CSHB 149(L&C): "An Act relating to the licensure of nursing professionals; relating to a multistate nurse licensure compact; and providing for an effective date."
00 CS FOR HOUSE BILL NO. 149(L&C) 01 "An Act relating to the licensure of nursing professionals; relating to a multistate nurse 02 licensure compact; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 08.01.065(c) is amended to read: 05 (c) Except as provided in (f) - (l) [(f) - (k)] of this section, the department shall 06 establish fee levels under (a) of this section so that the total amount of fees collected 07 for an occupation approximately equals the actual regulatory costs for the occupation. 08 The department shall annually review each fee level to determine whether the 09 regulatory costs of each occupation are approximately equal to fee collections related 10 to that occupation. If the review indicates that an occupation's fee collections and 11 regulatory costs are not approximately equal, the department shall calculate fee 12 adjustments and adopt regulations under (a) of this section to implement the 13 adjustments. In January of each year, the department shall report on all fee levels and 14 revisions for the previous year under this subsection to the office of management and
01 budget. If a board regulates an occupation covered by this chapter, the department 02 shall consider the board's recommendations concerning the occupation's fee levels and 03 regulatory costs before revising fee schedules to comply with this subsection. In this 04 subsection, "regulatory costs" means costs of the department that are attributable to 05 regulation of an occupation plus 06 (1) all expenses of the board that regulates the occupation if the board 07 regulates only one occupation; 08 (2) the expenses of a board that are attributable to the occupation if the 09 board regulates more than one occupation. 10 * Sec. 2. AS 08.01.065 is amended by adding a new subsection to read: 11 (l) Notwithstanding (c) of this section, the department shall establish fee levels 12 under (a) of this section so that the total amount of fees collected by the department 13 for individuals issued a 14 (1) single-state license to practice nursing approximately equals the 15 total regulatory costs to the department and the Board of Nursing for the practice of 16 nursing in the state under that license type; in this paragraph, "single-state license" has 17 the meaning given in AS 08.68.850; and 18 (2) multistate license to practice nursing or practicing under a 19 multistate licensure privilege approximately equals the total regulatory costs to the 20 department and the Board of Nursing for the practice of nursing under that license 21 type or privilege. 22 * Sec. 3. AS 08.02.110(a) is amended to read: 23 (a) An acupuncturist licensed under AS 08.06, an audiologist or speech- 24 language pathologist licensed under AS 08.11, a behavior analyst licensed under 25 AS 08.15, a person licensed in the state as a chiropractor under AS 08.20, a 26 professional counselor licensed under AS 08.29, a dentist under AS 08.36, a dietitian 27 or nutritionist licensed under AS 08.38, a massage therapist licensed under AS 08.61, 28 a marital and family therapist licensed under AS 08.63, a medical practitioner or 29 osteopath under AS 08.64, a direct-entry midwife certified under AS 08.65, a 30 registered nurse licensed or holding a multistate licensure privilege under 31 AS 08.68 or advanced practice registered nurse licensed under AS 08.68, an
01 optometrist under AS 08.72, a licensed pharmacist under AS 08.80, a physical 02 therapist or occupational therapist licensed under AS 08.84, a psychologist under 03 AS 08.86, or a clinical social worker licensed under AS 08.95, shall use as 04 professional identification appropriate letters or a title after that person's name that 05 represents the person's specific field of practice. The letters or title shall appear on all 06 signs, stationery, or other advertising in which the person offers or displays personal 07 professional services to the public. In addition, a person engaged in the practice of 08 medicine or osteopathy as defined in AS 08.64.380, or a person engaged in any 09 manner in the healing arts who diagnoses, treats, tests, or counsels other persons in 10 relation to human health or disease and uses the letters "M.D." or the title "doctor" or 11 "physician" or another title that tends to show that the person is willing or qualified to 12 diagnose, treat, test, or counsel another person, shall clarify the letters or title by 13 adding the appropriate specialist designation, if any, such as "dermatologist," 14 "radiologist," "audiologist," "naturopath," or the like. 15 * Sec. 4. AS 08.02.130(j)(1) is amended to read: 16 (1) "health care provider" means 17 (A) an audiologist or speech-language pathologist licensed 18 under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 19 licensed under AS 08.20; a professional counselor licensed under AS 08.29; a 20 dental hygienist licensed under AS 08.32; a dentist licensed under AS 08.36; a 21 dietitian or nutritionist licensed under AS 08.38; a naturopath licensed under 22 AS 08.45; a marital and family therapist licensed under AS 08.63; a physician 23 licensed under AS 08.64; a podiatrist, osteopath, or physician assistant licensed 24 under AS 08.64; a direct-entry midwife certified under AS 08.65; a nurse 25 licensed or holding a multistate licensure privilege under AS 08.68; a 26 dispensing optician licensed under AS 08.71; an optometrist licensed under 27 AS 08.72; a pharmacist licensed under AS 08.80; a physical therapist or 28 occupational therapist licensed under AS 08.84; a psychologist or 29 psychological associate licensed under AS 08.86; or a social worker licensed 30 under AS 08.95; or 31 (B) a physician licensed in another state;
01 * Sec. 5. AS 08.11.120(b) is amended to read: 02 (b) Notwithstanding the provisions of this chapter, 03 (1) a nurse licensed or holding a multistate licensure privilege under 04 AS 08.68 may perform hearing sensitivity evaluations; 05 (2) an individual licensed as a hearing aid dealer under AS 08.55 may 06 deal in hearing aids; 07 (3) an individual holding a class A certificate issued by the Conference 08 of Executives of American Schools of the Deaf may teach the hearing impaired; 09 (4) an individual may engage in the testing of hearing as part of a 10 hearing conservation program that complies with the regulations of the Occupational 11 Safety and Health Administration of the federal government if the individual is 12 certified to do the testing by a state or federal agency acceptable to the Occupational 13 Safety and Health Administration; 14 (5) an individual may perform hearing screening under AS 47.20.310 15 if authorized to do so under a protocol adopted under AS 47.20.310(e) by the 16 Department of Health. 17 * Sec. 6. AS 08.68.100 is amended to read: 18 Sec. 08.68.100. Duties and powers of board. (a) The board shall 19 (1) adopt regulations necessary to implement this chapter, including 20 regulations 21 (A) pertaining to practice as an advanced practice registered 22 nurse, including requirements for an advanced practice registered nurse to 23 practice as a certified registered nurse anesthetist, certified clinical nurse 24 specialist, certified nurse practitioner, or certified nurse midwife; regulations 25 for an advanced practice registered nurse who holds a valid federal Drug 26 Enforcement Administration registration number must address training in pain 27 management and opioid use and addiction; 28 (B) necessary to implement AS 08.68.331 - 08.68.336 relating 29 to certified nurse aides in order to protect the health, safety, and welfare of 30 clients served by nurse aides; 31 (C) pertaining to retired nurse status;
01 (D) establishing criteria for approval of practical nurse 02 education programs that are not accredited by a national nursing accrediting 03 body; [AND] 04 (E) establishing guidelines for rendering a diagnosis, providing 05 treatment, or prescribing, dispensing, or administering a prescription drug to a 06 person without conducting a physical examination under AS 08.68.710; the 07 guidelines must include a nationally recognized model policy for standards of 08 care of a patient who is at a different location than the advanced practice 09 registered nurse; and 10 (F) necessary to implement the Multistate Nurse Licensure 11 Compact under AS 08.68.500; 12 (2) approve curricula and adopt standards for basic education programs 13 that prepare persons for licensing under this chapter [AS 08.68.190]; 14 (3) provide for surveys of the basic nursing education programs in the 15 state at the times it considers necessary; 16 (4) approve education programs that meet the requirements of this 17 chapter and of the board, and deny, revoke, or suspend approval of education 18 programs for failure to meet the requirements; 19 (5) examine, license, and renew the licenses of [QUALIFIED] 20 applicants; 21 (6) prescribe requirements for competence before a former registered, 22 advanced practice registered, or [LICENSED] practical nurse licensed under this 23 chapter may resume the practice of nursing [UNDER THIS CHAPTER]; 24 (7) define by regulation the qualifications and duties of the executive 25 administrator and delegate authority to the executive administrator that is necessary to 26 conduct board business; 27 (8) develop reasonable and uniform standards for nursing practice; 28 (9) publish advisory opinions regarding whether nursing practice 29 procedures or policies comply with acceptable standards of nursing practice as defined 30 under this chapter; 31 (10) require applicants under this chapter to submit fingerprints and the
01 fees required by the Department of Public Safety under AS 12.62.160 for criminal 02 justice information and a national criminal history record check; the department shall 03 submit the fingerprints and fees to the Department of Public Safety for a report of 04 criminal justice information under AS 12.62 and a national criminal history record 05 check under AS 12.62.400; 06 (11) require that a licensed advanced practice registered nurse who has 07 a federal Drug Enforcement Administration registration number register with the 08 controlled substance prescription database under AS 17.30.200(n); 09 (12) appoint the executive administrator of the board to serve as 10 the state administrator of the Interstate Commission Nurse Licensure Compact 11 Administrators under AS 08.68.500; 12 (13) submit a report to the legislature if the board determines that 13 the requirements for a multistate license or multistate licensure privilege under 14 the Multistate Nurse Licensure Compact do not meet or exceed the requirements 15 for a license to practice registered nursing or practical nursing in this state under 16 AS 08.68.170(a) or (b); the board shall submit the report to the senate secretary 17 and the chief clerk of the house of representatives and notify the legislature that 18 the report is available within 30 days after making the determination. 19 (b) The board may 20 (1) conduct hearings upon charges of alleged violations of this chapter 21 or regulations adopted under it; 22 (2) invoke, or request the department to invoke, disciplinary action 23 against a license issued under this chapter or a person holding a multistate 24 licensure privilege [LICENSEE]; 25 (3) prescribe requirements for competence to continue practice. 26 * Sec. 7. AS 08.68.140 is amended to read: 27 Sec. 08.68.140. Applicability of Administrative Procedure Act. Except as 28 specified in AS 08.68.333(f) and 08.68.500, the board shall comply with AS 44.62 29 (Administrative Procedure Act). 30 * Sec. 8. AS 08.68.160 is amended to read: 31 Sec. 08.68.160. License required. A person practicing or offering to practice
01 as a registered [, ADVANCED PRACTICE REGISTERED,] or practical nurse 02 [NURSING] in the state shall submit evidence of qualification to practice and shall be 03 licensed or hold a multistate licensure privilege under this chapter. A person 04 practicing or offering to practice as an advanced practice registered nurse in the 05 state shall submit evidence of qualification to practice and shall be licensed under 06 this chapter. 07 * Sec. 9. AS 08.68.170 is amended to read: 08 Sec. 08.68.170. Qualifications of registered or practical nurse applicants. 09 (a) An applicant for a license to practice registered nursing shall submit to the board, 10 on forms and in the manner prescribed by the board, written evidence, verified by 11 oath, that the applicant has successfully completed a registered nurse education 12 program accredited by a national nursing accrediting body and approved by the board. 13 An applicant for a multistate license to practice registered nursing shall, in 14 addition to the requirements of this chapter, meet the requirements of 15 AS 08.68.500. 16 (b) An applicant for a license to practice practical nursing may obtain a 17 license to practice in this state under this chapter or a multistate license that 18 meets the requirements of this chapter and AS 08.68.500. An applicant for a 19 license to practice practical nursing under this chapter shall submit to the board, 20 on forms and in the manner prescribed by the board, written evidence, verified by 21 oath, that the applicant has successfully 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 in the state under a multistate licensure privilege; 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. 10. AS 08.68.190 is amended by adding a new subsection to read: 08 (c) If an applicant meets the qualifications set out in AS 08.68.170 and 09 08.68.500 for the license for which the applicant applied, the board shall issue a 10 multistate license to practice registered or practical nursing to an applicant who passes 11 the licensing examination to practice registered or practical nursing. 12 * Sec. 11. AS 08.68.220 is amended to read: 13 Sec. 08.68.220. Fees. The Department of Commerce, Community, and 14 Economic Development shall set fees under AS 08.01.065 for each of the following: 15 (1) registered nursing single-state license: 16 (A) application; 17 (B) license by examination; 18 (C) license by endorsement; 19 (D) license renewal; 20 (E) temporary permit; 21 (2) practical nursing single-state license: 22 (A) application; 23 (B) license by examination; 24 (C) license by endorsement; 25 (D) license renewal; 26 (E) temporary permit; 27 (3) advanced practice registered nursing: 28 (A) application; 29 (B) license by certification examination; 30 (C) license by endorsement; 31 (D) license renewal;
01 (E) temporary permit; 02 (4) registered nursing multistate license: 03 (A) application; 04 (B) license; 05 (C) license renewal; 06 (5) practical nursing multistate license: 07 (A) application; 08 (B) license; 09 (C) license renewal. 10 * Sec. 12. AS 08.68.230(a) is amended to read: 11 (a) A person who holds a license or multistate licensure privilege 12 [LICENSED] to practice registered nursing in the state may use the title "registered 13 nurse" and the abbreviation "R.N."[.] 14 * Sec. 13. AS 08.68.230(b) is amended to read: 15 (b) A person who holds a license or multistate licensure privilege 16 [LICENSED] to practice practical nursing in the state may use the title "licensed 17 practical nurse" and the abbreviation "L.P.N." 18 * Sec. 14. AS 08.68.251(a) is amended to read: 19 (a) A lapsed license issued by the board under this chapter may be 20 reinstated if it has not remained lapsed for more than five years by payment of the 21 license fees for the current renewal period and the penalty fee. The board, by 22 regulation, shall establish continuing competency and criminal background check 23 requirements for reinstatement of a lapsed license. 24 * Sec. 15. AS 08.68.275(c) is amended to read: 25 (c) The board may summarily suspend a license issued by the board under 26 this chapter before final hearing or during the appeals process if the board finds that 27 the licensee poses a clear and immediate danger to the public health and safety. A 28 person whose license is suspended under this section is entitled to a hearing conducted 29 by the office of administrative hearings (AS 44.64.010) within seven days after the 30 effective date of the order. If, after a hearing, the board upholds the suspension, the 31 licensee may appeal the suspension to a court of competent jurisdiction.
01 * Sec. 16. AS 08.68.275(d) is amended to read: 02 (d) The board may reinstate a license issued by the board under this chapter 03 that has been suspended or revoked if the board finds, after a hearing, that the 04 applicant is able to practice with skill and safety. 05 * Sec. 17. AS 08.68.275 is amended by adding a new subsection to read: 06 (g) The board may take the following disciplinary actions singly or in 07 combination against an individual who is practicing in this state under a multistate 08 licensure privilege: 09 (1) suspend the multistate licensure privilege in the state for a stated 10 period of time; 11 (2) censure the individual; 12 (3) issue a letter of reprimand; 13 (4) impose limitations or conditions on the professional practice of the 14 individual in the state; 15 (5) impose peer review; 16 (6) impose professional education requirements until a satisfactory 17 degree of skill has been attained in those aspects of professional practice determined 18 by the board to need improvement; 19 (7) impose probation and require the individual to report regularly to 20 the board on matters involving the basis for the probation. 21 * Sec. 18. AS 08.68 is amended by adding new sections to read: 22 Article 5A. Multistate Nurse Licensure Compact. 23 Sec. 08.68.500. Compact enacted. The Multistate Nurse Licensure Compact 24 as contained in this section is enacted into law and entered into on behalf of the state 25 with all other states and jurisdictions legally joining it in a form substantially as 26 follows: 27 ARTICLE I 28 Findings and Declaration of Purpose 29 (a) The legislature finds that: 30 (1) The health and safety of the public are affected by the degree of 31 compliance with and the effectiveness of enforcement activities related to state nurse
01 licensure laws; 02 (2) Violations of nurse licensure and other laws regulating the practice 03 of nursing may result in injury or harm to the public; 04 (3) The expanded mobility of nurses and the use of advanced 05 communication technologies as part of our nation's health care delivery system require 06 greater coordination and cooperation among states in the areas of nurse licensure and 07 regulation; 08 (4) New practice modalities and technology make compliance with 09 individual state nurse licensure laws difficult and complex; 10 (5) The current system of duplicative licensure for nurses practicing in 11 multiple states is cumbersome and redundant for both nurses and states; and 12 (6) Uniformity of nurse licensure requirements throughout the states 13 promotes public safety and public health benefits. 14 (b) The general purposes of this Compact are to: 15 (1) Facilitate the states' responsibility to protect the public's health and 16 safety; 17 (2) Ensure and encourage the cooperation of party states in the areas of 18 nurse licensure and regulation; 19 (3) Facilitate the exchange of information between party states in the 20 areas of nurse regulation, investigation and adverse actions; 21 (4) Promote compliance with the laws governing the practice of 22 nursing in each jurisdiction; 23 (5) Invest all party states with the authority to hold a nurse accountable 24 for meeting all state practice laws in the state in which the patient is located at the time 25 care is rendered through the mutual recognition of party state licenses; 26 (6) Decrease redundancies in the consideration and issuance of nurse 27 licenses; and 28 (7) Provide opportunities for interstate practice by nurses who meet 29 uniform licensure requirements. 30 ARTICLE II 31 Definitions
01 As used in this compact, unless the context clearly requires a different construction, 02 (1) "Adverse action" means any administrative, civil, equitable or 03 criminal action permitted by a state's laws which is imposed by a licensing board or 04 other authority against a nurse, including actions against an individual's license or 05 multistate licensure privilege such as revocation, suspension, probation, monitoring of 06 the licensee, limitation on the licensee's practice, or any other encumbrance on 07 licensure affecting a nurse's authorization to practice, including issuance of a cease 08 and desist action. 09 (2) "Alternative program" means a non-disciplinary monitoring 10 program approved by a licensing board. 11 (3) "Coordinated licensure information system" means an integrated 12 process for collecting, storing and sharing information on nurse licensure and 13 enforcement activities related to nurse licensure laws that is administered by a 14 nonprofit organization composed of and controlled by licensing boards. 15 (4) "Current significant investigative information" means: 16 (A) Investigative information that a licensing board, after a 17 preliminary inquiry that includes notification and an opportunity for the nurse 18 to respond, if required by state law, has reason to believe is not groundless and, 19 if proved true, would indicate more than a minor infraction; or 20 (B) Investigative information that indicates that the nurse 21 represents an immediate threat to public health and safety regardless of 22 whether the nurse has been notified and had an opportunity to respond. 23 (5) "Encumbrance" means a revocation or suspension of, or any 24 limitation on, the full and unrestricted practice of nursing imposed by a licensing 25 board. 26 (6) "Home state" means the party state which is the nurse's primary 27 state of residence. 28 (7) "Licensing board" means a party state's regulatory body 29 responsible for issuing nurse licenses. 30 (8) "Multistate license" means a license to practice as a registered or a 31 licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board
01 that authorizes the licensed nurse to practice in all party states under a multistate 02 licensure privilege. 03 (9) "Multistate licensure privilege" means a legal authorization 04 associated with a multistate license permitting the practice of nursing as either a 05 registered nurse (RN) or LPN/VN in a remote state. 06 (10) "Nurse" means RN or LPN/VN, as those terms are defined by 07 each party state's practice laws. 08 (11) "Party state" means any state that has adopted this Compact. 09 (12) "Remote state" means a party state, other than the home state. 10 (13) "Single-state license" means a nurse license issued by a party state 11 that authorizes practice only within the issuing state and does not include a multistate 12 licensure privilege to practice in any other party state. 13 (14) "State" means a state, territory or possession of the United States 14 and the District of Columbia. 15 (15) "State practice laws" means a party state's laws, rules and 16 regulations that govern the practice of nursing, define the scope of nursing practice, 17 and create the methods and grounds for imposing discipline. "State practice laws" do 18 not include requirements necessary to obtain and retain a license, except for 19 qualifications or requirements of the home state. 20 ARTICLE III 21 General Provisions and Jurisdiction 22 (a) A multistate license to practice registered or licensed practical/vocational 23 nursing issued by a home state to a resident in that state will be recognized by each 24 party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed 25 practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each 26 party state. 27 (b) A state must implement procedures for considering the criminal history 28 records of applicants for initial multistate license or licensure by endorsement. Such 29 procedures shall include the submission of fingerprints or other biometric-based 30 information by applicants for the purpose of obtaining an applicant's criminal history 31 record information from the Federal Bureau of Investigation and the agency
01 responsible for retaining that state's criminal records. 02 (c) Each party state shall require the following for an applicant to obtain or 03 retain a multistate license in the home state: 04 (1) Meets the home state's qualifications for licensure or renewal of 05 licensure, as well as, all other applicable state laws; 06 (2) Has graduated or is eligible to graduate from a licensing board- 07 approved RN or LPN/VN prelicensure education program; or has graduated from a 08 foreign RN or LPN/VN prelicensure education program that (a) has been approved by 09 the authorized accrediting body in the applicable country and (b) has been verified by 10 an independent credentials review agency to be comparable to a licensing board- 11 approved prelicensure education program; 12 (3) Has, if a graduate of a foreign prelicensure education program not 13 taught in English or if English is not the individual's native language, successfully 14 passed an English proficiency examination that includes the components of reading, 15 speaking, writing and listening; 16 (4) Has successfully passed an NCLEX-RN or NCLEX-PN 17 Examination or recognized predecessor, as applicable; 18 (5) Is eligible for or holds an active, unencumbered license; 19 (6) Has submitted, in connection with an application for initial 20 licensure or licensure by endorsement, fingerprints or other biometric data for the 21 purpose of obtaining criminal history record information from the Federal Bureau of 22 Investigation and the agency responsible for retaining that state's criminal records; 23 (7) Has not been convicted or found guilty, or has entered into an 24 agreed disposition, of a felony offense under applicable state or federal criminal law; 25 (8) Has not been convicted or found guilty, or has entered into an 26 agreed disposition, of a misdemeanor offense related to the practice of nursing as 27 determined on a case-by-case basis; 28 (9) Is not currently enrolled in an alternative program; 29 (10) Is subject to self-disclosure requirements regarding current 30 participation in an alternative program; and 31 (11) Has a valid United States Social Security number.
01 (d) All party states shall be authorized, in accordance with existing state due 02 process law, to take adverse action against a nurse's multistate licensure privilege such 03 as revocation, suspension, probation or any other action that affects a nurse's 04 authorization to practice under a multistate licensure privilege, including cease and 05 desist actions. If a party state takes such action, it shall promptly notify the 06 administrator of the coordinated licensure information system. The administrator of 07 the coordinated licensure information system shall promptly notify the home state of 08 any such actions by remote states. 09 (e) A nurse practicing in a party state must comply with the state practice laws 10 of the state in which the client is located at the time service is provided. The practice 11 of nursing is not limited to patient care, but shall include all nursing practice as 12 defined by the state practice laws of the party state in which the client is located. The 13 practice of nursing in a party state under a multistate licensure privilege will subject a 14 nurse to the jurisdiction of the licensing board, the courts and the laws of the party 15 state in which the client is located at the time service is provided. 16 (f) Individuals not residing in a party state shall continue to be able to apply 17 for a party state's single-state license as provided under the laws of each party state. 18 However, the single-state license granted to these individuals will not be recognized as 19 granting the privilege to practice nursing in any other party state. Nothing in this 20 Compact shall affect the requirements established by a party state for the issuance of a 21 single-state license. 22 (g) Any nurse holding a home state multistate license, on the effective date of 23 this Compact, may retain and renew the multistate license issued by the nurse's then- 24 current home state, provided that: 25 (1) A nurse, who changes primary state of residence after this 26 Compact's effective date, must meet all applicable Article III.c. requirements to obtain 27 a multistate license from a new home state. 28 (2) A nurse who fails to satisfy the multistate licensure requirements in 29 Article III.c. due to a disqualifying event occurring after this Compact's effective date 30 shall be ineligible to retain or renew a multistate license, and the nurse's multistate 31 license shall be revoked or deactivated in accordance with applicable rules adopted by
01 the Interstate Commission of Nurse Licensure Compact Administrators 02 ("Commission"). 03 ARTICLE IV 04 Applications for Licensure in a Party State 05 (a) Upon application for a multistate license, the licensing board in the issuing 06 party state shall ascertain, through the coordinated licensure information system, 07 whether the applicant has ever held, or is the holder of, a license issued by any other 08 state, whether there are any encumbrances on any license or multistate licensure 09 privilege held by the applicant, whether any adverse action has been taken against any 10 license or multistate licensure privilege held by the applicant and whether the 11 applicant is currently participating in an alternative program. 12 (b) A nurse may hold a multistate license, issued by the home state, in only 13 one party state at a time. 14 (c) If a nurse changes primary state of residence by moving between two party 15 states, the nurse must apply for licensure in the new home state, and the multistate 16 license issued by the prior home state will be deactivated in accordance with 17 applicable rules adopted by the Commission. 18 (1) The nurse may apply for licensure in advance of a change in 19 primary state of residence. 20 (2) A multistate license shall not be issued by the new home state until 21 the nurse provides satisfactory evidence of a change in primary state of residence to 22 the new home state and satisfies all applicable requirements to obtain a multistate 23 license from the new home state. 24 (d) If a nurse changes primary state of residence by moving from a party state 25 to a non-party state, the multistate license issued by the prior home state will convert 26 to a single-state license, valid only in the former home state. 27 ARTICLE V 28 Additional Authorities Invested in Party State Licensing Boards 29 (a) In addition to the other powers conferred by state law, a licensing board 30 shall have the authority to: 31 (1) Take adverse action against a nurse's multistate licensure privilege
01 to practice within that party state. 02 (A) Only the home state shall have the power to take adverse 03 action against a nurse's license issued by the home state. 04 (B) For purposes of taking adverse action, the home state 05 licensing board shall give the same priority and effect to reported conduct 06 received from a remote state as it would if such conduct had occurred within 07 the home state. In so doing, the home state shall apply its own state laws to 08 determine appropriate action. 09 (2) Issue cease and desist orders or impose an encumbrance on a 10 nurse's authority to practice within that party state. 11 (3) Complete any pending investigations of a nurse who changes 12 primary state of residence during the course of such investigations. The licensing 13 board shall also have the authority to take appropriate action(s) and shall promptly 14 report the conclusions of such investigations to the administrator of the coordinated 15 licensure information system. The administrator of the coordinated licensure 16 information system shall promptly notify the new home state of any such actions. 17 (4) Issue subpoenas for both hearings and investigations that require 18 the attendance and testimony of witnesses, as well as, the production of evidence. 19 Subpoenas issued by a licensing board in a party state for the attendance and 20 testimony of witnesses or the production of evidence from another party state shall be 21 enforced in the latter state by any court of competent jurisdiction, according to the 22 practice and procedure of that court applicable to subpoenas issued in proceedings 23 pending before it. The issuing authority shall pay any witness fees, travel expenses, 24 mileage and other fees required by the service statutes of the state in which the 25 witnesses or evidence are located. 26 (5) Obtain and submit, for each nurse licensure applicant, fingerprint 27 or other biometric-based information to the Federal Bureau of Investigation for 28 criminal background checks, receive the results of the Federal Bureau of Investigation 29 record search on criminal background checks and use the results in making licensure 30 decisions. 31 (6) If otherwise permitted by state law, recover from the affected nurse
01 the costs of investigations and disposition of cases resulting from any adverse action 02 taken against that nurse. 03 (7) Take adverse action based on the factual findings of the remote 04 state, provided that the licensing board follows its own procedures for taking such 05 adverse action. 06 (b) If adverse action is taken by the home state against a nurse's multistate 07 license, the nurse's multistate licensure privilege to practice in all other party states 08 shall be deactivated until all encumbrances have been removed from the multistate 09 license. All home state disciplinary orders that impose adverse action against a nurse's 10 multistate license shall include a statement that the nurse's multistate licensure 11 privilege is deactivated in all party states during the pendency of the order. Nothing in 12 this Compact shall override a party state's decision that participation in an alternative 13 program may be used in lieu of adverse action. The home state licensing board shall 14 deactivate the multistate licensure privilege under the multistate license of any nurse 15 for the duration of the nurse's participation in an alternative program. 16 ARTICLE VI 17 Coordinated Licensure Information System and Exchange of Information 18 (a) All party states shall participate in a coordinated licensure information 19 system of all licensed registered nurses (RNs) and licensed practical/vocational nurses 20 (LPNs/VNs). This system will include information on the licensure and disciplinary 21 history of each nurse, as submitted by party states, to assist in the coordination of 22 nurse licensure and enforcement efforts. 23 (b) The Commission, in consultation with the administrator of the coordinated 24 licensure information system, shall formulate necessary and proper procedures for the 25 identification, collection and exchange of information under this Compact. 26 (c) All licensing boards shall promptly report to the coordinated licensure 27 information system any adverse action, any current significant investigative 28 information, denials of applications (with the reasons for such denials) and nurse 29 participation in alternative programs known to the licensing board regardless of 30 whether such participation is deemed nonpublic or confidential under state law. 31 (d) Current significant investigative information and participation in nonpublic
01 or confidential alternative programs shall be transmitted through the coordinated 02 licensure information system only to party state licensing boards. 03 (e) Notwithstanding any other provision of law, all party state licensing boards 04 contributing information to the coordinated licensure information system may 05 designate information that may not be shared with non-party states or disclosed to 06 other entities or individuals without the express permission of the contributing state. 07 (f) Any personally identifiable information obtained from the coordinated 08 licensure information system by a party state licensing board shall not be shared with 09 non-party states or disclosed to other entities or individuals except to the extent 10 permitted by the laws of the party state contributing the information. 11 (g) Any information contributed to the coordinated licensure information 12 system that is subsequently required to be expunged by the laws of the party state 13 contributing that information shall also be expunged from the coordinated licensure 14 information system. 15 (h) The Compact administrator of each party state shall furnish a uniform data 16 set to the Compact administrator of each other party state, which shall include, at a 17 minimum: 18 (1) Identifying information; 19 (2) Licensure data; 20 (3) Information related to alternative program participation; and 21 (4) Other information that may facilitate the administration of this 22 Compact, as determined by Commission rules. 23 (i) The Compact administrator of a party state shall provide all investigative 24 documents and information requested by another party state. 25 ARTICLE VII 26 Establishment of the Interstate Commission of Nurse Licensure Compact Administrators 27 (a) The party states hereby create and establish a joint public entity known as 28 the Interstate Commission of Nurse Licensure Compact Administrators. 29 (1) The Commission is an instrumentality of the party states. 30 (2) Venue is proper, and judicial proceedings by or against the 31 Commission shall be brought solely and exclusively, in a court of competent
01 jurisdiction where the principal office of the Commission is located. The Commission 02 may waive venue and jurisdictional defenses to the extent it adopts or consents to 03 participate in alternative dispute resolution proceedings. 04 (3) Nothing in this Compact shall be construed to be a waiver of 05 sovereign immunity. 06 (b) Membership, Voting and Meetings 07 (1) Each party state shall have and be limited to one administrator. The 08 head of the state licensing board or designee shall be the administrator of this Compact 09 for each party state. Any administrator may be removed or suspended from office as 10 provided by the law of the state from which the Administrator is appointed. Any 11 vacancy occurring in the Commission shall be filled in accordance with the laws of the 12 party state in which the vacancy exists. 13 (2) Each administrator shall be entitled to one (1) vote with regard to 14 the promulgation of rules and creation of bylaws and shall otherwise have an 15 opportunity to participate in the business and affairs of the Commission. An 16 administrator shall vote in person or by such other means as provided in the bylaws. 17 The bylaws may provide for an administrator's participation in meetings by telephone 18 or other means of communication. 19 (3) The Commission shall meet at least once during each calendar 20 year. Additional meetings shall be held as set forth in the bylaws or rules of the 21 commission. 22 (4) All meetings shall be open to the public, and public notice of 23 meetings shall be given in the same manner as required under the rulemaking 24 provisions in Article VIII. 25 (5) The Commission may convene in a closed, nonpublic meeting if 26 the Commission must discuss: 27 (A) Noncompliance of a party state with its obligations under 28 this Compact; 29 (B) The employment, compensation, discipline or other 30 personnel matters, practices or procedures related to specific employees or 31 other matters related to the Commission's internal personnel practices and
01 procedures; 02 (C) Current, threatened or reasonably anticipated litigation; 03 (D) Negotiation of contracts for the purchase or sale of goods, 04 services or real estate; 05 (E) Accusing any person of a crime or formally censuring any 06 person; 07 (F) Disclosure of trade secrets or commercial or financial 08 information that is privileged or confidential; 09 (G) Disclosure of information of a personal nature where 10 disclosure would constitute a clearly unwarranted invasion of personal privacy; 11 (H) Disclosure of investigatory records compiled for law 12 enforcement purposes; 13 (I) Disclosure of information related to any reports prepared by 14 or on behalf of the Commission for the purpose of investigation of compliance 15 with this Compact; or 16 (J) Matters specifically exempted from disclosure by federal or 17 state statute. 18 (6) If a meeting, or portion of a meeting, is closed pursuant to this 19 provision, the Commission's legal counsel or designee shall certify that the meeting 20 may be closed and shall reference each relevant exempting provision. The 21 Commission shall keep minutes that fully and clearly describe all matters discussed in 22 a meeting and shall provide a full and accurate summary of actions taken, and the 23 reasons therefor, including a description of the views expressed. All documents 24 considered in connection with an action shall be identified in such minutes. All 25 minutes and documents of a closed meeting shall remain under seal, subject to release 26 by a majority vote of the Commission or order of a court of competent jurisdiction. 27 (c) The Commission shall, by a majority vote of the administrators, prescribe 28 bylaws or rules to govern its conduct as may be necessary or appropriate to carry out 29 the purposes and exercise the powers of this Compact, including but not limited to: 30 (1) Establishing the fiscal year of the Commission; 31 (2) Providing reasonable standards and procedures:
01 (A) For the establishment and meetings of other committees; 02 and 03 (B) Governing any general or specific delegation of any 04 authority or function of the Commission; 05 (3) Providing reasonable procedures for calling and conducting 06 meetings of the Commission, ensuring reasonable advance notice of all meetings and 07 providing an opportunity for attendance of such meetings by interested parties, with 08 enumerated exceptions designed to protect the public's interest, the privacy of 09 individuals, and proprietary information, including trade secrets. The Commission 10 may meet in closed session only after a majority of the administrators vote to close a 11 meeting in whole or in part. As soon as practicable, the Commission must make public 12 a copy of the vote to close the meeting revealing the vote of each administrator, with 13 no proxy votes allowed; 14 (4) Establishing the titles, duties and authority and reasonable 15 procedures for the election of the officers of the Commission; 16 (5) Providing reasonable standards and procedures for the 17 establishment of the personnel policies and programs of the Commission. 18 Notwithstanding any civil service or other similar laws of any party state, the bylaws 19 shall exclusively govern the personnel policies and programs of the Commission; and 20 (6) Providing a mechanism for winding up the operations of the 21 Commission and the equitable disposition of any surplus funds that may exist after the 22 termination of this Compact after the payment or reserving of all of its debts and 23 obligations; 24 (d) The Commission shall publish its bylaws and rules, and any amendments 25 thereto, in a convenient form on the website of the Commission. 26 (e) The Commission shall maintain its financial records in accordance with the 27 bylaws. 28 (f) The Commission shall meet and take such actions as are consistent with the 29 provisions of this Compact and the bylaws. 30 (g) The Commission shall have the following powers: 31 (1) To promulgate uniform rules to facilitate and coordinate
01 implementation and administration of this Compact. The rules shall have the force and 02 effect of law and shall be binding in all party states; 03 (2) To bring and prosecute legal proceedings or actions in the name of 04 the Commission, provided that the standing of any licensing board to sue or be sued 05 under applicable law shall not be affected; 06 (3) To purchase and maintain insurance and bonds; 07 (4) To borrow, accept or contract for services of personnel, including, 08 but not limited to, employees of a party state or nonprofit organizations; 09 (5) To cooperate with other organizations that administer state 10 compacts related to the regulation of nursing, including but not limited to sharing 11 administrative or staff expenses, office space or other resources; 12 (6) To hire employees, elect or appoint officers, fix compensation, 13 define duties, grant such individuals appropriate authority to carry out the purposes of 14 this Compact, and to establish the Commission's personnel policies and programs 15 relating to conflicts of interest, qualifications of personnel and other related personnel 16 matters; 17 (7) To accept any and all appropriate donations, grants and gifts of 18 money, equipment, supplies, materials and services, and to receive, utilize and dispose 19 of the same; provided that at all times the Commission shall avoid any appearance of 20 impropriety or conflict of interest; 21 (8) To lease, purchase, accept appropriate gifts or donations of, or 22 otherwise to own, hold, improve or use, any property, whether real, personal or mixed; 23 provided that at all times the Commission shall avoid any appearance of impropriety; 24 (9) To sell, convey, mortgage, pledge, lease, exchange, abandon or 25 otherwise dispose of any property, whether real, personal or mixed; 26 (10) To establish a budget and make expenditures; 27 (11) To borrow money; 28 (12) To appoint committees, including advisory committees comprised 29 of administrators, state nursing regulators, state legislators or their representatives, and 30 consumer representatives, and other such interested persons; 31 (13) To provide and receive information from, and to cooperate with,
01 law enforcement agencies; 02 (14) To adopt and use an official seal; and 03 (15) To perform such other functions as may be necessary or 04 appropriate to achieve the purposes of this Compact consistent with the state 05 regulation of nurse licensure and practice. 06 (h) Financing of the Commission 07 (1) The Commission shall pay, or provide for the payment of, the 08 reasonable expenses of its establishment, organization and ongoing activities. 09 (2) The Commission may also levy on and collect an annual 10 assessment from each party state to cover the cost of its operations, activities and staff 11 in its annual budget as approved each year. The aggregate annual assessment amount, 12 if any, shall be allocated based upon a formula to be determined by the Commission, 13 which shall promulgate a rule that is binding upon all party states. 14 (3) The Commission shall not incur obligations of any kind prior to 15 securing the funds adequate to meet the same; nor shall the Commission pledge the 16 credit of any of the party states, except by, and with the authority of, such party state. 17 (4) The Commission shall keep accurate accounts of all receipts and 18 disbursements. The receipts and disbursements of the Commission shall be subject to 19 the audit and accounting procedures established under its bylaws. However, all 20 receipts and disbursements of funds handled by the Commission shall be audited 21 yearly by a certified or licensed public accountant, and the report of the audit shall be 22 included in and become part of the annual report of the Commission. 23 (i) Qualified Immunity, Defense and Indemnification 24 (1) The administrators, officers, executive director, employees and 25 representatives of the Commission shall be immune from suit and liability, either 26 personally or in their official capacity, for any claim for damage to or loss of property 27 or personal injury or other civil liability caused by or arising out of any actual or 28 alleged act, error or omission that occurred, or that the person against whom the claim 29 is made had a reasonable basis for believing occurred, within the scope of 30 Commission employment, duties or responsibilities; provided that nothing in this 31 paragraph shall be construed to protect any such person from suit or liability for any
01 damage, loss, injury or liability caused by the intentional, willful or wanton 02 misconduct of that person. 03 (2) The Commission shall defend any administrator, officer, executive 04 director, employee or representative of the Commission in any civil action seeking to 05 impose liability arising out of any actual or alleged act, error or omission that occurred 06 within the scope of Commission employment, duties or responsibilities, or that the 07 person against whom the claim is made had a reasonable basis for believing occurred 08 within the scope of Commission employment, duties or responsibilities; provided that 09 nothing herein shall be construed to prohibit that person from retaining his or her own 10 counsel; and provided further that the actual or alleged act, error or omission did not 11 result from that person's intentional, willful or wanton misconduct. 12 (3) The Commission shall indemnify and hold harmless any 13 administrator, officer, executive director, employee or representative of the 14 Commission for the amount of any settlement or judgment obtained against that 15 person arising out of any actual or alleged act, error or omission that occurred within 16 the scope of Commission employment, duties or responsibilities, or that such person 17 had a reasonable basis for believing occurred within the scope of Commission 18 employment, duties or responsibilities, provided that the actual or alleged act, error or 19 omission did not result from the intentional, willful or wanton misconduct of that 20 person. 21 ARTICLE VIII 22 Rulemaking 23 (a) The Commission shall exercise its rulemaking powers pursuant to the 24 criteria set forth in this Article and the rules adopted thereunder. Rules and 25 amendments shall become binding as of the date specified in each rule or amendment 26 and shall have the same force and effect as provisions of this Compact. 27 (b) Rules or amendments to the rules shall be adopted at a regular or special 28 meeting of the Commission. 29 (c) Prior to promulgation and adoption of a final rule or rules by the 30 Commission, and at least sixty (60) days in advance of the meeting at which the rule 31 will be considered and voted upon, the Commission shall file a notice of proposed
01 rulemaking: 02 (1) On the website of the Commission; and 03 (2) On the website of each licensing board or the publication in which 04 each state would otherwise publish proposed rules. 05 (d) The notice of proposed rulemaking shall include: 06 (1) The proposed time, date and location of the meeting in which the 07 rule will be considered and voted upon; 08 (2) The text of the proposed rule or amendment, and the reason for the 09 proposed rule; 10 (3) A request for comments on the proposed rule from any interested 11 person; and 12 (4) The manner in which interested persons may submit notice to the 13 Commission of their intention to attend the public hearing and any written comments. 14 (e) Prior to adoption of a proposed rule, the Commission shall allow persons 15 to submit written data, facts, opinions and arguments, which shall be made available to 16 the public. 17 (f) The Commission shall grant an opportunity for a public hearing before it 18 adopts a rule or amendment. 19 (g) The Commission shall publish the place, time and date of the scheduled 20 public hearing. 21 (1) Hearings shall be conducted in a manner providing each person 22 who wishes to comment a fair and reasonable opportunity to comment orally or in 23 writing. All hearings will be recorded, and a copy will be made available upon request. 24 (2) Nothing in this section shall be construed as requiring a separate 25 hearing on each rule. Rules may be grouped for the convenience of the Commission at 26 hearings required by this section. 27 (h) If no one appears at the public hearing, the Commission may proceed with 28 promulgation of the proposed rule. 29 (i) Following the scheduled hearing date, or by the close of business on the 30 scheduled hearing date if the hearing was not held, the Commission shall consider all 31 written and oral comments received.
01 (j) The Commission shall, by majority vote of all administrators, take final 02 action on the proposed rule and shall determine the effective date of the rule, if any, 03 based on the rulemaking record and the full text of the rule. 04 (k) Upon determination that an emergency exists, the Commission may 05 consider and adopt an emergency rule without prior notice, opportunity for comment 06 or hearing, provided that the usual rulemaking procedures provided in this Compact 07 and in this section shall be retroactively applied to the rule as soon as reasonably 08 possible, in no event later than ninety (90) days after the effective date of the rule. For 09 the purposes of this provision, an emergency rule is one that must be adopted 10 immediately in order to: 11 (1) Meet an imminent threat to public health, safety or welfare; 12 (2) Prevent a loss of Commission or party state funds; or 13 (3) Meet a deadline for the promulgation of an administrative rule that 14 is required by federal law or rule. 15 (l) The Commission may direct revisions to a previously adopted rule or 16 amendment for purposes of correcting typographical errors, errors in format, errors in 17 consistency or grammatical errors. Public notice of any revisions shall be posted on 18 the website of the Commission. The revision shall be subject to challenge by any 19 person for a period of thirty (30) days after posting. The revision may be challenged 20 only on grounds that the revision results in a material change to a rule. A challenge 21 shall be made in writing, and delivered to the Commission, prior to the end of the 22 notice period. If no challenge is made, the revision will take effect without further 23 action. If the revision is challenged, the revision may not take effect without the 24 approval of the Commission. 25 ARTICLE IX 26 Oversight, Dispute Resolution and Enforcement 27 (a) Oversight 28 (1) Each party state shall enforce this Compact and take all actions 29 necessary and appropriate to effectuate this Compact's purposes and intent. 30 (2) The Commission shall be entitled to receive service of process in 31 any proceeding that may affect the powers, responsibilities or actions of the
01 Commission, and shall have standing to intervene in such a proceeding for all 02 purposes. Failure to provide service of process in such proceeding to the Commission 03 shall render a judgment or order void as to the Commission, this Compact or 04 promulgated rules. 05 (b) Default, Technical Assistance and Termination 06 (1) If the Commission determines that a party state has defaulted in the 07 performance of its obligations or responsibilities under this Compact or the 08 promulgated rules, the Commission shall: 09 (A) Provide written notice to the defaulting state and other 10 party states of the nature of the default, the proposed means of curing the 11 default or any other action to be taken by the Commission; and 12 (B) Provide remedial training and specific technical assistance 13 regarding the default. 14 (2) If a state in default fails to cure the default, the defaulting state's 15 membership in this Compact may be terminated upon an affirmative vote of a majority 16 of the administrators, and all rights, privileges and benefits conferred by this Compact 17 may be terminated on the effective date of termination. A cure of the default does not 18 relieve the offending state of obligations or liabilities incurred during the period of 19 default. 20 (3) Termination of membership in this Compact shall be imposed only 21 after all other means of securing compliance have been exhausted. Notice of intent to 22 suspend or terminate shall be given by the Commission to the governor of the 23 defaulting state and to the executive officer of the defaulting state's licensing board 24 and each of the party states. 25 (4) A state whose membership in this Compact has been terminated is 26 responsible for all assessments, obligations and liabilities incurred through the 27 effective date of termination, including obligations that extend beyond the effective 28 date of termination. 29 (5) The Commission shall not bear any costs related to a state that is 30 found to be in default or whose membership in this Compact has been terminated 31 unless agreed upon in writing between the Commission and the defaulting state.
01 (6) The defaulting state may appeal the action of the Commission by 02 petitioning the U.S. District Court for the District of Columbia or the federal district in 03 which the Commission has its principal offices. The prevailing party shall be awarded 04 all costs of such litigation, including reasonable attorneys' fees. 05 (c) Dispute Resolution 06 (1) Upon request by a party state, the Commission shall attempt to 07 resolve disputes related to the Compact that arise among party states and between 08 party and non-party states. 09 (2) The Commission shall promulgate a rule providing for both 10 mediation and binding dispute resolution for disputes, as appropriate. 11 (3) In the event the Commission cannot resolve disputes among party 12 states arising under this Compact: 13 (A) The party states may submit the issues in dispute to an 14 arbitration panel, which will be comprised of individuals appointed by the 15 Compact administrator in each of the affected party states and an individual 16 mutually agreed upon by the Compact administrators of all the party states 17 involved in the dispute. 18 (B) The decision of a majority of the arbitrators shall be final 19 and binding. 20 (d) Enforcement 21 (1) The Commission, in the reasonable exercise of its discretion, shall 22 enforce the provisions and rules of this Compact. 23 (2) By majority vote, the Commission may initiate legal action in the 24 U.S. District Court for the District of Columbia or the federal district in which the 25 Commission has its principal offices against a party state that is in default to enforce 26 compliance with the provisions of this Compact and its promulgated rules and bylaws. 27 The relief sought may include both injunctive relief and damages. In the event judicial 28 enforcement is necessary, the prevailing party shall be awarded all costs of such 29 litigation, including reasonable attorneys' fees. 30 (3) The remedies herein shall not be the exclusive remedies of the 31 Commission. The Commission may pursue any other remedies available under federal
01 or state law. 02 ARTICLE X 03 Effective Date, Withdrawal and Amendment 04 (a) This Compact shall become effective and binding on the earlier of the date 05 of legislative enactment of this Compact into law by no less than twenty-six (26) states 06 or December 31, 2018. All party states to this Compact, that also were parties to the 07 prior Nurse Licensure Compact, superseded by this Compact, ("Prior Compact"), shall 08 be deemed to have withdrawn from said Prior Compact within six (6) months after the 09 effective date of this Compact. 10 (b) Each party state to this Compact shall continue to recognize a nurse's 11 multistate licensure privilege to practice in that party state issued under the Prior 12 Compact until such party state has withdrawn from the Prior Compact. 13 (c) Any party state may withdraw from this Compact by enacting a statute 14 repealing the same. A party state's withdrawal shall not take effect until six (6) months 15 after enactment of the repealing statute. 16 (d) A party state's withdrawal or termination shall not affect the continuing 17 requirement of the withdrawing or terminated state's licensing board to report adverse 18 actions and significant investigations occurring prior to the effective date of such 19 withdrawal or termination. 20 (e) Nothing contained in this Compact shall be construed to invalidate or 21 prevent any nurse licensure agreement or other cooperative arrangement between a 22 party state and a non-party state that is made in accordance with the other provisions 23 of this Compact. 24 (f) This Compact may be amended by the party states. No amendment to this 25 Compact shall become effective and binding upon the party states unless and until it is 26 enacted into the laws of all party states. 27 (g) Representatives of non-party states to this Compact shall be invited to 28 participate in the activities of the Commission, on a nonvoting basis, prior to the 29 adoption of this Compact by all states. 30 ARTICLE XI 31 Construction and Severability
01 This Compact shall be liberally construed so as to effectuate the purposes thereof. The 02 provisions of this Compact shall be severable, and if any phrase, clause, sentence or provision 03 of this Compact is declared to be contrary to the constitution of any party state or of the 04 United States, or if the applicability thereof to any government, agency, person or 05 circumstance is held invalid, the validity of the remainder of this Compact and the 06 applicability thereof to any government, agency, person or circumstance shall not be affected 07 thereby. If this Compact shall be held to be contrary to the constitution of any party state, this 08 Compact shall remain in full force and effect as to the remaining party states and in full force 09 and effect as to the party state affected as to all severable matters. 10 * Sec. 19. AS 08.68.800(a) is amended to read: 11 (a) This chapter does not apply to 12 (1) a qualified nurse licensed in another state employed by the United 13 States government or a bureau, or agency, or division of the United States government 14 while in the discharge of official duties; 15 (2) nursing service given temporarily in the event of a public 16 emergency, epidemic, or disaster; 17 (3) the practice of nursing by a student enrolled in a nursing education 18 program accredited by the board when the practice is in connection with the student's 19 course of study; 20 (4) the practice of nursing by an individual enrolled in an approved 21 program or course of study approved by the board to satisfy the requirements of 22 AS 08.68.251; 23 (5) the practice of nursing by a nurse licensed in another state who 24 does not hold a multistate licensure privilege to practice in this state and who 25 engages in nursing education or nursing consultation activities, if these activities and 26 contact with clients do not exceed 20 working days within a licensing period; or 27 (6) the practice of nursing by a nurse licensed in another state who 28 does not hold a multistate licensure privilege to practice in this state and whose 29 employment responsibilities include transporting patients into, out of, or through this 30 state; however, this exception is valid for a period not to exceed 48 hours for each 31 transport.
01 * Sec. 20. AS 08.68.805 is amended to read: 02 Sec. 08.68.805. Delegation of nursing functions. A registered, advanced 03 practice registered, or practical nurse licensed under this chapter or a registered or 04 practical nurse holding a multistate licensure privilege may delegate nursing duties 05 to other persons, including unlicensed assistive personnel, under regulations adopted 06 by the board. A person to whom the nursing duties are delegated may perform the 07 delegated duties without a license or certificate under this chapter or a multistate 08 licensure privilege if the person meets the applicable requirements established by the 09 board. 10 * Sec. 21. AS 08.68.850(1) is amended to read: 11 (1) "advanced practice registered nurse" means a [REGISTERED] 12 nurse licensed to practice registered nursing in this state [IN THE STATE] who, 13 because of specialized education and experience, is licensed by the board 14 [CERTIFIED] to perform acts of medical diagnosis and the prescription and 15 dispensing of medical, therapeutic, or corrective measures under regulations adopted 16 by the board; 17 * Sec. 22. AS 08.68.850 is amended by adding new paragraphs to read: 18 (13) "multistate license" means a license issued by the board under 19 AS 08.68.500 to practice registered nursing or practical nursing in another state that is 20 a party to the Multistate Nurse Licensure Compact enacted under AS 08.68.500; 21 (14) "multistate licensure privilege" means a legal authorization for a 22 person holding a multistate license issued by another state to practice registered 23 nursing or practical nursing in this state under the terms of the Multistate Nurse 24 Licensure Compact enacted under AS 08.68.500; 25 (15) "single-state license" means a license issued under this chapter to 26 practice registered nursing or practical nursing in the state and does not authorize 27 practice in another state. 28 * Sec. 23. AS 09.55.560(2) is amended to read: 29 (2) "health care provider" means an acupuncturist licensed under 30 AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 31 chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a
01 dentist licensed under AS 08.36; a nurse licensed or holding a multistate licensure 02 privilege under AS 08.68; a dispensing optician licensed under AS 08.71; a 03 naturopath licensed under AS 08.45; an optometrist licensed under AS 08.72; a 04 pharmacist licensed under AS 08.80; a physical therapist or occupational therapist 05 licensed under AS 08.84; a physician or physician assistant licensed under AS 08.64; a 06 podiatrist; a psychologist and a psychological associate licensed under AS 08.86; a 07 hospital as defined in AS 47.32.900, including a governmentally owned or operated 08 hospital; an employee of a health care provider acting within the course and scope of 09 employment; an ambulatory surgical facility and other organizations whose primary 10 purpose is the delivery of health care, including a health maintenance organization, 11 individual practice association, integrated delivery system, preferred provider 12 organization or arrangement, and a physical hospital organization; 13 * Sec. 24. AS 09.65.095(c)(1) is amended to read: 14 (1) "health care provider" means a nurse licensed or holding a 15 multistate licensure privilege under AS 08.68, a physician licensed under AS 08.64, 16 and a person certified by a hospital as competent to take blood samples; 17 * Sec. 25. AS 18.20.095(e)(2) is amended to read: 18 (2) "licensed staff member" means a person who is employed by the 19 hospital to provide direct patient care and who is licensed or certified in the state as a 20 physician or physician assistant under AS 08.64, direct-entry midwife under AS 08.65, 21 nurse licensed or holding a multistate licensure privilege under AS 08.68 or nurse 22 aide under AS 08.68, or physical therapist or occupational therapist under AS 08.84; 23 * Sec. 26. AS 18.20.499(3) is amended to read: 24 (3) "nurse" means an individual licensed or holding a multistate 25 licensure privilege to practice registered nursing or practical nursing under AS 08.68 26 who provides nursing services through direct patient care or clinical services and 27 includes a nurse manager when delivering in-hospital patient care; 28 * Sec. 27. AS 18.23.070(3) is amended to read: 29 (3) "health care provider" means an acupuncturist licensed under 30 AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist licensed under 31 AS 08.32; a dentist licensed under AS 08.36; a nurse licensed or holding a multistate
01 licensure privilege under AS 08.68; a dispensing optician licensed under AS 08.71; 02 an optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 03 physical therapist or occupational therapist licensed under AS 08.84; a physician 04 licensed under AS 08.64; a podiatrist; a psychologist and a psychological associate 05 licensed under AS 08.86; a hospital as defined in AS 47.32.900, including a 06 governmentally owned or operated hospital; and an employee of a health care provider 07 acting within the course and scope of employment; 08 * Sec. 28. AS 47.07.045(b) is amended to read: 09 (b) Before the department may terminate payment for services provided under 10 (a) of this section, 11 (1) the recipient must have had an annual assessment to determine 12 whether the recipient continues to meet the standards under (a) of this section; 13 (2) the annual assessment must have been reviewed by an independent 14 qualified health care professional under contract with the department; for purposes of 15 this paragraph, "independent qualified health care professional" means, 16 (A) for a waiver based on intellectual or developmental 17 disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 18 intellectual disability professional; 19 (B) for other allowable waivers, a registered nurse licensed or 20 holding a multistate licensure privilege under AS 08.68 or an advanced 21 practice registered nurse licensed under AS 08.68 who is qualified to assess 22 children with complex medical conditions, older Alaskans, and adults with 23 physical disabilities for medical assistance waivers; and 24 (3) the annual assessment must find that the recipient's condition has 25 materially improved since the previous assessment; for purposes of this paragraph, 26 "materially improved" means that a recipient who has previously qualified for a 27 waiver for 28 (A) a child with complex medical conditions, no longer needs 29 technical assistance for a life-threatening condition, and is expected to be 30 placed in a skilled nursing facility for less than 30 days each year; 31 (B) intellectual or developmental disability, no longer needs the
01 level of care provided by an intermediate care facility for persons with 02 intellectual and developmental disabilities either because the qualifying 03 diagnosis has changed or the recipient is able to demonstrate the ability to 04 function in a home setting without the need for waiver services; or 05 (C) an older Alaskan or adult with a physical disability, no 06 longer has a functional limitation or cognitive impairment that would result in 07 the need for nursing home placement, and is able to demonstrate the ability to 08 function in a home setting without the need for waiver services. 09 * Sec. 29. AS 47.30.915(16) is amended to read: 10 (16) "mental health professional" means a psychiatrist or physician 11 who is licensed by the State Medical Board to practice in this state or is employed by 12 the federal government; a clinical psychologist licensed by the state Board of 13 Psychologist and Psychological Associate Examiners; a psychological associate 14 trained in clinical psychology and licensed by the Board of Psychologist and 15 Psychological Associate Examiners; an advanced practice registered nurse or a 16 registered nurse with a master's degree in psychiatric nursing, licensed by the State 17 Board of Nursing or holding a multistate licensure privilege under AS 08.68; a 18 marital and family therapist licensed by the Board of Marital and Family Therapy; a 19 professional counselor licensed by the Board of Professional Counselors; a clinical 20 social worker licensed by the Board of Social Work Examiners; and a person who 21 (A) has a master's degree in the field of mental health; 22 (B) has at least 12 months of post-masters working experience 23 in the field of mental illness; and 24 (C) is working under the supervision of a type of licensee listed 25 in this paragraph; 26 * Sec. 30. AS 47.33.020(d) is amended to read: 27 (d) An assisted living home may provide intermittent nursing services to a 28 resident who does not require 24-hour nursing services and supervision. Intermittent 29 nursing services may be provided only by a nurse licensed or holding a multistate 30 licensure privilege under AS 08.68 or by a person to whom a nursing task has been 31 delegated under (e) of this section.
01 * Sec. 31. AS 47.33.020(e) is amended to read: 02 (e) A person who is on the staff of an assisted living home and who is not a 03 nurse licensed or holding a multistate licensure privilege under AS 08.68 may 04 perform a nursing task in that home if 05 (1) the authority to perform that nursing task is delegated to that person 06 by a nurse licensed or holding a multistate licensure privilege under AS 08.68; and 07 (2) that nursing task is specified in regulations adopted by the Board of 08 Nursing as a task that may be delegated. 09 * Sec. 32. AS 47.33.020(f) is amended to read: 10 (f) A resident who needs skilled nursing care may, with the consent of the 11 assisted living home, arrange for that care to be provided in the home by a nurse 12 licensed or holding a multistate licensure privilege under AS 08.68 if that 13 arrangement does not interfere with the services provided to other residents. 14 * Sec. 33. AS 47.33.020(g) is amended to read: 15 (g) As part of a plan to avoid transfer of a resident from the home for medical 16 reasons, the home may provide, through the services of a nurse who is licensed or 17 holding a multistate licensure privilege under AS 08.68, 24-hour skilled nursing 18 care to the resident for not more than 45 consecutive days. 19 * Sec. 34. AS 47.33.020(h) is amended to read: 20 (h) If a resident has received 24-hour skilled nursing care for the 45-day limit 21 set by (g) of this section, the resident or the resident's representative may elect to have 22 the resident remain in the home without continuation of 24-hour skilled nursing care if 23 the home agrees to retain the resident after 24 (1) the home and either the resident or the resident's representative 25 have consulted with the resident's physician; 26 (2) the home and either the resident or the resident's representative 27 have discussed the consequences and risks involved in the election to remain in the 28 home; and 29 (3) the portion of the resident's assisted living plan that relates to 30 health-related services has been revised to provide for the resident's health-related 31 needs without the use of 24-hour skilled nursing care, and the revised plan has been
01 reviewed by a registered nurse licensed or holding a multistate licensure privilege 02 under AS 08.68, or advanced practice registered nurse licensed under AS 08.68, or by 03 the resident's attending physician. 04 * Sec. 35. AS 47.33.230(c) is amended to read: 05 (c) If the assisted living home provides or arranges for the provision of health- 06 related services to a resident, the home shall ensure that a 07 (1) registered nurse licensed or holding a multistate licensure 08 privilege under AS 08.68 or advanced practice registered nurse licensed under 09 AS 08.68 reviews the portion of an assisted living plan that describes how the 10 resident's need for health-related services will be met; and 11 (2) physician's statement about the resident is included in the plan. 12 * Sec. 36. The uncodified law of the State of Alaska is amended by adding a new section to 13 read: 14 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 15 Economic Development and the Board of Nursing may adopt regulations necessary to 16 implement the changes made by this Act. The regulations take effect under AS 44.62 17 (Administrative Procedure Act), but not before the effective date of the law implemented by 18 the regulation. 19 * Sec. 37. Section 36 of this Act takes effect immediately under AS 01.10.070(c). 20 * Sec. 38. Except as provided in sec. 37 of this Act, this Act takes effect July 1, 2024.