00 SENATE BILL NO. 130
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.