00 SENATE BILL NO. 124 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 Board of 13 Nursing for issuing a single-state license to practice registered, practical, or advanced 14 practice registered nursing is approximately equal to the total regulatory costs to the 15 department and the Board of Nursing for each of those license types. The department 16 shall establish fees for issuing a multistate license to practice registered or practical 17 nursing equal to double the fee set for the single-state version of that license type. In 18 this subsection, "single-state license" and "multistate license" have the meanings given 19 in AS 08.68.500. 20  * Sec. 3. AS 08.02.130(j)(1), as amended by sec. 2, ch. 44, SLA 2024, is amended to read: 21 (1) "health care provider" means 22 (A) an audiologist or speech-language pathologist licensed 23 under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 24 licensed under AS 08.20; a professional or associate counselor licensed under 25 AS 08.29; a dental hygienist licensed under AS 08.32; a dentist licensed under 26 AS 08.36; a dietitian or nutritionist licensed under AS 08.38; a naturopath 27 licensed under AS 08.45; a marital and family therapist licensed under 28 AS 08.63; a physician licensed under AS 08.64; a podiatrist, osteopath, or 29 physician assistant licensed under AS 08.64; a direct-entry midwife certified 30 under AS 08.65; a nurse licensed or privileged to practice under AS 08.68; a 31 dispensing optician licensed under AS 08.71; an optometrist licensed under 01 AS 08.72; a pharmacist licensed under AS 08.80; a physical therapist or 02 occupational therapist licensed under AS 08.84; a psychologist or 03 psychological associate licensed under AS 08.86; or a social worker licensed 04 under AS 08.95; 05 (B) a physician licensed in another state; or 06 (C) a member of a multidisciplinary care team who is licensed 07 in another state. 08  * Sec. 4. AS 08.11.120(b) is amended to read: 09 (b) Notwithstanding the provisions of this chapter,  10 (1) a nurse licensed or privileged to practice under AS 08.68 may 11 perform hearing sensitivity evaluations; 12 (2) an individual licensed as a hearing aid dealer under AS 08.55 may 13 deal in hearing aids; 14 (3) an individual holding a class A certificate issued by the Conference 15 of Executives of American Schools of the Deaf may teach the hearing impaired; 16 (4) an individual may engage in the testing of hearing as part of a 17 hearing conservation program that complies with the regulations of the Occupational 18 Safety and Health Administration of the federal government if the individual is 19 certified to do the testing by a state or federal agency acceptable to the Occupational 20 Safety and Health Administration; 21 (5) an individual may perform hearing screening under AS 47.20.310 22 if authorized to do so under a protocol adopted under AS 47.20.310(e) by the 23 Department of Health. 24  * Sec. 5. AS 08.68.100(a) is amended to read: 25 (a) The board shall  26 (1) adopt regulations necessary to implement this chapter, including 27 regulations 28 (A) pertaining to practice as an advanced practice registered 29 nurse, including requirements for an advanced practice registered nurse to 30 practice as a certified registered nurse anesthetist, certified clinical nurse 31 specialist, certified nurse practitioner, or certified nurse midwife; regulations 01 for an advanced practice registered nurse who holds a valid federal Drug 02 Enforcement Administration registration number must address training in pain 03 management and opioid use and addiction; 04 (B) necessary to implement AS 08.68.331 - 08.68.336 relating 05 to certified nurse aides in order to protect the health, safety, and welfare of 06 clients served by nurse aides; 07 (C) pertaining to retired nurse status; 08 (D) establishing criteria for approval of practical nurse 09 education programs that are not accredited by a national nursing accrediting 10 body; 11 (E) establishing guidelines for rendering a diagnosis, providing 12 treatment, or prescribing, dispensing, or administering a prescription drug to a 13 person without conducting a physical examination under AS 08.68.710; the 14 guidelines must include a nationally recognized model policy for standards of 15 care of a patient who is at a different location than the advanced practice 16 registered nurse;  17 (2) approve curricula and adopt standards for basic education programs 18 that prepare persons for licensing under AS 08.68.190; 19 (3) provide for surveys of the basic nursing education programs in the 20 state at the times it considers necessary; 21 (4) approve education programs that meet the requirements of this 22 chapter and of the board, and deny, revoke, or suspend approval of education 23 programs for failure to meet the requirements; 24 (5) examine, license, and renew the licenses of qualified applicants; 25 (6) prescribe requirements for competence before a former registered, 26 advanced practice registered, or licensed practical nurse may resume the practice of 27 nursing under this chapter; 28 (7) define by regulation the qualifications and duties of the executive 29 administrator and delegate authority to the executive administrator that is necessary to 30 conduct board business; 31 (8) develop reasonable and uniform standards for nursing practice; 01 (9) publish advisory opinions regarding whether nursing practice 02 procedures or policies comply with acceptable standards of nursing practice as defined 03 under this chapter; 04 (10) require applicants under this chapter to submit fingerprints and the 05 fees required by the Department of Public Safety under AS 12.62.160 for criminal 06 justice information and a national criminal history record check; the department shall 07 submit the fingerprints and fees to the Department of Public Safety for a report of 08 criminal justice information under AS 12.62 and a national criminal history record 09 check under AS 12.62.400; 10 (11) require that a licensed advanced practice registered nurse who has 11 a federal Drug Enforcement Administration registration number register with the 12 controlled substance prescription database under AS 17.30.200(n);  13 (12) implement the Multistate Nurse Licensure Compact entered  14 into under AS 08.68.500, including adopting any regulations necessary to  15 implement the compact.  16  * Sec. 6. AS 08.68.160 is amended to read: 17 Sec. 08.68.160. License or practice privilege required. A person practicing 18 or offering to practice registered, advanced practice registered, or practical nursing in 19 the state shall submit evidence of qualification to practice and shall be licensed or  20 privileged to practice under this chapter.  21  * Sec. 7. AS 08.68.170(c) is amended to read: 22 (c) An applicant for a license to practice advanced practice registered nursing 23 shall submit to the board, on forms and in the manner prescribed by the board, written 24 evidence, verified by oath, that the applicant  25 (1) is licensed or privileged to practice as a registered nurse in the 26 state; and 27 (2) has successfully completed an advanced practice registered nurse 28 education program that meets the criteria established by the board under 29 AS 08.68.100. 30  * Sec. 8. AS 08.68.220 is amended to read: 31 Sec. 08.68.220. Fees. The Department of Commerce, Community, and 01 Economic Development shall set fees under AS 08.01.065 for each of the following:  02 (1) registered nursing: 03 (A) application; 04 (B) license by examination; 05 (C) license by endorsement; 06 (D) license renewal; 07 (E) temporary permit; 08 (F) multistate licensure privilege;  09 (2) practical nursing: 10 (A) application; 11 (B) license by examination; 12 (C) license by endorsement; 13 (D) license renewal; 14 (E) temporary permit; 15 (F) multistate licensure privilege;  16 (3) advanced practice registered nursing: 17 (A) application; 18 (B) license by certification examination; 19 (C) license by endorsement; 20 (D) license renewal; 21 (E) temporary permit. 22  * Sec. 9. AS 08.68.270 is amended to read: 23 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 24 may deny, suspend, or revoke the license or practice privilege of a person who 25 (1) has obtained or attempted to obtain a license to practice nursing by 26 fraud or deceit; 27 (2) has been convicted of a felony or other crime if the felony or other 28 crime is substantially related to the qualifications, functions, or duties of the licensee; 29 (3) habitually abuses alcoholic beverages, or illegally uses controlled 30 substances; 31 (4) has impersonated a registered, advanced practice registered, or 01 practical nurse; 02 (5) has intentionally or negligently engaged in conduct that has 03 resulted in a significant risk to the health or safety of a client or in injury to a client; 04 (6) practices or attempts to practice nursing while afflicted with 05 physical or mental illness, deterioration, or disability that interferes with the 06 individual's performance of nursing functions; 07 (7) is guilty of unprofessional conduct as defined by regulations 08 adopted by the board; 09 (8) has wilfully or repeatedly violated a provision of this chapter or 10 regulations adopted under this chapter or AS 08.01; 11 (9) is professionally incompetent; 12 (10) denies care or treatment to a patient or person seeking assistance 13 if the sole reason for the denial is the failure or refusal of the patient or person seeking 14 assistance to agree to arbitrate as provided in AS 09.55.535(a); 15 (11) has prescribed or dispensed an opioid in excess of the maximum 16 dosage authorized under AS 08.68.705; or 17 (12) has procured, sold, prescribed, or dispensed drugs in violation of a 18 law, regardless of whether there has been a criminal action or harm to the patient. 19  * Sec. 10. AS 08.68.275(a) is amended to read: 20 (a) The board may take the following disciplinary actions singly or in 21 combination: 22 (1) permanently revoke a license, practice privilege, or permit to 23 practice; 24 (2) suspend a license or practice privilege for a stated period of time; 25 (3) censure a licensee; 26 (4) issue a letter of reprimand; 27 (5) impose limitations or conditions on the professional practice of a 28 licensee; 29 (6) impose peer review; 30 (7) impose professional education requirements until a satisfactory 31 degree of skill has been attained in those aspects of professional practice determined 01 by the board to need improvement; 02 (8) impose probation and require the licensee to report regularly to the 03 board upon matters involving the basis for the probation; 04 (9) accept a voluntary surrender of a license. 05  * Sec. 11. AS 08.68.275(c) is amended to read: 06 (c) The board may summarily suspend a license or practice privilege before 07 final hearing or during the appeals process if the board finds that the licensee or  08 holder of the practice privilege poses a clear and immediate danger to the public 09 health and safety. A person whose license is suspended under this section is entitled to 10 a hearing conducted by the office of administrative hearings (AS 44.64.010) within 11 seven days after the effective date of the order. If, after a hearing, the board upholds 12 the suspension, the licensee may appeal the suspension to a court of competent 13 jurisdiction. 14  * Sec. 12. AS 08.68.275(d) is amended to read: 15 (d) The board may reinstate a license or practice privilege that has been 16 suspended or revoked if the board finds, after a hearing, that the applicant is able to 17 practice with skill and safety. 18  * Sec. 13. AS 08.68.277(a) is amended to read: 19 (a) An employer of a nurse licensed or privileged to practice under this 20 chapter or a nurse aide certified under this chapter practicing within the scope of that 21 license, privilege, or certification that discharges or suspends a nurse or nurse aide or 22 conditions or restricts the practice of a nurse or nurse aide shall, within seven working 23 days after the action, report to the board the name and address of the person and the 24 reason for the action. An employer shall report to the board the name and address of a 25 nurse or nurse aide who resigns while under investigation by the employer. The 26 requirement of an employer to report under this section applies only to a discharge, 27 suspension, or restriction of practice that is based on a ground allowing action by the 28 board under AS 08.68.270 or 08.68.334 or for conduct prohibited under AS 08.68.340. 29  * Sec. 14. AS 08.68.278 is amended to read: 30 Sec. 08.68.278. Immunity for certain reports to the board. A person who, in 31 good faith, reports information to the board relating to alleged incidents of 01 incompetent, unprofessional, or unlawful conduct of a nurse licensed or privileged to  02 practice under this chapter, a nurse aide certified under this chapter, or an employer of 03 a nurse licensed or privileged to practice under this chapter or a nurse aide certified 04 under this chapter who reports to the board the information required under 05 AS 08.68.277 is not liable in a civil action for damages resulting from the reporting of 06 the information.  07  * Sec. 15. AS 08.68 is amended by adding a new section to read: 08 Article 5A. Multistate Nurse Licensure Compact.  09 Sec. 08.68.500. Compact enacted. The Multistate Nurse Licensure Compact 10 as contained in this section is enacted into law and entered into on behalf of the state 11 with all other states and jurisdictions legally joining it in a form substantially as 12 follows: 13 ARTICLE I 14 Findings and Declaration of Purpose 15 (a) The legislature finds that: 16 (1) The health and safety of the public are affected by the degree of 17 compliance with and the effectiveness of enforcement activities related to state nurse 18 licensure laws; 19 (2) Violations of nurse licensure and other laws regulating the practice 20 of nursing may result in injury or harm to the public; 21 (3) The expanded mobility of nurses and the use of advanced 22 communication technologies as part of our nation's health care delivery system require 23 greater coordination and cooperation among states in the areas of nurse licensure and 24 regulation; 25 (4) New practice modalities and technology make compliance with 26 individual state nurse licensure laws difficult and complex; 27 (5) The current system of duplicative licensure for nurses practicing in 28 multiple states is cumbersome and redundant for both nurses and states; and 29 (6) Uniformity of nurse licensure requirements throughout the states 30 promotes public safety and public health benefits. 31 (b) The general purposes of this Compact are to: 01 (1) Facilitate the states' responsibility to protect the public's health and 02 safety; 03 (2) Ensure and encourage the cooperation of party states in the areas of 04 nurse licensure and regulation; 05 (3) Facilitate the exchange of information between party states in the 06 areas of nurse regulation, investigation and adverse actions; 07 (4) Promote compliance with the laws governing the practice of 08 nursing in each jurisdiction; 09 (5) Invest all party states with the authority to hold a nurse accountable 10 for meeting all state practice laws in the state in which the patient is located at the time 11 care is rendered through the mutual recognition of party state licenses; 12 (6) Decrease redundancies in the consideration and issuance of nurse 13 licenses; and 14 (7) Provide opportunities for interstate practice by nurses who meet 15 uniform licensure requirements. 16 ARTICLE II 17 Definitions 18 As used in this compact, unless the context clearly requires a different construction, 19 (1) "Adverse action" means any administrative, civil, equitable or 20 criminal action permitted by a state's laws which is imposed by a licensing board or 21 other authority against a nurse, including actions against an individual's license or 22 multistate licensure privilege such as revocation, suspension, probation, monitoring of 23 the licensee, limitation on the licensee's practice, or any other encumbrance on 24 licensure affecting a nurse's authorization to practice, including issuance of a cease 25 and desist action. 26 (2) "Alternative program" means a non-disciplinary monitoring 27 program approved by a licensing board. 28 (3) "Coordinated licensure information system" means an integrated 29 process for collecting, storing and sharing information on nurse licensure and 30 enforcement activities related to nurse licensure laws that is administered by a 31 nonprofit organization composed of and controlled by licensing boards. 01 (4) "Current significant investigative information" means: 02 (A) Investigative information that a licensing board, after a 03 preliminary inquiry that includes notification and an opportunity for the nurse 04 to respond, if required by state law, has reason to believe is not groundless and, 05 if proved true, would indicate more than a minor infraction; or 06 (B) Investigative information that indicates that the nurse 07 represents an immediate threat to public health and safety regardless of 08 whether the nurse has been notified and had an opportunity to respond. 09 (5) "Encumbrance" means a revocation or suspension of, or any 10 limitation on, the full and unrestricted practice of nursing imposed by a licensing 11 board. 12 (6) "Home state" means the party state which is the nurse's primary 13 state of residence. 14 (7) "Licensing board" means a party state's regulatory body 15 responsible for issuing nurse licenses. 16 (8) "Multistate license" means a license to practice as a registered or a 17 licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board 18 that authorizes the licensed nurse to practice in all party states under a multistate 19 licensure privilege. 20 (9) "Multistate licensure privilege" means a legal authorization 21 associated with a multistate license permitting the practice of nursing as either a 22 registered nurse (RN) or LPN/VN in a remote state. 23 (10) "Nurse" means RN or LPN/VN, as those terms are defined by 24 each party state's practice laws. 25 (11) "Party state" means any state that has adopted this Compact. 26 (12) "Remote state" means a party state, other than the home state. 27 (13) "Single-state license" means a nurse license issued by a party state 28 that authorizes practice only within the issuing state and does not include a multistate 29 licensure privilege to practice in any other party state. 30 (14) "State" means a state, territory or possession of the United States 31 and the District of Columbia. 01 (15) "State practice laws" means a party state's laws, rules and 02 regulations that govern the practice of nursing, define the scope of nursing practice, 03 and create the methods and grounds for imposing discipline. "State practice laws" do 04 not include requirements necessary to obtain and retain a license, except for 05 qualifications or requirements of the home state. 06 ARTICLE III 07 General Provisions and Jurisdiction 08 (a) A multistate license to practice registered or licensed practical/vocational 09 nursing issued by a home state to a resident in that state will be recognized by each 10 party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed 11 practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each 12 party state. 13 (b) A state must implement procedures for considering the criminal history 14 records of applicants for initial multistate license or licensure by endorsement. Such 15 procedures shall include the submission of fingerprints or other biometric-based 16 information by applicants for the purpose of obtaining an applicant's criminal history 17 record information from the Federal Bureau of Investigation and the agency 18 responsible for retaining that state's criminal records. 19 (c) Each party state shall require the following for an applicant to obtain or 20 retain a multistate license in the home state: 21 (1) Meets the home state's qualifications for licensure or renewal of 22 licensure, as well as, all other applicable state laws; 23 (2) Has graduated or is eligible to graduate from a licensing board- 24 approved RN or LPN/VN prelicensure education program; or has graduated from a 25 foreign RN or LPN/VN prelicensure education program that (a) has been approved by 26 the authorized accrediting body in the applicable country and (b) has been verified by 27 an independent credentials review agency to be comparable to a licensing board- 28 approved prelicensure education program; 29 (3) Has, if a graduate of a foreign prelicensure education program not 30 taught in English or if English is not the individual's native language, successfully 31 passed an English proficiency examination that includes the components of reading, 01 speaking, writing and listening; 02 (4) Has successfully passed an NCLEX-RN or NCLEX-PN 03 Examination or recognized predecessor, as applicable; 04 (5) Is eligible for or holds an active, unencumbered license; 05 (6) Has submitted, in connection with an application for initial 06 licensure or licensure by endorsement, fingerprints or other biometric data for the 07 purpose of obtaining criminal history record information from the Federal Bureau of 08 Investigation and the agency responsible for retaining that state's criminal records; 09 (7) Has not been convicted or found guilty, or has entered into an 10 agreed disposition, of a felony offense under applicable state or federal criminal law; 11 (8) Has not been convicted or found guilty, or has entered into an 12 agreed disposition, of a misdemeanor offense related to the practice of nursing as 13 determined on a case-by-case basis; 14 (9) Is not currently enrolled in an alternative program; 15 (10) Is subject to self-disclosure requirements regarding current 16 participation in an alternative program; and 17 (11) Has a valid United States Social Security number. 18 (d) All party states shall be authorized, in accordance with existing state due 19 process law, to take adverse action against a nurse's multistate licensure privilege such 20 as revocation, suspension, probation or any other action that affects a nurse's 21 authorization to practice under a multistate licensure privilege, including cease and 22 desist actions. If a party state takes such action, it shall promptly notify the 23 administrator of the coordinated licensure information system. The administrator of 24 the coordinated licensure information system shall promptly notify the home state of 25 any such actions by remote states. 26 (e) A nurse practicing in a party state must comply with the state practice laws 27 of the state in which the client is located at the time service is provided. The practice 28 of nursing is not limited to patient care, but shall include all nursing practice as 29 defined by the state practice laws of the party state in which the client is located. The 30 practice of nursing in a party state under a multistate licensure privilege will subject a 31 nurse to the jurisdiction of the licensing board, the courts and the laws of the party 01 state in which the client is located at the time service is provided. 02 (f) Individuals not residing in a party state shall continue to be able to apply 03 for a party state's single-state license as provided under the laws of each party state. 04 However, the single-state license granted to these individuals will not be recognized as 05 granting the privilege to practice nursing in any other party state. Nothing in this 06 Compact shall affect the requirements established by a party state for the issuance of a 07 single-state license. 08 (g) Any nurse holding a home state multistate license, on the effective date of 09 this Compact, may retain and renew the multistate license issued by the nurse's then- 10 current home state, provided that: 11 (1) A nurse, who changes primary state of residence after this 12 Compact's effective date, must meet all applicable Article III.c. requirements to obtain 13 a multistate license from a new home state. 14 (2) A nurse who fails to satisfy the multistate licensure requirements in 15 Article III.c. due to a disqualifying event occurring after this Compact's effective date 16 shall be ineligible to retain or renew a multistate license, and the nurse's multistate 17 license shall be revoked or deactivated in accordance with applicable rules adopted by 18 the Interstate Commission of Nurse Licensure Compact Administrators 19 ("Commission"). 20 ARTICLE IV 21 Applications for Licensure in a Party State 22 (a) Upon application for a multistate license, the licensing board in the issuing 23 party state shall ascertain, through the coordinated licensure information system, 24 whether the applicant has ever held, or is the holder of, a license issued by any other 25 state, whether there are any encumbrances on any license or multistate licensure 26 privilege held by the applicant, whether any adverse action has been taken against any 27 license or multistate licensure privilege held by the applicant and whether the 28 applicant is currently participating in an alternative program. 29 (b) A nurse may hold a multistate license, issued by the home state, in only 30 one party state at a time. 31 (c) If a nurse changes primary state of residence by moving between two party 01 states, the nurse must apply for licensure in the new home state, and the multistate 02 license issued by the prior home state will be deactivated in accordance with 03 applicable rules adopted by the Commission. 04 (1) The nurse may apply for licensure in advance of a change in 05 primary state of residence. 06 (2) A multistate license shall not be issued by the new home state until 07 the nurse provides satisfactory evidence of a change in primary state of residence to 08 the new home state and satisfies all applicable requirements to obtain a multistate 09 license from the new home state. 10 (d) If a nurse changes primary state of residence by moving from a party state 11 to a non-party state, the multistate license issued by the prior home state will convert 12 to a single-state license, valid only in the former home state. 13 ARTICLE V 14 Additional Authorities Invested in Party State Licensing Boards 15 (a) In addition to the other powers conferred by state law, a licensing board 16 shall have the authority to: 17 (1) Take adverse action against a nurse's multistate licensure privilege 18 to practice within that party state. 19 (A) Only the home state shall have the power to take adverse 20 action against a nurse's license issued by the home state. 21 (B) For purposes of taking adverse action, the home state 22 licensing board shall give the same priority and effect to reported conduct 23 received from a remote state as it would if such conduct had occurred within 24 the home state. In so doing, the home state shall apply its own state laws to 25 determine appropriate action. 26 (2) Issue cease and desist orders or impose an encumbrance on a 27 nurse's authority to practice within that party state. 28 (3) Complete any pending investigations of a nurse who changes 29 primary state of residence during the course of such investigations. The licensing 30 board shall also have the authority to take appropriate action(s) and shall promptly 31 report the conclusions of such investigations to the administrator of the coordinated 01 licensure information system. The administrator of the coordinated licensure 02 information system shall promptly notify the new home state of any such actions. 03 (4) Issue subpoenas for both hearings and investigations that require 04 the attendance and testimony of witnesses, as well as, the production of evidence. 05 Subpoenas issued by a licensing board in a party state for the attendance and 06 testimony of witnesses or the production of evidence from another party state shall be 07 enforced in the latter state by any court of competent jurisdiction, according to the 08 practice and procedure of that court applicable to subpoenas issued in proceedings 09 pending before it. The issuing authority shall pay any witness fees, travel expenses, 10 mileage and other fees required by the service statutes of the state in which the 11 witnesses or evidence are located. 12 (5) Obtain and submit, for each nurse licensure applicant, fingerprint 13 or other biometric-based information to the Federal Bureau of Investigation for 14 criminal background checks, receive the results of the Federal Bureau of Investigation 15 record search on criminal background checks and use the results in making licensure 16 decisions. 17 (6) If otherwise permitted by state law, recover from the affected nurse 18 the costs of investigations and disposition of cases resulting from any adverse action 19 taken against that nurse. 20 (7) Take adverse action based on the factual findings of the remote 21 state, provided that the licensing board follows its own procedures for taking such 22 adverse action. 23 (b) If adverse action is taken by the home state against a nurse's multistate 24 license, the nurse's multistate licensure privilege to practice in all other party states 25 shall be deactivated until all encumbrances have been removed from the multistate 26 license. All home state disciplinary orders that impose adverse action against a nurse's 27 multistate license shall include a statement that the nurse's multistate licensure 28 privilege is deactivated in all party states during the pendency of the order. Nothing in 29 this Compact shall override a party state's decision that participation in an alternative 30 program may be used in lieu of adverse action. The home state licensing board shall 31 deactivate the multistate licensure privilege under the multistate license of any nurse 01 for the duration of the nurse's participation in an alternative program. 02 ARTICLE VI 03 Coordinated Licensure Information System and Exchange of Information 04 (a) All party states shall participate in a coordinated licensure information 05 system of all licensed registered nurses (RNs) and licensed practical/vocational nurses 06 (LPNs/VNs). This system will include information on the licensure and disciplinary 07 history of each nurse, as submitted by party states, to assist in the coordination of 08 nurse licensure and enforcement efforts. 09 (b) The Commission, in consultation with the administrator of the coordinated 10 licensure information system, shall formulate necessary and proper procedures for the 11 identification, collection and exchange of information under this Compact. 12 (c) All licensing boards shall promptly report to the coordinated licensure 13 information system any adverse action, any current significant investigative 14 information, denials of applications (with the reasons for such denials) and nurse 15 participation in alternative programs known to the licensing board regardless of 16 whether such participation is deemed nonpublic or confidential under state law. 17 (d) Current significant investigative information and participation in nonpublic 18 or confidential alternative programs shall be transmitted through the coordinated 19 licensure information system only to party state licensing boards. 20 (e) Notwithstanding any other provision of law, all party state licensing boards 21 contributing information to the coordinated licensure information system may 22 designate information that may not be shared with non-party states or disclosed to 23 other entities or individuals without the express permission of the contributing state. 24 (f) Any personally identifiable information obtained from the coordinated 25 licensure information system by a party state licensing board shall not be shared with 26 non-party states or disclosed to other entities or individuals except to the extent 27 permitted by the laws of the party state contributing the information. 28 (g) Any information contributed to the coordinated licensure information 29 system that is subsequently required to be expunged by the laws of the party state 30 contributing that information shall also be expunged from the coordinated licensure 31 information system. 01 (h) The Compact administrator of each party state shall furnish a uniform data 02 set to the Compact administrator of each other party state, which shall include, at a 03 minimum: 04 (1) Identifying information; 05 (2) Licensure data; 06 (3) Information related to alternative program participation; and 07 (4) Other information that may facilitate the administration of this 08 Compact, as determined by Commission rules. 09 (i) The Compact administrator of a party state shall provide all investigative 10 documents and information requested by another party state. 11 ARTICLE VII 12 Establishment of the Interstate Commission of Nurse Licensure Compact Administrators 13 (a) The party states hereby create and establish a joint public entity known as 14 the Interstate Commission of Nurse Licensure Compact Administrators. 15 (1) The Commission is an instrumentality of the party states. 16 (2) Venue is proper, and judicial proceedings by or against the 17 Commission shall be brought solely and exclusively, in a court of competent 18 jurisdiction where the principal office of the Commission is located. The Commission 19 may waive venue and jurisdictional defenses to the extent it adopts or consents to 20 participate in alternative dispute resolution proceedings. 21 (3) Nothing in this Compact shall be construed to be a waiver of 22 sovereign immunity. 23 (b) Membership, Voting and Meetings 24 (1) Each party state shall have and be limited to one administrator. The 25 head of the state licensing board or designee shall be the administrator of this Compact 26 for each party state. Any administrator may be removed or suspended from office as 27 provided by the law of the state from which the Administrator is appointed. Any 28 vacancy occurring in the Commission shall be filled in accordance with the laws of the 29 party state in which the vacancy exists. 30 (2) Each administrator shall be entitled to one (1) vote with regard to 31 the promulgation of rules and creation of bylaws and shall otherwise have an 01 opportunity to participate in the business and affairs of the Commission. An 02 administrator shall vote in person or by such other means as provided in the bylaws. 03 The bylaws may provide for an administrator's participation in meetings by telephone 04 or other means of communication. 05 (3) The Commission shall meet at least once during each calendar 06 year. Additional meetings shall be held as set forth in the bylaws or rules of the 07 commission. 08 (4) All meetings shall be open to the public, and public notice of 09 meetings shall be given in the same manner as required under the rulemaking 10 provisions in Article VIII. 11 (5) The Commission may convene in a closed, nonpublic meeting if 12 the Commission must discuss: 13 (A) Noncompliance of a party state with its obligations under 14 this Compact; 15 (B) The employment, compensation, discipline or other 16 personnel matters, practices or procedures related to specific employees or 17 other matters related to the Commission's internal personnel practices and 18 procedures; 19 (C) Current, threatened or reasonably anticipated litigation; 20 (D) Negotiation of contracts for the purchase or sale of goods, 21 services or real estate; 22 (E) Accusing any person of a crime or formally censuring any 23 person; 24 (F) Disclosure of trade secrets or commercial or financial 25 information that is privileged or confidential; 26 (G) Disclosure of information of a personal nature where 27 disclosure would constitute a clearly unwarranted invasion of personal privacy; 28 (H) Disclosure of investigatory records compiled for law 29 enforcement purposes; 30 (I) Disclosure of information related to any reports prepared by 31 or on behalf of the Commission for the purpose of investigation of compliance 01 with this Compact; or 02 (J) Matters specifically exempted from disclosure by federal or 03 state statute. 04 (6) If a meeting, or portion of a meeting, is closed pursuant to this 05 provision, the Commission's legal counsel or designee shall certify that the meeting 06 may be closed and shall reference each relevant exempting provision. The 07 Commission shall keep minutes that fully and clearly describe all matters discussed in 08 a meeting and shall provide a full and accurate summary of actions taken, and the 09 reasons therefor, including a description of the views expressed. All documents 10 considered in connection with an action shall be identified in such minutes. All 11 minutes and documents of a closed meeting shall remain under seal, subject to release 12 by a majority vote of the Commission or order of a court of competent jurisdiction. 13 (c) The Commission shall, by a majority vote of the administrators, prescribe 14 bylaws or rules to govern its conduct as may be necessary or appropriate to carry out 15 the purposes and exercise the powers of this Compact, including but not limited to: 16 (1) Establishing the fiscal year of the Commission; 17 (2) Providing reasonable standards and procedures: 18 (A) For the establishment and meetings of other committees; 19 and 20 (B) Governing any general or specific delegation of any 21 authority or function of the Commission; 22 (3) Providing reasonable procedures for calling and conducting 23 meetings of the Commission, ensuring reasonable advance notice of all meetings and 24 providing an opportunity for attendance of such meetings by interested parties, with 25 enumerated exceptions designed to protect the public's interest, the privacy of 26 individuals, and proprietary information, including trade secrets. The Commission 27 may meet in closed session only after a majority of the administrators vote to close a 28 meeting in whole or in part. As soon as practicable, the Commission must make public 29 a copy of the vote to close the meeting revealing the vote of each administrator, with 30 no proxy votes allowed; 31 (4) Establishing the titles, duties and authority and reasonable 01 procedures for the election of the officers of the Commission; 02 (5) Providing reasonable standards and procedures for the 03 establishment of the personnel policies and programs of the Commission. 04 Notwithstanding any civil service or other similar laws of any party state, the bylaws 05 shall exclusively govern the personnel policies and programs of the Commission; and 06 (6) Providing a mechanism for winding up the operations of the 07 Commission and the equitable disposition of any surplus funds that may exist after the 08 termination of this Compact after the payment or reserving of all of its debts and 09 obligations; 10 (d) The Commission shall publish its bylaws and rules, and any amendments 11 thereto, in a convenient form on the website of the Commission. 12 (e) The Commission shall maintain its financial records in accordance with the 13 bylaws. 14 (f) The Commission shall meet and take such actions as are consistent with the 15 provisions of this Compact and the bylaws. 16 (g) The Commission shall have the following powers: 17 (1) To promulgate uniform rules to facilitate and coordinate 18 implementation and administration of this Compact. The rules shall have the force and 19 effect of law and shall be binding in all party states; 20 (2) To bring and prosecute legal proceedings or actions in the name of 21 the Commission, provided that the standing of any licensing board to sue or be sued 22 under applicable law shall not be affected; 23 (3) To purchase and maintain insurance and bonds; 24 (4) To borrow, accept or contract for services of personnel, including, 25 but not limited to, employees of a party state or nonprofit organizations; 26 (5) To cooperate with other organizations that administer state 27 compacts related to the regulation of nursing, including but not limited to sharing 28 administrative or staff expenses, office space or other resources; 29 (6) To hire employees, elect or appoint officers, fix compensation, 30 define duties, grant such individuals appropriate authority to carry out the purposes of 31 this Compact, and to establish the Commission's personnel policies and programs 01 relating to conflicts of interest, qualifications of personnel and other related personnel 02 matters; 03 (7) To accept any and all appropriate donations, grants and gifts of 04 money, equipment, supplies, materials and services, and to receive, utilize and dispose 05 of the same; provided that at all times the Commission shall avoid any appearance of 06 impropriety or conflict of interest; 07 (8) To lease, purchase, accept appropriate gifts or donations of, or 08 otherwise to own, hold, improve or use, any property, whether real, personal or mixed; 09 provided that at all times the Commission shall avoid any appearance of impropriety; 10 (9) To sell, convey, mortgage, pledge, lease, exchange, abandon or 11 otherwise dispose of any property, whether real, personal or mixed; 12 (10) To establish a budget and make expenditures; 13 (11) To borrow money; 14 (12) To appoint committees, including advisory committees comprised 15 of administrators, state nursing regulators, state legislators or their representatives, and 16 consumer representatives, and other such interested persons; 17 (13) To provide and receive information from, and to cooperate with, 18 law enforcement agencies; 19 (14) To adopt and use an official seal; and 20 (15) To perform such other functions as may be necessary or 21 appropriate to achieve the purposes of this Compact consistent with the state 22 regulation of nurse licensure and practice. 23 (h) Financing of the Commission 24 (1) The Commission shall pay, or provide for the payment of, the 25 reasonable expenses of its establishment, organization and ongoing activities. 26 (2) The Commission may also levy on and collect an annual 27 assessment from each party state to cover the cost of its operations, activities and staff 28 in its annual budget as approved each year. The aggregate annual assessment amount, 29 if any, shall be allocated based upon a formula to be determined by the Commission, 30 which shall promulgate a rule that is binding upon all party states. 31 (3) The Commission shall not incur obligations of any kind prior to 01 securing the funds adequate to meet the same; nor shall the Commission pledge the 02 credit of any of the party states, except by, and with the authority of, such party state. 03 (4) The Commission shall keep accurate accounts of all receipts and 04 disbursements. The receipts and disbursements of the Commission shall be subject to 05 the audit and accounting procedures established under its bylaws. However, all 06 receipts and disbursements of funds handled by the Commission shall be audited 07 yearly by a certified or licensed public accountant, and the report of the audit shall be 08 included in and become part of the annual report of the Commission. 09 (i) Qualified Immunity, Defense and Indemnification 10 (1) The administrators, officers, executive director, employees and 11 representatives of the Commission shall be immune from suit and liability, either 12 personally or in their official capacity, for any claim for damage to or loss of property 13 or personal injury or other civil liability caused by or arising out of any actual or 14 alleged act, error or omission that occurred, or that the person against whom the claim 15 is made had a reasonable basis for believing occurred, within the scope of 16 Commission employment, duties or responsibilities; provided that nothing in this 17 paragraph shall be construed to protect any such person from suit or liability for any 18 damage, loss, injury or liability caused by the intentional, willful or wanton 19 misconduct of that person. 20 (2) The Commission shall defend any administrator, officer, executive 21 director, employee or representative of the Commission in any civil action seeking to 22 impose liability arising out of any actual or alleged act, error or omission that occurred 23 within the scope of Commission employment, duties or responsibilities, or that the 24 person against whom the claim is made had a reasonable basis for believing occurred 25 within the scope of Commission employment, duties or responsibilities; provided that 26 nothing herein shall be construed to prohibit that person from retaining his or her own 27 counsel; and provided further that the actual or alleged act, error or omission did not 28 result from that person's intentional, willful or wanton misconduct. 29 (3) The Commission shall indemnify and hold harmless any 30 administrator, officer, executive director, employee or representative of the 31 Commission for the amount of any settlement or judgment obtained against that 01 person arising out of any actual or alleged act, error or omission that occurred within 02 the scope of Commission employment, duties or responsibilities, or that such person 03 had a reasonable basis for believing occurred within the scope of Commission 04 employment, duties or responsibilities, provided that the actual or alleged act, error or 05 omission did not result from the intentional, willful or wanton misconduct of that 06 person. 07 ARTICLE VIII 08 Rulemaking 09 (a) The Commission shall exercise its rulemaking powers pursuant to the 10 criteria set forth in this Article and the rules adopted thereunder. Rules and 11 amendments shall become binding as of the date specified in each rule or amendment 12 and shall have the same force and effect as provisions of this Compact. 13 (b) Rules or amendments to the rules shall be adopted at a regular or special 14 meeting of the Commission. 15 (c) Prior to promulgation and adoption of a final rule or rules by the 16 Commission, and at least sixty (60) days in advance of the meeting at which the rule 17 will be considered and voted upon, the Commission shall file a notice of proposed 18 rulemaking: 19 (1) On the website of the Commission; and 20 (2) On the website of each licensing board or the publication in which 21 each state would otherwise publish proposed rules. 22 (d) The notice of proposed rulemaking shall include: 23 (1) The proposed time, date and location of the meeting in which the 24 rule will be considered and voted upon; 25 (2) The text of the proposed rule or amendment, and the reason for the 26 proposed rule; 27 (3) A request for comments on the proposed rule from any interested 28 person; and 29 (4) The manner in which interested persons may submit notice to the 30 Commission of their intention to attend the public hearing and any written comments. 31 (e) Prior to adoption of a proposed rule, the Commission shall allow persons 01 to submit written data, facts, opinions and arguments, which shall be made available to 02 the public. 03 (f) The Commission shall grant an opportunity for a public hearing before it 04 adopts a rule or amendment. 05 (g) The Commission shall publish the place, time and date of the scheduled 06 public hearing. 07 (1) Hearings shall be conducted in a manner providing each person 08 who wishes to comment a fair and reasonable opportunity to comment orally or in 09 writing. All hearings will be recorded, and a copy will be made available upon request. 10 (2) Nothing in this section shall be construed as requiring a separate 11 hearing on each rule. Rules may be grouped for the convenience of the Commission at 12 hearings required by this section. 13 (h) If no one appears at the public hearing, the Commission may proceed with 14 promulgation of the proposed rule. 15 (i) Following the scheduled hearing date, or by the close of business on the 16 scheduled hearing date if the hearing was not held, the Commission shall consider all 17 written and oral comments received. 18 (j) The Commission shall, by majority vote of all administrators, take final 19 action on the proposed rule and shall determine the effective date of the rule, if any, 20 based on the rulemaking record and the full text of the rule. 21 (k) Upon determination that an emergency exists, the Commission may 22 consider and adopt an emergency rule without prior notice, opportunity for comment 23 or hearing, provided that the usual rulemaking procedures provided in this Compact 24 and in this section shall be retroactively applied to the rule as soon as reasonably 25 possible, in no event later than ninety (90) days after the effective date of the rule. For 26 the purposes of this provision, an emergency rule is one that must be adopted 27 immediately in order to: 28 (1) Meet an imminent threat to public health, safety or welfare; 29 (2) Prevent a loss of Commission or party state funds; or 30 (3) Meet a deadline for the promulgation of an administrative rule that 31 is required by federal law or rule. 01 (l) The Commission may direct revisions to a previously adopted rule or 02 amendment for purposes of correcting typographical errors, errors in format, errors in 03 consistency or grammatical errors. Public notice of any revisions shall be posted on 04 the website of the Commission. The revision shall be subject to challenge by any 05 person for a period of thirty (30) days after posting. The revision may be challenged 06 only on grounds that the revision results in a material change to a rule. A challenge 07 shall be made in writing, and delivered to the Commission, prior to the end of the 08 notice period. If no challenge is made, the revision will take effect without further 09 action. If the revision is challenged, the revision may not take effect without the 10 approval of the Commission. 11 ARTICLE IX 12 Oversight, Dispute Resolution and Enforcement 13 (a) Oversight 14 (1) Each party state shall enforce this Compact and take all actions 15 necessary and appropriate to effectuate this Compact's purposes and intent. 16 (2) The Commission shall be entitled to receive service of process in 17 any proceeding that may affect the powers, responsibilities or actions of the 18 Commission, and shall have standing to intervene in such a proceeding for all 19 purposes. Failure to provide service of process in such proceeding to the Commission 20 shall render a judgment or order void as to the Commission, this Compact or 21 promulgated rules. 22 (b) Default, Technical Assistance and Termination 23 (1) If the Commission determines that a party state has defaulted in the 24 performance of its obligations or responsibilities under this Compact or the 25 promulgated rules, the Commission shall: 26 (A) Provide written notice to the defaulting state and other 27 party states of the nature of the default, the proposed means of curing the 28 default or any other action to be taken by the Commission; and 29 (B) Provide remedial training and specific technical assistance 30 regarding the default. 31 (2) If a state in default fails to cure the default, the defaulting state's 01 membership in this Compact may be terminated upon an affirmative vote of a majority 02 of the administrators, and all rights, privileges and benefits conferred by this Compact 03 may be terminated on the effective date of termination. A cure of the default does not 04 relieve the offending state of obligations or liabilities incurred during the period of 05 default. 06 (3) Termination of membership in this Compact shall be imposed only 07 after all other means of securing compliance have been exhausted. Notice of intent to 08 suspend or terminate shall be given by the Commission to the governor of the 09 defaulting state and to the executive officer of the defaulting state's licensing board 10 and each of the party states. 11 (4) A state whose membership in this Compact has been terminated is 12 responsible for all assessments, obligations and liabilities incurred through the 13 effective date of termination, including obligations that extend beyond the effective 14 date of termination. 15 (5) The Commission shall not bear any costs related to a state that is 16 found to be in default or whose membership in this Compact has been terminated 17 unless agreed upon in writing between the Commission and the defaulting state. 18 (6) The defaulting state may appeal the action of the Commission by 19 petitioning the U.S. District Court for the District of Columbia or the federal district in 20 which the Commission has its principal offices. The prevailing party shall be awarded 21 all costs of such litigation, including reasonable attorneys' fees. 22 (c) Dispute Resolution 23 (1) Upon request by a party state, the Commission shall attempt to 24 resolve disputes related to the Compact that arise among party states and between 25 party and non-party states. 26 (2) The Commission shall promulgate a rule providing for both 27 mediation and binding dispute resolution for disputes, as appropriate. 28 (3) In the event the Commission cannot resolve disputes among party 29 states arising under this Compact: 30 (A) The party states may submit the issues in dispute to an 31 arbitration panel, which will be comprised of individuals appointed by the 01 Compact administrator in each of the affected party states and an individual 02 mutually agreed upon by the Compact administrators of all the party states 03 involved in the dispute. 04 (B) The decision of a majority of the arbitrators shall be final 05 and binding. 06 (d) Enforcement 07 (1) The Commission, in the reasonable exercise of its discretion, shall 08 enforce the provisions and rules of this Compact. 09 (2) By majority vote, the Commission may initiate legal action in the 10 U.S. District Court for the District of Columbia or the federal district in which the 11 Commission has its principal offices against a party state that is in default to enforce 12 compliance with the provisions of this Compact and its promulgated rules and bylaws. 13 The relief sought may include both injunctive relief and damages. In the event judicial 14 enforcement is necessary, the prevailing party shall be awarded all costs of such 15 litigation, including reasonable attorneys' fees. 16 (3) The remedies herein shall not be the exclusive remedies of the 17 Commission. The Commission may pursue any other remedies available under federal 18 or state law. 19 ARTICLE X 20 Effective Date, Withdrawal and Amendment 21 (a) This Compact shall become effective and binding on the earlier of the date 22 of legislative enactment of this Compact into law by no less than twenty-six (26) states 23 or December 31, 2018. All party states to this Compact, that also were parties to the 24 prior Nurse Licensure Compact, superseded by this Compact, ("Prior Compact"), shall 25 be deemed to have withdrawn from said Prior Compact within six (6) months after the 26 effective date of this Compact. 27 (b) Each party state to this Compact shall continue to recognize a nurse's 28 multistate licensure privilege to practice in that party state issued under the Prior 29 Compact until such party state has withdrawn from the Prior Compact. 30 (c) Any party state may withdraw from this Compact by enacting a statute 31 repealing the same. A party state's withdrawal shall not take effect until six (6) months 01 after enactment of the repealing statute. 02 (d) A party state's withdrawal or termination shall not affect the continuing 03 requirement of the withdrawing or terminated state's licensing board to report adverse 04 actions and significant investigations occurring prior to the effective date of such 05 withdrawal or termination. 06 (e) Nothing contained in this Compact shall be construed to invalidate or 07 prevent any nurse licensure agreement or other cooperative arrangement between a 08 party state and a non-party state that is made in accordance with the other provisions 09 of this Compact. 10 (f) This Compact may be amended by the party states. No amendment to this 11 Compact shall become effective and binding upon the party states unless and until it is 12 enacted into the laws of all party states. 13 (g) Representatives of non-party states to this Compact shall be invited to 14 participate in the activities of the Commission, on a nonvoting basis, prior to the 15 adoption of this Compact by all states. 16 ARTICLE XI 17 Construction and Severability 18 This Compact shall be liberally construed so as to effectuate the purposes 19 thereof. The provisions of this Compact shall be severable, and if any phrase, clause, 20 sentence or provision of this Compact is declared to be contrary to the constitution of 21 any party state or of the United States, or if the applicability thereof to any 22 government, agency, person or circumstance is held invalid, the validity of the 23 remainder of this Compact and the applicability thereof to any government, agency, 24 person or circumstance shall not be affected thereby. If this Compact shall be held to 25 be contrary to the constitution of any party state, this Compact shall remain in full 26 force and effect as to the remaining party states and in full force and effect as to the 27 party state affected as to all severable matters. 28  * Sec. 16. AS 08.68.800(a) is amended to read: 29 (a) This chapter does not apply to 30 (1) a qualified nurse licensed in another state employed by the United 31 States government or a bureau, or agency, or division of the United States government 01 while in the discharge of official duties; 02 (2) nursing service given temporarily in the event of a public 03 emergency, epidemic, or disaster; 04 (3) the practice of nursing by a student enrolled in a nursing education 05 program accredited by the board when the practice is in connection with the student's 06 course of study; 07 (4) the practice of nursing by an individual enrolled in an approved 08 program or course of study approved by the board to satisfy the requirements of 09 AS 08.68.251; 10 (5) the practice of nursing by a nurse licensed in another state, except  11 for a nurse holding a multistate license under AS 08.68.500, who engages in 12 nursing education or nursing consultation activities, if these activities and contact with 13 clients do not exceed 20 working days within a licensing period; or 14 (6) the practice of nursing by a nurse licensed in another state, except  15 for a nurse holding a multistate license under AS 08.68.500, whose employment 16 responsibilities include transporting patients into, out of, or through this state; 17 however, this exception is valid for a period not to exceed 48 hours for each transport. 18  * Sec. 17. AS 08.68.805 is amended to read: 19 Sec. 08.68.805. Delegation of nursing functions. A registered, advanced 20 practice registered, or practical nurse licensed or privileged to practice under this 21 chapter may delegate nursing duties to other persons, including unlicensed assistive 22 personnel, under regulations adopted by the board. A person to whom the nursing 23 duties are delegated may perform the delegated duties without a license or certificate 24 under this chapter if the person meets the applicable requirements established by the 25 board.  26  * Sec. 18. AS 09.55.560(2) is amended to read: 27 (2) "health care provider" means an acupuncturist licensed under 28 AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 29 chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a 30 dentist licensed under AS 08.36; a nurse licensed or privileged to practice under 31 AS 08.68; a dispensing optician licensed under AS 08.71; a naturopath licensed under 01 AS 08.45; an optometrist licensed under AS 08.72; a pharmacist licensed under 02 AS 08.80; a physical therapist or occupational therapist licensed under AS 08.84; a 03 physician or physician assistant licensed under AS 08.64; a podiatrist; a psychologist 04 and a psychological associate licensed under AS 08.86; a hospital as defined in 05 AS 47.32.900, including a governmentally owned or operated hospital; an employee 06 of a health care provider acting within the course and scope of employment; an 07 ambulatory surgical facility and other organizations whose primary purpose is the 08 delivery of health care, including a health maintenance organization, individual 09 practice association, integrated delivery system, preferred provider organization or 10 arrangement, and a physical hospital organization; 11  * Sec. 19. AS 09.65.095(c)(1) is amended to read: 12 (1) "health care provider" means a nurse licensed or privileged to  13 practice under AS 08.68, a physician licensed under AS 08.64, and a person certified 14 by a hospital as competent to take blood samples; 15  * Sec. 20. AS 18.20.095(e)(2) is amended to read: 16 (2) "licensed staff member" means a person who is employed by the 17 hospital to provide direct patient care and who is licensed, [OR] certified, or  18 privileged to practice in the state as a physician or physician assistant under 19 AS 08.64, direct-entry midwife under AS 08.65, nurse or nurse aide under AS 08.68, 20 or physical therapist or occupational therapist under AS 08.84; 21  * Sec. 21. AS 18.20.499(3) is amended to read: 22 (3) "nurse" means an individual licensed or privileged to practice 23 registered nursing or practical nursing under AS 08.68 who provides nursing services 24 through direct patient care or clinical services and includes a nurse manager when 25 delivering in-hospital patient care; 26  * Sec. 22. AS 18.23.070(3) is amended to read: 27 (3) "health care provider" means an acupuncturist licensed under 28 AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist licensed under 29 AS 08.32; a dentist licensed under AS 08.36; a nurse licensed or privileged to  30 practice under AS 08.68; a dispensing optician licensed under AS 08.71; an 31 optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 01 physical therapist or occupational therapist licensed under AS 08.84; a physician 02 licensed under AS 08.64; a podiatrist; a psychologist and a psychological associate 03 licensed under AS 08.86; a hospital as defined in AS 47.32.900, including a 04 governmentally owned or operated hospital; and an employee of a health care provider 05 acting within the course and scope of employment; 06  * Sec. 23. AS 47.07.045(b) is amended to read: 07 (b) Before the department may terminate payment for services provided under 08 (a) of this section 09 (1) the recipient must have had an annual assessment to determine 10 whether the recipient continues to meet the standards under (a) of this section; 11 (2) the annual assessment must have been reviewed by an independent 12 qualified health care professional under contract with the department; for purposes of 13 this paragraph, "independent qualified health care professional" means, 14 (A) for a waiver based on intellectual or developmental 15 disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 16 intellectual disability professional; 17 (B) for other allowable waivers, a registered or advanced 18 practice registered nurse licensed or privileged to practice under AS 08.68 19 who is qualified to assess children with complex medical conditions, older 20 Alaskans, and adults with physical disabilities for medical assistance waivers; 21 and 22 (3) the annual assessment must find that the recipient's condition has 23 materially improved since the previous assessment; for purposes of this paragraph, 24 "materially improved" means that a recipient who has previously qualified for a 25 waiver for 26 (A) a child with complex medical conditions, no longer needs 27 technical assistance for a life-threatening condition, and is expected to be 28 placed in a skilled nursing facility for less than 30 days each year; 29 (B) intellectual or developmental disability, no longer needs the 30 level of care provided by an intermediate care facility for persons with 31 intellectual and developmental disabilities either because the qualifying 01 diagnosis has changed or the recipient is able to demonstrate the ability to 02 function in a home setting without the need for waiver services; or 03 (C) an older Alaskan or adult with a physical disability, no 04 longer has a functional limitation or cognitive impairment that would result in 05 the need for nursing home placement, and is able to demonstrate the ability to 06 function in a home setting without the need for waiver services. 07  * Sec. 24. AS 47.33.020(d) is amended to read: 08 (d) An assisted living home may provide intermittent nursing services to a 09 resident who does not require 24-hour nursing services and supervision. Intermittent 10 nursing services may be provided only by a nurse licensed or privileged to practice 11 under AS 08.68 or by a person to whom a nursing task has been delegated under (e) of 12 this section. 13  * Sec. 25. AS 47.33.020(e) is amended to read: 14 (e) A person who is on the staff of an assisted living home and who is not a 15 nurse licensed or privileged to practice under AS 08.68 may perform a nursing task 16 in that home if 17 (1) the authority to perform that nursing task is delegated to that person 18 by a nurse licensed or privileged to practice under AS 08.68; and 19 (2) that nursing task is specified in regulations adopted by the Board of 20 Nursing as a task that may be delegated. 21  * Sec. 26. AS 47.33.020(f) is amended to read: 22 (f) A resident who needs skilled nursing care may, with the consent of the 23 assisted living home, arrange for that care to be provided in the home by a nurse 24 licensed or privileged to practice under AS 08.68 if that arrangement does not 25 interfere with the services provided to other residents. 26  * Sec. 27. AS 47.33.020(g) is amended to read: 27 (g) As part of a plan to avoid transfer of a resident from the home for medical 28 reasons, the home may provide, through the services of a nurse who is licensed or  29 privileged to practice under AS 08.68, 24-hour skilled nursing care to the resident for 30 not more than 45 consecutive days. 31  * Sec. 28. AS 47.33.020(h) is amended to read: 01 (h) If a resident has received 24-hour skilled nursing care for the 45-day limit 02 set by (g) of this section, the resident or the resident's representative may elect to have 03 the resident remain in the home without continuation of 24-hour skilled nursing care if 04 the home agrees to retain the resident after  05 (1) the home and either the resident or the resident's representative 06 have consulted with the resident's physician; 07 (2) the home and either the resident or the resident's representative 08 have discussed the consequences and risks involved in the election to remain in the 09 home; and 10 (3) the portion of the resident's assisted living plan that relates to 11 health-related services has been revised to provide for the resident's health-related 12 needs without the use of 24-hour skilled nursing care, and the revised plan has been 13 reviewed by a registered or advanced practice registered nurse licensed or privileged  14 to practice under AS 08.68 or by the resident's attending physician. 15  * Sec. 29. AS 47.33.230(c) is amended to read: 16 (c) If the assisted living home provides or arranges for the provision of health- 17 related services to a resident, the home shall ensure that a 18 (1) registered or advanced practice registered nurse licensed or  19 privileged to practice under AS 08.68 reviews the portion of an assisted living plan 20 that describes how the resident's need for health-related services will be met; and 21 (2) physician's statement about the resident is included in the plan. 22  * Sec. 30. The uncodified law of the State of Alaska is amended by adding a new section to 23 read: 24 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 25 Economic Development and the Board of Nursing may proceed to adopt regulations to 26 implement this Act. The regulations take effect under AS 44.62 (Administrative Procedure 27 Act) but not before the effective date of the law implemented by the regulation. 28  * Sec. 31. Section 30 of this Act takes effect immediately under AS 01.10.070(c). 29  * Sec. 32. Except as provided in sec. 31 of this Act, this Act takes effect July 1, 2026.