HB 83: "An Act relating to the licensure of nursing professionals; relating to a multistate nurse licensure compact; and providing for an effective date."
00 HOUSE BILL NO. 83 01 "An Act relating to the licensure of nursing professionals; relating to a multistate nurse 02 licensure compact; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 08.02.010(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 10 relating to certified nurse aides in order to protect the health, safety, and 11 welfare of 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 08.69 and this chapter [AS 08.68.190]; 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] 24 applicants under this chapter and for the multistate licenses issued under 25 AS 08.69; 26 (6) prescribe requirements for competence before a former registered, 27 advanced practice registered, or [LICENSED] practical nurse licensed under this 28 chapter may resume the practice of nursing [UNDER THIS CHAPTER]; 29 (7) define by regulation the qualifications and duties of the executive 30 administrator and delegate authority to the executive administrator that is necessary to 31 conduct board business and to comply with AS 08.69 and this chapter;
01 (8) develop reasonable and uniform standards for nursing practice; 02 (9) publish advisory opinions regarding whether nursing practice 03 procedures or policies comply with acceptable standards of nursing practice as defined 04 under this chapter; 05 (10) require applicants under AS 08.69 and this chapter to submit 06 fingerprints and the fees required by the Department of Public Safety under 07 AS 12.62.160 for criminal justice information and a national criminal history record 08 check; the department shall submit the fingerprints and fees to the Department of 09 Public Safety for a report of criminal justice information under AS 12.62 and a 10 national criminal history record check under AS 12.62.400; 11 (11) require that a licensed advanced practice registered nurse who has 12 a federal Drug Enforcement Administration registration number register with the 13 controlled substance prescription database under AS 17.30.200(n); 14 (12) appoint the executive director of the board of nursing to serve 15 as the Interstate Commission Nurse Licensure Compact Administrator. 16 (b) The board may 17 (1) conduct hearings upon charges of alleged violations of AS 08.69, 18 this chapter, or regulations adopted under it; 19 (2) invoke, or request the department to invoke, disciplinary action 20 against a license issued under this chapter or a multistate license issued by the 21 board consistent with the provisions of this chapter and AS 08.69 [LICENSEE]; 22 (3) prescribe requirements for competence to continue practice. 23 * Sec. 4. AS 08.68.140 is amended to read: 24 Sec. 08.68.140. Applicability of Administrative Procedure Act. Except as 25 specified in AS 08.68.333(f) and AS 08.69, the board shall comply with AS 44.62 26 (Administrative Procedure Act). 27 * Sec. 5. AS 08.68.160 is amended to read: 28 Sec. 08.68.160. License required. A person practicing or offering to practice 29 as a registered [, ADVANCED PRACTICE REGISTERED,] or practical nurse 30 [NURSING] in the state shall submit evidence of qualification to practice and shall be 31 licensed under this chapter or AS 08.69. A person practicing or offering to practice
01 as an advanced practice registered nurse shall submit evidence of qualification to 02 practice and shall be licensed under this chapter. 03 * Sec. 6. AS 08.68.170 is amended to read: 04 Sec. 08.68.170. Qualifications of registered or practical nurse applicants. 05 (a) An applicant for a license to practice registered nursing may obtain a license 06 under this chapter or a multistate license that meets the requirements of this 07 chapter and AS 08.69. An applicant for a license to practice registered nursing 08 under this chapter shall submit to the board, on forms and in the manner prescribed 09 by the board, written evidence, verified by oath, that the applicant has successfully 10 completed a registered nurse education program accredited by a national nursing 11 accrediting body and approved by the board. An applicant for a multistate license to 12 practice registered nursing shall, in addition to the requirements of this chapter, 13 meet the requirements of AS 08.69. 14 (b) An applicant for a license to practice practical nursing may obtain a 15 license under this chapter or a multistate license that meets the requirements of 16 this chapter and AS 08.69. An applicant for a multistate license to practice 17 registered nursing shall, in addition to the requirements of this chapter, meet the 18 requirements of AS 08.69. An applicant for a license to practice practical nursing 19 under this chapter shall submit to the board, on forms and in the manner prescribed 20 by the board, written evidence, verified by oath, that the applicant has successfully 21 completed 22 (1) a practical nurse education program accredited by a national 23 nursing accrediting body; 24 (2) a practical nurse education program that meets the criteria 25 established by the board under AS 08.68.100; or 26 (3) a registered nurse education program accredited by a national 27 nursing accrediting body and approved by the board and, if the applicant has failed the 28 registered nurse licensing examination, a practical nurse scope of practice course 29 approved by the board. 30 (c) An applicant for a license to practice advanced practice registered nursing 31 shall submit to the board, on forms and in the manner prescribed by the board, written
01 evidence, verified by oath, that the applicant 02 (1) is licensed as a registered nurse in the state or is practicing as a 03 registered nurse with a multistate license under AS 08.69; and 04 (2) has successfully completed an advanced practice registered nurse 05 education program that meets the criteria established by the board under 06 AS 08.68.100. 07 * Sec. 7. AS 08.68.190(b) is amended to read: 08 (b) If an applicant meets the qualifications set out in AS 08.68.170 for the 09 license for which the applicant applied, the board shall issue a license under this 10 chapter to practice in this state 11 (1) registered or practical nursing to an applicant who passes the 12 licensing examination to practice registered or practical nursing; or 13 (2) advanced practice registered nursing to an applicant who passes the 14 advanced practice registered nursing certification examination to practice advanced 15 practice registered nursing. 16 * Sec. 8. AS 08.68.190 is amended by adding a new subsection to read: 17 (c) If an applicant meets the qualifications set out in AS 08.68.170 and 18 AS 08.69 for the license for which the applicant applied, the board shall issue a 19 multistate license to practice registered or practical nursing to an applicant who passes 20 the licensing examination to practice registered or practical nursing. 21 * Sec. 9. AS 08.68.200 is amended to read: 22 Sec. 08.68.200. License by endorsement. (a) The board may issue a license 23 by endorsement to practice in this state as a registered, advanced practice registered, 24 or practical nurse, whichever is appropriate, to an applicant who has worked as a nurse 25 within the past five years if the applicant is licensed as a registered, advanced practice 26 registered, or practical nurse under the laws of another state if, in the opinion of the 27 board, the applicant meets the qualifications required for licensing in the state and 28 meets the requirements of AS 08.68.170. 29 (b) The board may issue a license by endorsement to practice in this state as a 30 registered, advanced practice registered, or practical nurse, whichever is appropriate, 31 to an applicant who has not worked as a nurse within the past five years if the
01 applicant meets the requirements of (a) of this section and 02 (1) meets the continuing competency requirements of the board; or 03 (2) completes a course of study approved by the board. 04 * Sec. 10. AS 08.68.220 is amended to read: 05 Sec. 08.68.220. Fees. The Department of Commerce, Community, and 06 Economic Development shall set fees under AS 08.01.065 for each of the following: 07 (1) registered nursing licenses issued for multistate practice or 08 practice in this state: 09 (A) application; 10 (B) license by examination; 11 (C) license by endorsement; 12 (D) license renewal; 13 (E) temporary permit; 14 (2) practical nursing licenses issued for multistate practice or 15 practice in this state: 16 (A) application; 17 (B) license by examination; 18 (C) license by endorsement; 19 (D) license renewal; 20 (E) temporary permit; 21 (3) advanced practice registered nursing licenses issued for practice 22 in this state: 23 (A) application; 24 (B) license by certification examination; 25 (C) license by endorsement; 26 (D) license renewal; 27 (E) temporary permit. 28 * Sec. 11. AS 08.68.230(a) is amended to read: 29 (a) A person who holds a license [LICENSED] to practice registered nursing 30 in the state or who holds a multistate license under AS 08.69 may use the title 31 "registered nurse" and the abbreviation "R.N".
01 * Sec. 12. AS 08.68.230(b) is amended to read: 02 (b) A person who holds a license [LICENSED] to practice practical nursing 03 in the state or who holds a multistate license under AS 08.69 may use the title 04 "licensed practical nurse" and the abbreviation "L.P.N." 05 * Sec. 13. AS 08.68.230(d) is amended to read: 06 (d) A person who holds a temporary permit to practice as a licensed practical 07 nurse in the state shall use the title "Temporary Licensed Practical Nurse" and the 08 abbreviation "TLPN." 09 * Sec. 14. AS 08.68.251(a) is amended to read: 10 (a) A lapsed license to practice in this state or a multistate license issued by 11 the board under this chapter and AS 08.69 may be reinstated if it has not remained 12 lapsed for more than five years by payment of the license fees for the current renewal 13 period and the penalty fee. The board, by regulation, shall establish continuing 14 competency and criminal background check requirements for reinstatement of a lapsed 15 license. 16 * Sec. 15. AS 08.68.270 is amended to read: 17 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 18 may deny, suspend, or revoke the license issued by the board under this chapter or 19 AS 08.69 of a person who 20 (1) has obtained or attempted to obtain a license to practice nursing by 21 fraud or deceit; 22 (2) has been convicted of a felony or other crime if the felony or other 23 crime is substantially related to the qualifications, functions, or duties of the licensee; 24 (3) habitually abuses alcoholic beverages, or illegally uses controlled 25 substances; 26 (4) has impersonated a registered, advanced practice registered, or 27 practical nurse; 28 (5) has intentionally or negligently engaged in conduct that has 29 resulted in a significant risk to the health or safety of a client or in injury to a client; 30 (6) practices or attempts to practice nursing while afflicted with 31 physical or mental illness, deterioration, or disability that interferes with the
01 individual's performance of nursing functions; 02 (7) is guilty of unprofessional conduct as defined by regulations 03 adopted by the board; 04 (8) has wilfully or repeatedly violated a provision of this chapter or 05 regulations adopted under this chapter or AS 08.01; 06 (9) is professionally incompetent; 07 (10) denies care or treatment to a patient or person seeking assistance 08 if the sole reason for the denial is the failure or refusal of the patient or person seeking 09 assistance to agree to arbitrate as provided in AS 09.55.535(a); 10 (11) has prescribed or dispensed an opioid in excess of the maximum 11 dosage authorized under AS 08.68.705; or 12 (12) has procured, sold, prescribed, or dispensed drugs in violation of a 13 law, regardless of whether there has been a criminal action or harm to the patient. 14 * Sec. 16. AS 08.68.275(a) is amended to read: 15 (a) The board may take the following disciplinary actions singly or in 16 combination, against any license granted by the board under this chapter or 17 AS 08.69: 18 (1) permanently revoke a license or permit to practice; 19 (2) suspend a license for a stated period of time; 20 (3) censure a licensee; 21 (4) issue a letter of reprimand; 22 (5) impose limitations or conditions on the professional practice of a 23 licensee; 24 (6) impose peer review; 25 (7) impose professional education requirements until a satisfactory 26 degree of skill has been attained in those aspects of professional practice determined 27 by the board to need improvement; 28 (8) impose probation and require the licensee to report regularly to the 29 board upon matters involving the basis for the probation; 30 (9) accept a voluntary surrender of a license. 31 * Sec. 17. AS 08.68.275(c) is amended to read:
01 (c) The board may summarily suspend a license that the board issued before 02 final hearing or during the appeals process if the board finds that the licensee poses a 03 clear and immediate danger to the public health and safety. A person whose license is 04 suspended under this section is entitled to a hearing conducted by the office of 05 administrative hearings (AS 44.64.010) within seven days after the effective date of 06 the order. If, after a hearing, the board upholds the suspension, the licensee may 07 appeal the suspension to a court of competent jurisdiction. 08 * Sec. 18. AS 08.68.275(d) is amended to read: 09 (d) The board may reinstate a license that the board issued, that has been 10 suspended or revoked if the board finds, after a hearing, that the applicant is able to 11 practice with skill and safety. 12 * Sec. 19. AS 08.68.275 is amended by adding a new subsection to read: 13 (g) The board may take the following disciplinary actions singly or in 14 combination, against any licensee who is practicing in this state under a multistate 15 license issued by another state under AS 08.69: 16 (1) suspend a license for a stated period of time; 17 (2) censure a licensee; 18 (3) issue a letter of reprimand; 19 (4) impose limitations or conditions on the professional practice of a 20 licensee; 21 (5) impose peer review; 22 (6) impose professional education requirements until a satisfactory 23 degree of skill has been attained in those aspects of professional practice determined 24 by the board to need improvement; 25 (7) impose probation and require the licensee to report regularly to the 26 board on matters involving the basis for the probation. 27 * Sec. 20. AS 08.68.800(a) is amended to read: 28 (a) This chapter does not apply to 29 (1) a qualified nurse licensed in another state employed by the United 30 States government or a bureau, or agency, or division of the United States government 31 while in the discharge of official duties;
01 (2) nursing service given temporarily in the event of a public 02 emergency, epidemic, or disaster; 03 (3) the practice of nursing by a student enrolled in a nursing education 04 program accredited by the board when the practice is in connection with the student's 05 course of study; 06 (4) the practice of nursing by an individual enrolled in an approved 07 program or course of study approved by the board to satisfy the requirements of 08 AS 08.68.251; 09 (5) the practice of nursing by a nurse licensed in another state but not 10 under a multistate license issued under AS 08.69, who engages in nursing education 11 or nursing consultation activities, if these activities and contact with clients do not 12 exceed 20 working days within a licensing period; or 13 (6) the practice of nursing by a nurse licensed in another state but not 14 under a multistate license issued under AS 08.69, whose employment 15 responsibilities include transporting patients into, out of, or through this state; 16 however, this exception is valid for a period not to exceed 48 hours for each transport. 17 * Sec. 21. AS 08.68.805 is amended to read: 18 Sec. 08.68.805. Delegation of nursing functions. A registered, advanced 19 practice registered, or practical nurse licensed under this chapter or AS 08.69 may 20 delegate nursing duties to other persons, including unlicensed assistive personnel, 21 under regulations adopted by the board. A person to whom the nursing duties are 22 delegated may perform the delegated duties without a license or certificate under this 23 chapter if the person meets the applicable requirements established by the board. 24 * Sec. 22. AS 08.68.850(1) is amended to read: 25 (1) "advanced practice registered nurse" means a [REGISTERED] 26 nurse who holds a license [LICENSED] to practice registered nursing in this state 27 under this chapter or AS 08.69 and [IN THE STATE] who, because of specialized 28 education and experience, is licensed by the board [CERTIFIED] to perform acts of 29 medical diagnosis and the prescription and dispensing of medical, therapeutic, or 30 corrective measures under regulations adopted by the board; 31 * Sec. 23. AS 08 is amended by adding a new chapter to read:
01 Chapter 69. Multistate Nurse Licensure Compact. 02 Sec. 08.69.010. Compact enacted. The Multistate Nurse Licensure Compact 03 as contained in this section is enacted into law and entered into on behalf of the state 04 with all other states and jurisdictions legally joining it in a form substantially as 05 follows: 06 ARTICLE I 07 Findings and Declaration of Purpose 08 (a) The legislature finds 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 for both nurses and states; and 22 (6) Uniformity of nurse licensure requirements throughout the states 23 promotes public safety and public health benefits. 24 (b) The general purposes of this Compact are to: 25 (1) Facilitate the states' responsibility to protect the public's health and 26 safety; 27 (2) Ensure and encourage the cooperation of party states in the areas of 28 nurse licensure and regulation; 29 (3) Facilitate the exchange of information between party states in the 30 areas of nurse regulation, investigation and adverse actions; 31 (4) Promote compliance with the laws governing the practice of
01 nursing in each jurisdiction; 02 (5) Invest all party states with the authority to hold a nurse accountable 03 for meeting all state practice laws in the state in which the patient is located at the time 04 care is rendered through the mutual recognition of party state licenses; 05 (6) Decrease redundancies in the consideration and issuance of nurse 06 licenses; and 07 (7) Provide opportunities for interstate practice by nurses who meet 08 uniform licensure requirements. 09 ARTICLE II 10 Definitions 11 As used in this compact, unless the context clearly requires a different construction, 12 (1) "Adverse action" means any administrative, civil, equitable or 13 criminal action permitted by a state's laws which is imposed by a licensing board or 14 other authority against a nurse, including actions against an individual's license or 15 multistate licensure privilege such as revocation, suspension, probation, monitoring of 16 the licensee, limitation on the licensee's practice, or any other encumbrance on 17 licensure affecting a nurse's authorization to practice, including issuance of a cease 18 and desist action. 19 (2) "Alternative program" means a non-disciplinary monitoring 20 program approved by a licensing board. 21 (3) "Coordinated licensure information system" means an integrated 22 process for collecting, storing and sharing information on nurse licensure and 23 enforcement activities related to nurse licensure laws that is administered by a 24 nonprofit organization composed of and controlled by licensing boards. 25 (4) "Current significant investigative information" means: 26 (A) Investigative information that a licensing board, after a 27 preliminary inquiry that includes notification and an opportunity for the nurse 28 to respond, if required by state law, has reason to believe is not groundless and, 29 if proved true, would indicate more than a minor infraction; or 30 (B) Investigative information that indicates that the nurse 31 represents an immediate threat to public health and safety regardless of
01 whether the nurse has been notified and had an opportunity to respond. 02 (5) "Encumbrance" means a revocation or suspension of, or any 03 limitation on, the full and unrestricted practice of nursing imposed by a licensing 04 board. 05 (6) "Home state" means the party state which is the nurse's primary 06 state of residence. 07 (7) "Licensing board" means a party state's regulatory body 08 responsible for issuing nurse licenses. 09 (8) "Multistate license" means a license to practice as a registered or a 10 licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board 11 that authorizes the licensed nurse to practice in all party states under a multistate 12 licensure privilege. 13 (9) "Multistate licensure privilege" means a legal authorization 14 associated with a multistate license permitting the practice of nursing as either a 15 registered nurse (RN) or LPN/VN in a remote state. 16 (10) "Nurse" means RN or LPN/VN, as those terms are defined by 17 each party state's practice laws. 18 (11) "Party state" means any state that has adopted this Compact. 19 (12) "Remote state" means a party state, other than the home state. 20 (13) "Single-state license" means a nurse license issued by a party state 21 that authorizes practice only within the issuing state and does not include a multistate 22 licensure privilege to practice in any other party state. 23 (14) "State" means a state, territory or possession of the United States 24 and the District of Columbia. 25 (15) "State practice laws" means a party state's laws, rules and 26 regulations that govern the practice of nursing, define the scope of nursing practice, 27 and create the methods and grounds for imposing discipline. "State practice laws" do 28 not include requirements necessary to obtain and retain a license, except for 29 qualifications or requirements of the home state. 30 ARTICLE III 31 General Provisions and Jurisdiction
01 (a) A multistate license to practice registered or licensed practical/vocational 02 nursing issued by a home state to a resident in that state will be recognized by each 03 party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed 04 practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each 05 party state. 06 (b) A state must implement procedures for considering the criminal history 07 records of applicants for initial multistate license or licensure by endorsement. Such 08 procedures shall include the submission of fingerprints or other biometric-based 09 information by applicants for the purpose of obtaining an applicant's criminal history 10 record information from the Federal Bureau of Investigation and the agency 11 responsible for retaining that state's criminal records. 12 (c) Each party state shall require the following for an applicant to obtain or 13 retain a multistate license in the home state: 14 (1) Meets the home state's qualifications for licensure or renewal of 15 licensure, as well as, all other applicable state laws; 16 (2) Has graduated or is eligible to graduate from a licensing board- 17 approved RN or LPN/VN prelicensure education program; or has graduated from a 18 foreign RN or LPN/VN prelicensure education program that (a) has been approved by 19 the authorized accrediting body in the applicable country and (b) has been verified by 20 an independent credentials review agency to be comparable to a licensing board- 21 approved prelicensure education program; 22 (3) Has, if a graduate of a foreign prelicensure education program not 23 taught in English or if English is not the individual's native language, successfully 24 passed an English proficiency examination that includes the components of reading, 25 speaking, writing and listening; 26 (4) Has successfully passed an NCLEX-RN or NCLEX-PN 27 Examination or recognized predecessor, as applicable; 28 (5) Is eligible for or holds an active, unencumbered license; 29 (6) Has submitted, in connection with an application for initial 30 licensure or licensure by endorsement, fingerprints or other biometric data for the 31 purpose of obtaining criminal history record information from the Federal Bureau of
01 Investigation and the agency responsible for retaining that state's criminal records; 02 (7) Has not been convicted or found guilty, or has entered into an 03 agreed disposition, of a felony offense under applicable state or federal criminal law; 04 (8) Has not been convicted or found guilty, or has entered into an 05 agreed disposition, of a misdemeanor offense related to the practice of nursing as 06 determined on a case-by-case basis; 07 (9) Is not currently enrolled in an alternative program; 08 (10) Is subject to self-disclosure requirements regarding current 09 participation in an alternative program; and 10 (11) Has a valid United States Social Security number. 11 (d) All party states shall be authorized, in accordance with existing state due 12 process law, to take adverse action against a nurse's multistate licensure privilege such 13 as revocation, suspension, probation or any other action that affects a nurse's 14 authorization to practice under a multistate licensure privilege, including cease and 15 desist actions. If a party state takes such action, it shall promptly notify the 16 administrator of the coordinated licensure information system. The administrator of 17 the coordinated licensure information system shall promptly notify the home state of 18 any such actions by remote states. 19 (e) A nurse practicing in a party state must comply with the state practice laws 20 of the state in which the client is located at the time service is provided. The practice 21 of nursing is not limited to patient care, but shall include all nursing practice as 22 defined by the state practice laws of the party state in which the client is located. The 23 practice of nursing in a party state under a multistate licensure privilege will subject a 24 nurse to the jurisdiction of the licensing board, the courts and the laws of the party 25 state in which the client is located at the time service is provided. 26 (f) Individuals not residing in a party state shall continue to be able to apply 27 for a party state's single-state license as provided under the laws of each party state. 28 However, the single-state license granted to these individuals will not be recognized as 29 granting the privilege to practice nursing in any other party state. Nothing in this 30 Compact shall affect the requirements established by a party state for the issuance of a 31 single-state license.
01 (g) Any nurse holding a home state multistate license, on the effective date of 02 this Compact, may retain and renew the multistate license issued by the nurse's then- 03 current home state, provided that: 04 (1) A nurse, who changes primary state of residence after this 05 Compact's effective date, must meet all applicable Article III.c. requirements to obtain 06 a multistate license from a new home state. 07 (2) A nurse who fails to satisfy the multistate licensure requirements in 08 Article III.c. due to a disqualifying event occurring after this Compact's effective date 09 shall be ineligible to retain or renew a multistate license, and the nurse's multistate 10 license shall be revoked or deactivated in accordance with applicable rules adopted by 11 the Interstate Commission of Nurse Licensure Compact Administrators 12 ("Commission"). 13 ARTICLE IV 14 Applications for Licensure in a Party State 15 (a) Upon application for a multistate license, the licensing board in the issuing 16 party state shall ascertain, through the coordinated licensure information system, 17 whether the applicant has ever held, or is the holder of, a license issued by any other 18 state, whether there are any encumbrances on any license or multistate licensure 19 privilege held by the applicant, whether any adverse action has been taken against any 20 license or multistate licensure privilege held by the applicant and whether the 21 applicant is currently participating in an alternative program. 22 (b) A nurse may hold a multistate license, issued by the home state, in only 23 one party state at a time. 24 (c) If a nurse changes primary state of residence by moving between two party 25 states, the nurse must apply for licensure in the new home state, and the multistate 26 license issued by the prior home state will be deactivated in accordance with 27 applicable rules adopted by the Commission. 28 (1) The nurse may apply for licensure in advance of a change in 29 primary state of residence. 30 (2) A multistate license shall not be issued by the new home state until 31 the nurse provides satisfactory evidence of a change in primary state of residence to
01 the new home state and satisfies all applicable requirements to obtain a multistate 02 license from the new home state. 03 (d) If a nurse changes primary state of residence by moving from a party state 04 to a non-party state, the multistate license issued by the prior home state will convert 05 to a single-state license, valid only in the former home state. 06 ARTICLE V 07 Additional Authorities Invested in Party State Licensing Boards 08 (a) In addition to the other powers conferred by state law, a licensing board 09 shall have the authority to: 10 (1) Take adverse action against a nurse's multistate licensure privilege 11 to practice within that party state. 12 (A) Only the home state shall have the power to take adverse 13 action against a nurse's license issued by the home state. 14 (B) For purposes of taking adverse action, the home state 15 licensing board shall give the same priority and effect to reported conduct 16 received from a remote state as it would if such conduct had occurred within 17 the home state. In so doing, the home state shall apply its own state laws to 18 determine appropriate action. 19 (2) Issue cease and desist orders or impose an encumbrance on a 20 nurse's authority to practice within that party state. 21 (3) Complete any pending investigations of a nurse who changes 22 primary state of residence during the course of such investigations. The licensing 23 board shall also have the authority to take appropriate action(s) and shall promptly 24 report the conclusions of such investigations to the administrator of the coordinated 25 licensure information system. The administrator of the coordinated licensure 26 information system shall promptly notify the new home state of any such actions. 27 (4) Issue subpoenas for both hearings and investigations that require 28 the attendance and testimony of witnesses, as well as, the production of evidence. 29 Subpoenas issued by a licensing board in a party state for the attendance and 30 testimony of witnesses or the production of evidence from another party state shall be 31 enforced in the latter state by any court of competent jurisdiction, according to the
01 practice and procedure of that court applicable to subpoenas issued in proceedings 02 pending before it. The issuing authority shall pay any witness fees, travel expenses, 03 mileage and other fees required by the service statutes of the state in which the 04 witnesses or evidence are located. 05 (5) Obtain and submit, for each nurse licensure applicant, fingerprint 06 or other biometric-based information to the Federal Bureau of Investigation for 07 criminal background checks, receive the results of the Federal Bureau of Investigation 08 record search on criminal background checks and use the results in making licensure 09 decisions. 10 (6) If otherwise permitted by state law, recover from the affected nurse 11 the costs of investigations and disposition of cases resulting from any adverse action 12 taken against that nurse. 13 (7) Take adverse action based on the factual findings of the remote 14 state, provided that the licensing board follows its own procedures for taking such 15 adverse action. 16 (b) If adverse action is taken by the home state against a nurse's multistate 17 license, the nurse's multistate licensure privilege to practice in all other party states 18 shall be deactivated until all encumbrances have been removed from the multistate 19 license. All home state disciplinary orders that impose adverse action against a nurse's 20 multistate license shall include a statement that the nurse's multistate licensure 21 privilege is deactivated in all party states during the pendency of the order. Nothing in 22 this Compact shall override a party state's decision that participation in an alternative 23 program may be used in lieu of adverse action. The home state licensing board shall 24 deactivate the multistate licensure privilege under the multistate license of any nurse 25 for the duration of the nurse's participation in an alternative program. 26 ARTICLE VI 27 Coordinated Licensure Information System and Exchange of Information 28 (a) All party states shall participate in a coordinated licensure information 29 system of all licensed registered nurses (RNs) and licensed practical/vocational nurses 30 (LPNs/VNs). This system will include information on the licensure and disciplinary 31 history of each nurse, as submitted by party states, to assist in the coordination of
01 nurse licensure and enforcement efforts. 02 (b) The Commission, in consultation with the administrator of the coordinated 03 licensure information system, shall formulate necessary and proper procedures for the 04 identification, collection and exchange of information under this Compact. 05 (c) All licensing boards shall promptly report to the coordinated licensure 06 information system any adverse action, any current significant investigative 07 information, denials of applications (with the reasons for such denials) and nurse 08 participation in alternative programs known to the licensing board regardless of 09 whether such participation is deemed nonpublic or confidential under state law. 10 (d) Current significant investigative information and participation in nonpublic 11 or confidential alternative programs shall be transmitted through the coordinated 12 licensure information system only to party state licensing boards. 13 (e) Notwithstanding any other provision of law, all party state licensing boards 14 contributing information to the coordinated licensure information system may 15 designate information that may not be shared with non-party states or disclosed to 16 other entities or individuals without the express permission of the contributing state. 17 (f) Any personally identifiable information obtained from the coordinated 18 licensure information system by a party state licensing board shall not be shared with 19 non-party states or disclosed to other entities or individuals except to the extent 20 permitted by the laws of the party state contributing the information. 21 (g) Any information contributed to the coordinated licensure information 22 system that is subsequently required to be expunged by the laws of the party state 23 contributing that information shall also be expunged from the coordinated licensure 24 information system. 25 (h) The Compact administrator of each party state shall furnish a uniform data 26 set to the Compact administrator of each other party state, which shall include, at a 27 minimum: 28 (1) Identifying information; 29 (2) Licensure data; 30 (3) Information related to alternative program participation; and 31 (4) Other information that may facilitate the administration of this
01 Compact, as determined by Commission rules. 02 (i) The Compact administrator of a party state shall provide all investigative 03 documents and information requested by another party state. 04 ARTICLE VII 05 Establishment of the Interstate Commission of Nurse Licensure Compact Administrators 06 (a) The party states hereby create and establish a joint public entity known as 07 the Interstate Commission of Nurse Licensure Compact Administrators. 08 (1) The Commission is an instrumentality of the party states. 09 (2) Venue is proper, and judicial proceedings by or against the 10 Commission shall be brought solely and exclusively, in a court of competent 11 jurisdiction where the principal office of the Commission is located. The Commission 12 may waive venue and jurisdictional defenses to the extent it adopts or consents to 13 participate in alternative dispute resolution proceedings. 14 (3) Nothing in this Compact shall be construed to be a waiver of 15 sovereign immunity. 16 (b) Membership, Voting and Meetings 17 (1) Each party state shall have and be limited to one administrator. The 18 head of the state licensing board or designee shall be the administrator of this Compact 19 for each party state. Any administrator may be removed or suspended from office as 20 provided by the law of the state from which the Administrator is appointed. Any 21 vacancy occurring in the Commission shall be filled in accordance with the laws of the 22 party state in which the vacancy exists. 23 (2) Each administrator shall be entitled to one (1) vote with regard to 24 the promulgation of rules and creation of bylaws and shall otherwise have an 25 opportunity to participate in the business and affairs of the Commission. An 26 administrator shall vote in person or by such other means as provided in the bylaws. 27 The bylaws may provide for an administrator's participation in meetings by telephone 28 or other means of communication. 29 (3) The Commission shall meet at least once during each calendar 30 year. Additional meetings shall be held as set forth in the bylaws or rules of the 31 commission.
01 (4) All meetings shall be open to the public, and public notice of 02 meetings shall be given in the same manner as required under the rulemaking 03 provisions in Article VIII. 04 (5) The Commission may convene in a closed, nonpublic meeting if 05 the Commission must discuss: 06 (A) Noncompliance of a party state with its obligations under 07 this Compact; 08 (B) The employment, compensation, discipline or other 09 personnel matters, practices or procedures related to specific employees or 10 other matters related to the Commission's internal personnel practices and 11 procedures; 12 (C) Current, threatened or reasonably anticipated litigation; 13 (D) Negotiation of contracts for the purchase or sale of goods, 14 services or real estate; 15 (E) Accusing any person of a crime or formally censuring any 16 person; 17 (F) Disclosure of trade secrets or commercial or financial 18 information that is privileged or confidential; 19 (G) Disclosure of information of a personal nature where 20 disclosure would constitute a clearly unwarranted invasion of personal privacy; 21 (H) Disclosure of investigatory records compiled for law 22 enforcement purposes; 23 (I) Disclosure of information related to any reports prepared by 24 or on behalf of the Commission for the purpose of investigation of compliance 25 with this Compact; or 26 (J) Matters specifically exempted from disclosure by federal or 27 state statute. 28 (6) If a meeting, or portion of a meeting, is closed pursuant to this 29 provision, the Commission's legal counsel or designee shall certify that the meeting 30 may be closed and shall reference each relevant exempting provision. The 31 Commission shall keep minutes that fully and clearly describe all matters discussed in
01 a meeting and shall provide a full and accurate summary of actions taken, and the 02 reasons therefor, including a description of the views expressed. All documents 03 considered in connection with an action shall be identified in such minutes. All 04 minutes and documents of a closed meeting shall remain under seal, subject to release 05 by a majority vote of the Commission or order of a court of competent jurisdiction. 06 (c) The Commission shall, by a majority vote of the administrators, prescribe 07 bylaws or rules to govern its conduct as may be necessary or appropriate to carry out 08 the purposes and exercise the powers of this Compact, including but not limited to: 09 (1) Establishing the fiscal year of the Commission; 10 (2) Providing reasonable standards and procedures: 11 (A) For the establishment and meetings of other committees; 12 and 13 (B) Governing any general or specific delegation of any 14 authority or function of the Commission; 15 (3) Providing reasonable procedures for calling and conducting 16 meetings of the Commission, ensuring reasonable advance notice of all meetings and 17 providing an opportunity for attendance of such meetings by interested parties, with 18 enumerated exceptions designed to protect the public's interest, the privacy of 19 individuals, and proprietary information, including trade secrets. The Commission 20 may meet in closed session only after a majority of the administrators vote to close a 21 meeting in whole or in part. As soon as practicable, the Commission must make public 22 a copy of the vote to close the meeting revealing the vote of each administrator, with 23 no proxy votes allowed; 24 (4) Establishing the titles, duties and authority and reasonable 25 procedures for the election of the officers of the Commission; 26 (5) Providing reasonable standards and procedures for the 27 establishment of the personnel policies and programs of the Commission. 28 Notwithstanding any civil service or other similar laws of any party state, the bylaws 29 shall exclusively govern the personnel policies and programs of the Commission; and 30 (6) Providing a mechanism for winding up the operations of the 31 Commission and the equitable disposition of any surplus funds that may exist after the
01 termination of this Compact after the payment or reserving of all of its debts and 02 obligations; 03 (d) The Commission shall publish its bylaws and rules, and any amendments 04 thereto, in a convenient form on the website of the Commission. 05 (e) The Commission shall maintain its financial records in accordance with the 06 bylaws. 07 (f) The Commission shall meet and take such actions as are consistent with the 08 provisions of this Compact and the bylaws. 09 (g) The Commission shall have the following powers: 10 (1) To promulgate uniform rules to facilitate and coordinate 11 implementation and administration of this Compact. The rules shall have the force and 12 effect of law and shall be binding in all party states; 13 (2) To bring and prosecute legal proceedings or actions in the name of 14 the Commission, provided that the standing of any licensing board to sue or be sued 15 under applicable law shall not be affected; 16 (3) To purchase and maintain insurance and bonds; 17 (4) To borrow, accept or contract for services of personnel, including, 18 but not limited to, employees of a party state or nonprofit organizations; 19 (5) To cooperate with other organizations that administer state 20 compacts related to the regulation of nursing, including but not limited to sharing 21 administrative or staff expenses, office space or other resources; 22 (6) To hire employees, elect or appoint officers, fix compensation, 23 define duties, grant such individuals appropriate authority to carry out the purposes of 24 this Compact, and to establish the Commission's personnel policies and programs 25 relating to conflicts of interest, qualifications of personnel and other related personnel 26 matters; 27 (7) To accept any and all appropriate donations, grants and gifts of 28 money, equipment, supplies, materials and services, and to receive, utilize and dispose 29 of the same; provided that at all times the Commission shall avoid any appearance of 30 impropriety or conflict of interest; 31 (8) To lease, purchase, accept appropriate gifts or donations of, or
01 otherwise to own, hold, improve or use, any property, whether real, personal or mixed; 02 provided that at all times the Commission shall avoid any appearance of impropriety; 03 (9) To sell, convey, mortgage, pledge, lease, exchange, abandon or 04 otherwise dispose of any property, whether real, personal or mixed; 05 (10) To establish a budget and make expenditures; 06 (11) To borrow money; 07 (12) To appoint committees, including advisory committees comprised 08 of administrators, state nursing regulators, state legislators or their representatives, and 09 consumer representatives, and other such interested persons; 10 (13) To provide and receive information from, and to cooperate with, 11 law enforcement agencies; 12 (14) To adopt and use an official seal; and 13 (15) To perform such other functions as may be necessary or 14 appropriate to achieve the purposes of this Compact consistent with the state 15 regulation of nurse licensure and practice. 16 (h) Financing of the Commission 17 (1) The Commission shall pay, or provide for the payment of, the 18 reasonable expenses of its establishment, organization and ongoing activities. 19 (2) The Commission may also levy on and collect an annual 20 assessment from each party state to cover the cost of its operations, activities and staff 21 in its annual budget as approved each year. The aggregate annual assessment amount, 22 if any, shall be allocated based upon a formula to be determined by the Commission, 23 which shall promulgate a rule that is binding upon all party states. 24 (3) The Commission shall not incur obligations of any kind prior to 25 securing the funds adequate to meet the same; nor shall the Commission pledge the 26 credit of any of the party states, except by, and with the authority of, such party state. 27 (4) The Commission shall keep accurate accounts of all receipts and 28 disbursements. The receipts and disbursements of the Commission shall be subject to 29 the audit and accounting procedures established under its bylaws. However, all 30 receipts and disbursements of funds handled by the Commission shall be audited 31 yearly by a certified or licensed public accountant, and the report of the audit shall be
01 included in and become part of the annual report of the Commission. 02 (i) Qualified Immunity, Defense and Indemnification 03 (1) The administrators, officers, executive director, employees and 04 representatives of the Commission shall be immune from suit and liability, either 05 personally or in their official capacity, for any claim for damage to or loss of property 06 or personal injury or other civil liability caused by or arising out of any actual or 07 alleged act, error or omission that occurred, or that the person against whom the claim 08 is made had a reasonable basis for believing occurred, within the scope of 09 Commission employment, duties or responsibilities; provided that nothing in this 10 paragraph shall be construed to protect any such person from suit or liability for any 11 damage, loss, injury or liability caused by the intentional, willful or wanton 12 misconduct of that person. 13 (2) The Commission shall defend any administrator, officer, executive 14 director, employee or representative of the Commission in any civil action seeking to 15 impose liability arising out of any actual or alleged act, error or omission that occurred 16 within the scope of Commission employment, duties or responsibilities, or that the 17 person against whom the claim is made had a reasonable basis for believing occurred 18 within the scope of Commission employment, duties or responsibilities; provided that 19 nothing herein shall be construed to prohibit that person from retaining his or her own 20 counsel; and provided further that the actual or alleged act, error or omission did not 21 result from that person's intentional, willful or wanton misconduct. 22 (3) The Commission shall indemnify and hold harmless any 23 administrator, officer, executive director, employee or representative of the 24 Commission for the amount of any settlement or judgment obtained against that 25 person arising out of any actual or alleged act, error or omission that occurred within 26 the scope of Commission employment, duties or responsibilities, or that such person 27 had a reasonable basis for believing occurred within the scope of Commission 28 employment, duties or responsibilities, provided that the actual or alleged act, error or 29 omission did not result from the intentional, willful or wanton misconduct of that 30 person. 31 ARTICLE VIII
01 Rulemaking 02 (a) The Commission shall exercise its rulemaking powers pursuant to the 03 criteria set forth in this Article and the rules adopted thereunder. Rules and 04 amendments shall become binding as of the date specified in each rule or amendment 05 and shall have the same force and effect as provisions of this Compact. 06 (b) Rules or amendments to the rules shall be adopted at a regular or special 07 meeting of the Commission. 08 (c) Prior to promulgation and adoption of a final rule or rules by the 09 Commission, and at least sixty (60) days in advance of the meeting at which the rule 10 will be considered and voted upon, the Commission shall file a notice of proposed 11 rulemaking: 12 (1) On the website of the Commission; and 13 (2) On the website of each licensing board or the publication in which 14 each state would otherwise publish proposed rules. 15 (d) The notice of proposed rulemaking shall include: 16 (1) The proposed time, date and location of the meeting in which the 17 rule will be considered and voted upon; 18 (2) The text of the proposed rule or amendment, and the reason for the 19 proposed rule; 20 (3) A request for comments on the proposed rule from any interested 21 person; and 22 (4) The manner in which interested persons may submit notice to the 23 Commission of their intention to attend the public hearing and any written comments. 24 (e) Prior to adoption of a proposed rule, the Commission shall allow persons 25 to submit written data, facts, opinions and arguments, which shall be made available to 26 the public. 27 (f) The Commission shall grant an opportunity for a public hearing before it 28 adopts a rule or amendment. 29 (g) The Commission shall publish the place, time and date of the scheduled 30 public hearing. 31 (1) Hearings shall be conducted in a manner providing each person
01 who wishes to comment a fair and reasonable opportunity to comment orally or in 02 writing. All hearings will be recorded, and a copy will be made available upon request. 03 (2) Nothing in this section shall be construed as requiring a separate 04 hearing on each rule. Rules may be grouped for the convenience of the Commission at 05 hearings required by this section. 06 (h) If no one appears at the public hearing, the Commission may proceed with 07 promulgation of the proposed rule. 08 (i) Following the scheduled hearing date, or by the close of business on the 09 scheduled hearing date if the hearing was not held, the Commission shall consider all 10 written and oral comments received. 11 (j) The Commission shall, by majority vote of all administrators, take final 12 action on the proposed rule and shall determine the effective date of the rule, if any, 13 based on the rulemaking record and the full text of the rule. 14 (k) Upon determination that an emergency exists, the Commission may 15 consider and adopt an emergency rule without prior notice, opportunity for comment 16 or hearing, provided that the usual rulemaking procedures provided in this Compact 17 and in this section shall be retroactively applied to the rule as soon as reasonably 18 possible, in no event later than ninety (90) days after the effective date of the rule. For 19 the purposes of this provision, an emergency rule is one that must be adopted 20 immediately in order to: 21 (1) Meet an imminent threat to public health, safety or welfare; 22 (2) Prevent a loss of Commission or party state funds; or 23 (3) Meet a deadline for the promulgation of an administrative rule that 24 is required by federal law or rule. 25 (l) The Commission may direct revisions to a previously adopted rule or 26 amendment for purposes of correcting typographical errors, errors in format, errors in 27 consistency or grammatical errors. Public notice of any revisions shall be posted on 28 the website of the Commission. The revision shall be subject to challenge by any 29 person for a period of thirty (30) days after posting. The revision may be challenged 30 only on grounds that the revision results in a material change to a rule. A challenge 31 shall be made in writing, and delivered to the Commission, prior to the end of the
01 notice period. If no challenge is made, the revision will take effect without further 02 action. If the revision is challenged, the revision may not take effect without the 03 approval of the Commission. 04 ARTICLE IX 05 Oversight, Dispute Resolution and Enforcement 06 (a) Oversight 07 (1) Each party state shall enforce this Compact and take all actions 08 necessary and appropriate to effectuate this Compact's purposes and intent. 09 (2) The Commission shall be entitled to receive service of process in 10 any proceeding that may affect the powers, responsibilities or actions of the 11 Commission, and shall have standing to intervene in such a proceeding for all 12 purposes. Failure to provide service of process in such proceeding to the Commission 13 shall render a judgment or order void as to the Commission, this Compact or 14 promulgated rules. 15 (b) Default, Technical Assistance and Termination 16 (1) If the Commission determines that a party state has defaulted in the 17 performance of its obligations or responsibilities under this Compact or the 18 promulgated rules, the Commission shall: 19 (A) Provide written notice to the defaulting state and other 20 party states of the nature of the default, the proposed means of curing the 21 default or any other action to be taken by the Commission; and 22 (B) Provide remedial training and specific technical assistance 23 regarding the default. 24 (2) If a state in default fails to cure the default, the defaulting state's 25 membership in this Compact may be terminated upon an affirmative vote of a majority 26 of the administrators, and all rights, privileges and benefits conferred by this Compact 27 may be terminated on the effective date of termination. A cure of the default does not 28 relieve the offending state of obligations or liabilities incurred during the period of 29 default. 30 (3) Termination of membership in this Compact shall be imposed only 31 after all other means of securing compliance have been exhausted. Notice of intent to
01 suspend or terminate shall be given by the Commission to the governor of the 02 defaulting state and to the executive officer of the defaulting state's licensing board 03 and each of the party states. 04 (4) A state whose membership in this Compact has been terminated is 05 responsible for all assessments, obligations and liabilities incurred through the 06 effective date of termination, including obligations that extend beyond the effective 07 date of termination. 08 (5) The Commission shall not bear any costs related to a state that is 09 found to be in default or whose membership in this Compact has been terminated 10 unless agreed upon in writing between the Commission and the defaulting state. 11 (6) The defaulting state may appeal the action of the Commission by 12 petitioning the U.S. District Court for the District of Columbia or the federal district in 13 which the Commission has its principal offices. The prevailing party shall be awarded 14 all costs of such litigation, including reasonable attorneys' fees. 15 (c) Dispute Resolution 16 (1) Upon request by a party state, the Commission shall attempt to 17 resolve disputes related to the Compact that arise among party states and between 18 party and non-party states. 19 (2) The Commission shall promulgate a rule providing for both 20 mediation and binding dispute resolution for disputes, as appropriate. 21 (3) In the event the Commission cannot resolve disputes among party 22 states arising under this Compact: 23 (A) The party states may submit the issues in dispute to an 24 arbitration panel, which will be comprised of individuals appointed by the 25 Compact administrator in each of the affected party states and an individual 26 mutually agreed upon by the Compact administrators of all the party states 27 involved in the dispute. 28 (B) The decision of a majority of the arbitrators shall be final 29 and binding. 30 (d) Enforcement 31 (1) The Commission, in the reasonable exercise of its discretion, shall
01 enforce the provisions and rules of this Compact. 02 (2) By majority vote, the Commission may initiate legal action in the 03 U.S. District Court for the District of Columbia or the federal district in which the 04 Commission has its principal offices against a party state that is in default to enforce 05 compliance with the provisions of this Compact and its promulgated rules and bylaws. 06 The relief sought may include both injunctive relief and damages. In the event judicial 07 enforcement is necessary, the prevailing party shall be awarded all costs of such 08 litigation, including reasonable attorneys' fees. 09 (3) The remedies herein shall not be the exclusive remedies of the 10 Commission. The Commission may pursue any other remedies available under federal 11 or state law. 12 ARTICLE X 13 Effective Date, Withdrawal and Amendment 14 (a) This Compact shall become effective and binding on the earlier of the date 15 of legislative enactment of this Compact into law by no less than twenty-six (26) states 16 or December 31, 2018. All party states to this Compact, that also were parties to the 17 prior Nurse Licensure Compact, superseded by this Compact, ("Prior Compact"), shall 18 be deemed to have withdrawn from said Prior Compact within six (6) months after the 19 effective date of this Compact. 20 (b) Each party state to this Compact shall continue to recognize a nurse's 21 multistate licensure privilege to practice in that party state issued under the Prior 22 Compact until such party state has withdrawn from the Prior Compact. 23 (c) Any party state may withdraw from this Compact by enacting a statute 24 repealing the same. A party state's withdrawal shall not take effect until six (6) months 25 after enactment of the repealing statute. 26 (d) A party state's withdrawal or termination shall not affect the continuing 27 requirement of the withdrawing or terminated state's licensing board to report adverse 28 actions and significant investigations occurring prior to the effective date of such 29 withdrawal or termination. 30 (e) Nothing contained in this Compact shall be construed to invalidate or 31 prevent any nurse licensure agreement or other cooperative arrangement between a
01 party state and a non-party state that is made in accordance with the other provisions 02 of this Compact. 03 (f) This Compact may be amended by the party states. No amendment to this 04 Compact shall become effective and binding upon the party states unless and until it is 05 enacted into the laws of all party states. 06 (g) Representatives of non-party states to this Compact shall be invited to 07 participate in the activities of the Commission, on a nonvoting basis, prior to the 08 adoption of this Compact by all states. 09 ARTICLE XI 10 Construction and Severability 11 This Compact shall be liberally construed so as to effectuate the purposes 12 thereof. The provisions of this Compact shall be severable, and if any phrase, clause, 13 sentence or provision of this Compact is declared to be contrary to the constitution of 14 any party state or of the United States, or if the applicability thereof to any 15 government, agency, person or circumstance is held invalid, the validity of the 16 remainder of this Compact and the applicability thereof to any government, agency, 17 person or circumstance shall not be affected thereby. If this Compact shall be held to 18 be contrary to the constitution of any party state, this Compact shall remain in full 19 force and effect as to the remaining party states and in full force and effect as to the 20 party state affected as to all severable matters. 21 * Sec. 24. AS 09.55.560(2) is amended to read: 22 (2) "health care provider" means an acupuncturist licensed under 23 AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 24 chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a 25 dentist licensed under AS 08.36; a nurse licensed under AS 08.68 or AS 08.69; a 26 dispensing optician licensed under AS 08.71; a naturopath licensed under AS 08.45; 27 an optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 28 physical therapist or occupational therapist licensed under AS 08.84; a physician or 29 physician assistant licensed under AS 08.64; a podiatrist; a psychologist and a 30 psychological associate licensed under AS 08.86; a hospital as defined in 31 AS 47.32.900, including a governmentally owned or operated hospital; an employee
01 of a health care provider acting within the course and scope of employment; an 02 ambulatory surgical facility and other organizations whose primary purpose is the 03 delivery of health care, including a health maintenance organization, individual 04 practice association, integrated delivery system, preferred provider organization or 05 arrangement, and a physical hospital organization; 06 * Sec. 25. AS 09.65.095(c)(1) is amended to read: 07 (1) "health care provider" means a nurse licensed under AS 08.68 or 08 AS 08.69, a physician licensed under AS 08.64, and a person certified by a hospital as 09 competent to take blood samples; 10 * Sec. 26. AS 12.62.400(a) is amended to read: 11 (a) To obtain a national criminal history record check for determining a 12 person's qualifications for a license, permit, registration, employment, or position, a 13 person shall submit the person's fingerprints to the department with the fee established 14 by AS 12.62.160. The department may submit the fingerprints to the Federal Bureau 15 of Investigation to obtain a national criminal history record check of the person for the 16 purpose of evaluating a person's qualifications for 17 (1) a license or conditional contractor's permit to manufacture, sell, 18 offer for sale, possess for sale or barter, traffic in, or barter an alcoholic beverage 19 under AS 04.11; 20 (2) licensure as a mortgage lender, a mortgage broker, or a mortgage 21 loan originator under AS 06.60; 22 (3) admission to the Alaska Bar Association under AS 08.08; 23 (4) licensure as a collection agency operator under AS 08.24; 24 (5) a certificate of fitness to handle explosives under AS 08.52; 25 (6) licensure as a massage therapist under AS 08.61; 26 (7) licensure to practice nursing under AS 08.68 or AS 08.69, or 27 certification as a nurse aide under AS 08.68; 28 (8) certification as a real estate appraiser under as 08.87; 29 (9) a position involving supervisory or disciplinary power over a minor 30 or dependent adult for which criminal justice information may be released under 31 AS 12.62.160(b)(9);
01 (10) a teacher certificate under AS 14.20; 02 (11) a registration or license to operate a marijuana establishment 03 under AS 17.38; 04 (12) admittance to a police training program under AS 18.65.230 or for 05 certification as a police officer under AS 18.65.240 if that person's prospective 06 employer does not have access to a criminal justice information system; 07 (13) licensure as a security guard under AS 18.65.400 — 18.65.490; 08 (14) a concealed handgun permit under AS 18.65.700 — 18.65.790; 09 (15) licensure as an insurance producer, managing general agent, 10 reinsurance intermediary broker, reinsurance intermediary manager, surplus lines 11 broker, or independent adjuster under AS 21.27; 12 (16) serving and executing process issued by a court by a person 13 designated under AS 22.20.130; 14 (17) a school bus driver license under AS 28.15.046; 15 (18) licensure as an operator or an instructor for a commercial driver 16 training school under AS 28.17; 17 (19) registration as a broker-dealer, agent, investment adviser 18 representative, or investment adviser under AS 45.56.300 — 45.56.350; 19 (20) licensure, license renewal, certification, certification renewal, or 20 payment from the Department of Health and Social Services of an individual and an 21 entity subject to the requirements for a criminal history check under AS 47.05.310, 22 including 23 (A) a public home care provider described in AS 47.05.017; 24 (B) a provider of home and community-based waiver services 25 financed under AS 47.07.030(c); 26 (C) a case manager to coordinate community mental health 27 services under AS 47.30.530; 28 (D) an entity listed in AS 47.32.010(b), including an owner, 29 officer, director, member, partner, employee, volunteer, or contractor of an 30 entity; or 31 (E) an individual or entity not described in (A) — (D) of this
01 paragraph that is required by statute or regulation to be licensed or certified by 02 the Department of Health and Social Services or that is eligible to receive 03 payments, in whole or in part, from the Department of Health and Social 04 Services to provide for the health, safety, and welfare of persons who are 05 served by the programs administered by the Department of Health and Social 06 Services. 07 * Sec. 27. AS 18.20.095(e)(2) is amended to read: 08 (2) "licensed staff member" means a person who is employed by the 09 hospital to provide direct patient care and who is licensed or certified in the state as a 10 physician or physician assistant under AS 08.64, direct-entry midwife under AS 08.65, 11 nurse under AS 08.68 or AS 08.69, or nurse aide under AS 08.68, or physical 12 therapist or occupational therapist under AS 08.84; 13 * Sec. 28. AS 18.20.499(3) is amended to read: 14 (3) "nurse" means an individual licensed to practice registered nursing 15 or practical nursing under AS 08.68 or AS 08.69 who provides nursing services 16 through direct patient care or clinical services and includes a nurse manager when 17 delivering in-hospital patient care; 18 * Sec. 29. AS 18.23.070(3) is amended to read: 19 (3) "health care provider" means an acupuncturist licensed under 20 AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist licensed under 21 AS 08.32; a dentist licensed under AS 08.36; a nurse licensed under AS 08.68 or 22 AS 08.69; a dispensing optician licensed under AS 08.71; an optometrist licensed 23 under AS 08.72; a pharmacist licensed under AS 08.80; a physical therapist or 24 occupational therapist licensed under AS 08.84; a physician licensed under AS 08.64; 25 a podiatrist; a psychologist and a psychological associate licensed under AS 08.86; a 26 hospital as defined in AS 47.32.900, including a governmentally owned or operated 27 hospital; and an employee of a health care provider acting within the course and scope 28 of employment; 29 * Sec. 30. AS 47.07.045(b) is amended to read: 30 (b) Before the department may terminate payment for services provided under 31 (a) of this section
01 (1) the recipient must have had an annual assessment to determine 02 whether the recipient continues to meet the standards under (a) of this section; 03 (2) the annual assessment must have been reviewed by an independent 04 qualified health care professional under contract with the department; for purposes of 05 this paragraph, "independent qualified health care professional" means, 06 (A) for a waiver based on intellectual or developmental 07 disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 08 intellectual disability professional; 09 (B) for other allowable waivers, a registered nurse licensed 10 under AS 08.68 or AS 08.69, or advanced practice registered nurse licensed 11 under AS 08.68 who is qualified to assess children with complex medical 12 conditions, older Alaskans, and adults with physical disabilities for medical 13 assistance waivers; and 14 (3) the annual assessment must find that the recipient's condition has 15 materially improved since the previous assessment; for purposes of this paragraph, 16 "materially improved" means that a recipient who has previously qualified for a 17 waiver for 18 (A) a child with complex medical conditions, no longer needs 19 technical assistance for a life-threatening condition, and is expected to be 20 placed in a skilled nursing facility for less than 30 days each year; 21 (B) intellectual or developmental disability, no longer needs the 22 level of care provided by an intermediate care facility for persons with 23 intellectual and developmental disabilities either because the qualifying 24 diagnosis has changed or the recipient is able to demonstrate the ability to 25 function in a home setting without the need for waiver services; or 26 (C) an older Alaskan or adult with a physical disability, no 27 longer has a functional limitation or cognitive impairment that would result in 28 the need for nursing home placement, and is able to demonstrate the ability to 29 function in a home setting without the need for waiver services. 30 * Sec. 31. AS 47.33.020(d) is amended to read: 31 (d) An assisted living home may provide intermittent nursing services to a
01 resident who does not require 24-hour nursing services and supervision. Intermittent 02 nursing services may be provided only by a nurse licensed under AS 08.68 or 03 AS 08.69, or by a person to whom a nursing task has been delegated under (e) of this 04 section. 05 * Sec. 32. AS 47.33.020(e) is amended to read: 06 (e) A person who is on the staff of an assisted living home and who is not a 07 nurse licensed under AS 08.68 or AS 08.69 may perform a nursing task in that home 08 if 09 (1) the authority to perform that nursing task is delegated to that person 10 by a nurse licensed under AS 08.68 or AS 08.69; and 11 (2) that nursing task is specified in regulations adopted by the Board of 12 Nursing as a task that may be delegated. 13 * Sec. 33. AS 47.33.020(f) is amended to read: 14 (f) A resident who needs skilled nursing care may, with the consent of the 15 assisted living home, arrange for that care to be provided in the home by a nurse 16 licensed under AS 08.68 or AS 08.69 if that arrangement does not interfere with the 17 services provided to other residents. 18 * Sec. 34. AS 47.33.020(g) is amended to read: 19 (g) As part of a plan to avoid transfer of a resident from the home for medical 20 reasons, the home may provide, through the services of a nurse who is licensed under 21 AS 08.68 or AS 08.69, 24-hour skilled nursing care to the resident for not more than 22 45 consecutive days. 23 * Sec. 35. AS 47.33.020(h) is amended to read: 24 (h) If a resident has received 24-hour skilled nursing care for the 45-day limit 25 set by (g) of this section, the resident or the resident's representative may elect to have 26 the resident remain in the home without continuation of 24-hour skilled nursing care if 27 the home agrees to retain the resident after 28 (1) the home and either the resident or the resident's representative 29 have consulted with the resident's physician; 30 (2) the home and either the resident or the resident's representative 31 have discussed the consequences and risks involved in the election to remain in the
01 home; and 02 (3) the portion of the resident's assisted living plan that relates to 03 health-related services has been revised to provide for the resident's health-related 04 needs without the use of 24-hour skilled nursing care, and the revised plan has been 05 reviewed by a registered nurse licensed under AS 08.68 or AS 08.69, or advanced 06 practice registered nurse licensed under AS 08.68, or by the resident's attending 07 physician. 08 * Sec. 36. AS 47.33.230(c) is amended to read: 09 (c) If the assisted living home provides or arranges for the provision of health- 10 related services to a resident, the home shall ensure that a 11 (1) registered nurse licensed under AS 08.68 or AS 08.69, or 12 advanced practice registered nurse licensed under AS 08.68 reviews the portion of an 13 assisted living plan that describes how the resident's need for health-related services 14 will be met; and 15 (2) physician's statement about the resident is included in the plan. 16 * Sec. 37. The uncodified law of the State of Alaska is amended by adding a new section to 17 read: 18 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 19 Economic Development may adopt regulations necessary to implement the changes made by 20 this Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 21 before the effective date of the law implemented by the regulation. 22 * Sec. 38. Section 37 of this Act takes effect immediately under AS 01.10.070(c). 23 * Sec. 39. Except as provided in sec. 38 of this Act, this Act takes effect January 1, 2022.