North Carolina HB 514: Advanced Practice Registered Nurses Definitions.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 514

Short Title: APRN Definitions. (Public)
Sponsors: Representatives White, Lambeth, Setzer, and Cunningham (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Health, if favorable, Judiciary 1, if favorable, Finance, if favorable, Rules,
Calendar, and Operations of the House
March 26, 2025
*H514-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO DEFINE THE PRACTICE OF NURSING FOR ADVANCED PRACTICE 2
REGISTERED NURSES: NURSE PRACTITIONERS (NP), CERTIFIED NURSE 3
MIDWIVES (CNM), CERTIFIED REGISTERED NURSE ANESTHETISTS (CRNA), 4
AND CLINICAL NURSE SPECIALISTS (CNS). 5
Whereas, North Carolina is expected to be the seventh largest state in the nation by 6
2035 and demand for health care will continue to increase; and 7
Whereas, North Carolina has provided over 628,000 North Carolinians access to 8
insurance through Medicaid expansion but lacks the health care providers to ensure their access 9
to care; and 10
Whereas, APRNs are registered nurses with master's or doctorate degrees and 11
advanced education and training; and 12
Whereas, North Carolina has over 20,000 advanced practice registered nurses 13
(APRNs) who have been educated and licensed to practice to their full scope; and 14
Whereas, more than three decades of research demonstrates that APRNs improve 15
access to safe, high-quality, cost-effective, patient-centered health care; and 16
Whereas, the Institute of Medicine (IOM) has called for states to allow APRNs to 17
practice to the full extent of their licensure and education since the 2010 release of the IOM 18
Report on the Future of Nursing; and 19
Whereas, health care costs in North Carolina are among the highest in the nation; and 20
Whereas, a recent report by a Ph.D. health care economist at Duke University 21
estimates savings of at least $700 million annually for North Carolina patients, employers, and 22
taxpayers by removing unnecessary and antiquated government regulations; and 23
Whereas, 36 other states have rolled back these costly and burdensome government 24
regulations on advanced practice registered nurses over the past 31 years with no evidence of 25
negative effects on patient safety, and indeed positive impact on patient care, according to 26
numerous studies; and 27
Whereas, no state has enacted these reforms and later reversed course to reinstate 28
these government regulations; and 29
Whereas, the APRN role has existed for over a half century but remains undefined in 30
North Carolina statute; and 31
Whereas, North Carolina's courts and executive branch have called on the legislature, 32
the body of the people, to remove the ambiguity surrounding APRN practice by clearly defining 33
it in statute; Now, therefore, 34

General Assembly Of North Carolina Session 2025
Page 2 House Bill 514-First Edition
The General Assembly of North Carolina enacts: 1
SECTION 1. G.S. 90-171.20 reads as rewritten: 2
"§ 90-171.20. Definitions. 3
As used in this Article, unless the context requires otherwise: 4
(1) Advanced assessment. – The taking by an advanced practice registered nurse 5
of the history, physical, and psychological assessment of a patient's signs, 6
symptoms, pathophysiologic status, and psychosocial variations in the 7
determination of differential diagnoses and treatment. 8
(1a) Advanced practice registered nurse or APRN. – An individual licensed by the 9
Board as an advanced practice registered nurse within one of the following 10
four roles: 11
a. Certified nurse practitioner or CNP. 12
b. Certified nurse midwife or CNM. 13
c. Clinical nurse specialist or CNS. 14
d. Certified registered nurse anesthetist or CRNA. 15
(1b) "Board" means the Board. – The North Carolina Board of Nursing. 16
(2) "Health care provider" means any Health care provider. – Any licensed health 17
care professional and any agent or employee of any health care institution, 18
health care insurer, health care professional school, or a member of any allied 19
health profession. For purposes of this Article, a person enrolled in a program 20
that prepares the person to be a licensed health care professional or an allied 21
health professional shall be deemed a health care provider. 22
(3) "License" means a License. – A permit issued by the Board to practice nursing 23
as an advanced practice registered nurse, as a registered nurse nurse, or as a 24
licensed practical nurse, including a renewal or reinstatement thereof. 25
(3a) "Licensee" means any Licensee. – Any person issued a license by the Board, 26
whether the license is active or inactive, including an inactive license by 27
means of surrender. 28
(4) "Nursing" is a Nursing. – A dynamic discipline which includes the assessing, 29
caring, counseling, teaching, referring and implementing of prescribed 30
treatment in the maintenance of health, prevention and management of illness, 31
injury, disability or the achievement of a dignifie