OLR Research Report

February 5, 2008




By: John Kasprak, Senior Attorney

You asked for brief summaries of public acts passed since 1997 concerning advanced practice registered nurses (APRNs).


No legislation was passed.


PA 99-168 required APRNs to work in collaborative relationships with physicians instead of under their direction and according to written protocols. The collaborative agreement, with respect to prescriptive authority, must be in writing. The act (1) defined collaboration, (2) amended the APRN's prescriptive authority to reflect the collaborative approach, (3) made minor changes in licensure criteria, and (4) made technical changes.

The act also required APRNs providing direct patient care services to have professional liability insurance or other indemnity against professional malpractice liability.


PA 00-147 permitted APRNs to issue emergency certificates authorizing people with mental illness to be taken to a general hospital for examination.

Under prior law, APRNs providing direct patient care services had to have professional liability insurance or other indemnity against professional malpractice liability. PA 00-135 exempted from this requirement any APRN maintaining current certification from the American Association of Nurse Anesthetists and providing services under a physician's direction. Under this same act, an APRN had to be “eligible” for a registered nursed (RN) license instead of “maintaining” such a license.


No legislation was passed.


PA 03-8 specified that RNs could implement medical orders for a patient under the direction of an APRN, as well as of a physician or dentist.

PA 03-211 allowed students with diabetes to test their glucose levels if his or her physician or APRN wrote an order saying the student needs to and is capable of doing this.


PA 04-255 allowed an APRN to make a determination and pronouncement of death of a patient if the APRN (1) attests to the pronouncement on the death certificate and (2) signs it within 24 hours of the pronouncement.

This act also permitted the state to receive federal Medicaid reimbursement for services the then Department of Mental Retardation Birth-to-Three providers rendered under an individualized family service plan signed by an APRN. Previously, Department of Social Services (DSS) regulations required a physician to sign the plan.

PA 04-221 allowed APRNs working in noninstitutional settings (e.g., a doctor' office) to request, sign for, and receive drug samples. The law already allowed them to dispense such drugs.


No legislation.


PA 06-169 allowed APRNs to request, receive, and dispense sample medications in all health care settings. Prior law allowed APRNs to do this only in noninstitutional settings.

PA 06-195 permitted a graduate APRN to work without a license for 120 days after graduating in a hospital or other setting under the supervision of a physician or other APRN. The graduate APRN cannot prescribe or dispense drugs. The hospital or other setting must verify that the graduate has applied to take the national certification exam and must end his or her work if notified of exam failure.

PA 06-108 limited the circumstances under which insurers had to provide certain medical malpractice insurance coverage at no cost to APRNs, among others.


PA 07-01, June Special Session, doubled the annual license fees for APRNs from $60 to $120.

PA 07-219 required DSS, within available appropriations and in consultation with the Department of Public Health, to establish a pilot training program for nurse practitioners seeking to specialize in family practice.

PA 07-103 allowed state or local health professional societies to establish a single confidential assistance program to serve all health professionals, including APRNs, with substance abuse or other problems affecting their work.