HB 149: "An Act relating to the licensure of nursing professionals; relating to a multistate nurse licensure compact; and providing for an effective date."
00 HOUSE BILL NO. 149 01 "An Act relating to the licensure of nursing professionals; relating to a multistate nurse 02 licensure compact; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 08.01.065(c) is amended to read: 05 (c) Except as provided in (f) - (l) [(f) - (k)] of this section, the department shall 06 establish fee levels under (a) of this section so that the total amount of fees collected 07 for an occupation approximately equals the actual regulatory costs for the occupation. 08 The department shall annually review each fee level to determine whether the 09 regulatory costs of each occupation are approximately equal to fee collections related 10 to that occupation. If the review indicates that an occupation's fee collections and 11 regulatory costs are not approximately equal, the department shall calculate fee 12 adjustments and adopt regulations under (a) of this section to implement the 13 adjustments. In January of each year, the department shall report on all fee levels and 14 revisions for the previous year under this subsection to the office of management and
01 budget. If a board regulates an occupation covered by this chapter, the department 02 shall consider the board's recommendations concerning the occupation's fee levels and 03 regulatory costs before revising fee schedules to comply with this subsection. In this 04 subsection, "regulatory costs" means costs of the department that are attributable to 05 regulation of an occupation plus 06 (1) all expenses of the board that regulates the occupation if the board 07 regulates only one occupation; 08 (2) the expenses of a board that are attributable to the occupation if the 09 board regulates more than one occupation. 10 * Sec. 2. AS 08.01.065 is amended by adding a new subsection to read: 11 (l) Notwithstanding (c) of this section, the department shall establish fee levels 12 under (a) of this section so that the total amount of fees collected by the department 13 for individuals issued a 14 (1) single-state license to practice nursing approximately equals the 15 total regulatory costs to the department and the Board of Nursing for the practice of 16 nursing in the state under that license type; in this paragraph, "single-state license" has 17 the meaning given in AS 08.68.850; and 18 (2) multistate license to practice nursing or practicing under a 19 multistate licensure privilege approximately equals the total regulatory costs to the 20 department and the Board of Nursing for the practice of nursing under that license 21 type or privilege. 22 * Sec. 3. AS 08.02.110(a) is amended to read: 23 (a) An acupuncturist licensed under AS 08.06, an audiologist or speech- 24 language pathologist licensed under AS 08.11, a behavior analyst licensed under 25 AS 08.15, a person licensed in the state as a chiropractor under AS 08.20, a 26 professional counselor licensed under AS 08.29, a dentist under AS 08.36, a dietitian 27 or nutritionist licensed under AS 08.38, a massage therapist licensed under AS 08.61, 28 a marital and family therapist licensed under AS 08.63, a medical practitioner or 29 osteopath under AS 08.64, a direct-entry midwife certified under AS 08.65, a 30 registered nurse licensed or holding a multistate licensure privilege under 31 AS 08.68 or advanced practice registered nurse licensed under AS 08.68, an
01 optometrist under AS 08.72, a licensed pharmacist under AS 08.80, a physical 02 therapist or occupational therapist licensed under AS 08.84, a psychologist under 03 AS 08.86, or a clinical social worker licensed under AS 08.95, shall use as 04 professional identification appropriate letters or a title after that person's name that 05 represents the person's specific field of practice. The letters or title shall appear on all 06 signs, stationery, or other advertising in which the person offers or displays personal 07 professional services to the public. In addition, a person engaged in the practice of 08 medicine or osteopathy as defined in AS 08.64.380, or a person engaged in any 09 manner in the healing arts who diagnoses, treats, tests, or counsels other persons in 10 relation to human health or disease and uses the letters "M.D." or the title "doctor" or 11 "physician" or another title that tends to show that the person is willing or qualified to 12 diagnose, treat, test, or counsel another person, shall clarify the letters or title by 13 adding the appropriate specialist designation, if any, such as "dermatologist," 14 "radiologist," "audiologist," "naturopath," or the like. 15 * Sec. 4. AS 08.02.130(j)(1) is amended to read: 16 (1) "health care provider" means 17 (A) an audiologist or speech-language pathologist licensed 18 under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 19 licensed under AS 08.20; a professional counselor licensed under AS 08.29; a 20 dental hygienist licensed under AS 08.32; a dentist licensed under AS 08.36; a 21 dietitian or nutritionist licensed under AS 08.38; a naturopath licensed under 22 AS 08.45; a marital and family therapist licensed under AS 08.63; a physician 23 licensed under AS 08.64; a podiatrist, osteopath, or physician assistant licensed 24 under AS 08.64; a direct-entry midwife certified under AS 08.65; a nurse 25 licensed or holding a multistate licensure privilege under AS 08.68; a 26 dispensing optician licensed under AS 08.71; an optometrist licensed under 27 AS 08.72; a pharmacist licensed under AS 08.80; a physical therapist or 28 occupational therapist licensed under AS 08.84; a psychologist or 29 psychological associate licensed under AS 08.86; or a social worker licensed 30 under AS 08.95; or 31 (B) a physician licensed in another state;
01 * Sec. 5. AS 08.11.120(b) is amended to read: 02 (b) Notwithstanding the provisions of this chapter, 03 (1) a nurse licensed or holding a multistate licensure privilege under 04 AS 08.68 may perform hearing sensitivity evaluations; 05 (2) an individual licensed as a hearing aid dealer under AS 08.55 may 06 deal in hearing aids; 07 (3) an individual holding a class A certificate issued by the Conference 08 of Executives of American Schools of the Deaf may teach the hearing impaired; 09 (4) an individual may engage in the testing of hearing as part of a 10 hearing conservation program that complies with the regulations of the Occupational 11 Safety and Health Administration of the federal government if the individual is 12 certified to do the testing by a state or federal agency acceptable to the Occupational 13 Safety and Health Administration; 14 (5) an individual may perform hearing screening under AS 47.20.310 15 if authorized to do so under a protocol adopted under AS 47.20.310(e) by the 16 Department of Health. 17 * Sec. 6. AS 08.68.100 is amended to read: 18 Sec. 08.68.100. Duties and powers of board. (a) The board shall 19 (1) adopt regulations necessary to implement this chapter, including 20 regulations 21 (A) pertaining to practice as an advanced practice registered 22 nurse, including requirements for an advanced practice registered nurse to 23 practice as a certified registered nurse anesthetist, certified clinical nurse 24 specialist, certified nurse practitioner, or certified nurse midwife; regulations 25 for an advanced practice registered nurse who holds a valid federal Drug 26 Enforcement Administration registration number must address training in pain 27 management and opioid use and addiction; 28 (B) necessary to implement AS 08.68.331 - 08.68.336 relating 29 to certified nurse aides in order to protect the health, safety, and welfare of 30 clients served by nurse aides; 31 (C) pertaining to retired nurse status;
01 (D) establishing criteria for approval of practical nurse 02 education programs that are not accredited by a national nursing accrediting 03 body; [AND] 04 (E) establishing guidelines for rendering a diagnosis, providing 05 treatment, or prescribing, dispensing, or administering a prescription drug to a 06 person without conducting a physical examination under AS 08.68.710; the 07 guidelines must include a nationally recognized model policy for standards of 08 care of a patient who is at a different location than the advanced practice 09 registered nurse; and 10 (F) necessary to implement the Multistate Nurse Licensure 11 Compact under AS 08.68.500; 12 (2) approve curricula and adopt standards for basic education programs 13 that prepare persons for licensing under this chapter [AS 08.68.190]; 14 (3) provide for surveys of the basic nursing education programs in the 15 state at the times it considers necessary; 16 (4) approve education programs that meet the requirements of this 17 chapter and of the board, and deny, revoke, or suspend approval of education 18 programs for failure to meet the requirements; 19 (5) examine, license, and renew the licenses of [QUALIFIED] 20 applicants; 21 (6) prescribe requirements for competence before a former registered, 22 advanced practice registered, or [LICENSED] practical nurse licensed under this 23 chapter may resume the practice of nursing [UNDER THIS CHAPTER]; 24 (7) define by regulation the qualifications and duties of the executive 25 administrator and delegate authority to the executive administrator that is necessary to 26 conduct board business; 27 (8) develop reasonable and uniform standards for nursing practice; 28 (9) publish advisory opinions regarding whether nursing practice 29 procedures or policies comply with acceptable standards of nursing practice as defined 30 under this chapter; 31 (10) require applicants under this chapter to submit fingerprints and the
01 fees required by the Department of Public Safety under AS 12.62.160 for criminal 02 justice information and a national criminal history record check; the department shall 03 submit the fingerprints and fees to the Department of Public Safety for a report of 04 criminal justice information under AS 12.62 and a national criminal history record 05 check under AS 12.62.400; 06 (11) require that a licensed advanced practice registered nurse who has 07 a federal Drug Enforcement Administration registration number register with the 08 controlled substance prescription database under AS 17.30.200(n); 09 (12) appoint the executive administrator of the board to serve as 10 the state administrator of the Interstate Commission Nurse Licensure Compact 11 Administrators under AS 08.68.500. 12 (b) The board may 13 (1) conduct hearings upon charges of alleged violations of this chapter 14 or regulations adopted under it; 15 (2) invoke, or request the department to invoke, disciplinary action 16 against a license issued under this chapter or a person holding a multistate 17 licensure privilege [LICENSEE]; 18 (3) prescribe requirements for competence to continue practice. 19 * Sec. 7. AS 08.68.140 is amended to read: 20 Sec. 08.68.140. Applicability of Administrative Procedure Act. Except as 21 specified in AS 08.68.333(f) and 08.68.500, the board shall comply with AS 44.62 22 (Administrative Procedure Act). 23 * Sec. 8. AS 08.68.160 is amended to read: 24 Sec. 08.68.160. License required. A person practicing or offering to practice 25 as a registered [, ADVANCED PRACTICE REGISTERED,] or practical nurse 26 [NURSING] in the state shall submit evidence of qualification to practice and shall be 27 licensed or hold a multistate licensure privilege under this chapter. A person 28 practicing or offering to practice as an advanced practice registered nurse in the 29 state shall submit evidence of qualification to practice and shall be licensed under 30 this chapter. 31 * Sec. 9. AS 08.68.170 is amended to read:
01 Sec. 08.68.170. Qualifications of registered or practical nurse applicants. 02 (a) An applicant for a license to practice registered nursing shall submit to the board, 03 on forms and in the manner prescribed by the board, written evidence, verified by 04 oath, that the applicant has successfully completed a registered nurse education 05 program accredited by a national nursing accrediting body and approved by the board. 06 An applicant for a multistate license to practice registered nursing shall, in 07 addition to the requirements of this chapter, meet the requirements of 08 AS 08.68.500. 09 (b) An applicant for a license to practice practical nursing may obtain a 10 license to practice in this state under this chapter or a multistate license that 11 meets the requirements of this chapter and AS 08.68.500. An applicant for a 12 license to practice practical nursing under this chapter shall submit to the board, 13 on forms and in the manner prescribed by the board, written evidence, verified by 14 oath, that the applicant has successfully completed 15 (1) a practical nurse education program accredited by a national 16 nursing accrediting body; 17 (2) a practical nurse education program that meets the criteria 18 established by the board under AS 08.68.100; or 19 (3) a registered nurse education program accredited by a national 20 nursing accrediting body and approved by the board and, if the applicant has failed the 21 registered nurse licensing examination, a practical nurse scope of practice course 22 approved by the board. 23 (c) An applicant for a license to practice advanced practice registered nursing 24 shall submit to the board, on forms and in the manner prescribed by the board, written 25 evidence, verified by oath, that the applicant 26 (1) is licensed as a registered nurse in the state or is practicing as a 27 registered nurse in the state under a multistate licensure privilege; and 28 (2) has successfully completed an advanced practice registered nurse 29 education program that meets the criteria established by the board under 30 AS 08.68.100. 31 * Sec. 10. AS 08.68.190 is amended by adding a new subsection to read:
01 (c) If an applicant meets the qualifications set out in AS 08.68.170 and 02 08.68.500 for the license for which the applicant applied, the board shall issue a 03 multistate license to practice registered or practical nursing to an applicant who passes 04 the licensing examination to practice registered or practical nursing. 05 * Sec. 11. AS 08.68.220 is amended to read: 06 Sec. 08.68.220. Fees. The Department of Commerce, Community, and 07 Economic Development shall set fees under AS 08.01.065 for each of the following: 08 (1) registered nursing single-state license: 09 (A) application; 10 (B) license by examination; 11 (C) license by endorsement; 12 (D) license renewal; 13 (E) temporary permit; 14 (2) practical nursing single-state license: 15 (A) application; 16 (B) license by examination; 17 (C) license by endorsement; 18 (D) license renewal; 19 (E) temporary permit; 20 (3) advanced practice registered nursing: 21 (A) application; 22 (B) license by certification examination; 23 (C) license by endorsement; 24 (D) license renewal; 25 (E) temporary permit; 26 (4) registered nursing multistate license: 27 (A) application; 28 (B) license; 29 (C) license renewal; 30 (5) practical nursing multistate license: 31 (A) application;
01 (B) license; 02 (C) license renewal. 03 * Sec. 12. AS 08.68.230(a) is amended to read: 04 (a) A person who holds a license or multistate licensure privilege 05 [LICENSED] to practice registered nursing in the state may use the title "registered 06 nurse " and the abbreviation "R.N."[.] 07 * Sec. 13. AS 08.68.230(b) is amended to read: 08 (b) A person who holds a license or multistate licensure privilege 09 [LICENSED] to practice practical nursing in the state may use the title "licensed 10 practical nurse" and the abbreviation "L.P.N." 11 * Sec. 14. AS 08.68.251(a) is amended to read: 12 (a) A lapsed license issued by the board under this chapter may be 13 reinstated if it has not remained lapsed for more than five years by payment of the 14 license fees for the current renewal period and the penalty fee. The board, by 15 regulation, shall establish continuing competency and criminal background check 16 requirements for reinstatement of a lapsed license. 17 * Sec. 15. AS 08.68.275(c) is amended to read: 18 (c) The board may summarily suspend a license issued by the board under 19 this chapter before final hearing or during the appeals process if the board finds that 20 the licensee poses a clear and immediate danger to the public health and safety. A 21 person whose license is suspended under this section is entitled to a hearing conducted 22 by the office of administrative hearings (AS 44.64.010) within seven days after the 23 effective date of the order. If, after a hearing, the board upholds the suspension, the 24 licensee may appeal the suspension to a court of competent jurisdiction. 25 * Sec. 16. AS 08.68.275(d) is amended to read: 26 (d) The board may reinstate a license issued by the board under this chapter 27 that has been suspended or revoked if the board finds, after a hearing, that the 28 applicant is able to practice with skill and safety. 29 * Sec. 17. AS 08.68.275 is amended by adding a new subsection to read: 30 (g) The board may take the following disciplinary actions singly or in 31 combination against an individual who is practicing in this state under a multistate
01 licensure privilege: 02 (1) suspend the multistate licensure privilege in the state for a stated 03 period of time; 04 (2) censure the individual; 05 (3) issue a letter of reprimand; 06 (4) impose limitations or conditions on the professional practice of the 07 individual in the state; 08 (5) impose peer review; 09 (6) impose professional education requirements until a satisfactory 10 degree of skill has been attained in those aspects of professional practice determined 11 by the board to need improvement; 12 (7) impose probation and require the individual to report regularly to 13 the board on matters involving the basis for the probation. 14 * Sec. 18. AS 08.68 is amended by adding new sections to read: 15 Article 5A. Multistate Nurse Licensure Compact. 16 Sec. 08.68.500. Compact enacted. The Multistate Nurse Licensure Compact 17 as contained in this section is enacted into law and entered into on behalf of the state 18 with all other states and jurisdictions legally joining it in a form substantially as 19 follows: 20 ARTICLE I 21 Findings and Declaration of Purpose 22 (a) The legislature finds that: 23 (1) The health and safety of the public are affected by the degree of 24 compliance with and the effectiveness of enforcement activities related to state nurse 25 licensure laws; 26 (2) Violations of nurse licensure and other laws regulating the practice 27 of nursing may result in injury or harm to the public; 28 (3) The expanded mobility of nurses and the use of advanced 29 communication technologies as part of our nation's health care delivery system require 30 greater coordination and cooperation among states in the areas of nurse licensure and 31 regulation;
01 (4) New practice modalities and technology make compliance with 02 individual state nurse licensure laws difficult and complex; 03 (5) The current system of duplicative licensure for nurses practicing in 04 multiple states is cumbersome and redundant for both nurses and states; and 05 (6) Uniformity of nurse licensure requirements throughout the states 06 promotes public safety and public health benefits. 07 (b) The general purposes of this Compact are to: 08 (1) Facilitate the states' responsibility to protect the public's health and 09 safety; 10 (2) Ensure and encourage the cooperation of party states in the areas of 11 nurse licensure and regulation; 12 (3) Facilitate the exchange of information between party states in the 13 areas of nurse regulation, investigation and adverse actions; 14 (4) Promote compliance with the laws governing the practice of 15 nursing in each jurisdiction; 16 (5) Invest all party states with the authority to hold a nurse accountable 17 for meeting all state practice laws in the state in which the patient is located at the time 18 care is rendered through the mutual recognition of party state licenses; 19 (6) Decrease redundancies in the consideration and issuance of nurse 20 licenses; and 21 (7) Provide opportunities for interstate practice by nurses who meet 22 uniform licensure requirements. 23 ARTICLE II 24 Definitions 25 As used in this compact, unless the context clearly requires a different construction, 26 (1) "Adverse action" means any administrative, civil, equitable or 27 criminal action permitted by a state's laws which is imposed by a licensing board or 28 other authority against a nurse, including actions against an individual's license or 29 multistate licensure privilege such as revocation, suspension, probation, monitoring of 30 the licensee, limitation on the licensee's practice, or any other encumbrance on 31 licensure affecting a nurse's authorization to practice, including issuance of a cease
01 and desist action. 02 (2) "Alternative program" means a non-disciplinary monitoring 03 program approved by a licensing board. 04 (3) "Coordinated licensure information system" means an integrated 05 process for collecting, storing and sharing information on nurse licensure and 06 enforcement activities related to nurse licensure laws that is administered by a 07 nonprofit organization composed of and controlled by licensing boards. 08 (4) "Current significant investigative information" means: 09 (A) Investigative information that a licensing board, after a 10 preliminary inquiry that includes notification and an opportunity for the nurse 11 to respond, if required by state law, has reason to believe is not groundless and, 12 if proved true, would indicate more than a minor infraction; or 13 (B) Investigative information that indicates that the nurse 14 represents an immediate threat to public health and safety regardless of 15 whether the nurse has been notified and had an opportunity to respond. 16 (5) "Encumbrance" means a revocation or suspension of, or any 17 limitation on, the full and unrestricted practice of nursing imposed by a licensing 18 board. 19 (6) "Home state" means the party state which is the nurse's primary 20 state of residence. 21 (7) "Licensing board" means a party state's regulatory body 22 responsible for issuing nurse licenses. 23 (8) "Multistate license" means a license to practice as a registered or a 24 licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board 25 that authorizes the licensed nurse to practice in all party states under a multistate 26 licensure privilege. 27 (9) "Multistate licensure privilege" means a legal authorization 28 associated with a multistate license permitting the practice of nursing as either a 29 registered nurse (RN) or LPN/VN in a remote state. 30 (10) "Nurse" means RN or LPN/VN, as those terms are defined by 31 each party state's practice laws.
01 (11) "Party state" means any state that has adopted this Compact. 02 (12) "Remote state" means a party state, other than the home state. 03 (13) "Single-state license" means a nurse license issued by a party state 04 that authorizes practice only within the issuing state and does not include a multistate 05 licensure privilege to practice in any other party state. 06 (14) "State" means a state, territory or possession of the United States 07 and the District of Columbia. 08 (15) "State practice laws" means a party state's laws, rules and 09 regulations that govern the practice of nursing, define the scope of nursing practice, 10 and create the methods and grounds for imposing discipline. "State practice laws" do 11 not include requirements necessary to obtain and retain a license, except for 12 qualifications or requirements of the home state. 13 ARTICLE III 14 General Provisions and Jurisdiction 15 (a) A multistate license to practice registered or licensed practical/vocational 16 nursing issued by a home state to a resident in that state will be recognized by each 17 party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed 18 practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each 19 party state. 20 (b) A state must implement procedures for considering the criminal history 21 records of applicants for initial multistate license or licensure by endorsement. Such 22 procedures shall include the submission of fingerprints or other biometric-based 23 information by applicants for the purpose of obtaining an applicant's criminal history 24 record information from the Federal Bureau of Investigation and the agency 25 responsible for retaining that state's criminal records. 26 (c) Each party state shall require the following for an applicant to obtain or 27 retain a multistate license in the home state: 28 (1) Meets the home state's qualifications for licensure or renewal of 29 licensure, as well as, all other applicable state laws; 30 (2) Has graduated or is eligible to graduate from a licensing board- 31 approved RN or LPN/VN prelicensure education program; or has graduated from a
01 foreign RN or LPN/VN prelicensure education program that (a) has been approved by 02 the authorized accrediting body in the applicable country and (b) has been verified by 03 an independent credentials review agency to be comparable to a licensing board- 04 approved prelicensure education program; 05 (3) Has, if a graduate of a foreign prelicensure education program not 06 taught in English or if English is not the individual's native language, successfully 07 passed an English proficiency examination that includes the components of reading, 08 speaking, writing and listening; 09 (4) Has successfully passed an NCLEX-RN or NCLEX-PN 10 Examination or recognized predecessor, as applicable; 11 (5) Is eligible for or holds an active, unencumbered license; 12 (6) Has submitted, in connection with an application for initial 13 licensure or licensure by endorsement, fingerprints or other biometric data for the 14 purpose of obtaining criminal history record information from the Federal Bureau of 15 Investigation and the agency responsible for retaining that state's criminal records; 16 (7) Has not been convicted or found guilty, or has entered into an 17 agreed disposition, of a felony offense under applicable state or federal criminal law; 18 (8) Has not been convicted or found guilty, or has entered into an 19 agreed disposition, of a misdemeanor offense related to the practice of nursing as 20 determined on a case-by-case basis; 21 (9) Is not currently enrolled in an alternative program; 22 (10) Is subject to self-disclosure requirements regarding current 23 participation in an alternative program; and 24 (11) Has a valid United States Social Security number. 25 (d) All party states shall be authorized, in accordance with existing state due 26 process law, to take adverse action against a nurse's multistate licensure privilege such 27 as revocation, suspension, probation or any other action that affects a nurse's 28 authorization to practice under a multistate licensure privilege, including cease and 29 desist actions. If a party state takes such action, it shall promptly notify the 30 administrator of the coordinated licensure information system. The administrator of 31 the coordinated licensure information system shall promptly notify the home state of
01 any such actions by remote states. 02 (e) A nurse practicing in a party state must comply with the state practice laws 03 of the state in which the client is located at the time service is provided. The practice 04 of nursing is not limited to patient care, but shall include all nursing practice as 05 defined by the state practice laws of the party state in which the client is located. The 06 practice of nursing in a party state under a multistate licensure privilege will subject a 07 nurse to the jurisdiction of the licensing board, the courts and the laws of the party 08 state in which the client is located at the time service is provided. 09 (f) Individuals not residing in a party state shall continue to be able to apply 10 for a party state's single-state license as provided under the laws of each party state. 11 However, the single-state license granted to these individuals will not be recognized as 12 granting the privilege to practice nursing in any other party state. Nothing in this 13 Compact shall affect the requirements established by a party state for the issuance of a 14 single-state license. 15 (g) Any nurse holding a home state multistate license, on the effective date of 16 this Compact, may retain and renew the multistate license issued by the nurse's then- 17 current home state, provided that: 18 (1) A nurse, who changes primary state of residence after this 19 Compact's effective date, must meet all applicable Article III.c. requirements to obtain 20 a multistate license from a new home state. 21 (2) A nurse who fails to satisfy the multistate licensure requirements in 22 Article III.c. due to a disqualifying event occurring after this Compact's effective date 23 shall be ineligible to retain or renew a multistate license, and the nurse's multistate 24 license shall be revoked or deactivated in accordance with applicable rules adopted by 25 the Interstate Commission of Nurse Licensure Compact Administrators 26 ("Commission"). 27 ARTICLE IV 28 Applications for Licensure in a Party State 29 (a) Upon application for a multistate license, the licensing board in the issuing 30 party state shall ascertain, through the coordinated licensure information system, 31 whether the applicant has ever held, or is the holder of, a license issued by any other
01 state, whether there are any encumbrances on any license or multistate licensure 02 privilege held by the applicant, whether any adverse action has been taken against any 03 license or multistate licensure privilege held by the applicant and whether the 04 applicant is currently participating in an alternative program. 05 (b) A nurse may hold a multistate license, issued by the home state, in only 06 one party state at a time. 07 (c) If a nurse changes primary state of residence by moving between two party 08 states, the nurse must apply for licensure in the new home state, and the multistate 09 license issued by the prior home state will be deactivated in accordance with 10 applicable rules adopted by the Commission. 11 (1) The nurse may apply for licensure in advance of a change in 12 primary state of residence. 13 (2) A multistate license shall not be issued by the new home state until 14 the nurse provides satisfactory evidence of a change in primary state of residence to 15 the new home state and satisfies all applicable requirements to obtain a multistate 16 license from the new home state. 17 (d) If a nurse changes primary state of residence by moving from a party state 18 to a non-party state, the multistate license issued by the prior home state will convert 19 to a single-state license, valid only in the former home state. 20 ARTICLE V 21 Additional Authorities Invested in Party State Licensing Boards 22 (a) In addition to the other powers conferred by state law, a licensing board 23 shall have the authority to: 24 (1) Take adverse action against a nurse's multistate licensure privilege 25 to practice within that party state. 26 (A) Only the home state shall have the power to take adverse 27 action against a nurse's license issued by the home state. 28 (B) For purposes of taking adverse action, the home state 29 licensing board shall give the same priority and effect to reported conduct 30 received from a remote state as it would if such conduct had occurred within 31 the home state. In so doing, the home state shall apply its own state laws to
01 determine appropriate action. 02 (2) Issue cease and desist orders or impose an encumbrance on a 03 nurse's authority to practice within that party state. 04 (3) Complete any pending investigations of a nurse who changes 05 primary state of residence during the course of such investigations. The licensing 06 board shall also have the authority to take appropriate action(s) and shall promptly 07 report the conclusions of such investigations to the administrator of the coordinated 08 licensure information system. The administrator of the coordinated licensure 09 information system shall promptly notify the new home state of any such actions. 10 (4) Issue subpoenas for both hearings and investigations that require 11 the attendance and testimony of witnesses, as well as, the production of evidence. 12 Subpoenas issued by a licensing board in a party state for the attendance and 13 testimony of witnesses or the production of evidence from another party state shall be 14 enforced in the latter state by any court of competent jurisdiction, according to the 15 practice and procedure of that court applicable to subpoenas issued in proceedings 16 pending before it. The issuing authority shall pay any witness fees, travel expenses, 17 mileage and other fees required by the service statutes of the state in which the 18 witnesses or evidence are located. 19 (5) Obtain and submit, for each nurse licensure applicant, fingerprint 20 or other biometric-based information to the Federal Bureau of Investigation for 21 criminal background checks, receive the results of the Federal Bureau of Investigation 22 record search on criminal background checks and use the results in making licensure 23 decisions. 24 (6) If otherwise permitted by state law, recover from the affected nurse 25 the costs of investigations and disposition of cases resulting from any adverse action 26 taken against that nurse. 27 (7) Take adverse action based on the factual findings of the remote 28 state, provided that the licensing board follows its own procedures for taking such 29 adverse action. 30 (b) If adverse action is taken by the home state against a nurse's multistate 31 license, the nurse's multistate licensure privilege to practice in all other party states
01 shall be deactivated until all encumbrances have been removed from the multistate 02 license. All home state disciplinary orders that impose adverse action against a nurse's 03 multistate license shall include a statement that the nurse's multistate licensure 04 privilege is deactivated in all party states during the pendency of the order. Nothing in 05 this Compact shall override a party state's decision that participation in an alternative 06 program may be used in lieu of adverse action. The home state licensing board shall 07 deactivate the multistate licensure privilege under the multistate license of any nurse 08 for the duration of the nurse's participation in an alternative program. 09 ARTICLE VI 10 Coordinated Licensure Information System and Exchange of Information 11 (a) All party states shall participate in a coordinated licensure information 12 system of all licensed registered nurses (RNs) and licensed practical/vocational nurses 13 (LPNs/VNs). This system will include information on the licensure and disciplinary 14 history of each nurse, as submitted by party states, to assist in the coordination of 15 nurse licensure and enforcement efforts. 16 (b) The Commission, in consultation with the administrator of the coordinated 17 licensure information system, shall formulate necessary and proper procedures for the 18 identification, collection and exchange of information under this Compact. 19 (c) All licensing boards shall promptly report to the coordinated licensure 20 information system any adverse action, any current significant investigative 21 information, denials of applications (with the reasons for such denials) and nurse 22 participation in alternative programs known to the licensing board regardless of 23 whether such participation is deemed nonpublic or confidential under state law. 24 (d) Current significant investigative information and participation in nonpublic 25 or confidential alternative programs shall be transmitted through the coordinated 26 licensure information system only to party state licensing boards. 27 (e) Notwithstanding any other provision of law, all party state licensing boards 28 contributing information to the coordinated licensure information system may 29 designate information that may not be shared with non-party states or disclosed to 30 other entities or individuals without the express permission of the contributing state. 31 (f) Any personally identifiable information obtained from the coordinated
01 licensure information system by a party state licensing board shall not be shared with 02 non-party states or disclosed to other entities or individuals except to the extent 03 permitted by the laws of the party state contributing the information. 04 (g) Any information contributed to the coordinated licensure information 05 system that is subsequently required to be expunged by the laws of the party state 06 contributing that information shall also be expunged from the coordinated licensure 07 information system. 08 (h) The Compact administrator of each party state shall furnish a uniform data 09 set to the Compact administrator of each other party state, which shall include, at a 10 minimum: 11 (1) Identifying information; 12 (2) Licensure data; 13 (3) Information related to alternative program participation; and 14 (4) Other information that may facilitate the administration of this 15 Compact, as determined by Commission rules. 16 (i) The Compact administrator of a party state shall provide all investigative 17 documents and information requested by another party state. 18 ARTICLE VII 19 Establishment of the Interstate Commission of Nurse Licensure Compact Administrators 20 (a) The party states hereby create and establish a joint public entity known as 21 the Interstate Commission of Nurse Licensure Compact Administrators. 22 (1) The Commission is an instrumentality of the party states. 23 (2) Venue is proper, and judicial proceedings by or against the 24 Commission shall be brought solely and exclusively, in a court of competent 25 jurisdiction where the principal office of the Commission is located. The Commission 26 may waive venue and jurisdictional defenses to the extent it adopts or consents to 27 participate in alternative dispute resolution proceedings. 28 (3) Nothing in this Compact shall be construed to be a waiver of 29 sovereign immunity. 30 (b) Membership, Voting and Meetings 31 (1) Each party state shall have and be limited to one administrator. The
01 head of the state licensing board or designee shall be the administrator of this Compact 02 for each party state. Any administrator may be removed or suspended from office as 03 provided by the law of the state from which the Administrator is appointed. Any 04 vacancy occurring in the Commission shall be filled in accordance with the laws of the 05 party state in which the vacancy exists. 06 (2) Each administrator shall be entitled to one (1) vote with regard to 07 the promulgation of rules and creation of bylaws and shall otherwise have an 08 opportunity to participate in the business and affairs of the Commission. An 09 administrator shall vote in person or by such other means as provided in the bylaws. 10 The bylaws may provide for an administrator's participation in meetings by telephone 11 or other means of communication. 12 (3) The Commission shall meet at least once during each calendar 13 year. Additional meetings shall be held as set forth in the bylaws or rules of the 14 commission. 15 (4) All meetings shall be open to the public, and public notice of 16 meetings shall be given in the same manner as required under the rulemaking 17 provisions in Article VIII. 18 (5) The Commission may convene in a closed, nonpublic meeting if 19 the Commission must discuss: 20 (A) Noncompliance of a party state with its obligations under 21 this Compact; 22 (B) The employment, compensation, discipline or other 23 personnel matters, practices or procedures related to specific employees or 24 other matters related to the Commission's internal personnel practices and 25 procedures; 26 (C) Current, threatened or reasonably anticipated litigation; 27 (D) Negotiation of contracts for the purchase or sale of goods, 28 services or real estate; 29 (E) Accusing any person of a crime or formally censuring any 30 person; 31 (F) Disclosure of trade secrets or commercial or financial
01 information that is privileged or confidential; 02 (G) Disclosure of information of a personal nature where 03 disclosure would constitute a clearly unwarranted invasion of personal privacy; 04 (H) Disclosure of investigatory records compiled for law 05 enforcement purposes; 06 (I) Disclosure of information related to any reports prepared by 07 or on behalf of the Commission for the purpose of investigation of compliance 08 with this Compact; or 09 (J) Matters specifically exempted from disclosure by federal or 10 state statute. 11 (6) If a meeting, or portion of a meeting, is closed pursuant to this 12 provision, the Commission's legal counsel or designee shall certify that the meeting 13 may be closed and shall reference each relevant exempting provision. The 14 Commission shall keep minutes that fully and clearly describe all matters discussed in 15 a meeting and shall provide a full and accurate summary of actions taken, and the 16 reasons therefor, including a description of the views expressed. All documents 17 considered in connection with an action shall be identified in such minutes. All 18 minutes and documents of a closed meeting shall remain under seal, subject to release 19 by a majority vote of the Commission or order of a court of competent jurisdiction. 20 (c) The Commission shall, by a majority vote of the administrators, prescribe 21 bylaws or rules to govern its conduct as may be necessary or appropriate to carry out 22 the purposes and exercise the powers of this Compact, including but not limited to: 23 (1) Establishing the fiscal year of the Commission; 24 (2) Providing reasonable standards and procedures: 25 (A) For the establishment and meetings of other committees; 26 and 27 (B) Governing any general or specific delegation of any 28 authority or function of the Commission; 29 (3) Providing reasonable procedures for calling and conducting 30 meetings of the Commission, ensuring reasonable advance notice of all meetings and 31 providing an opportunity for attendance of such meetings by interested parties, with
01 enumerated exceptions designed to protect the public's interest, the privacy of 02 individuals, and proprietary information, including trade secrets. The Commission 03 may meet in closed session only after a majority of the administrators vote to close a 04 meeting in whole or in part. As soon as practicable, the Commission must make public 05 a copy of the vote to close the meeting revealing the vote of each administrator, with 06 no proxy votes allowed; 07 (4) Establishing the titles, duties and authority and reasonable 08 procedures for the election of the officers of the Commission; 09 (5) Providing reasonable standards and procedures for the 10 establishment of the personnel policies and programs of the Commission. 11 Notwithstanding any civil service or other similar laws of any party state, the bylaws 12 shall exclusively govern the personnel policies and programs of the Commission; and 13 (6) Providing a mechanism for winding up the operations of the 14 Commission and the equitable disposition of any surplus funds that may exist after the 15 termination of this Compact after the payment or reserving of all of its debts and 16 obligations; 17 (d) The Commission shall publish its bylaws and rules, and any amendments 18 thereto, in a convenient form on the website of the Commission. 19 (e) The Commission shall maintain its financial records in accordance with the 20 bylaws. 21 (f) The Commission shall meet and take such actions as are consistent with the 22 provisions of this Compact and the bylaws. 23 (g) The Commission shall have the following powers: 24 (1) To promulgate uniform rules to facilitate and coordinate 25 implementation and administration of this Compact. The rules shall have the force and 26 effect of law and shall be binding in all party states; 27 (2) To bring and prosecute legal proceedings or actions in the name of 28 the Commission, provided that the standing of any licensing board to sue or be sued 29 under applicable law shall not be affected; 30 (3) To purchase and maintain insurance and bonds; 31 (4) To borrow, accept or contract for services of personnel, including,
01 but not limited to, employees of a party state or nonprofit organizations; 02 (5) To cooperate with other organizations that administer state 03 compacts related to the regulation of nursing, including but not limited to sharing 04 administrative or staff expenses, office space or other resources; 05 (6) To hire employees, elect or appoint officers, fix compensation, 06 define duties, grant such individuals appropriate authority to carry out the purposes of 07 this Compact, and to establish the Commission's personnel policies and programs 08 relating to conflicts of interest, qualifications of personnel and other related personnel 09 matters; 10 (7) To accept any and all appropriate donations, grants and gifts of 11 money, equipment, supplies, materials and services, and to receive, utilize and dispose 12 of the same; provided that at all times the Commission shall avoid any appearance of 13 impropriety or conflict of interest; 14 (8) To lease, purchase, accept appropriate gifts or donations of, or 15 otherwise to own, hold, improve or use, any property, whether real, personal or mixed; 16 provided that at all times the Commission shall avoid any appearance of impropriety; 17 (9) To sell, convey, mortgage, pledge, lease, exchange, abandon or 18 otherwise dispose of any property, whether real, personal or mixed; 19 (10) To establish a budget and make expenditures; 20 (11) To borrow money; 21 (12) To appoint committees, including advisory committees comprised 22 of administrators, state nursing regulators, state legislators or their representatives, and 23 consumer representatives, and other such interested persons; 24 (13) To provide and receive information from, and to cooperate with, 25 law enforcement agencies; 26 (14) To adopt and use an official seal; and 27 (15) To perform such other functions as may be necessary or 28 appropriate to achieve the purposes of this Compact consistent with the state 29 regulation of nurse licensure and practice. 30 (h) Financing of the Commission 31 (1) The Commission shall pay, or provide for the payment of, the
01 reasonable expenses of its establishment, organization and ongoing activities. 02 (2) The Commission may also levy on and collect an annual 03 assessment from each party state to cover the cost of its operations, activities and staff 04 in its annual budget as approved each year. The aggregate annual assessment amount, 05 if any, shall be allocated based upon a formula to be determined by the Commission, 06 which shall promulgate a rule that is binding upon all party states. 07 (3) The Commission shall not incur obligations of any kind prior to 08 securing the funds adequate to meet the same; nor shall the Commission pledge the 09 credit of any of the party states, except by, and with the authority of, such party state. 10 (4) The Commission shall keep accurate accounts of all receipts and 11 disbursements. The receipts and disbursements of the Commission shall be subject to 12 the audit and accounting procedures established under its bylaws. However, all 13 receipts and disbursements of funds handled by the Commission shall be audited 14 yearly by a certified or licensed public accountant, and the report of the audit shall be 15 included in and become part of the annual report of the Commission. 16 (i) Qualified Immunity, Defense and Indemnification 17 (1) The administrators, officers, executive director, employees and 18 representatives of the Commission shall be immune from suit and liability, either 19 personally or in their official capacity, for any claim for damage to or loss of property 20 or personal injury or other civil liability caused by or arising out of any actual or 21 alleged act, error or omission that occurred, or that the person against whom the claim 22 is made had a reasonable basis for believing occurred, within the scope of 23 Commission employment, duties or responsibilities; provided that nothing in this 24 paragraph shall be construed to protect any such person from suit or liability for any 25 damage, loss, injury or liability caused by the intentional, willful or wanton 26 misconduct of that person. 27 (2) The Commission shall defend any administrator, officer, executive 28 director, employee or representative of the Commission in any civil action seeking to 29 impose liability arising out of any actual or alleged act, error or omission that occurred 30 within the scope of Commission employment, duties or responsibilities, or that the 31 person against whom the claim is made had a reasonable basis for believing occurred
01 within the scope of Commission employment, duties or responsibilities; provided that 02 nothing herein shall be construed to prohibit that person from retaining his or her own 03 counsel; and provided further that the actual or alleged act, error or omission did not 04 result from that person's intentional, willful or wanton misconduct. 05 (3) The Commission shall indemnify and hold harmless any 06 administrator, officer, executive director, employee or representative of the 07 Commission for the amount of any settlement or judgment obtained against that 08 person arising out of any actual or alleged act, error or omission that occurred within 09 the scope of Commission employment, duties or responsibilities, or that such person 10 had a reasonable basis for believing occurred within the scope of Commission 11 employment, duties or responsibilities, provided that the actual or alleged act, error or 12 omission did not result from the intentional, willful or wanton misconduct of that 13 person. 14 ARTICLE VIII 15 Rulemaking 16 (a) The Commission shall exercise its rulemaking powers pursuant to the 17 criteria set forth in this Article and the rules adopted thereunder. Rules and 18 amendments shall become binding as of the date specified in each rule or amendment 19 and shall have the same force and effect as provisions of this Compact. 20 (b) Rules or amendments to the rules shall be adopted at a regular or special 21 meeting of the Commission. 22 (c) Prior to promulgation and adoption of a final rule or rules by the 23 Commission, and at least sixty (60) days in advance of the meeting at which the rule 24 will be considered and voted upon, the Commission shall file a notice of proposed 25 rulemaking: 26 (1) On the website of the Commission; and 27 (2) On the website of each licensing board or the publication in which 28 each state would otherwise publish proposed rules. 29 (d) The notice of proposed rulemaking shall include: 30 (1) The proposed time, date and location of the meeting in which the 31 rule will be considered and voted upon;
01 (2) The text of the proposed rule or amendment, and the reason for the 02 proposed rule; 03 (3) A request for comments on the proposed rule from any interested 04 person; and 05 (4) The manner in which interested persons may submit notice to the 06 Commission of their intention to attend the public hearing and any written comments. 07 (e) Prior to adoption of a proposed rule, the Commission shall allow persons 08 to submit written data, facts, opinions and arguments, which shall be made available to 09 the public. 10 (f) The Commission shall grant an opportunity for a public hearing before it 11 adopts a rule or amendment. 12 (g) The Commission shall publish the place, time and date of the scheduled 13 public hearing. 14 (1) Hearings shall be conducted in a manner providing each person 15 who wishes to comment a fair and reasonable opportunity to comment orally or in 16 writing. All hearings will be recorded, and a copy will be made available upon request. 17 (2) Nothing in this section shall be construed as requiring a separate 18 hearing on each rule. Rules may be grouped for the convenience of the Commission at 19 hearings required by this section. 20 (h) If no one appears at the public hearing, the Commission may proceed with 21 promulgation of the proposed rule. 22 (i) Following the scheduled hearing date, or by the close of business on the 23 scheduled hearing date if the hearing was not held, the Commission shall consider all 24 written and oral comments received. 25 (j) The Commission shall, by majority vote of all administrators, take final 26 action on the proposed rule and shall determine the effective date of the rule, if any, 27 based on the rulemaking record and the full text of the rule. 28 (k) Upon determination that an emergency exists, the Commission may 29 consider and adopt an emergency rule without prior notice, opportunity for comment 30 or hearing, provided that the usual rulemaking procedures provided in this Compact 31 and in this section shall be retroactively applied to the rule as soon as reasonably
01 possible, in no event later than ninety (90) days after the effective date of the rule. For 02 the purposes of this provision, an emergency rule is one that must be adopted 03 immediately in order to: 04 (1) Meet an imminent threat to public health, safety or welfare; 05 (2) Prevent a loss of Commission or party state funds; or 06 (3) Meet a deadline for the promulgation of an administrative rule that 07 is required by federal law or rule. 08 (l) The Commission may direct revisions to a previously adopted rule or 09 amendment for purposes of correcting typographical errors, errors in format, errors in 10 consistency or grammatical errors. Public notice of any revisions shall be posted on 11 the website of the Commission. The revision shall be subject to challenge by any 12 person for a period of thirty (30) days after posting. The revision may be challenged 13 only on grounds that the revision results in a material change to a rule. A challenge 14 shall be made in writing, and delivered to the Commission, prior to the end of the 15 notice period. If no challenge is made, the revision will take effect without further 16 action. If the revision is challenged, the revision may not take effect without the 17 approval of the Commission. 18 ARTICLE IX 19 Oversight, Dispute Resolution and Enforcement 20 (a) Oversight 21 (1) Each party state shall enforce this Compact and take all actions 22 necessary and appropriate to effectuate this Compact's purposes and intent. 23 (2) The Commission shall be entitled to receive service of process in 24 any proceeding that may affect the powers, responsibilities or actions of the 25 Commission, and shall have standing to intervene in such a proceeding for all 26 purposes. Failure to provide service of process in such proceeding to the Commission 27 shall render a judgment or order void as to the Commission, this Compact or 28 promulgated rules. 29 (b) Default, Technical Assistance and Termination 30 (1) If the Commission determines that a party state has defaulted in the 31 performance of its obligations or responsibilities under this Compact or the
01 promulgated rules, the Commission shall: 02 (A) Provide written notice to the defaulting state and other 03 party states of the nature of the default, the proposed means of curing the 04 default or any other action to be taken by the Commission; and 05 (B) Provide remedial training and specific technical assistance 06 regarding the default. 07 (2) If a state in default fails to cure the default, the defaulting state's 08 membership in this Compact may be terminated upon an affirmative vote of a majority 09 of the administrators, and all rights, privileges and benefits conferred by this Compact 10 may be terminated on the effective date of termination. A cure of the default does not 11 relieve the offending state of obligations or liabilities incurred during the period of 12 default. 13 (3) Termination of membership in this Compact shall be imposed only 14 after all other means of securing compliance have been exhausted. Notice of intent to 15 suspend or terminate shall be given by the Commission to the governor of the 16 defaulting state and to the executive officer of the defaulting state's licensing board 17 and each of the party states. 18 (4) A state whose membership in this Compact has been terminated is 19 responsible for all assessments, obligations and liabilities incurred through the 20 effective date of termination, including obligations that extend beyond the effective 21 date of termination. 22 (5) The Commission shall not bear any costs related to a state that is 23 found to be in default or whose membership in this Compact has been terminated 24 unless agreed upon in writing between the Commission and the defaulting state. 25 (6) The defaulting state may appeal the action of the Commission by 26 petitioning the U.S. District Court for the District of Columbia or the federal district in 27 which the Commission has its principal offices. The prevailing party shall be awarded 28 all costs of such litigation, including reasonable attorneys' fees. 29 (c) Dispute Resolution 30 (1) Upon request by a party state, the Commission shall attempt to 31 resolve disputes related to the Compact that arise among party states and between
01 party and non-party states. 02 (2) The Commission shall promulgate a rule providing for both 03 mediation and binding dispute resolution for disputes, as appropriate. 04 (3) In the event the Commission cannot resolve disputes among party 05 states arising under this Compact: 06 (A) The party states may submit the issues in dispute to an 07 arbitration panel, which will be comprised of individuals appointed by the 08 Compact administrator in each of the affected party states and an individual 09 mutually agreed upon by the Compact administrators of all the party states 10 involved in the dispute. 11 (B) The decision of a majority of the arbitrators shall be final 12 and binding. 13 (d) Enforcement 14 (1) The Commission, in the reasonable exercise of its discretion, shall 15 enforce the provisions and rules of this Compact. 16 (2) By majority vote, the Commission may initiate legal action in the 17 U.S. District Court for the District of Columbia or the federal district in which the 18 Commission has its principal offices against a party state that is in default to enforce 19 compliance with the provisions of this Compact and its promulgated rules and bylaws. 20 The relief sought may include both injunctive relief and damages. In the event judicial 21 enforcement is necessary, the prevailing party shall be awarded all costs of such 22 litigation, including reasonable attorneys' fees. 23 (3) The remedies herein shall not be the exclusive remedies of the 24 Commission. The Commission may pursue any other remedies available under federal 25 or state law. 26 ARTICLE X 27 Effective Date, Withdrawal and Amendment 28 (a) This Compact shall become effective and binding on the earlier of the date 29 of legislative enactment of this Compact into law by no less than twenty-six (26) states 30 or December 31, 2018. All party states to this Compact, that also were parties to the 31 prior Nurse Licensure Compact, superseded by this Compact, ("Prior Compact"), shall
01 be deemed to have withdrawn from said Prior Compact within six (6) months after the 02 effective date of this Compact. 03 (b) Each party state to this Compact shall continue to recognize a nurse's 04 multistate licensure privilege to practice in that party state issued under the Prior 05 Compact until such party state has withdrawn from the Prior Compact. 06 (c) Any party state may withdraw from this Compact by enacting a statute 07 repealing the same. A party state's withdrawal shall not take effect until six (6) months 08 after enactment of the repealing statute. 09 (d) A party state's withdrawal or termination shall not affect the continuing 10 requirement of the withdrawing or terminated state's licensing board to report adverse 11 actions and significant investigations occurring prior to the effective date of such 12 withdrawal or termination. 13 (e) Nothing contained in this Compact shall be construed to invalidate or 14 prevent any nurse licensure agreement or other cooperative arrangement between a 15 party state and a non-party state that is made in accordance with the other provisions 16 of this Compact. 17 (f) This Compact may be amended by the party states. No amendment to this 18 Compact shall become effective and binding upon the party states unless and until it is 19 enacted into the laws of all party states. 20 (g) Representatives of non-party states to this Compact shall be invited to 21 participate in the activities of the Commission, on a nonvoting basis, prior to the 22 adoption of this Compact by all states. 23 ARTICLE XI 24 Construction and Severability 25 This Compact shall be liberally construed so as to effectuate the purposes thereof. The 26 provisions of this Compact shall be severable, and if any phrase, clause, sentence or provision 27 of this Compact is declared to be contrary to the constitution of any party state or of the 28 United States, or if the applicability thereof to any government, agency, person or 29 circumstance is held invalid, the validity of the remainder of this Compact and the 30 applicability thereof to any government, agency, person or circumstance shall not be affected 31 thereby. If this Compact shall be held to be contrary to the constitution of any party state, this
01 Compact shall remain in full force and effect as to the remaining party states and in full force 02 and effect as to the party state affected as to all severable matters. 03 * Sec. 19. AS 08.68.800(a) is amended to read: 04 (a) This chapter does not apply to 05 (1) a qualified nurse licensed in another state employed by the United 06 States government or a bureau, or agency, or division of the United States government 07 while in the discharge of official duties; 08 (2) nursing service given temporarily in the event of a public 09 emergency, epidemic, or disaster; 10 (3) the practice of nursing by a student enrolled in a nursing education 11 program accredited by the board when the practice is in connection with the student's 12 course of study; 13 (4) the practice of nursing by an individual enrolled in an approved 14 program or course of study approved by the board to satisfy the requirements of 15 AS 08.68.251; 16 (5) the practice of nursing by a nurse licensed in another state who 17 does not hold a multistate licensure privilege to practice in this state and who 18 engages in nursing education or nursing consultation activities, if these activities and 19 contact with clients do not exceed 20 working days within a licensing period; or 20 (6) the practice of nursing by a nurse licensed in another state who 21 does not hold a multistate licensure privilege to practice in this state and whose 22 employment responsibilities include transporting patients into, out of, or through this 23 state; however, this exception is valid for a period not to exceed 48 hours for each 24 transport. 25 * Sec. 20. AS 08.68.805 is amended to read: 26 Sec. 08.68.805. Delegation of nursing functions. A registered, advanced 27 practice registered, or practical nurse licensed under this chapter or a registered or 28 practical nurse holding a multistate licensure privilege may delegate nursing duties 29 to other persons, including unlicensed assistive personnel, under regulations adopted 30 by the board. A person to whom the nursing duties are delegated may perform the 31 delegated duties without a license or certificate under this chapter or a multistate
01 licensure privilege if the person meets the applicable requirements established by the 02 board. 03 * Sec. 21. AS 08.68.850(1) is amended to read: 04 (1) "advanced practice registered nurse" means a [REGISTERED] 05 nurse licensed to practice registered nursing in this state [IN THE STATE] who, 06 because of specialized education and experience, is licensed by the board 07 [CERTIFIED] to perform acts of medical diagnosis and the prescription and 08 dispensing of medical, therapeutic, or corrective measures under regulations adopted 09 by the board; 10 * Sec. 22. AS 08.68.850 is amended by adding new paragraphs to read: 11 (13) "multistate license" means a license issued by the board under 12 AS 08.68.500 to practice registered nursing or practical nursing in another state that is 13 a party to the Multistate Nurse Licensure Compact enacted under AS 08.68.500; 14 (14) "multistate licensure privilege" means a legal authorization for a 15 person holding a multistate license issued by another state to practice registered 16 nursing or practical nursing in this state under the terms of the Multistate Nurse 17 Licensure Compact enacted under AS 08.68.500; 18 (15) "single-state license" means a license issued under this chapter to 19 practice registered nursing or practical nursing in the state and does not authorize 20 practice in another state. 21 * Sec. 23. AS 09.55.560(2) is amended to read: 22 (2) "health care provider" means an acupuncturist licensed under 23 AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 24 chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a 25 dentist licensed under AS 08.36; a nurse licensed or holding a multistate licensure 26 privilege under AS 08.68; a dispensing optician licensed under AS 08.71; a 27 naturopath licensed under AS 08.45; an optometrist licensed under AS 08.72; a 28 pharmacist licensed under AS 08.80; a physical therapist or occupational therapist 29 licensed under AS 08.84; a physician or physician assistant licensed under AS 08.64; a 30 podiatrist; a psychologist and a psychological associate licensed under AS 08.86; a 31 hospital as defined in AS 47.32.900, including a governmentally owned or operated
01 hospital; an employee of a health care provider acting within the course and scope of 02 employment; an ambulatory surgical facility and other organizations whose primary 03 purpose is the delivery of health care, including a health maintenance organization, 04 individual practice association, integrated delivery system, preferred provider 05 organization or arrangement, and a physical hospital organization; 06 * Sec. 24. AS 09.65.095(c)(1) is amended to read: 07 (1) "health care provider" means a nurse licensed or holding a 08 multistate licensure privilege under AS 08.68, a physician licensed under AS 08.64, 09 and a person certified by a hospital as competent to take blood samples; 10 * Sec. 25. AS 18.20.095(e)(2) is amended to read: 11 (2) "licensed staff member" means a person who is employed by the 12 hospital to provide direct patient care and who is licensed or certified in the state as a 13 physician or physician assistant under AS 08.64, direct-entry midwife under AS 08.65, 14 nurse licensed or holding a multistate licensure privilege under AS 08.68 or nurse 15 aide under AS 08.68, or physical therapist or occupational therapist under AS 08.84; 16 * Sec. 26. AS 18.20.499(3) is amended to read: 17 (3) "nurse" means an individual licensed or holding a multistate 18 licensure privilege to practice registered nursing or practical nursing under AS 08.68 19 who provides nursing services through direct patient care or clinical services and 20 includes a nurse manager when delivering in-hospital patient care; 21 * Sec. 27. AS 18.23.070(3) is amended to read: 22 (3) "health care provider" means an acupuncturist licensed under 23 AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist licensed under 24 AS 08.32; a dentist licensed under AS 08.36; a nurse licensed or holding a multistate 25 licensure privilege under AS 08.68; a dispensing optician licensed under AS 08.71; 26 an optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 27 physical therapist or occupational therapist licensed under AS 08.84; a physician 28 licensed under AS 08.64; a podiatrist; a psychologist and a psychological associate 29 licensed under AS 08.86; a hospital as defined in AS 47.32.900, including a 30 governmentally owned or operated hospital; and an employee of a health care provider 31 acting within the course and scope of employment;
01 * Sec. 28. AS 47.07.045(b) is amended to read: 02 (b) Before the department may terminate payment for services provided under 03 (a) of this section, 04 (1) the recipient must have had an annual assessment to determine 05 whether the recipient continues to meet the standards under (a) of this section; 06 (2) the annual assessment must have been reviewed by an independent 07 qualified health care professional under contract with the department; for purposes of 08 this paragraph, "independent qualified health care professional" means, 09 (A) for a waiver based on intellectual or developmental 10 disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 11 intellectual disability professional; 12 (B) for other allowable waivers, a registered nurse licensed or 13 holding a multistate licensure privilege under AS 08.68 or an advanced 14 practice registered nurse licensed under AS 08.68 who is qualified to assess 15 children with complex medical conditions, older Alaskans, and adults with 16 physical disabilities for medical assistance waivers; and 17 (3) the annual assessment must find that the recipient's condition has 18 materially improved since the previous assessment; for purposes of this paragraph, 19 "materially improved" means that a recipient who has previously qualified for a 20 waiver for 21 (A) a child with complex medical conditions, no longer needs 22 technical assistance for a life-threatening condition, and is expected to be 23 placed in a skilled nursing facility for less than 30 days each year; 24 (B) intellectual or developmental disability, no longer needs the 25 level of care provided by an intermediate care facility for persons with 26 intellectual and developmental disabilities either because the qualifying 27 diagnosis has changed or the recipient is able to demonstrate the ability to 28 function in a home setting without the need for waiver services; or 29 (C) an older Alaskan or adult with a physical disability, no 30 longer has a functional limitation or cognitive impairment that would result in 31 the need for nursing home placement, and is able to demonstrate the ability to
01 function in a home setting without the need for waiver services. 02 * Sec. 29. AS 47.30.915(16) is amended to read: 03 (16) "mental health professional" means a psychiatrist or physician 04 who is licensed by the State Medical Board to practice in this state or is employed by 05 the federal government; a clinical psychologist licensed by the state Board of 06 Psychologist and Psychological Associate Examiners; a psychological associate 07 trained in clinical psychology and licensed by the Board of Psychologist and 08 Psychological Associate Examiners; an advanced practice registered nurse or a 09 registered nurse with a master's degree in psychiatric nursing, licensed by the State 10 Board of Nursing or holding a multistate licensure privilege under AS 08.68; a 11 marital and family therapist licensed by the Board of Marital and Family Therapy; a 12 professional counselor licensed by the Board of Professional Counselors; a clinical 13 social worker licensed by the Board of Social Work Examiners; and a person who 14 (A) has a master's degree in the field of mental health; 15 (B) has at least 12 months of post-masters working experience 16 in the field of mental illness; and 17 (C) is working under the supervision of a type of licensee listed 18 in this paragraph; 19 * Sec. 30. AS 47.33.020(d) is amended to read: 20 (d) An assisted living home may provide intermittent nursing services to a 21 resident who does not require 24-hour nursing services and supervision. Intermittent 22 nursing services may be provided only by a nurse licensed or holding a multistate 23 licensure privilege under AS 08.68 or by a person to whom a nursing task has been 24 delegated under (e) of this section. 25 * Sec. 31. AS 47.33.020(e) is amended to read: 26 (e) A person who is on the staff of an assisted living home and who is not a 27 nurse licensed or holding a multistate licensure privilege under AS 08.68 may 28 perform a nursing task in that home if 29 (1) the authority to perform that nursing task is delegated to that person 30 by a nurse licensed or holding a multistate licensure privilege under AS 08.68; and 31 (2) that nursing task is specified in regulations adopted by the Board of
01 Nursing as a task that may be delegated. 02 * Sec. 32. AS 47.33.020(f) is amended to read: 03 (f) A resident who needs skilled nursing care may, with the consent of the 04 assisted living home, arrange for that care to be provided in the home by a nurse 05 licensed or holding a multistate licensure privilege under AS 08.68 if that 06 arrangement does not interfere with the services provided to other residents. 07 * Sec. 33. AS 47.33.020(g) is amended to read: 08 (g) As part of a plan to avoid transfer of a resident from the home for medical 09 reasons, the home may provide, through the services of a nurse who is licensed or 10 holding a multistate licensure privilege under AS 08.68, 24-hour skilled nursing 11 care to the resident for not more than 45 consecutive days. 12 * Sec. 34. AS 47.33.020(h) is amended to read: 13 (h) If a resident has received 24-hour skilled nursing care for the 45-day limit 14 set by (g) of this section, the resident or the resident's representative may elect to have 15 the resident remain in the home without continuation of 24-hour skilled nursing care if 16 the home agrees to retain the resident after 17 (1) the home and either the resident or the resident's representative 18 have consulted with the resident's physician; 19 (2) the home and either the resident or the resident's representative 20 have discussed the consequences and risks involved in the election to remain in the 21 home; and 22 (3) the portion of the resident's assisted living plan that relates to 23 health-related services has been revised to provide for the resident's health-related 24 needs without the use of 24-hour skilled nursing care, and the revised plan has been 25 reviewed by a registered nurse licensed or holding a multistate licensure privilege 26 under AS 08.68, or advanced practice registered nurse licensed under AS 08.68, or by 27 the resident's attending physician. 28 * Sec. 35. AS 47.33.230(c) is amended to read: 29 (c) If the assisted living home provides or arranges for the provision of health- 30 related services to a resident, the home shall ensure that a 31 (1) registered nurse licensed or holding a multistate licensure
01 privilege under AS 08.68 or advanced practice registered nurse licensed under 02 AS 08.68 reviews the portion of an assisted living plan that describes how the 03 resident's need for health-related services will be met; and 04 (2) physician's statement about the resident is included in the plan. 05 * Sec. 36. The uncodified law of the State of Alaska is amended by adding a new section to 06 read: 07 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 08 Economic Development and the Board of Nursing may adopt regulations necessary to 09 implement the changes made by this Act. The regulations take effect under AS 44.62 10 (Administrative Procedure Act), but not before the effective date of the law implemented by 11 the regulation. 12 * Sec. 37. Section 36 of this Act takes effect immediately under AS 01.10.070(c). 13 * Sec. 38. Except as provided in sec. 37 of this Act, this Act takes effect July 1, 2024.