HB 14: "An Act relating to licensure of nursing professionals; relating to a multistate nurse licensure compact; and providing for an effective date."
00 HOUSE BILL NO. 14 01 "An Act relating to 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 08.02.010(a) is amended to read: 05 (a) An acupuncturist licensed under AS 08.06, an audiologist or speech- 06 language pathologist licensed under AS 08.11, a behavior analyst licensed under 07 AS 08.15, a person licensed in the state as a chiropractor under AS 08.20, a 08 professional counselor licensed under AS 08.29, a dentist under AS 08.36, a dietitian 09 or nutritionist licensed under AS 08.38, a massage therapist licensed under AS 08.61, 10 a marital and family therapist licensed under AS 08.63, a medical practitioner or 11 osteopath under AS 08.64, a direct-entry midwife certified under AS 08.65, a 12 registered nurse licensed under AS 08.68 or AS 08.69 or advanced practice 13 registered nurse under AS 08.68, an optometrist under AS 08.72, a licensed 14 pharmacist under AS 08.80, a physical therapist or occupational therapist licensed
01 under AS 08.84, a psychologist under AS 08.86, or a clinical social worker licensed 02 under AS 08.95 [,] shall use as professional identification appropriate letters or a title 03 after that person's name that represents the person's specific field of practice. The 04 letters or title shall appear on all signs, stationery, or other advertising in which the 05 person offers or displays personal professional services to the public. In addition, a 06 person engaged in the practice of medicine or osteopathy as defined in AS 08.64.380, 07 or a person engaged in any manner in the healing arts who diagnoses, treats, tests, or 08 counsels other persons in relation to human health or disease and uses the letters 09 "M.D." or the title "doctor" or "physician" or another title that tends to show that the 10 person is willing or qualified to diagnose, treat, test, or counsel another person, shall 11 clarify the letters or title by adding the appropriate specialist designation, if any, such 12 as "dermatologist," "radiologist," "audiologist," "naturopath," or the like. 13 * Sec. 2. AS 08.11.120(b) is amended to read: 14 (b) Notwithstanding the provisions of this chapter, 15 (1) a nurse licensed under AS 08.68 or AS 08.69 may perform hearing 16 sensitivity evaluations; 17 (2) an individual licensed as a hearing aid dealer under AS 08.55 may 18 deal in hearing aids; 19 (3) an individual holding a class A certificate issued by the Conference 20 of Executives of American Schools of the Deaf may teach the hearing impaired; 21 (4) an individual may engage in the testing of hearing as part of a 22 hearing conservation program that complies with the regulations of the Occupational 23 Safety and Health Administration of the federal government if the individual is 24 certified to do the testing by a state or federal agency acceptable to the Occupational 25 Safety and Health Administration; 26 (5) an individual may perform hearing screening under AS 47.20.310 27 if authorized to do so under a protocol adopted under AS 47.20.310(e) by the 28 Department of Health and Social Services. 29 * Sec. 3. AS 08.68.100 is amended to read: 30 Sec. 08.68.100. Duties and powers of board. (a) The board shall 31 (1) adopt regulations necessary to implement this chapter and
01 AS 08.69, including regulations 02 (A) pertaining to practice as an advanced practice registered 03 nurse, including requirements for an advanced practice registered nurse to 04 practice as a certified registered nurse anesthetist, certified clinical nurse 05 specialist, certified nurse practitioner, or certified nurse midwife; regulations 06 for an advanced practice registered nurse who holds a valid federal Drug 07 Enforcement Administration registration number must address training in pain 08 management and opioid use and addiction; 09 (B) necessary to implement AS 08.68.331 - 08.68.336 relating 10 to certified nurse aides in order to protect the health, safety, and welfare of 11 clients served by nurse aides; 12 (C) pertaining to retired nurse status; and 13 (D) establishing criteria for approval of practical nurse 14 education programs that are not accredited by a national nursing accrediting 15 body; 16 (2) approve curricula and adopt standards for basic education programs 17 that prepare persons for licensing under AS 08.68.190 and AS 08.69; 18 (3) provide for surveys of the basic nursing education programs in the 19 state at the times it considers necessary; 20 (4) approve education programs that meet the requirements of this 21 chapter and of the board, and deny, revoke, or suspend approval of education 22 programs for failure to meet the requirements; 23 (5) examine, license, and renew the licenses of qualified applicants 24 issued under this chapter and the multistate licenses issued under AS 08.69; 25 (6) prescribe requirements for competence before a former registered, 26 advanced practice registered, or [LICENSED] practical nurse licensed under this 27 chapter may resume the practice of 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 and comply with this chapter and AS 08.69; 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 and AS 08.69 to submit 05 fingerprints and the fees required by the Department of Public Safety under 06 AS 12.62.160 for criminal justice information and a national criminal history record 07 check; the department shall submit the fingerprints and fees to the Department of 08 Public Safety for a report of criminal justice information under AS 12.62 and a 09 national criminal history record 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) appoint the executive administrator of the Board of Nursing 14 to serve as the state administrator of the Interstate Commission of Nurse 15 Licensure Compact Administrators under AS 08.69. 16 (b) The board may 17 (1) conduct hearings upon charges of alleged violations of this chapter, 18 AS 08.69, or regulations adopted under this chapter or AS 08.69 [IT]; 19 (2) invoke, or request the department to invoke, disciplinary action 20 against a person licensed under this chapter or AS 08.69 [LICENSEE]; 21 (3) prescribe requirements for competence to continue practice. 22 * Sec. 4. AS 08.68.140 is amended to read: 23 Sec. 08.68.140. Applicability of Administrative Procedure Act. Except as 24 specified in AS 08.68.333(f) and AS 08.69, the board shall comply with AS 44.62 25 (Administrative Procedure Act). 26 * Sec. 5. AS 08.68.160 is amended to read: 27 Sec. 08.68.160. License required. A person practicing or offering to practice 28 as a registered [, ADVANCED PRACTICE REGISTERED,] or practical nurse 29 [NURSING] in the state shall submit evidence of qualification to practice and shall be 30 licensed under this chapter or AS 08.69. A person practicing or offering to practice 31 as an advanced practice registered nurse in the state shall submit evidence of
01 qualification to practice and shall be licensed under this chapter. 02 * Sec. 6. AS 08.68.170 is amended to read: 03 Sec. 08.68.170. Qualifications of registered or practical nurse applicants. 04 (a) An applicant for a license to practice registered nursing may obtain a license 05 under this chapter or a multistate license that meets the requirements of this 06 chapter and AS 08.69. An applicant for a license to practice registered nursing 07 under this chapter shall submit to the board, on forms and in the manner prescribed 08 by the board, written evidence, verified by oath, that the applicant has successfully 09 completed a registered nurse education program accredited by a national nursing 10 accrediting body and approved by the board. An applicant for a multistate license to 11 practice registered nursing shall meet the requirements of AS 08.69 in addition to 12 the requirements of this chapter. 13 (b) An applicant for a license to practice practical nursing may obtain a 14 license under this chapter or a multistate license that meets the requirements of 15 this chapter and AS 08.69. An applicant for a license to practice practical nursing 16 under this chapter shall submit to the board, on forms and in the manner prescribed 17 by the board, written evidence, verified by oath, that the applicant has successfully 18 completed 19 (1) a practical nurse education program accredited by a national 20 nursing accrediting body; 21 (2) a practical nurse education program that meets the criteria 22 established by the board under AS 08.68.100; or 23 (3) a registered nurse education program accredited by a national 24 nursing accrediting body and approved by the board and, if the applicant has failed the 25 registered nurse licensing examination, a practical nurse scope of practice course 26 approved by the board. 27 (c) An applicant for a license to practice advanced practice registered nursing 28 shall submit to the board, on forms and in the manner prescribed by the board, written 29 evidence, verified by oath, that the applicant 30 (1) is licensed as a registered nurse in the state or is a licensed 31 registered nurse whose license meets the requirements of AS 08.69; and
01 (2) has successfully completed an advanced practice registered nurse 02 education program that meets the criteria established by the board under 03 AS 08.68.100. 04 * Sec. 7. AS 08.68.190(b) is amended to read: 05 (b) If an applicant applies for a license to practice in this state and meets 06 the qualifications under [SET OUT IN] AS 08.68.170 for the license for which the 07 applicant applied, the board shall issue a license to practice 08 (1) registered or practical nursing in the state to an applicant who 09 passes the licensing examination to practice registered or practical nursing; or 10 (2) advanced practice registered nursing in the state to an applicant 11 who passes the advanced practice registered nursing certification examination to 12 practice advanced practice registered nursing. 13 * Sec. 8. AS 08.68.190 is amended by adding a new subsection to read: 14 (c) If an applicant applies for a multistate license and meets the qualifications 15 under AS 08.68.170 and AS 08.69 for the license for which the applicant applied, the 16 board shall issue a multistate license to practice registered or practical nursing to an 17 applicant who passes the licensing examination to practice registered or practical 18 nursing. 19 * Sec. 9. AS 08.68.200 is amended to read: 20 Sec. 08.68.200. License by endorsement. (a) The board may issue a license 21 by endorsement to practice in the state as a registered, advanced practice registered, 22 or practical nurse, whichever is appropriate, to an applicant who has worked as a nurse 23 within the past five years if the applicant is licensed as a registered, advanced practice 24 registered, or practical nurse under the laws of another state if, in the opinion of the 25 board, the applicant meets the qualifications required for licensing in the state and 26 meets the requirements of AS 08.68.170. 27 (b) The board may issue a license by endorsement to practice in the state as a 28 registered, advanced practice registered, or practical nurse, whichever is appropriate, 29 to an applicant who has not worked as a nurse within the past five years if the 30 applicant meets the requirements of (a) of this section and 31 (1) meets the continuing competency requirements of the board; or
01 (2) completes a course of study approved by the board. 02 * Sec. 10. AS 08.68.220 is amended to read: 03 Sec. 08.68.220. Fees. The Department of Commerce, Community, and 04 Economic Development shall set fees under AS 08.01.065 for each of the following: 05 (1) registered nursing licenses issued under this chapter or 06 AS 08.69: 07 (A) application; 08 (B) license by examination; 09 (C) license by endorsement; 10 (D) license renewal; 11 (E) temporary permit; 12 (2) practical nursing licenses issued under this chapter or AS 08.69: 13 (A) application; 14 (B) license by examination; 15 (C) license by endorsement; 16 (D) license renewal; 17 (E) temporary permit; 18 (3) advanced practice registered nursing licenses issued for practice 19 in the state: 20 (A) application; 21 (B) license by certification examination; 22 (C) license by endorsement; 23 (D) license renewal; 24 (E) temporary permit. 25 * Sec. 11. AS 08.68.230(a) is amended to read: 26 (a) A person who holds a license [LICENSED] to practice registered nursing 27 in the state or who holds a multistate license under AS 08.69 may use the title 28 "registered nurse " and the abbreviation "R.N." ["R.N".] 29 * Sec. 12. AS 08.68.230(b) is amended to read: 30 (b) A person who holds a license [LICENSED] to practice practical nursing 31 in the state or who holds a multistate license under AS 08.69 may use the title
01 "licensed practical nurse" and the abbreviation "L.P.N." 02 * Sec. 13. AS 08.68.230(d) is amended to read: 03 (d) A person who holds a temporary permit to practice as a licensed practical 04 nurse in the state shall use the title "Temporary Licensed Practical Nurse" and the 05 abbreviation "TLPN." 06 * Sec. 14. AS 08.68.251(a) is amended to read: 07 (a) A lapsed license under this chapter or AS 08.69 may be reinstated if it 08 has not remained lapsed for more than five years by payment of the license fees for the 09 current renewal period and the penalty fee. The board, by regulation, shall establish 10 continuing competency and criminal background check requirements for reinstatement 11 of a lapsed license. 12 * Sec. 15. AS 08.68.270 is amended to read: 13 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 14 may deny, suspend, or revoke a [THE] license issued by the board under this 15 chapter or AS 08.69 of a person who 16 (1) has obtained or attempted to obtain a license to practice nursing by 17 fraud or deceit; 18 (2) has been convicted of a felony or other crime if the felony or other 19 crime is substantially related to the qualifications, functions, or duties of the licensee; 20 (3) habitually abuses alcoholic beverages [,] or illegally uses controlled 21 substances; 22 (4) has impersonated a registered, advanced practice registered, or 23 practical nurse; 24 (5) has intentionally or negligently engaged in conduct that has 25 resulted in a significant risk to the health or safety of a client or in injury to a client; 26 (6) practices or attempts to practice nursing while afflicted with 27 physical or mental illness, deterioration, or disability that interferes with the 28 individual's performance of nursing functions; 29 (7) is guilty of unprofessional conduct as defined by regulations 30 adopted by the board; 31 (8) has wilfully or repeatedly violated a provision of this chapter or
01 AS 08.69 or regulations adopted under this chapter, [OR] AS 08.01, or AS 08.69; 02 (9) is professionally incompetent; 03 (10) denies care or treatment to a patient or person seeking assistance 04 if the sole reason for the denial is the failure or refusal of the patient or person seeking 05 assistance to agree to arbitrate as provided in AS 09.55.535(a); 06 (11) has prescribed or dispensed an opioid in excess of the maximum 07 dosage authorized under AS 08.68.705; or 08 (12) has procured, sold, prescribed, or dispensed drugs in violation of a 09 law, regardless of whether there has been a criminal action or harm to the patient. 10 * Sec. 16. AS 08.68.275(a) is amended to read: 11 (a) The board may take the following disciplinary actions singly or in 12 combination against a license granted by the board under this chapter or 13 AS 08.69: 14 (1) permanently revoke a license or permit to practice; 15 (2) suspend a license for a stated period of time; 16 (3) censure a licensee; 17 (4) issue a letter of reprimand; 18 (5) impose limitations or conditions on the professional practice of a 19 licensee; 20 (6) impose peer review; 21 (7) impose professional education requirements until a satisfactory 22 degree of skill has been attained in those aspects of professional practice determined 23 by the board to need improvement; 24 (8) impose probation and require the licensee to report regularly to the 25 board upon matters involving the basis for the probation; 26 (9) accept a voluntary surrender of a license. 27 * Sec. 17. AS 08.68.275(c) is amended to read: 28 (c) The board may summarily suspend a license issued by the board before 29 final hearing or during the appeals process if the board finds that the licensee poses a 30 clear and immediate danger to the public health and safety. A person whose license is 31 suspended under this section is entitled to a hearing conducted by the office of
01 administrative hearings (AS 44.64.010) within seven days after the effective date of 02 the order. If, after a hearing, the board upholds the suspension, the licensee may 03 appeal the suspension to a court of competent jurisdiction. 04 * Sec. 18. AS 08.68.275(d) is amended to read: 05 (d) The board may reinstate a license issued by the board that has been 06 suspended or revoked if the board finds, after a hearing, that the applicant is able to 07 practice with skill and safety. 08 * Sec. 19. AS 08.68.275 is amended by adding a new subsection to read: 09 (g) The board may take the following disciplinary actions singly or in 10 combination against a licensee who is practicing in this state under a multistate license 11 issued by another state under AS 08.69: 12 (1) suspend a license for a stated period of time; 13 (2) censure a licensee; 14 (3) issue a letter of reprimand; 15 (4) impose limitations or conditions on the professional practice of a 16 licensee; 17 (5) impose peer review; 18 (6) impose professional education requirements until a satisfactory 19 degree of skill has been attained in those aspects of professional practice determined 20 by the board to need improvement; 21 (7) impose probation and require the licensee to report regularly to the 22 board on matters involving the basis for the probation. 23 * Sec. 20. AS 08.68.800(a) is amended to read: 24 (a) This chapter does not apply to 25 (1) a qualified nurse licensed in another state employed by the United 26 States government or a bureau, or agency, or division of the United States government 27 while in the discharge of official duties; 28 (2) nursing service given temporarily in the event of a public 29 emergency, epidemic, or disaster; 30 (3) the practice of nursing by a student enrolled in a nursing education 31 program accredited by the board when the practice is in connection with the student's
01 course of study; 02 (4) the practice of nursing by an individual enrolled in an approved 03 program or course of study approved by the board to satisfy the requirements of 04 AS 08.68.251; 05 (5) the practice of nursing by a nurse licensed in another state, under a 06 license that is not a multistate license issued under AS 08.69, who engages in 07 nursing education or nursing consultation activities, if the [THESE] activities and 08 contact with clients do not exceed 20 working days within a licensing period; or 09 (6) the practice of nursing by a nurse licensed in another state, under a 10 license that is not a multistate license issued under AS 08.69, whose employment 11 responsibilities include transporting patients into, out of, or through this state if the 12 transport is [; HOWEVER, THIS EXCEPTION IS VALID FOR A PERIOD NOT 13 TO EXCEED] 48 hours or less [FOR EACH TRANSPORT]. 14 * Sec. 21. AS 08.68.805 is amended to read: 15 Sec. 08.68.805. Delegation of nursing functions. A registered, advanced 16 practice registered, or practical nurse licensed under this chapter or AS 08.69 may 17 delegate nursing duties to other persons, including unlicensed assistive personnel, 18 under regulations adopted by the board. A person to whom the nursing duties are 19 delegated may perform the delegated duties without a license or certificate under this 20 chapter or AS 08.69 if the person meets the applicable requirements established by the 21 board. 22 * Sec. 22. AS 08.68.850(1) is amended to read: 23 (1) "advanced practice registered nurse" means a registered nurse 24 licensed under this chapter or AS 08.69 to practice in the state who, because of 25 specialized education and experience, is certified by the board to perform acts of 26 medical diagnosis and the prescription and dispensing of medical, therapeutic, or 27 corrective measures under regulations adopted by the board; 28 * Sec. 23. AS 08 is amended by adding a new chapter to read: 29 Chapter 69. Multistate Nurse Licensure Compact. 30 Sec. 08.69.010. Compact enacted. The Multistate Nurse Licensure Compact 31 as contained in this section is enacted into law and entered into on behalf of the state
01 with all other states and jurisdictions legally joining it in a form substantially as 02 follows: 03 ARTICLE I 04 Findings and Declaration of Purpose 05 (a) The legislature finds that: 06 (1) The health and safety of the public are affected by the degree of 07 compliance with and the effectiveness of enforcement activities related to state nurse 08 licensure laws; 09 (2) Violations of nurse licensure and other laws regulating the practice 10 of nursing may result in injury or harm to the public; 11 (3) The expanded mobility of nurses and the use of advanced 12 communication technologies as part of our nation's health care delivery system require 13 greater coordination and cooperation among states in the areas of nurse licensure and 14 regulation; 15 (4) New practice modalities and technology make compliance with 16 individual state nurse licensure laws difficult and complex; 17 (5) The current system of duplicative licensure for nurses practicing in 18 multiple states is cumbersome and redundant for both nurses and states; and 19 (6) Uniformity of nurse licensure requirements throughout the states 20 promotes public safety and public health benefits. 21 (b) The general purposes of this Compact are to: 22 (1) Facilitate the states' responsibility to protect the public's health and 23 safety; 24 (2) Ensure and encourage the cooperation of party states in the areas of 25 nurse licensure and regulation; 26 (3) Facilitate the exchange of information between party states in the 27 areas of nurse regulation, investigation and adverse actions; 28 (4) Promote compliance with the laws governing the practice of 29 nursing in each jurisdiction; 30 (5) Invest all party states with the authority to hold a nurse accountable 31 for meeting all state practice laws in the state in which the patient is located at the time
01 care is rendered through the mutual recognition of party state licenses; 02 (6) Decrease redundancies in the consideration and issuance of nurse 03 licenses; and 04 (7) Provide opportunities for interstate practice by nurses who meet 05 uniform licensure requirements. 06 ARTICLE II 07 Definitions 08 As used in this compact, unless the context clearly requires a different construction, 09 (1) "Adverse action" means any administrative, civil, equitable or 10 criminal action permitted by a state's laws which is imposed by a licensing board or 11 other authority against a nurse, including actions against an individual's license or 12 multistate licensure privilege such as revocation, suspension, probation, monitoring of 13 the licensee, limitation on the licensee's practice, or any other encumbrance on 14 licensure affecting a nurse's authorization to practice, including issuance of a cease 15 and desist action. 16 (2) "Alternative program" means a non-disciplinary monitoring 17 program approved by a licensing board. 18 (3) "Coordinated licensure information system" means an integrated 19 process for collecting, storing and sharing information on nurse licensure and 20 enforcement activities related to nurse licensure laws that is administered by a 21 nonprofit organization composed of and controlled by licensing boards. 22 (4) "Current significant investigative information" means: 23 (A) Investigative information that a licensing board, after a 24 preliminary inquiry that includes notification and an opportunity for the nurse 25 to respond, if required by state law, has reason to believe is not groundless and, 26 if proved true, would indicate more than a minor infraction; or 27 (B) Investigative information that indicates that the nurse 28 represents an immediate threat to public health and safety regardless of 29 whether the nurse has been notified and had an opportunity to respond. 30 (5) "Encumbrance" means a revocation or suspension of, or any 31 limitation on, the full and unrestricted practice of nursing imposed by a licensing
01 board. 02 (6) "Home state" means the party state which is the nurse's primary 03 state of residence. 04 (7) "Licensing board" means a party state's regulatory body 05 responsible for issuing nurse licenses. 06 (8) "Multistate license" means a license to practice as a registered or a 07 licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board 08 that authorizes the licensed nurse to practice in all party states under a multistate 09 licensure privilege. 10 (9) "Multistate licensure privilege" means a legal authorization 11 associated with a multistate license permitting the practice of nursing as either a 12 registered nurse (RN) or LPN/VN in a remote state. 13 (10) "Nurse" means RN or LPN/VN, as those terms are defined by 14 each party state's practice laws. 15 (11) "Party state" means any state that has adopted this Compact. 16 (12) "Remote state" means a party state, other than the home state. 17 (13) "Single-state license" means a nurse license issued by a party state 18 that authorizes practice only within the issuing state and does not include a multistate 19 licensure privilege to practice in any other party state. 20 (14) "State" means a state, territory or possession of the United States 21 and the District of Columbia. 22 (15) "State practice laws" means a party state's laws, rules and 23 regulations that govern the practice of nursing, define the scope of nursing practice, 24 and create the methods and grounds for imposing discipline. "State practice laws" do 25 not include requirements necessary to obtain and retain a license, except for 26 qualifications or requirements of the home state. 27 ARTICLE III 28 General Provisions and Jurisdiction 29 (a) A multistate license to practice registered or licensed practical/vocational 30 nursing issued by a home state to a resident in that state will be recognized by each 31 party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed
01 practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each 02 party state. 03 (b) A state must implement procedures for considering the criminal history 04 records of applicants for initial multistate license or licensure by endorsement. Such 05 procedures shall include the submission of fingerprints or other biometric-based 06 information by applicants for the purpose of obtaining an applicant's criminal history 07 record information from the Federal Bureau of Investigation and the agency 08 responsible for retaining that state's criminal records. 09 (c) Each party state shall require the following for an applicant to obtain or 10 retain a multistate license in the home state: 11 (1) Meets the home state's qualifications for licensure or renewal of 12 licensure, as well as, all other applicable state laws; 13 (2) Has graduated or is eligible to graduate from a licensing board- 14 approved RN or LPN/VN prelicensure education program; or has graduated from a 15 foreign RN or LPN/VN prelicensure education program that (a) has been approved by 16 the authorized accrediting body in the applicable country and (b) has been verified by 17 an independent credentials review agency to be comparable to a licensing board- 18 approved prelicensure education program; 19 (3) Has, if a graduate of a foreign prelicensure education program not 20 taught in English or if English is not the individual's native language, successfully 21 passed an English proficiency examination that includes the components of reading, 22 speaking, writing and listening; 23 (4) Has successfully passed an NCLEX-RN or NCLEX-PN 24 Examination or recognized predecessor, as applicable; 25 (5) Is eligible for or holds an active, unencumbered license; 26 (6) Has submitted, in connection with an application for initial 27 licensure or licensure by endorsement, fingerprints or other biometric data for the 28 purpose of obtaining criminal history record information from the Federal Bureau of 29 Investigation and the agency responsible for retaining that state's criminal records; 30 (7) Has not been convicted or found guilty, or has entered into an 31 agreed disposition, of a felony offense under applicable state or federal criminal law;
01 (8) Has not been convicted or found guilty, or has entered into an 02 agreed disposition, of a misdemeanor offense related to the practice of nursing as 03 determined on a case-by-case basis; 04 (9) Is not currently enrolled in an alternative program; 05 (10) Is subject to self-disclosure requirements regarding current 06 participation in an alternative program; and 07 (11) Has a valid United States Social Security number. 08 (d) All party states shall be authorized, in accordance with existing state due 09 process law, to take adverse action against a nurse's multistate licensure privilege such 10 as revocation, suspension, probation or any other action that affects a nurse's 11 authorization to practice under a multistate licensure privilege, including cease and 12 desist actions. If a party state takes such action, it shall promptly notify the 13 administrator of the coordinated licensure information system. The administrator of 14 the coordinated licensure information system shall promptly notify the home state of 15 any such actions by remote states. 16 (e) A nurse practicing in a party state must comply with the state practice laws 17 of the state in which the client is located at the time service is provided. The practice 18 of nursing is not limited to patient care, but shall include all nursing practice as 19 defined by the state practice laws of the party state in which the client is located. The 20 practice of nursing in a party state under a multistate licensure privilege will subject a 21 nurse to the jurisdiction of the licensing board, the courts and the laws of the party 22 state in which the client is located at the time service is provided. 23 (f) Individuals not residing in a party state shall continue to be able to apply 24 for a party state's single-state license as provided under the laws of each party state. 25 However, the single-state license granted to these individuals will not be recognized as 26 granting the privilege to practice nursing in any other party state. Nothing in this 27 Compact shall affect the requirements established by a party state for the issuance of a 28 single-state license. 29 (g) Any nurse holding a home state multistate license, on the effective date of 30 this Compact, may retain and renew the multistate license issued by the nurse's then- 31 current home state, provided that:
01 (1) A nurse, who changes primary state of residence after this 02 Compact's effective date, must meet all applicable Article III.c. requirements to obtain 03 a multistate license from a new home state. 04 (2) A nurse who fails to satisfy the multistate licensure requirements in 05 Article III.c. due to a disqualifying event occurring after this Compact's effective date 06 shall be ineligible to retain or renew a multistate license, and the nurse's multistate 07 license shall be revoked or deactivated in accordance with applicable rules adopted by 08 the Interstate Commission of Nurse Licensure Compact Administrators 09 ("Commission"). 10 ARTICLE IV 11 Applications for Licensure in a Party State 12 (a) Upon application for a multistate license, the licensing board in the issuing 13 party state shall ascertain, through the coordinated licensure information system, 14 whether the applicant has ever held, or is the holder of, a license issued by any other 15 state, whether there are any encumbrances on any license or multistate licensure 16 privilege held by the applicant, whether any adverse action has been taken against any 17 license or multistate licensure privilege held by the applicant and whether the 18 applicant is currently participating in an alternative program. 19 (b) A nurse may hold a multistate license, issued by the home state, in only 20 one party state at a time. 21 (c) If a nurse changes primary state of residence by moving between two party 22 states, the nurse must apply for licensure in the new home state, and the multistate 23 license issued by the prior home state will be deactivated in accordance with 24 applicable rules adopted by the Commission. 25 (1) The nurse may apply for licensure in advance of a change in 26 primary state of residence. 27 (2) A multistate license shall not be issued by the new home state until 28 the nurse provides satisfactory evidence of a change in primary state of residence to 29 the new home state and satisfies all applicable requirements to obtain a multistate 30 license from the new home state. 31 (d) If a nurse changes primary state of residence by moving from a party state
01 to a non-party state, the multistate license issued by the prior home state will convert 02 to a single-state license, valid only in the former home state. 03 ARTICLE V 04 Additional Authorities Invested in Party State Licensing Boards 05 (a) In addition to the other powers conferred by state law, a licensing board 06 shall have the authority to: 07 (1) Take adverse action against a nurse's multistate licensure privilege 08 to practice within that party state. 09 (A) Only the home state shall have the power to take adverse 10 action against a nurse's license issued by the home state. 11 (B) For purposes of taking adverse action, the home state 12 licensing board shall give the same priority and effect to reported conduct 13 received from a remote state as it would if such conduct had occurred within 14 the home state. In so doing, the home state shall apply its own state laws to 15 determine appropriate action. 16 (2) Issue cease and desist orders or impose an encumbrance on a 17 nurse's authority to practice within that party state. 18 (3) Complete any pending investigations of a nurse who changes 19 primary state of residence during the course of such investigations. The licensing 20 board shall also have the authority to take appropriate action(s) and shall promptly 21 report the conclusions of such investigations to the administrator of the coordinated 22 licensure information system. The administrator of the coordinated licensure 23 information system shall promptly notify the new home state of any such actions. 24 (4) Issue subpoenas for both hearings and investigations that require 25 the attendance and testimony of witnesses, as well as, the production of evidence. 26 Subpoenas issued by a licensing board in a party state for the attendance and 27 testimony of witnesses or the production of evidence from another party state shall be 28 enforced in the latter state by any court of competent jurisdiction, according to the 29 practice and procedure of that court applicable to subpoenas issued in proceedings 30 pending before it. The issuing authority shall pay any witness fees, travel expenses, 31 mileage and other fees required by the service statutes of the state in which the
01 witnesses or evidence are located. 02 (5) Obtain and submit, for each nurse licensure applicant, fingerprint 03 or other biometric-based information to the Federal Bureau of Investigation for 04 criminal background checks, receive the results of the Federal Bureau of Investigation 05 record search on criminal background checks and use the results in making licensure 06 decisions. 07 (6) If otherwise permitted by state law, recover from the affected nurse 08 the costs of investigations and disposition of cases resulting from any adverse action 09 taken against that nurse. 10 (7) Take adverse action based on the factual findings of the remote 11 state, provided that the licensing board follows its own procedures for taking such 12 adverse action. 13 (b) If adverse action is taken by the home state against a nurse's multistate 14 license, the nurse's multistate licensure privilege to practice in all other party states 15 shall be deactivated until all encumbrances have been removed from the multistate 16 license. All home state disciplinary orders that impose adverse action against a nurse's 17 multistate license shall include a statement that the nurse's multistate licensure 18 privilege is deactivated in all party states during the pendency of the order. Nothing in 19 this Compact shall override a party state's decision that participation in an alternative 20 program may be used in lieu of adverse action. The home state licensing board shall 21 deactivate the multistate licensure privilege under the multistate license of any nurse 22 for the duration of the nurse's participation in an alternative program. 23 ARTICLE VI 24 Coordinated Licensure Information System and Exchange of Information 25 (a) All party states shall participate in a coordinated licensure information 26 system of all licensed registered nurses (RNs) and licensed practical/vocational nurses 27 (LPNs/VNs). This system will include information on the licensure and disciplinary 28 history of each nurse, as submitted by party states, to assist in the coordination of 29 nurse licensure and enforcement efforts. 30 (b) The Commission, in consultation with the administrator of the coordinated 31 licensure information system, shall formulate necessary and proper procedures for the
01 identification, collection and exchange of information under this Compact. 02 (c) All licensing boards shall promptly report to the coordinated licensure 03 information system any adverse action, any current significant investigative 04 information, denials of applications (with the reasons for such denials) and nurse 05 participation in alternative programs known to the licensing board regardless of 06 whether such participation is deemed nonpublic or confidential under state law. 07 (d) Current significant investigative information and participation in nonpublic 08 or confidential alternative programs shall be transmitted through the coordinated 09 licensure information system only to party state licensing boards. 10 (e) Notwithstanding any other provision of law, all party state licensing boards 11 contributing information to the coordinated licensure information system may 12 designate information that may not be shared with non-party states or disclosed to 13 other entities or individuals without the express permission of the contributing state. 14 (f) Any personally identifiable information obtained from the coordinated 15 licensure information system by a party state licensing board shall not be shared with 16 non-party states or disclosed to other entities or individuals except to the extent 17 permitted by the laws of the party state contributing the information. 18 (g) Any information contributed to the coordinated licensure information 19 system that is subsequently required to be expunged by the laws of the party state 20 contributing that information shall also be expunged from the coordinated licensure 21 information system. 22 (h) The Compact administrator of each party state shall furnish a uniform data 23 set to the Compact administrator of each other party state, which shall include, at a 24 minimum: 25 (1) Identifying information; 26 (2) Licensure data; 27 (3) Information related to alternative program participation; and 28 (4) Other information that may facilitate the administration of this 29 Compact, as determined by Commission rules. 30 (i) The Compact administrator of a party state shall provide all investigative 31 documents and information requested by another party state.
01 ARTICLE VII 02 Establishment of the Interstate Commission of Nurse Licensure Compact Administrators 03 (a) The party states hereby create and establish a joint public entity known as 04 the Interstate Commission of Nurse Licensure Compact Administrators. 05 (1) The Commission is an instrumentality of the party states. 06 (2) Venue is proper, and judicial proceedings by or against the 07 Commission shall be brought solely and exclusively, in a court of competent 08 jurisdiction where the principal office of the Commission is located. The Commission 09 may waive venue and jurisdictional defenses to the extent it adopts or consents to 10 participate in alternative dispute resolution proceedings. 11 (3) Nothing in this Compact shall be construed to be a waiver of 12 sovereign immunity. 13 (b) Membership, Voting and Meetings 14 (1) Each party state shall have and be limited to one administrator. The 15 head of the state licensing board or designee shall be the administrator of this Compact 16 for each party state. Any administrator may be removed or suspended from office as 17 provided by the law of the state from which the Administrator is appointed. Any 18 vacancy occurring in the Commission shall be filled in accordance with the laws of the 19 party state in which the vacancy exists. 20 (2) Each administrator shall be entitled to one (1) vote with regard to 21 the promulgation of rules and creation of bylaws and shall otherwise have an 22 opportunity to participate in the business and affairs of the Commission. An 23 administrator shall vote in person or by such other means as provided in the bylaws. 24 The bylaws may provide for an administrator's participation in meetings by telephone 25 or other means of communication. 26 (3) The Commission shall meet at least once during each calendar 27 year. Additional meetings shall be held as set forth in the bylaws or rules of the 28 commission. 29 (4) All meetings shall be open to the public, and public notice of 30 meetings shall be given in the same manner as required under the rulemaking 31 provisions in Article VIII.
01 (5) The Commission may convene in a closed, nonpublic meeting if 02 the Commission must discuss: 03 (A) Noncompliance of a party state with its obligations under 04 this Compact; 05 (B) The employment, compensation, discipline or other 06 personnel matters, practices or procedures related to specific employees or 07 other matters related to the Commission's internal personnel practices and 08 procedures; 09 (C) Current, threatened or reasonably anticipated litigation; 10 (D) Negotiation of contracts for the purchase or sale of goods, 11 services or real estate; 12 (E) Accusing any person of a crime or formally censuring any 13 person; 14 (F) Disclosure of trade secrets or commercial or financial 15 information that is privileged or confidential; 16 (G) Disclosure of information of a personal nature where 17 disclosure would constitute a clearly unwarranted invasion of personal privacy; 18 (H) Disclosure of investigatory records compiled for law 19 enforcement purposes; 20 (I) Disclosure of information related to any reports prepared by 21 or on behalf of the Commission for the purpose of investigation of compliance 22 with this Compact; or 23 (J) Matters specifically exempted from disclosure by federal or 24 state statute. 25 (6) If a meeting, or portion of a meeting, is closed pursuant to this 26 provision, the Commission's legal counsel or designee shall certify that the meeting 27 may be closed and shall reference each relevant exempting provision. The 28 Commission shall keep minutes that fully and clearly describe all matters discussed in 29 a meeting and shall provide a full and accurate summary of actions taken, and the 30 reasons therefor, including a description of the views expressed. All documents 31 considered in connection with an action shall be identified in such minutes. All
01 minutes and documents of a closed meeting shall remain under seal, subject to release 02 by a majority vote of the Commission or order of a court of competent jurisdiction. 03 (c) The Commission shall, by a majority vote of the administrators, prescribe 04 bylaws or rules to govern its conduct as may be necessary or appropriate to carry out 05 the purposes and exercise the powers of this Compact, including but not limited to: 06 (1) Establishing the fiscal year of the Commission; 07 (2) Providing reasonable standards and procedures: 08 (A) For the establishment and meetings of other committees; 09 and 10 (B) Governing any general or specific delegation of any 11 authority or function of the Commission; 12 (3) Providing reasonable procedures for calling and conducting 13 meetings of the Commission, ensuring reasonable advance notice of all meetings and 14 providing an opportunity for attendance of such meetings by interested parties, with 15 enumerated exceptions designed to protect the public's interest, the privacy of 16 individuals, and proprietary information, including trade secrets. The Commission 17 may meet in closed session only after a majority of the administrators vote to close a 18 meeting in whole or in part. As soon as practicable, the Commission must make public 19 a copy of the vote to close the meeting revealing the vote of each administrator, with 20 no proxy votes allowed; 21 (4) Establishing the titles, duties and authority and reasonable 22 procedures for the election of the officers of the Commission; 23 (5) Providing reasonable standards and procedures for the 24 establishment of the personnel policies and programs of the Commission. 25 Notwithstanding any civil service or other similar laws of any party state, the bylaws 26 shall exclusively govern the personnel policies and programs of the Commission; and 27 (6) Providing a mechanism for winding up the operations of the 28 Commission and the equitable disposition of any surplus funds that may exist after the 29 termination of this Compact after the payment or reserving of all of its debts and 30 obligations; 31 (d) The Commission shall publish its bylaws and rules, and any amendments
01 thereto, in a convenient form on the website of the Commission. 02 (e) The Commission shall maintain its financial records in accordance with the 03 bylaws. 04 (f) The Commission shall meet and take such actions as are consistent with the 05 provisions of this Compact and the bylaws. 06 (g) The Commission shall have the following powers: 07 (1) To promulgate uniform rules to facilitate and coordinate 08 implementation and administration of this Compact. The rules shall have the force and 09 effect of law and shall be binding in all party states; 10 (2) To bring and prosecute legal proceedings or actions in the name of 11 the Commission, provided that the standing of any licensing board to sue or be sued 12 under applicable law shall not be affected; 13 (3) To purchase and maintain insurance and bonds; 14 (4) To borrow, accept or contract for services of personnel, including, 15 but not limited to, employees of a party state or nonprofit organizations; 16 (5) To cooperate with other organizations that administer state 17 compacts related to the regulation of nursing, including but not limited to sharing 18 administrative or staff expenses, office space or other resources; 19 (6) To hire employees, elect or appoint officers, fix compensation, 20 define duties, grant such individuals appropriate authority to carry out the purposes of 21 this Compact, and to establish the Commission's personnel policies and programs 22 relating to conflicts of interest, qualifications of personnel and other related personnel 23 matters; 24 (7) To accept any and all appropriate donations, grants and gifts of 25 money, equipment, supplies, materials and services, and to receive, utilize and dispose 26 of the same; provided that at all times the Commission shall avoid any appearance of 27 impropriety or conflict of interest; 28 (8) To lease, purchase, accept appropriate gifts or donations of, or 29 otherwise to own, hold, improve or use, any property, whether real, personal or mixed; 30 provided that at all times the Commission shall avoid any appearance of impropriety; 31 (9) To sell, convey, mortgage, pledge, lease, exchange, abandon or
01 otherwise dispose of any property, whether real, personal or mixed; 02 (10) To establish a budget and make expenditures; 03 (11) To borrow money; 04 (12) To appoint committees, including advisory committees comprised 05 of administrators, state nursing regulators, state legislators or their representatives, and 06 consumer representatives, and other such interested persons; 07 (13) To provide and receive information from, and to cooperate with, 08 law enforcement agencies; 09 (14) To adopt and use an official seal; and 10 (15) To perform such other functions as may be necessary or 11 appropriate to achieve the purposes of this Compact consistent with the state 12 regulation of nurse licensure and practice. 13 (h) Financing of the Commission 14 (1) The Commission shall pay, or provide for the payment of, the 15 reasonable expenses of its establishment, organization and ongoing activities. 16 (2) The Commission may also levy on and collect an annual 17 assessment from each party state to cover the cost of its operations, activities and staff 18 in its annual budget as approved each year. The aggregate annual assessment amount, 19 if any, shall be allocated based upon a formula to be determined by the Commission, 20 which shall promulgate a rule that is binding upon all party states. 21 (3) The Commission shall not incur obligations of any kind prior to 22 securing the funds adequate to meet the same; nor shall the Commission pledge the 23 credit of any of the party states, except by, and with the authority of, such party state. 24 (4) The Commission shall keep accurate accounts of all receipts and 25 disbursements. The receipts and disbursements of the Commission shall be subject to 26 the audit and accounting procedures established under its bylaws. However, all 27 receipts and disbursements of funds handled by the Commission shall be audited 28 yearly by a certified or licensed public accountant, and the report of the audit shall be 29 included in and become part of the annual report of the Commission. 30 (i) Qualified Immunity, Defense and Indemnification 31 (1) The administrators, officers, executive director, employees and
01 representatives of the Commission shall be immune from suit and liability, either 02 personally or in their official capacity, for any claim for damage to or loss of property 03 or personal injury or other civil liability caused by or arising out of any actual or 04 alleged act, error or omission that occurred, or that the person against whom the claim 05 is made had a reasonable basis for believing occurred, within the scope of 06 Commission employment, duties or responsibilities; provided that nothing in this 07 paragraph shall be construed to protect any such person from suit or liability for any 08 damage, loss, injury or liability caused by the intentional, willful or wanton 09 misconduct of that person. 10 (2) The Commission shall defend any administrator, officer, executive 11 director, employee or representative of the Commission in any civil action seeking to 12 impose liability arising out of any actual or alleged act, error or omission that occurred 13 within the scope of Commission employment, duties or responsibilities, or that the 14 person against whom the claim is made had a reasonable basis for believing occurred 15 within the scope of Commission employment, duties or responsibilities; provided that 16 nothing herein shall be construed to prohibit that person from retaining his or her own 17 counsel; and provided further that the actual or alleged act, error or omission did not 18 result from that person's intentional, willful or wanton misconduct. 19 (3) The Commission shall indemnify and hold harmless any 20 administrator, officer, executive director, employee or representative of the 21 Commission for the amount of any settlement or judgment obtained against that 22 person arising out of any actual or alleged act, error or omission that occurred within 23 the scope of Commission employment, duties or responsibilities, or that such person 24 had a reasonable basis for believing occurred within the scope of Commission 25 employment, duties or responsibilities, provided that the actual or alleged act, error or 26 omission did not result from the intentional, willful or wanton misconduct of that 27 person. 28 ARTICLE VIII 29 Rulemaking 30 (a) The Commission shall exercise its rulemaking powers pursuant to the 31 criteria set forth in this Article and the rules adopted thereunder. Rules and
01 amendments shall become binding as of the date specified in each rule or amendment 02 and shall have the same force and effect as provisions of this Compact. 03 (b) Rules or amendments to the rules shall be adopted at a regular or special 04 meeting of the Commission. 05 (c) Prior to promulgation and adoption of a final rule or rules by the 06 Commission, and at least sixty (60) days in advance of the meeting at which the rule 07 will be considered and voted upon, the Commission shall file a notice of proposed 08 rulemaking: 09 (1) On the website of the Commission; and 10 (2) On the website of each licensing board or the publication in which 11 each state would otherwise publish proposed rules. 12 (d) The notice of proposed rulemaking shall include: 13 (1) The proposed time, date and location of the meeting in which the 14 rule will be considered and voted upon; 15 (2) The text of the proposed rule or amendment, and the reason for the 16 proposed rule; 17 (3) A request for comments on the proposed rule from any interested 18 person; and 19 (4) The manner in which interested persons may submit notice to the 20 Commission of their intention to attend the public hearing and any written comments. 21 (e) Prior to adoption of a proposed rule, the Commission shall allow persons 22 to submit written data, facts, opinions and arguments, which shall be made available to 23 the public. 24 (f) The Commission shall grant an opportunity for a public hearing before it 25 adopts a rule or amendment. 26 (g) The Commission shall publish the place, time and date of the scheduled 27 public hearing. 28 (1) Hearings shall be conducted in a manner providing each person 29 who wishes to comment a fair and reasonable opportunity to comment orally or in 30 writing. All hearings will be recorded, and a copy will be made available upon request. 31 (2) Nothing in this section shall be construed as requiring a separate
01 hearing on each rule. Rules may be grouped for the convenience of the Commission at 02 hearings required by this section. 03 (h) If no one appears at the public hearing, the Commission may proceed with 04 promulgation of the proposed rule. 05 (i) Following the scheduled hearing date, or by the close of business on the 06 scheduled hearing date if the hearing was not held, the Commission shall consider all 07 written and oral comments received. 08 (j) The Commission shall, by majority vote of all administrators, take final 09 action on the proposed rule and shall determine the effective date of the rule, if any, 10 based on the rulemaking record and the full text of the rule. 11 (k) Upon determination that an emergency exists, the Commission may 12 consider and adopt an emergency rule without prior notice, opportunity for comment 13 or hearing, provided that the usual rulemaking procedures provided in this Compact 14 and in this section shall be retroactively applied to the rule as soon as reasonably 15 possible, in no event later than ninety (90) days after the effective date of the rule. For 16 the purposes of this provision, an emergency rule is one that must be adopted 17 immediately in order to: 18 (1) Meet an imminent threat to public health, safety or welfare; 19 (2) Prevent a loss of Commission or party state funds; or 20 (3) Meet a deadline for the promulgation of an administrative rule that 21 is required by federal law or rule. 22 (l) The Commission may direct revisions to a previously adopted rule or 23 amendment for purposes of correcting typographical errors, errors in format, errors in 24 consistency or grammatical errors. Public notice of any revisions shall be posted on 25 the website of the Commission. The revision shall be subject to challenge by any 26 person for a period of thirty (30) days after posting. The revision may be challenged 27 only on grounds that the revision results in a material change to a rule. A challenge 28 shall be made in writing, and delivered to the Commission, prior to the end of the 29 notice period. If no challenge is made, the revision will take effect without further 30 action. If the revision is challenged, the revision may not take effect without the 31 approval of the Commission.
01 ARTICLE IX 02 Oversight, Dispute Resolution and Enforcement 03 (a) Oversight 04 (1) Each party state shall enforce this Compact and take all actions 05 necessary and appropriate to effectuate this Compact's purposes and intent. 06 (2) The Commission shall be entitled to receive service of process in 07 any proceeding that may affect the powers, responsibilities or actions of the 08 Commission, and shall have standing to intervene in such a proceeding for all 09 purposes. Failure to provide service of process in such proceeding to the Commission 10 shall render a judgment or order void as to the Commission, this Compact or 11 promulgated rules. 12 (b) Default, Technical Assistance and Termination 13 (1) If the Commission determines that a party state has defaulted in the 14 performance of its obligations or responsibilities under this Compact or the 15 promulgated rules, the Commission shall: 16 (A) Provide written notice to the defaulting state and other 17 party states of the nature of the default, the proposed means of curing the 18 default or any other action to be taken by the Commission; and 19 (B) Provide remedial training and specific technical assistance 20 regarding the default. 21 (2) If a state in default fails to cure the default, the defaulting state's 22 membership in this Compact may be terminated upon an affirmative vote of a majority 23 of the administrators, and all rights, privileges and benefits conferred by this Compact 24 may be terminated on the effective date of termination. A cure of the default does not 25 relieve the offending state of obligations or liabilities incurred during the period of 26 default. 27 (3) Termination of membership in this Compact shall be imposed only 28 after all other means of securing compliance have been exhausted. Notice of intent to 29 suspend or terminate shall be given by the Commission to the governor of the 30 defaulting state and to the executive officer of the defaulting state's licensing board 31 and each of the party states.
01 (4) A state whose membership in this Compact has been terminated is 02 responsible for all assessments, obligations and liabilities incurred through the 03 effective date of termination, including obligations that extend beyond the effective 04 date of termination. 05 (5) The Commission shall not bear any costs related to a state that is 06 found to be in default or whose membership in this Compact has been terminated 07 unless agreed upon in writing between the Commission and the defaulting state. 08 (6) The defaulting state may appeal the action of the Commission by 09 petitioning the U.S. District Court for the District of Columbia or the federal district in 10 which the Commission has its principal offices. The prevailing party shall be awarded 11 all costs of such litigation, including reasonable attorneys' fees. 12 (c) Dispute Resolution 13 (1) Upon request by a party state, the Commission shall attempt to 14 resolve disputes related to the Compact that arise among party states and between 15 party and non-party states. 16 (2) The Commission shall promulgate a rule providing for both 17 mediation and binding dispute resolution for disputes, as appropriate. 18 (3) In the event the Commission cannot resolve disputes among party 19 states arising under this Compact: 20 (A) The party states may submit the issues in dispute to an 21 arbitration panel, which will be comprised of individuals appointed by the 22 Compact administrator in each of the affected party states and an individual 23 mutually agreed upon by the Compact administrators of all the party states 24 involved in the dispute. 25 (B) The decision of a majority of the arbitrators shall be final 26 and binding. 27 (d) Enforcement 28 (1) The Commission, in the reasonable exercise of its discretion, shall 29 enforce the provisions and rules of this Compact. 30 (2) By majority vote, the Commission may initiate legal action in the 31 U.S. District Court for the District of Columbia or the federal district in which the
01 Commission has its principal offices against a party state that is in default to enforce 02 compliance with the provisions of this Compact and its promulgated rules and bylaws. 03 The relief sought may include both injunctive relief and damages. In the event judicial 04 enforcement is necessary, the prevailing party shall be awarded all costs of such 05 litigation, including reasonable attorneys' fees. 06 (3) The remedies herein shall not be the exclusive remedies of the 07 Commission. The Commission may pursue any other remedies available under federal 08 or state law. 09 ARTICLE X 10 Effective Date, Withdrawal and Amendment 11 (a) This Compact shall become effective and binding on the earlier of the date 12 of legislative enactment of this Compact into law by no less than twenty-six (26) states 13 or December 31, 2018. All party states to this Compact, that also were parties to the 14 prior Nurse Licensure Compact, superseded by this Compact, ("Prior Compact"), shall 15 be deemed to have withdrawn from said Prior Compact within six (6) months after the 16 effective date of this Compact. 17 (b) Each party state to this Compact shall continue to recognize a nurse's 18 multistate licensure privilege to practice in that party state issued under the Prior 19 Compact until such party state has withdrawn from the Prior Compact. 20 (c) Any party state may withdraw from this Compact by enacting a statute 21 repealing the same. A party state's withdrawal shall not take effect until six (6) months 22 after enactment of the repealing statute. 23 (d) A party state's withdrawal or termination shall not affect the continuing 24 requirement of the withdrawing or terminated state's licensing board to report adverse 25 actions and significant investigations occurring prior to the effective date of such 26 withdrawal or termination. 27 (e) Nothing contained in this Compact shall be construed to invalidate or 28 prevent any nurse licensure agreement or other cooperative arrangement between a 29 party state and a non-party state that is made in accordance with the other provisions 30 of this Compact. 31 (f) This Compact may be amended by the party states. No amendment to this
01 Compact shall become effective and binding upon the party states unless and until it is 02 enacted into the laws of all party states. 03 (g) Representatives of non-party states to this Compact shall be invited to 04 participate in the activities of the Commission, on a nonvoting basis, prior to the 05 adoption of this Compact by all states. 06 ARTICLE XI 07 Construction and Severability 08 This Compact shall be liberally construed so as to effectuate the purposes 09 thereof. The provisions of this Compact shall be severable, and if any phrase, clause, 10 sentence or provision of this Compact is declared to be contrary to the constitution of 11 any party state or of the United States, or if the applicability thereof to any 12 government, agency, person or circumstance is held invalid, the validity of the 13 remainder of this Compact and the applicability thereof to any government, agency, 14 person or circumstance shall not be affected thereby. If this Compact shall be held to 15 be contrary to the constitution of any party state, this Compact shall remain in full 16 force and effect as to the remaining party states and in full force and effect as to the 17 party state affected as to all severable matters. 18 * Sec. 24. AS 09.55.560(2) is amended to read: 19 (2) "health care provider" means an acupuncturist licensed under 20 AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 21 chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a 22 dentist licensed under AS 08.36; a nurse licensed under AS 08.68 or AS 08.69; a 23 dispensing optician licensed under AS 08.71; a naturopath licensed under AS 08.45; 24 an optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 25 physical therapist or occupational therapist licensed under AS 08.84; a physician or 26 physician assistant licensed under AS 08.64; a podiatrist; a psychologist and a 27 psychological associate licensed under AS 08.86; a hospital as defined in 28 AS 47.32.900, including a governmentally owned or operated hospital; an employee 29 of a health care provider acting within the course and scope of employment; an 30 ambulatory surgical facility and other organizations whose primary purpose is the 31 delivery of health care, including a health maintenance organization, individual
01 practice association, integrated delivery system, preferred provider organization or 02 arrangement, and a physical hospital organization; 03 * Sec. 25. AS 09.65.095(c)(1) is amended to read: 04 (1) "health care provider" means a nurse licensed under AS 08.68 or 05 AS 08.69, a physician licensed under AS 08.64, and a person certified by a hospital as 06 competent to take blood samples; 07 * Sec. 26. AS 12.62.400(a) is amended to read: 08 (a) To obtain a national criminal history record check for determining a 09 person's qualifications for a license, permit, registration, employment, or position, a 10 person shall submit the person's fingerprints to the department with the fee established 11 by AS 12.62.160. The department may submit the fingerprints to the Federal Bureau 12 of Investigation to obtain a national criminal history record check of the person for the 13 purpose of evaluating a person's qualifications for 14 (1) a license or conditional contractor's permit to manufacture, sell, 15 offer for sale, possess for sale or barter, traffic in, or barter an alcoholic beverage 16 under AS 04.11; 17 (2) licensure as a mortgage lender, a mortgage broker, or a mortgage 18 loan originator under AS 06.60; 19 (3) admission to the Alaska Bar Association under AS 08.08; 20 (4) licensure as a collection agency operator under AS 08.24; 21 (5) a certificate of fitness to handle explosives under AS 08.52; 22 (6) licensure as a massage therapist under AS 08.61; 23 (7) licensure to practice nursing under AS 08.68 or AS 08.69 or 24 certification as a nurse aide under AS 08.68; 25 (8) certification as a real estate appraiser under as 08.87; 26 (9) a position involving supervisory or disciplinary power over a minor 27 or dependent adult for which criminal justice information may be released under 28 AS 12.62.160(b)(9); 29 (10) a teacher certificate under AS 14.20; 30 (11) a registration or license to operate a marijuana establishment 31 under AS 17.38;
01 (12) admittance to a police training program under AS 18.65.230 or for 02 certification as a police officer under AS 18.65.240 if that person's prospective 03 employer does not have access to a criminal justice information system; 04 (13) licensure as a security guard under AS 18.65.400 - 18.65.490; 05 (14) a concealed handgun permit under AS 18.65.700 - 18.65.790; 06 (15) licensure as an insurance producer, managing general agent, 07 reinsurance intermediary broker, reinsurance intermediary manager, surplus lines 08 broker, or independent adjuster under AS 21.27; 09 (16) serving and executing process issued by a court by a person 10 designated under AS 22.20.130; 11 (17) a school bus driver license under AS 28.15.046; 12 (18) licensure as an operator or an instructor for a commercial driver 13 training school under AS 28.17; 14 (19) registration as a broker-dealer, agent, investment adviser 15 representative, or investment adviser under AS 45.56.300 - 45.56.350; 16 (20) licensure, license renewal, certification, certification renewal, or 17 payment from the Department of Health and Social Services of an individual and an 18 entity subject to the requirements for a criminal history check under AS 47.05.310, 19 including 20 (A) a public home care provider described in AS 47.05.017; 21 (B) a provider of home and community-based waiver services 22 financed under AS 47.07.030(c); 23 (C) a case manager to coordinate community mental health 24 services under AS 47.30.530; 25 (D) an entity listed in AS 47.32.010(b), including an owner, 26 officer, director, member, partner, employee, volunteer, or contractor of an 27 entity; or 28 (E) an individual or entity not described in (A) - (D) of this 29 paragraph that is required by statute or regulation to be licensed or certified by 30 the Department of Health and Social Services or that is eligible to receive 31 payments, in whole or in part, from the Department of Health and Social
01 Services to provide for the health, safety, and welfare of persons who are 02 served by the programs administered by the Department of Health and Social 03 Services. 04 * Sec. 27. AS 18.20.095(e)(2) is amended to read: 05 (2) "licensed staff member" means a person who is employed by the 06 hospital to provide direct patient care and who is licensed or certified in the state as a 07 physician or physician assistant under AS 08.64, direct-entry midwife under AS 08.65, 08 nurse under AS 08.68 or AS 08.69, [OR] nurse aide under AS 08.68, or physical 09 therapist or occupational therapist under AS 08.84; 10 * Sec. 28. AS 18.20.499(3) is amended to read: 11 (3) "nurse" means an individual licensed to practice registered nursing 12 or practical nursing under AS 08.68 or AS 08.69 who provides nursing services 13 through direct patient care or clinical services and includes a nurse manager when 14 delivering in-hospital patient care; 15 * Sec. 29. AS 18.23.070(3) is amended to read: 16 (3) "health care provider" means an acupuncturist licensed under 17 AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist licensed under 18 AS 08.32; a dentist licensed under AS 08.36; a nurse licensed under AS 08.68 or 19 AS 08.69; a dispensing optician licensed under AS 08.71; an optometrist licensed 20 under AS 08.72; a pharmacist licensed under AS 08.80; a physical therapist or 21 occupational therapist licensed under AS 08.84; a physician licensed under AS 08.64; 22 a podiatrist; a psychologist and a psychological associate licensed under AS 08.86; a 23 hospital as defined in AS 47.32.900, including a governmentally owned or operated 24 hospital; and an employee of a health care provider acting within the course and scope 25 of employment; 26 * Sec. 30. AS 47.07.045(b) is amended to read: 27 (b) Before the department may terminate payment for services provided under 28 (a) of this section, 29 (1) the recipient must have had an annual assessment to determine 30 whether the recipient continues to meet the standards under (a) of this section; 31 (2) the annual assessment must have been reviewed by an independent
01 qualified health care professional under contract with the department; in [FOR 02 PURPOSES OF] this paragraph, "independent qualified health care professional" 03 means, 04 (A) for a waiver based on intellectual or developmental 05 disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 06 intellectual disability professional; 07 (B) for other allowable waivers, a registered nurse licensed 08 under AS 08.68 or AS 08.69 or an advanced practice registered nurse licensed 09 under AS 08.68 who is qualified to assess children with complex medical 10 conditions, older Alaskans, and adults with physical disabilities for medical 11 assistance waivers; and 12 (3) the annual assessment must find that the recipient's condition has 13 materially improved since the previous assessment; for purposes of this paragraph, 14 "materially improved" means that a recipient who has previously qualified for a 15 waiver for 16 (A) a child with complex medical conditions, no longer needs 17 technical assistance for a life-threatening condition, and is expected to be 18 placed in a skilled nursing facility for less than 30 days each year; 19 (B) intellectual or developmental disability, no longer needs the 20 level of care provided by an intermediate care facility for persons with 21 intellectual and developmental disabilities either because the qualifying 22 diagnosis has changed or the recipient is able to demonstrate the ability to 23 function in a home setting without the need for waiver services; or 24 (C) an older Alaskan or adult with a physical disability, no 25 longer has a functional limitation or cognitive impairment that would result in 26 the need for nursing home placement, and is able to demonstrate the ability to 27 function in a home setting without the need for waiver services. 28 * Sec. 31. AS 47.33.020(d) is amended to read: 29 (d) An assisted living home may provide intermittent nursing services to a 30 resident who does not require 24-hour nursing services and supervision. Intermittent 31 nursing services may be provided only by a nurse licensed under AS 08.68 or
01 AS 08.69 or by a person to whom a nursing task has been delegated under (e) of this 02 section. 03 * Sec. 32. AS 47.33.020(e) is amended to read: 04 (e) A person who is on the staff of an assisted living home and who is not a 05 nurse licensed under AS 08.68 or AS 08.69 may perform a nursing task in that home 06 if 07 (1) the authority to perform that nursing task is delegated to that person 08 by a nurse licensed under AS 08.68 or AS 08.69; and 09 (2) that nursing task is specified in regulations adopted by the Board of 10 Nursing as a task that may be delegated. 11 * Sec. 33. AS 47.33.020(f) is amended to read: 12 (f) A resident who needs skilled nursing care may, with the consent of the 13 assisted living home, arrange for that care to be provided in the home by a nurse 14 licensed under AS 08.68 or AS 08.69 if that arrangement does not interfere with the 15 services provided to other residents. 16 * Sec. 34. AS 47.33.020(g) is amended to read: 17 (g) As part of a plan to avoid transfer of a resident from the home for medical 18 reasons, the home may provide, through the services of a nurse who is licensed under 19 AS 08.68 or AS 08.69, 24-hour skilled nursing care to the resident for not more than 20 45 consecutive days. 21 * Sec. 35. AS 47.33.020(h) is amended to read: 22 (h) If a resident has received 24-hour skilled nursing care for the 45-day limit 23 set by (g) of this section, the resident or the resident's representative may elect to have 24 the resident remain in the home without continuation of 24-hour skilled nursing care if 25 the home agrees to retain the resident after 26 (1) the home and either the resident or the resident's representative 27 have consulted with the resident's physician; 28 (2) the home and either the resident or the resident's representative 29 have discussed the consequences and risks involved in the election to remain in the 30 home; and 31 (3) the portion of the resident's assisted living plan that relates to
01 health-related services has been revised to provide for the resident's health-related 02 needs without the use of 24-hour skilled nursing care, and the revised plan has been 03 reviewed by a registered nurse licensed under AS 08.68 or AS 08.69, by an [OR] 04 advanced practice registered nurse licensed under AS 08.68, or by the resident's 05 attending physician. 06 * Sec. 36. AS 47.33.230(c) is amended to read: 07 (c) If the assisted living home provides or arranges for the provision of health- 08 related services to a resident, the home shall ensure that a 09 (1) registered nurse licensed under AS 08.68 or AS 08.69 or an 10 advanced practice registered nurse licensed under AS 08.68 reviews the portion of an 11 assisted living plan that describes how the resident's need for health-related services 12 will be met; and 13 (2) physician's statement about the resident is included in the plan. 14 * Sec. 37. The uncodified law of the State of Alaska is amended by adding a new section to 15 read: 16 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 17 Economic Development may adopt regulations necessary to implement the changes made by 18 this Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 19 before the effective date of the law implemented by the regulation. 20 * Sec. 38. Section 37 of this Act takes effect immediately under AS 01.10.070(c). 21 * Sec. 39. Except as provided in sec. 38 of this Act, this Act takes effect July 1, 2022.