authorizing advanced practice registered nurses and physician associates to make certain certifications.

SB 453 allows advanced practice registered nurses and physician associates to certify two specific medical needs currently only permitted for physicians. It extends vehicle equipment waivers for people with disabilities from 2 to 4 years when such nurses or associates certify "lasting medical necessity." It also permits these professionals to exempt children from certain immunizations if they certify that a specific vaccine could harm the child’s health. These changes update existing laws (RSA 266:61-a and RSA 141-C:20-c) to expand who can make these certifications, directly affecting disabled drivers seeking vehicle modifications and parents navigating school immunization requirements.