recommend standards of practice for APRN.  If BON rejects a recommendation of the                        council, the board must state with particularity the basis for rejecting the recommendations and                            provide the council an opportunity to modify its recommendation.

• Registration renewal:

                 - Biennial renewal

                         At least 10 CE approved by the BON

                         With additional 30 hrs established by board rules

• Report adverse events as physicians
• Health plans or insurance company cannot mandate patients to see ARPNs only.
• Loan repayment program for APRN who engage in autonomous practice in primary care HPSA area. 

effective 7/1/2020