SB 251: "An Act relating to an interstate compact on nurse licensure."
00 SENATE BILL NO. 251 01 "An Act relating to an interstate compact on nurse licensure." 02 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 03 * Section 1. AS 08.68.100(a)(1) is amended to read: 04 (1) adopt regulations necessary to implement this chapter, including 05 regulations pertaining to practice as an advanced nurse practitioner and a nurse 06 anesthetist, regulations to implement AS 08.68.391 and 08.68.392, relating to the 07 Interstate Nurse Licensure Compact, and regulations necessary to implement 08 AS 08.68.331 - 08.68.336, relating to certified nurse aides in order to protect the 09 health, safety, and welfare of clients served by nurse aides; 10 * Sec. 2. AS 08.68.160 is amended to read: 11 Sec. 08.68.160. License required. A person practicing or offering to practice 12 professional or practical nursing in the state shall submit evidence of qualification to 13 practice and shall have a license issued or recognized [BE LICENSED] under this 14 chapter. 15 * Sec. 3. AS 08.68 is amended by adding new sections to read:
01 Article 5A. Interstate Nurse Licensure Compact. 02 Sec. 08.68.391. Compact enacted. The Interstate Nurse Licensure Compact as 03 contained in this section is enacted into law and entered into on behalf of the state with 04 all other states and jurisdictions legally joining in it in a form substantially as follows: 05 INTERSTATE NURSE LICENSURE COMPACT 06 ARTICLE I 07 FINDINGS AND DECLARATION OF PURPOSE 08 (a) The party states find that 09 (1) the health and safety of the public are affected by the degree of 10 compliance with and the effectiveness of enforcement activities related to state nurse 11 licensure laws; 12 (2) violations of nurse licensure and other laws regulating the practice 13 of nursing may result in injury or harm to the public; 14 (3) the expanded mobility of nurses and the use of advanced 15 communication technologies as part of our nation's health care delivery system require 16 greater coordination and cooperation among states in the areas of nurse licensure and 17 regulation; 18 (4) new practice modalities and technology make compliance with 19 individual state nurse licensure laws difficult and complex; 20 (5) the current system of duplicative licensure for nurses practicing in 21 multiple states is cumbersome and redundant to both nurses and states. 22 (b) The general purposes of this compact are to 23 (1) facilitate the states' responsibility to protect the public's health and 24 safety; 25 (2) ensure and encourage the cooperation of party states in the areas of 26 nurse licensure and regulation; 27 (3) facilitate the exchange of information between party states in the 28 areas of nurse regulation, investigation, and adverse actions; 29 (4) promote compliance with the laws governing the practice of 30 nursing in each jurisdiction; 31 (5) invest all party states with the authority to hold a nurse accountable
01 for meeting all state practice laws in the state in which the patient is located at the time 02 care is rendered through the mutual recognition of party state licenses. 03 ARTICLE II 04 DEFINITIONS 05 As used in this compact: 06 (a) "Adverse action" means a home or remote state action; 07 (b) "Alternative program" means a voluntary, nondisciplinary monitoring 08 program approved by a nurse licensing board; 09 (c) "Coordinated licensure information system" means an integrated process 10 for collecting, storing, and sharing information on nurse licensure and enforcement 11 activities related to nurse licensure laws, which is administered by a nonprofit 12 organization composed of and controlled by state nurse licensing boards; 13 (d) "Current significant investigative information" means either 14 (1) Investigative information that a licensing board, after a preliminary 15 inquiry that includes notification and an opportunity for the nurse to respond if 16 required by state law, has reason to believe is not groundless and, if proved true, 17 would indicate more than a minor infraction; or 18 (2) Investigative information that indicates that the nurse represents an 19 immediate threat to public health and safety regardless of whether the nurse has been 20 notified and had an opportunity to respond; 21 (e) "Home state" means the party state which is the nurse's primary state of 22 residence; 23 (f) "Home state action" means any administrative, civil, equitable, or criminal 24 action permitted by the home state's laws, which are imposed on a nurse by the home 25 state's licensing board or other authority, including actions against an individual's 26 license such as revocation, suspension, probation, or any other action which affects a 27 nurse's authorization to practice; 28 (g) "Licensing board" means a party state's regulatory body responsible for 29 issuing nurse licenses; 30 (h) "Multistate licensure privilege" means current, official authority from a 31 remote state permitting the practice of nursing as either a registered nurse or a licensed
01 practical or vocational nurse in such party state. All party states have the authority, in 02 accordance with existing state due process law, to take actions against the nurse's 03 privilege, such as revocation, suspension, probation, or any other action which affects 04 a nurse's authorization to practice; 05 (i) "Nurse" means a registered nurse or licensed practical or vocational nurse, 06 as those terms are defined by each party state's practice laws; 07 (j) "Party state" means any state that has adopted this compact; 08 (k) "Remote state" means a party state, other than the home state, 09 (1) Where the patient is located at the time nursing care is provided; or 10 (2) In the case of the practice of nursing not involving a patient, in 11 such party state where the recipient of nursing practice is located; 12 (l) "Remote state action" means 13 (1) any administrative, civil, equitable, or criminal action permitted by 14 a remote state's laws which is imposed on a nurse by the remote state's licensing board 15 or other authority, including actions against an individual's multistate licensure 16 privilege to practice in the remote state; and 17 (2) cease and desist and other injunctive or equitable orders issued by 18 remote states or the licensing boards of remote states; 19 (m) "State" means a state, territory, or possession of the United States, the 20 District of Columbia, or the Commonwealth of Puerto Rico; 21 (n) "State practice laws" means those individual party's state laws and 22 regulations that govern the practice of nursing, define the scope of nursing practice, 23 and create the methods and grounds for imposing discipline. 24 (o) "state practice laws" does not include the initial qualifications for licensure 25 or requirements necessary to obtain and retain a license, except for qualifications or 26 requirements of the home state. 27 ARTICLE III 28 GENERAL PROVISIONS AND JURISDICTION 29 (a) A license to practice registered nursing issued by a home state to a resident 30 in that state will be recognized by each party state as authorizing a multistate licensure 31 privilege to practice as a registered nurse in such party state. A license to practice
01 licensed practical or vocational nursing issued by a home state to a resident in that 02 state will be recognized by each party state as authorizing a multistate licensure 03 privilege to practice as a licensed practical or vocational nurse in such party state. In 04 order to obtain or retain a license, an applicant must meet the home state's 05 qualifications for licensure and license renewal as well as all other applicable state 06 laws. 07 (b) Party states may, in accordance with state due process laws, limit or 08 revoke the multistate licensure privilege of any nurse to practice in their state and may 09 take any other actions under their applicable state laws necessary to protect the health 10 and safety of their citizens. If a party state takes such action, it shall promptly notify 11 the administrator of the coordinated licensure information system. The administrator 12 of the coordinated licensure information system shall promptly notify the home state 13 of any such actions by remote states. 14 (c) Every nurse practicing in a party state must comply with the state practice 15 laws of the state in which the patient is located at the time care is rendered. In 16 addition, the practice of nursing is not limited to patient care, but shall include all 17 nursing will practice as defined by the state practice laws of a party state. The practice 18 of nursing will subject a nurse to the jurisdiction of the nurse licensing board and the 19 courts, as well as the laws, in that party state. 20 (d) This compact does not affect additional requirements imposed by states for 21 advanced practice registered nursing. However, a multistate licensure privilege to 22 practice registered nursing granted by a party state shall be recognized by other party 23 states as a license to practice registered nursing if one is required by state law as a 24 precondition for qualifying for advanced practice registered nurse authorization. 25 (e) Individuals not residing in a party state shall continue to be able to apply 26 for nurse licensure as provided for under the laws of each party state. However, the 27 license granted to these individuals shall not be recognized as granting the privilege to 28 practice nursing in any other party state unless explicitly agreed to by that party state. 29 ARTICLE IV 30 APPLICATIONS FOR LICENSURE IN A PARTY STATE 31 (a) Upon application for a license, the licensing board in a party state shall
01 ascertain, through the coordinated licensure information system, whether the applicant 02 has ever held, or is the holder of, a license issued by any other state, whether there are 03 any restrictions on the multistate licensure privilege, and whether any other adverse 04 action by any state has been taken against the license. 05 (b) A nurse in a party state shall hold licensure in only one party state at a 06 time, issued by the home state. 07 (c) A nurse who intends to change primary state of residence may apply for 08 licensure in the new home state in advance of such change. However, new licenses 09 will not be issued by a party state until after a nurse provides evidence of change in 10 primary state of residence satisfactory to the new home state's licensing board. 11 (d) When a nurse changes primary state of residence by moving 12 (1) between two party states, and obtains a license from the new home 13 state, the license from the former home state is no longer valid; 14 (2) from a nonparty state to a party state, and obtains a license from the 15 new home state, the individual state license issued by the nonparty state is not affected 16 and will remain in full force if so provided by the laws of the nonparty state; 17 (3) from a party state to a nonparty state, the license issued by the prior 18 home state converts to an individual state license, valid only in the former home state, 19 without the multistate licensure privilege to practice in other party states. 20 ARTICLE V 21 ADVERSE ACTIONS 22 In addition to the general provisions described in article III, the following 23 provisions apply: 24 (a) The licensing board of a remote state shall promptly report to the 25 administrator of the coordinated licensure information system any remote state 26 actions, including the factual and legal basis for such action, if known. The licensing 27 board of a remote state shall also promptly report any significant current investigative 28 information yet to result in a remote state action. The administrator of the coordinated 29 licensure information system shall promptly notify the home state of any such reports. 30 (b) The licensing board of a party state shall have the authority to complete 31 any pending investigations for a nurse who changes primary state of residence during
01 the course of such investigations. It shall also have the authority to take appropriate 02 action and shall promptly report the conclusions of such investigations to the 03 administrator of the coordinated licensure information system. The administrator of 04 the coordinated licensure information system shall promptly notify the new home state 05 of any such actions. 06 (c) A remote state may take adverse action affecting the multistate licensure 07 privilege to practice within that party state. However, only the home state shall have 08 the power to impose adverse action against the license issued by the home state. 09 (d) For purposes of imposing adverse action, the licensing board of the home 10 state shall give the same priority and effect to reported conduct received from a remote 11 state as it would if such conduct had occurred within the home state. In so doing, it 12 shall apply its own state laws to determine appropriate action. 13 (e) The home state may take adverse action based on the factual findings of 14 the remote state, so long as each state follows its own procedures for imposing such 15 adverse action. 16 (f) Nothing in this compact shall override a party state's decision that 17 participation in an alternative program may be used in lieu of licensure action and that 18 such participation shall remain nonpublic if required by the party state's laws. Party 19 states must require nurses who enter any alternative programs to agree not to practice 20 in any other party state during the term of the alternative program without prior 21 authorization from such other party state. 22 ARTICLE VI 23 ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE NURSE LICENSING 24 BOARDS 25 Notwithstanding any other powers, party state nurse licensing boards shall 26 have the authority to: 27 (a) If otherwise permitted by state law, recover from the affected nurse the 28 costs of investigations and disposition of cases resulting from any adverse action taken 29 against that nurse. 30 (b) Issue subpoenas for both hearings and investigations which require the 31 attendance and testimony of witnesses, and the production of evidence. Subpoenas
01 issued by a nurse licensing board in a party state for the attendance and testimony of 02 witnesses and/or the production of evidence from another party state shall be enforced 03 in the latter state by any court of competent jurisdiction, according to the practice and 04 procedure of that court applicable to subpoenas issued in proceedings pending before 05 it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other 06 fees required by the service statutes of the state where the witnesses and/or evidence is 07 located. 08 (c) Issue cease and desist orders to limit or revoke a nurse's authority to 09 practice in their state. 10 (d) Promulgate uniform rules and regulations as provided for in article VIII 11 (c). 12 ARTICLE VII 13 COORDINATED LICENSURE INFORMATION SYSTEM 14 (a) All party states shall participate in a cooperative effort to create a 15 coordinated database of all licensed registered nurses and licensed practical or 16 vocational nurses. This system will include information on the licensure and 17 disciplinary history of each nurse, as contributed by party states, to assist in the 18 coordination of nurse licensure and enforcement efforts. 19 (b) Notwithstanding any other provision of law, all party states' licensing 20 boards shall promptly report adverse actions, actions against multistate licensure 21 privileges, any current significant investigative information yet to result in adverse 22 action, denials of applications, and the reasons for such denials, to the coordinated 23 licensure information system. 24 (c) Current significant investigative information shall be transmitted through 25 the coordinated licensure information system only to party state licensing boards. 26 (d) Notwithstanding any other provision of law, all party states' licensing 27 boards contributing information to the coordinated licensure information system may 28 designate information that may not be shared with nonparty states or disclosed to other 29 entities or individuals without the express permission of the contributing state. 30 (e) Any personally identifiable information obtained by a party state's 31 licensing board from the coordinated licensure information system may not be shared
01 with nonparty states or disclosed to other entities or individuals except to the extent 02 permitted by the laws of the party state contributing the information. 03 (f) Any information contributed to the coordinated licensure information 04 system that is subsequently required to be expunged by the laws of the party state 05 contributing that information shall also be expunged from the coordinated licensure 06 information system. 07 (g) The compact administrators, acting jointly with each other and in 08 consultation with the administrator of the coordinated licensure information system, 09 shall formulate necessary and proper procedures for the identification, collection, and 10 exchange of information under this compact. 11 ARTICLE VIII 12 COMPACT ADMINISTRATION AND INTERCHANGE OF INFORMATION 13 (a) The head of the nurse licensing board, or the head's designee, of each party 14 state shall be the administrator of this compact for the head's state. 15 (b) The compact administrator of each party state shall furnish to the compact 16 administrator of each other party state any information and documents including, but 17 not limited to, a uniform data set of investigations, identifying information, licensure 18 data, and disclosable alternative program participation information to facilitate the 19 administration of this compact. 20 (c) Compact administrators shall have the authority to develop uniform rules 21 to facilitate and coordinate implementation of this compact. These uniform rules shall 22 be adopted by party states, under the authority invested under article VI, section d. 23 ARTICLE IX 24 IMMUNITY 25 No party state or the officers or employees or agents of a party state's nurse licensing 26 board who acts in accordance with the provisions of this compact shall not be liable on 27 account of any act or omission in good faith while engaged in the performance of their 28 duties under this compact. Good faith in this article shall not include willful 29 misconduct, gross negligence, or recklessness. 30 ARTICLE X 31 ENTRY INTO FORCE, WITHDRAWAL, AND AMENDMENT
01 (a) This compact shall enter into force and become effective as to any state 02 when it has been enacted into the laws of that state. Any party state may withdraw 03 from this compact by enacting a statute repealing the same, but no such withdrawal 04 shall take effect until six months after the withdrawing state has given notice of the 05 withdrawal to the executive heads of all other party states. 06 (b) No withdrawal shall affect the validity or applicability by the licensing 07 boards of states remaining party to the compact of any report of adverse action 08 occurring prior to the withdrawal. 09 (c) Nothing contained in this compact shall be construed to invalidate or 10 prevent any nurse licensure agreement or other cooperative arrangement between a 11 party state and a nonparty state that is made in accordance with the other provisions of 12 this compact. 13 (d) This compact may be amended by the party states. No amendment to this 14 compact shall become effective and binding upon the party states unless and until it is 15 enacted into the laws of all party states. 16 ARTICLE XI 17 CONSTRUCTION AND SEVERABILITY 18 (a) 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 the applicability thereof to any government, 22 agency, person, or circumstance is held invalid, the validity of the remainder of this 23 compact and the applicability thereof to any government, agency, person, or 24 circumstance shall not be affected thereby. If this compact shall be held contrary to the 25 constitution of any state party thereto, the compact shall remain in full force and effect 26 as to the remaining party states and in full force and effect as to the party state affected 27 as to all severable matters. 28 (b) In the event party states find a need for settling disputes arising under this 29 compact: 30 (1) The party states may submit the issues in dispute to an arbitration 31 panel which will be comprised of an individual appointed by the compact
01 administrator in the home state, an individual appointed by the compact administrator 02 in the remote state or states involved, and an individual mutually agreed upon by the 03 compact administrators of all the party states involved in the dispute. 04 (2) The decision of a majority of the arbitrators shall be final and 05 binding. 06 Sec. 08.68.392. Compact administrator. Under the compact established in 07 AS 08.68.391, the chair of the board may designate a person to serve as the compact 08 administrator. The compact administrator shall cooperate with all departments, 09 agencies, and officers of and in the government of this state and its subdivisions in 10 facilitating the proper administration of the compact.