Bill Text: NY A07946 | 2023-2024 | General Assembly | Introduced


Bill Title: Adopts the interstate nurse licensure compact (Part A); adopts the advanced practice registered nurse compact (Part B).

Spectrum: Partisan Bill (Republican 10-0)

Status: (Introduced) 2024-05-07 - held for consideration in higher education [A07946 Detail]

Download: New_York-2023-A07946-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                          7946

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                     August 4, 2023
                                       ___________

        Introduced by M. of A. MILLER -- read once and referred to the Committee
          on Higher Education

        AN  ACT  to  amend the education law, in relation to adopting the inter-
          state nurse licensure compact (Part A); and  to  amend  the  education
          law,  in  relation  to adopting the advanced practice registered nurse
          compact (Part B)

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section 1. This act enacts into law components of legislation relating
     2  to  enacting  the  interstate  nurse  licensure compact and the advanced
     3  practice registered nurse compact. Each component  is  wholly  contained
     4  within  a  Part  identified as Parts A through B. The effective date for
     5  each particular provision contained within such Part is set forth in the
     6  last section of such Part. Any provision in any section contained within
     7  a Part, including the effective date of the Part, which makes  reference
     8  to a section "of this act", when used in connection with that particular
     9  component,  shall  be  deemed  to  mean  and  refer to the corresponding
    10  section of the Part in which it is found. Section three of this act sets
    11  forth the general effective date of this act.

    12                                   PART A

    13    Section 1. The education law is amended by adding a new  section  6912
    14  to read as follows:
    15    §  6912.  Interstate  nurse  licensure  compact.  The interstate nurse
    16  licensure compact is hereby enacted into law and entered into  with  all
    17  jurisdictions  legally  joining  therein  in  the  form substantially as
    18  follows:


         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11345-01-3

        A. 7946                             2

     1                     INTERSTATE NURSE LICENSURE COMPACT
     2                                 ARTICLE I.
     3                     Findings and declaration of purpose
     4    a. The party states find that:
     5    1.  The  health and safety of the public are affected by the degree of
     6  compliance with and the effectiveness of enforcement activities  related
     7  to state nurse licensure laws;
     8    2.  Violations  of nurse licensure and other laws regulating the prac-
     9  tice of nursing may result in injury or harm to the public;
    10    3. The expanded mobility of nurses and the use  of  advanced  communi-
    11  cation  technologies as part of our nation's health care delivery system
    12  require greater coordination and cooperation among states in  the  areas
    13  of nurse licensure and regulation;
    14    4.  New  practice modalities and technology make compliance with indi-
    15  vidual state nurse licensure laws difficult and complex;
    16    5. The current system of duplicative licensure for  nurses  practicing
    17  in  multiple  states  is  cumbersome  and  redundant for both nurses and
    18  states; and
    19    6. Uniformity of nurse licensure requirements  throughout  the  states
    20  promotes public safety and public health benefits.
    21    b. The general purposes of this compact are to:
    22    1.  Facilitate  the  states'  responsibility  to  protect the public's
    23  health and safety;
    24    2. Ensure and encourage the cooperation of party states in  the  areas
    25  of nurse licensure and regulation;
    26    3.  Facilitate the exchange of information between party states in the
    27  areas of nurse regulation, investigation and adverse actions;
    28    4. Promote compliance with the laws governing the practice of  nursing
    29  in each jurisdiction;
    30    5. Invest all party states with the authority to hold a nurse account-
    31  able  for  meeting  all  state  practice  laws in the state in which the
    32  patient is located at the time  care  is  rendered  through  the  mutual
    33  recognition of party state licenses;
    34    6.  Decrease  redundancies  in the consideration and issuance of nurse
    35  licenses; and
    36    7. Provide opportunities for interstate practice by  nurses  who  meet
    37  uniform licensure requirements.

    38                                 ARTICLE II.
    39                                 Definitions

    40    As used in this compact:
    41    a.  "adverse  action"  means  any  administrative, civil, equitable or
    42  criminal action permitted by a  state's  laws  which  is  imposed  by  a
    43  licensing  board  or  other authority against a nurse, including actions
    44  against an individual's license or multistate licensure  privilege  such
    45  as  revocation, suspension, probation, monitoring of the licensee, limi-
    46  tation on the licensee's practice, or any other encumbrance on licensure
    47  affecting a nurse's authorization to practice, including issuance  of  a
    48  cease and desist action.
    49    b.  "alternative  program" means a non-disciplinary monitoring program
    50  approved by a licensing board.
    51    c. "coordinated licensure  information  system"  means  an  integrated
    52  process  for collecting, storing and sharing information on nurse licen-
    53  sure and enforcement activities related to nurse licensure laws that  is

        A. 7946                             3

     1  administered  by  a nonprofit organization composed of and controlled by
     2  licensing boards.
     3    d. "current significant investigative information" means:
     4    1.  Investigative information that a licensing board, after a prelimi-
     5  nary inquiry that includes notification and an opportunity for the nurse
     6  to respond, if required by state law,  has  reason  to  believe  is  not
     7  groundless and, if proved true, would indicate more than a minor infrac-
     8  tion; or
     9    2.  Investigative information that indicates that the nurse represents
    10  an immediate threat to public health and safety  regardless  of  whether
    11  the nurse has been notified and had an opportunity to respond.
    12    e.  "encumbrance"  means a revocation or suspension of, or any limita-
    13  tion on, the full and unrestricted practice  of  nursing  imposed  by  a
    14  licensing board.
    15    f.  "home  state"  means  the party state which is the nurse's primary
    16  state of residence.
    17    g. "licensing board" means a party state's regulatory body responsible
    18  for issuing nurse licenses.
    19    h. "multistate license" means a license to practice as a registered or
    20  a licensed practical/vocational nurse (lpn/vn) issued by  a  home  state
    21  licensing  board  that  authorizes the licensed nurse to practice in all
    22  party states under a multistate licensure privilege.
    23    i. "multistate licensure privilege" means a legal authorization  asso-
    24  ciated  with  a multistate license permitting the practice of nursing as
    25  either a registered nurse (rn) or lpn/vn in a remote state.
    26    j. "nurse" means rn or lpn/vn, as those  terms  are  defined  by  each
    27  party state's practice laws.
    28    k. "party state" means any state that has adopted this compact.
    29    l. "remote state" means a party state, other than the home state.
    30    m.  "single-state  license"  means  a  nurse license issued by a party
    31  state that authorizes practice only within the issuing  state  and  does
    32  not  include  a  multistate licensure privilege to practice in any other
    33  party state.
    34    n. "state" means a state, territory or possession of the United States
    35  and the District of Columbia.
    36    o. "state practice laws" means a party state's laws, rules  and  regu-
    37  lations that govern the practice of nursing, define the scope of nursing
    38  practice,  and  create  the methods and grounds for imposing discipline.
    39  "state practice laws" do not include requirements  necessary  to  obtain
    40  and  retain  a license, except for qualifications or requirements of the
    41  home state.

    42                                ARTICLE III.
    43                     General provisions and jurisdiction

    44    a.  A  multistate  license  to   practice   registered   or   licensed
    45  practical/vocational  nursing  issued  by  a home state to a resident in
    46  that state will be recognized by each party state as authorizing a nurse
    47  to  practice  as  a   registered   nurse   (rn)   or   as   a   licensed
    48  practical/vocational nurse (lpn/vn), under a multistate licensure privi-
    49  lege, in each party state.
    50    b.  A  state  must  implement  procedures for considering the criminal
    51  history records of applicants for initial multistate license  or  licen-
    52  sure  by  endorsement.  Such  procedures shall include the submission of
    53  fingerprints or other biometric-based information by applicants for  the
    54  purpose  of obtaining an applicant's criminal history record information

        A. 7946                             4

     1  from the federal bureau of investigation and the agency responsible  for
     2  retaining that state's criminal records.
     3    c.  Each  party  state shall require the following for an applicant to
     4  obtain or retain a multistate license in the home state:
     5    1. Meets the home state's qualifications for licensure or  renewal  of
     6  licensure, as well as, all other applicable state laws;
     7    2. i. Has graduated or is eligible to graduate from a licensing board-
     8  approved rn or lpn/vn prelicensure education program; or
     9    ii.  Has  graduated from a foreign rn or lpn/vn prelicensure education
    10  program that (a) has been approved by the authorized accrediting body in
    11  the applicable country and (b)  has  been  verified  by  an  independent
    12  credentials review agency to be comparable to a licensing board-approved
    13  prelicensure education program;
    14    3.  Has, if a graduate of a foreign prelicensure education program not
    15  taught in english or if english is not the individual's native language,
    16  successfully passed an English proficiency examination that includes the
    17  components of reading, speaking, writing and listening;
    18    4. Has successfully passed an  nclex-rn  or  nclex-pn  examination  or
    19  recognized predecessor, as applicable;
    20    5. Is eligible for or holds an active, unencumbered license;
    21    6. Has submitted, in connection with an application for initial licen-
    22  sure  or  licensure by endorsement, fingerprints or other biometric data
    23  for the purpose of obtaining criminal history  record  information  from
    24  the  federal  bureau  of  investigation  and  the agency responsible for
    25  retaining that state's criminal records;
    26    7. Has not been convicted or found guilty,  or  has  entered  into  an
    27  agreed disposition, of a felony offense under applicable state or feder-
    28  al criminal law;
    29    8.  Has  not  been  convicted  or found guilty, or has entered into an
    30  agreed disposition, of a misdemeanor offense related to the practice  of
    31  nursing as determined on a case-by-case basis;
    32    9. Is not currently enrolled in an alternative program;
    33    10.  Is  subject  to  self-disclosure  requirements  regarding current
    34  participation in an alternative program; and
    35    11. Has a valid united states social security number.
    36    d. All party states shall be authorized, in accordance  with  existing
    37  state  due  process law, to take adverse action against a nurse's multi-
    38  state licensure privilege such as revocation, suspension,  probation  or
    39  any  other action that affects a nurse's authorization to practice under
    40  a multistate licensure privilege, including cease  and  desist  actions.
    41  If  a party state takes such action, it shall promptly notify the admin-
    42  istrator of the coordinated licensure information system.  The  adminis-
    43  trator  of  the  coordinated licensure information system shall promptly
    44  notify the home state of any such actions by remote states.
    45    e. A nurse practicing in a party state  must  comply  with  the  state
    46  practice  laws  of  the state in which the client is located at the time
    47  service is provided. The practice of nursing is not limited  to  patient
    48  care,  but  shall  include  all nursing practice as defined by the state
    49  practice laws of the party state in which the  client  is  located.  The
    50  practice of nursing in a party state under a multistate licensure privi-
    51  lege  will  subject  a nurse to the jurisdiction of the licensing board,
    52  the courts and the laws of the  party  state  in  which  the  client  is
    53  located at the time service is provided.
    54    f. Individuals not residing in a party state shall continue to be able
    55  to  apply for a party state's single-state license as provided under the
    56  laws of each party state. However, the single-state license  granted  to

        A. 7946                             5

     1  these  individuals  will  not be recognized as granting the privilege to
     2  practice nursing in any other party state. Nothing in this compact shall
     3  affect the requirements established by a party state for the issuance of
     4  a single-state license.
     5    g. Any nurse holding a home state multistate license, on the effective
     6  date of this compact, may retain and renew the multistate license issued
     7  by the nurse's then-current home state, provided that:
     8    1.  A  nurse,  who  changes  primary  state  of  residence  after this
     9  compact's effective date,  must  meet  all  applicable  requirements  of
    10  subdivision  c of this article to obtain a multistate license from a new
    11  home state.
    12    2. A nurse who fails to satisfy the multistate licensure  requirements
    13  in  subdivision  c of this article.  Due to a disqualifying event occur-
    14  ring after this compact's effective date shall be ineligible  to  retain
    15  or  renew a multistate license, and the nurse's multistate license shall
    16  be revoked or deactivated in accordance with applicable rules adopted by
    17  the interstate commission  of  nurse  licensure  compact  administrators
    18  ("commission").

    19                                 ARTICLE IV.
    20                 Applications for licensure in a party state

    21    a.  Upon  application for a multistate license, the licensing board in
    22  the issuing party state shall ascertain, through the coordinated  licen-
    23  sure  information system, whether the applicant has ever held, or is the
    24  holder of, a license issued by any other state, whether  there  are  any
    25  encumbrances  on  any  license or multistate licensure privilege held by
    26  the applicant, whether any adverse action has  been  taken  against  any
    27  license  or  multistate  licensure  privilege  held by the applicant and
    28  whether the applicant  is  currently  participating  in  an  alternative
    29  program.
    30    b. A nurse may hold a multistate license, issued by the home state, in
    31  only one party state at a time.
    32    c. If a nurse changes primary state of residence by moving between two
    33  party  states, the nurse must apply for licensure in the new home state,
    34  and the multistate license issued by the prior home state will be  deac-
    35  tivated in accordance with applicable rules adopted by the commission.
    36    1. The nurse may apply for licensure in advance of a change in primary
    37  state of residence.
    38    2.  A  multistate  license  shall  not be issued by the new home state
    39  until the nurse provides satisfactory evidence of a  change  in  primary
    40  state  of  residence  to the new home state and satisfies all applicable
    41  requirements to obtain a multistate license from the new home state.
    42    d. If a nurse changes primary state of  residence  by  moving  from  a
    43  party  state  to a non-party state, the multistate license issued by the
    44  prior home state will convert to a single-state license, valid  only  in
    45  the former home state.

    46                                 ARTICLE V.
    47       Additional authorities invested in party state licensing boards

    48    a. In addition to the other powers conferred by state law, a licensing
    49  board shall have the authority to:
    50    1.  Take  adverse action against a nurse's multistate licensure privi-
    51  lege to practice within that party state.

        A. 7946                             6

     1    i. Only the home state shall have the power  to  take  adverse  action
     2  against a nurse's license issued by the home state.
     3    ii.  For  purposes  of taking adverse action, the home state licensing
     4  board shall give the  same  priority  and  effect  to  reported  conduct
     5  received  from  a  remote state as it would if such conduct had occurred
     6  within the home state. In so doing, the home state shall apply  its  own
     7  state laws to determine appropriate action.
     8    2. Issue cease and desist orders or impose an encumbrance on a nurse's
     9  authority to practice within that party state.
    10    3.  Complete any pending investigations of a nurse who changes primary
    11  state of residence during the course of such investigations. The licens-
    12  ing board shall also have the authority to  take  appropriate  action(s)
    13  and  shall promptly report the conclusions of such investigations to the
    14  administrator of  the  coordinated  licensure  information  system.  The
    15  administrator  of  the  coordinated  licensure  information system shall
    16  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
    19  evidence. Subpoenas issued by a licensing board in a party state for the
    20  attendance and testimony of witnesses or the production of evidence from
    21  another  party  state shall be enforced in the latter state by any court
    22  of competent jurisdiction, according to the practice  and  procedure  of
    23  that  court applicable to subpoenas issued in proceedings pending before
    24  it. The issuing authority shall pay any witness fees,  travel  expenses,
    25  mileage  and other fees required by the service statutes of the state in
    26  which the witnesses or evidence are located.
    27    5. Obtain and submit, for each nurse licensure applicant,  fingerprint
    28  or  other  biometric-based information to the federal bureau of investi-
    29  gation for criminal background checks, receive the results of the feder-
    30  al bureau of investigation record search on criminal  background  checks
    31  and use the results in making licensure decisions.
    32    6.  If  otherwise  permitted  by  state law, recover from the affected
    33  nurse the costs of investigations and  disposition  of  cases  resulting
    34  from any adverse action taken against that nurse.
    35    7.  Take  adverse  action  based on the factual findings of the remote
    36  state, provided that the licensing board follows its own procedures  for
    37  taking such adverse action.
    38    b.  If  adverse  action  is  taken by the home state against a nurse's
    39  multistate license, the nurse's multistate licensure privilege to  prac-
    40  tice  in  all  other  party states shall be deactivated until all encum-
    41  brances have been removed from the multistate license.  All  home  state
    42  disciplinary  orders that impose adverse action against a nurse's multi-
    43  state license shall include a  statement  that  the  nurse's  multistate
    44  licensure  privilege  is  deactivated  in  all  party  states during the
    45  pendency of the order.
    46    c. Nothing in this compact shall override  a  party  state's  decision
    47  that  participation  in  an  alternative  program may be used in lieu of
    48  adverse action. The home state  licensing  board  shall  deactivate  the
    49  multistate licensure privilege under the multistate license of any nurse
    50  for the duration of the nurse's participation in an alternative program.

    51                                 ARTICLE VI.
    52    Coordinated licensure information system and exchange of information

    53    a.  All  party  states  shall  participate  in a coordinated licensure
    54  information system of all licensed registered nurses (rns) and  licensed

        A. 7946                             7

     1  practical/vocational  nurses (lpns/vns). This system will include infor-
     2  mation on the licensure and  disciplinary  history  of  each  nurse,  as
     3  submitted by party states, to assist in the coordination of nurse licen-
     4  sure and enforcement efforts.
     5    b. The commission, in consultation with the administrator of the coor-
     6  dinated  licensure  information  system,  shall  formulate necessary and
     7  proper procedures for the identification,  collection  and  exchange  of
     8  information under this compact.
     9    c.  All  licensing  boards  shall  promptly  report to the coordinated
    10  licensure information system any adverse action, any current significant
    11  investigative information, denials of applications (with the reasons for
    12  such denials) and nurse participation in alternative programs  known  to
    13  the  licensing  board regardless of whether such participation is deemed
    14  nonpublic or confidential under state law.
    15    d. Current significant investigative information and participation  in
    16  nonpublic  or  confidential  alternative  programs  shall be transmitted
    17  through the coordinated licensure information system only to party state
    18  licensing boards.
    19    e. Notwithstanding any other provision of law, all party state licens-
    20  ing boards contributing information to the coordinated licensure  infor-
    21  mation  system  may  designate  information  that may not be shared with
    22  non-party states or disclosed to other entities or  individuals  without
    23  the express permission of the contributing state.
    24    f.  Any  personally identifiable information obtained from the coordi-
    25  nated licensure information system by  a  party  state  licensing  board
    26  shall not be shared with non-party states or disclosed to other entities
    27  or  individuals  except to the extent permitted by the laws of the party
    28  state contributing the information.
    29    g. Any information contributed to the coordinated  licensure  informa-
    30  tion  system that is subsequently required to be expunged by the laws of
    31  the party state contributing that information  shall  also  be  expunged
    32  from the coordinated licensure information system.
    33    h.  The  compact  administrator  of  each  party state shall furnish a
    34  uniform data set to the compact administrator of each other party state,
    35  which shall include, at a minimum:
    36    1. Identifying information;
    37    2. Licensure data;
    38    3. Information related to alternative program participation; and
    39    4. Other information that may facilitate the  administration  of  this
    40  compact, as determined by commission rules.
    41    i. The compact administrator of a party state shall provide all inves-
    42  tigative documents and information requested by another party state.

    43                                ARTICLE VII.
    44    Establishment of the interstate commission of nurse licensure compact
    45                               administrators

    46    a.  The party states hereby create and establish a joint public entity
    47  known as the interstate commission of nurse licensure  compact  adminis-
    48  trators.
    49    1. The commission is an instrumentality of the party states.
    50    2. Venue is proper, and judicial proceedings by or against the commis-
    51  sion  shall  be  brought solely and exclusively, in a court of competent
    52  jurisdiction where the principal office of the  commission  is  located.
    53  The commission may waive venue and jurisdictional defenses to the extent

        A. 7946                             8

     1  it  adopts  or consents to participate in alternative dispute resolution
     2  proceedings.
     3    3. Nothing in this compact shall be construed to be a waiver of sover-
     4  eign immunity.
     5    b. Membership, voting and meetings.
     6    1.  Each  party  state shall have and be limited to one administrator.
     7  The head of the state licensing board or designee shall be the  adminis-
     8  trator  of  this  compact for each party state. Any administrator may be
     9  removed or suspended from office as provided by the  law  of  the  state
    10  from  which the administrator is appointed. Any vacancy occurring in the
    11  commission shall be filled in accordance with  the  laws  of  the  party
    12  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
    15  have an opportunity to participate in the business and  affairs  of  the
    16  commission. An administrator shall vote in person or by such other means
    17  as provided in the bylaws. The bylaws may provide for an administrator's
    18  participation in meetings by telephone or other means of communication.
    19    3.  The commission shall meet at least once during each calendar year.
    20  Additional meetings shall be held as set forth in the bylaws or rules of
    21  the 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 rule-
    24  making provisions in article VIII of this compact.
    25    5. The commission may convene in a closed, nonpublic  meeting  if  the
    26  commission must discuss:
    27    i.  Noncompliance  of  a  party  state with its obligations under this
    28  compact;
    29    ii.  The  employment,  compensation,  discipline  or  other  personnel
    30  matters,  practices or procedures related to specific employees or other
    31  matters related to the commission's  internal  personnel  practices  and
    32  procedures;
    33    iii. Current, threatened or reasonably anticipated litigation;
    34    iv.  Negotiation  of  contracts  for  the  purchase  or sale of goods,
    35  services or real estate;
    36    v. Accusing any person of a crime or formally censuring any person;
    37    vi. Disclosure of trade secrets or commercial or financial information
    38  that is privileged or confidential;
    39    vii. Disclosure of information of a personal nature  where  disclosure
    40  would constitute a clearly unwarranted invasion of personal privacy;
    41    viii. Disclosure of investigatory records compiled for law enforcement
    42  purposes;
    43    ix. Disclosure of information related to any reports prepared by or on
    44  behalf  of the commission for the purpose of investigation of compliance
    45  with this compact; or
    46    x. Matters specifically exempted from disclosure by federal  or  state
    47  statute.
    48    6.  If  a meeting, or portion of a meeting, is closed pursuant to this
    49  provision, the commission's legal counsel or designee shall certify that
    50  the meeting may be closed and shall reference  each  relevant  exempting
    51  provision.  The  commission  shall  keep  minutes that fully and clearly
    52  describe all matters discussed in a meeting and shall provide a full and
    53  accurate summary of actions taken, and the reasons therefor, including a
    54  description  of  the  views  expressed.  All  documents  considered   in
    55  connection  with  an  action  shall  be  identified in such minutes. All
    56  minutes and documents of a  closed  meeting  shall  remain  under  seal,

        A. 7946                             9

     1  subject  to  release  by a majority vote of the commission or order of a
     2  court of competent jurisdiction.
     3    c.  The  commission  shall,  by a majority vote of the administrators,
     4  prescribe bylaws or rules to govern its conduct as may be  necessary  or
     5  appropriate  to  carry  out the purposes and exercise the powers of this
     6  compact, including but not limited to:
     7    1. Establishing the fiscal year of the commission;
     8    2. Providing reasonable standards and procedures:
     9    i. For the establishment and meetings of other committees; and
    10    ii. Governing any general or specific delegation of any  authority  or
    11  function of the commission;
    12    3. Providing reasonable procedures for calling and conducting meetings
    13  of  the  commission,  ensuring reasonable advance notice of all meetings
    14  and providing an opportunity for attendance of such meetings  by  inter-
    15  ested  parties,  with  enumerated  exceptions  designed  to  protect the
    16  public's interest, the privacy of individuals, and proprietary  informa-
    17  tion, including trade secrets. The commission may meet in closed session
    18  only  after  a majority of the administrators vote to close a meeting in
    19  whole or in part. As soon  as  practicable,  the  commission  must  make
    20  public  a  copy  of  the vote to close the meeting revealing the vote of
    21  each administrator, with no proxy votes allowed;
    22    4. Establishing the titles, duties and authority and reasonable proce-
    23  dures for the election of the officers of the commission;
    24    5. Providing reasonable standards and procedures for the establishment
    25  of the personnel policies and programs of the commission.  Notwithstand-
    26  ing  any  civil  service  or  other similar laws of any party state, the
    27  bylaws shall exclusively govern the personnel policies and  programs  of
    28  the commission; and
    29    6.  Providing a mechanism for winding up the operations of the commis-
    30  sion and the equitable disposition of any surplus funds that  may  exist
    31  after  the termination of this compact after the payment or reserving of
    32  all of its debts and obligations.
    33    d. The commission shall publish its bylaws and rules, and  any  amend-
    34  ments thereto, in a convenient form on the website of the commission.
    35    e.  The  commission shall maintain its financial records in accordance
    36  with the bylaws.
    37    f. The commission shall meet and take such actions as  are  consistent
    38  with the provisions of this compact and the bylaws.
    39    g. The commission shall have the following powers:
    40    1.  To promulgate uniform rules to facilitate and coordinate implemen-
    41  tation and administration of this compact.  The  rules  shall  have  the
    42  force and effect of law and shall be binding in all party states;
    43    2.  To bring and prosecute legal proceedings or actions in the name of
    44  the commission, provided that the standing of any licensing board to sue
    45  or be sued under applicable law shall not be affected;
    46    3. To purchase and maintain insurance and bonds;
    47    4. To borrow, accept or contract for services of personnel, including,
    48  but not limited to, employees of a party state  or  nonprofit  organiza-
    49  tions;
    50    5.  To  cooperate  with  other  organizations  that  administer  state
    51  compacts related to the regulation of nursing, including but not limited
    52  to sharing administrative or  staff  expenses,  office  space  or  other
    53  resources;
    54    6.  To  hire  employees,  elect or appoint officers, fix compensation,
    55  define duties, grant such individuals appropriate authority to carry out
    56  the purposes of this compact, and to establish the commission's  person-

        A. 7946                            10

     1  nel  policies and programs relating to conflicts of interest, qualifica-
     2  tions of personnel and other related personnel matters;
     3    7.  To  accept  any and all appropriate donations, grants and gifts of
     4  money, equipment, supplies, materials  and  services,  and  to  receive,
     5  utilize  and dispose of the same; provided that at all times the commis-
     6  sion shall avoid any appearance of impropriety or conflict of interest;
     7    8. To lease, purchase, accept appropriate gifts or  donations  of,  or
     8  otherwise  to  own,  hold,  improve  or use, any property, whether real,
     9  personal or mixed; provided that at all times the commission shall avoid
    10  any appearance of impropriety;
    11    9. To sell, convey, mortgage,  pledge,  lease,  exchange,  abandon  or
    12  otherwise dispose of any property, whether real, personal or mixed;
    13    10. To establish a budget and make expenditures;
    14    11. To borrow money;
    15    12.  To appoint committees, including advisory committees comprised of
    16  administrators, state nursing regulators,  state  legislators  or  their
    17  representatives, and consumer representatives, and other such interested
    18  persons;
    19    13.  To  provide  and receive information from, and to cooperate with,
    20  law enforcement agencies;
    21    14. To adopt and use an official seal; and
    22    15. To perform such other functions as may be necessary or appropriate
    23  to achieve the purposes of this compact consistent with the state  regu-
    24  lation of nurse licensure and practice.
    25    h. Financing of the commission.
    26    1.  The  commission  shall  pay,  or  provide  for the payment of, the
    27  reasonable expenses  of  its  establishment,  organization  and  ongoing
    28  activities.
    29    2.  The  commission  may also levy on and collect an annual assessment
    30  from each party state to cover the cost of  its  operations,  activities
    31  and  staff  in  its  annual  budget as approved each year. The aggregate
    32  annual assessment amount, if any, shall be allocated based upon a formu-
    33  la to be determined by the commission, which  shall  promulgate  a  rule
    34  that is binding upon all party states.
    35    3.  The  commission  shall  not incur obligations of any kind prior to
    36  securing the funds adequate to meet the same; nor shall  the  commission
    37  pledge  the  credit  of any of the party states, except by, and with the
    38  authority of, such party state.
    39    4. The commission shall keep accurate accounts  of  all  receipts  and
    40  disbursements.    The receipts and disbursements of the commission shall
    41  be subject to the audit and accounting procedures established under  its
    42  bylaws.  However, all receipts and disbursements of funds handled by the
    43  commission shall be audited yearly by a  certified  or  licensed  public
    44  accountant,  and the report of the audit shall be included in and become
    45  part of the annual report of the commission.
    46    i. Qualified immunity, defense and indemnification.
    47    1. The administrators, officers,  executive  director,  employees  and
    48  representatives  of the commission shall be immune from suit and liabil-
    49  ity, either personally or in their official capacity, for any claim  for
    50  damage  to or loss of property or personal injury or other civil liabil-
    51  ity caused by or arising out of any actual  or  alleged  act,  error  or
    52  omission  that  occurred,  or  that the person against whom the claim is
    53  made had a reasonable basis for believing occurred, within the scope  of
    54  commission employment, duties or responsibilities; provided that nothing
    55  in  this  paragraph  shall  be construed to protect any such person from

        A. 7946                            11

     1  suit or liability for any damage, loss, injury or  liability  caused  by
     2  the intentional, willful or wanton misconduct of that person.
     3    2.  The  commission shall defend any administrator, officer, executive
     4  director, employee or representative of  the  commission  in  any  civil
     5  action  seeking to impose liability arising out of any actual or alleged
     6  act, error or omission that occurred  within  the  scope  of  commission
     7  employment,  duties or responsibilities, or that the person against whom
     8  the claim is made had a reasonable basis for believing  occurred  within
     9  the scope of commission employment, duties or responsibilities; provided
    10  that  nothing  herein  shall  be  construed to prohibit that person from
    11  retaining his or her own counsel; and provided further that  the  actual
    12  or  alleged  act,  error  or  omission did not result from that person's
    13  intentional, willful or wanton misconduct.
    14    3. The commission shall indemnify and hold harmless any administrator,
    15  officer, executive director, employee or representative of  the  commis-
    16  sion  for the amount of any settlement or judgment obtained against that
    17  person arising out of any actual or alleged act, error or omission  that
    18  occurred  within the scope of commission employment, duties or responsi-
    19  bilities, or that such person  had  a  reasonable  basis  for  believing
    20  occurred  within the scope of commission employment, duties or responsi-
    21  bilities, provided that the actual or alleged act, error or omission did
    22  not result from the intentional, willful or wanton  misconduct  of  that
    23  person.

    24                                ARTICLE VIII.
    25                                 Rulemaking

    26    a. The commission shall exercise its rulemaking powers pursuant to the
    27  criteria  set  forth  in  this article and the rules adopted thereunder.
    28  Rules and amendments shall become binding as of the  date  specified  in
    29  each  rule  or  amendment  and  shall  have the same force and effect as
    30  provisions of this compact.
    31    b. Rules or amendments to the rules shall be adopted at a  regular  or
    32  special meeting of the commission.
    33    c.  Prior to promulgation and adoption of a final rule or rules by the
    34  commission, and at least sixty (60) days in advance of  the  meeting  at
    35  which  the  rule will be considered and voted upon, the commission shall
    36  file a notice of proposed rulemaking:
    37    1. On the website of the commission; and
    38    2. On the website of each licensing board or the publication in  which
    39  each state would otherwise publish proposed rules.
    40    d. The notice of proposed rulemaking shall include:
    41    1.  The  proposed  time, date and location of the meeting in which the
    42  rule will be considered and voted upon;
    43    2. The text of the proposed rule or amendment, and the reason for  the
    44  proposed rule;
    45    3.  A  request  for  comments on the proposed rule from any interested
    46  person; and
    47    4. The manner in which interested persons may  submit  notice  to  the
    48  commission of their intention to attend the public hearing and any writ-
    49  ten comments.
    50    e.  Prior  to  adoption of a proposed rule, the commission shall allow
    51  persons to submit written data, facts,  opinions  and  arguments,  which
    52  shall be made available to the public.
    53    f.  The  commission  shall  grant  an opportunity for a public hearing
    54  before it adopts a rule or amendment.

        A. 7946                            12

     1    g. The commission shall publish the place, time and date of the sched-
     2  uled public hearing.
     3    1.  Hearings  shall be conducted in a manner providing each person who
     4  wishes to comment a fair and reasonable opportunity to comment orally or
     5  in writing. All hearings will be recorded,  and  a  copy  will  be  made
     6  available upon request.
     7    2.  Nothing in this section shall be construed as requiring a separate
     8  hearing on each rule. Rules may be grouped for the  convenience  of  the
     9  commission at hearings required by this section.
    10    h. If no one appears at the public hearing, the commission may proceed
    11  with promulgation of the proposed rule.
    12    i.  Following  the scheduled hearing date, or by the close of business
    13  on the scheduled hearing date if the hearing was not held,  the  commis-
    14  sion shall consider all written and oral comments received.
    15    j.  The commission shall, by majority vote of all administrators, take
    16  final action on the proposed rule and shall determine the effective date
    17  of the rule, if any, based on the rulemaking record and the full text of
    18  the rule.
    19    k. Upon determination that an emergency  exists,  the  commission  may
    20  consider  and  adopt an emergency rule without prior notice, opportunity
    21  for comment or hearing, provided that the  usual  rulemaking  procedures
    22  provided  in  this  compact  and  in this section shall be retroactively
    23  applied to the rule as soon as reasonably possible, in  no  event  later
    24  than  ninety  (90)  days  after  the effective date of the rule. For the
    25  purposes of this provision, an  emergency  rule  is  one  that  must  be
    26  adopted immediately in order to:
    27    1. Meet an imminent threat to public health, safety or welfare;
    28    2. Prevent a loss of commission or party state funds; or
    29    3. Meet a deadline for the promulgation of an administrative rule that
    30  is required by federal law or rule.
    31    l. The commission may direct revisions to a previously adopted rule or
    32  amendment  for  purposes  of  correcting typographical errors, errors in
    33  format, errors in consistency or grammatical errors.  Public  notice  of
    34  any  revisions  shall  be  posted  on the website of the commission. The
    35  revision shall be subject to challenge by any person  for  a  period  of
    36  thirty  (30)  days after posting. The revision may be challenged only on
    37  grounds that the revision results in a material  change  to  a  rule.  A
    38  challenge  shall  be  made  in writing, and delivered to the commission,
    39  prior to the end of the notice period. If  no  challenge  is  made,  the
    40  revision  will  take  effect  without further action. If the revision is
    41  challenged, the revision may not take effect without the approval of the
    42  commission.

    43                                 ARTICLE IX.
    44                Oversight, dispute resolution and enforcement

    45    a. Oversight.
    46    1. Each party state shall enforce this compact and  take  all  actions
    47  necessary  and  appropriate  to  effectuate  this compact's purposes and
    48  intent.
    49    2. The commission shall be entitled to receive service of  process  in
    50  any  proceeding  that may affect the powers, responsibilities or actions
    51  of the commission, and shall  have  standing  to  intervene  in  such  a
    52  proceeding  for  all  purposes. Failure to provide service of process in
    53  such proceeding to the commission shall render a judgment or order  void
    54  as to the commission, this compact or promulgated rules.

        A. 7946                            13

     1    b. Default, technical assistance and termination.
     2    1.  If  the  commission determines that a party state has defaulted in
     3  the performance  of  its  obligations  or  responsibilities  under  this
     4  compact or the promulgated rules, the commission shall:
     5    i.  Provide  written  notice  to  the defaulting state and other party
     6  states of the nature of the default, the proposed means  of  curing  the
     7  default or any other action to be taken by the commission; and
     8    ii.  Provide  remedial  training  and  specific  technical  assistance
     9  regarding the default.
    10    2. If a state in default fails to cure  the  default,  the  defaulting
    11  state's membership in this compact may be terminated upon an affirmative
    12  vote of a majority of the administrators, and all rights, privileges and
    13  benefits  conferred  by  this compact may be terminated on the effective
    14  date of termination. A cure of the default does not relieve the  offend-
    15  ing  state  of  obligations or liabilities incurred during the period of
    16  default.
    17    3. Termination of membership in this compact  shall  be  imposed  only
    18  after all other means of securing compliance have been exhausted. Notice
    19  of  intent  to  suspend or terminate shall be given by the commission to
    20  the governor of the defaulting state and to the executive officer of the
    21  defaulting state's licensing board and each of the party states.
    22    4. A state whose membership in this compact  has  been  terminated  is
    23  responsible  for  all  assessments, obligations and liabilities incurred
    24  through the effective date of termination,  including  obligations  that
    25  extend beyond the effective date of termination.
    26    5.  The commission shall not bear any costs related to a state that is
    27  found to be in default or whose membership  in  this  compact  has  been
    28  terminated  unless agreed upon in writing between the commission and the
    29  defaulting state.
    30    6. The defaulting state may appeal the action  of  the  commission  by
    31  petitioning  the u.s. district court for the district of columbia or the
    32  federal district in which the commission has its principal offices.  The
    33  prevailing  party shall be awarded all costs of such litigation, includ-
    34  ing reasonable attorneys' fees.
    35    c. Dispute resolution.
    36    1. Upon request by a party state,  the  commission  shall  attempt  to
    37  resolve  disputes  related  to the compact that arise among party states
    38  and between party and non-party states.
    39    2. The commission shall promulgate a rule providing for both mediation
    40  and binding dispute resolution for disputes, as appropriate.
    41    3. In the event the commission cannot  resolve  disputes  among  party
    42  states arising under this compact:
    43    i. The party states may submit the issues in dispute to an arbitration
    44  panel,  which  will be comprised of individuals appointed by the compact
    45  administrator in each of the affected party  states  and  an  individual
    46  mutually  agreed  upon  by  the  compact administrators of all the party
    47  states involved in the dispute.
    48    ii. The decision of a majority of the arbitrators shall be  final  and
    49  binding.
    50    d. Enforcement.
    51    1. The commission, in the reasonable exercise of its discretion, shall
    52  enforce the provisions and rules of this compact.
    53    2.  By  majority vote, the commission may initiate legal action in the
    54  u.s. district court for the district of columbia or the federal district
    55  in which the commission has its principal offices against a party  state
    56  that  is  in  default  to enforce compliance with the provisions of this

        A. 7946                            14

     1  compact and its promulgated rules and  bylaws.  The  relief  sought  may
     2  include  both  injunctive  relief  and  damages.  In  the event judicial
     3  enforcement is necessary, the prevailing  party  shall  be  awarded  all
     4  costs of such litigation, including reasonable attorneys' fees.
     5    3.  The  remedies  herein  shall  not be the exclusive remedies of the
     6  commission. The commission may pursue any other remedies available under
     7  federal or state law.

     8                                 ARTICLE X.
     9                  Effective date, withdrawal and amendment

    10    a. This compact shall become effective and binding on the  earlier  of
    11  the  date  of  legislative enactment of this compact into law by no less
    12  than twenty-six (26) states or December 31, 2018. All  party  states  to
    13  this  compact,  that  also  were  parties  to  the prior nurse licensure
    14  compact, superseded by this compact, ("prior compact"), shall be  deemed
    15  to  have  withdrawn  from said prior compact within six (6) months after
    16  the effective date of this compact.
    17    b. Each party state to this compact  shall  continue  to  recognize  a
    18  nurse's  multistate  licensure privilege to practice in that party state
    19  issued under the prior compact until such party state has withdrawn from
    20  the prior compact.
    21    c. Any party state may withdraw from this compact by enacting a  stat-
    22  ute repealing the same. A party state's withdrawal shall not take effect
    23  until six (6) months after enactment of the repealing statute.
    24    d.  A  party  state's  withdrawal  or termination shall not affect the
    25  continuing requirement of the withdrawing or terminated state's  licens-
    26  ing  board  to  report  adverse  actions  and significant investigations
    27  occurring prior to the effective date of such withdrawal or termination.
    28    e. Nothing contained in this compact shall be construed to  invalidate
    29  or  prevent  any nurse licensure agreement or other cooperative arrange-
    30  ment between a party state and a non-party state that is made in accord-
    31  ance with the other provisions of this compact.
    32    f. This compact may be amended by the party states.  No  amendment  to
    33  this  compact  shall  become effective and binding upon the party states
    34  unless and until it is enacted into the laws of all party states.
    35    g. Representatives of  non-party  states  to  this  compact  shall  be
    36  invited to participate in the activities of the commission, on a nonvot-
    37  ing basis, prior to the adoption of this compact by all states.

    38                                 ARTICLE XI.
    39                        Construction and severability

    40    This  compact  shall  be  liberally  construed so as to effectuate the
    41  purposes thereof. The provisions of this compact shall be severable, and
    42  if any phrase, clause, sentence or provision of this compact is declared
    43  to be contrary to the constitution of any party state or of  the  united
    44  states,  or  if  the  applicability  thereof  to any government, agency,
    45  person or circumstance is held invalid, the validity of the remainder of
    46  this compact and the applicability thereof to  any  government,  agency,
    47  person  or  circumstance  shall not be affected thereby. If this compact
    48  shall be held to be contrary to the constitution  of  any  party  state,
    49  this  compact  shall remain in full force and effect as to the remaining
    50  party states and in full force and effect as to the party state affected
    51  as to all severable matters.

        A. 7946                            15

     1    § 2. This act shall take effect on the ninetieth day  after  it  shall
     2  have  become  a  law.    Effective  immediately, the addition, amendment
     3  and/or repeal of any rule or regulation necessary for the implementation
     4  of this act on  its  effective  date  are  authorized  to  be  made  and
     5  completed on or before such effective date.

     6                                   PART B

     7    Section  1.  The education law is amended by adding a new section 6913
     8  to read as follows:
     9    § 6913. Advanced Practice Registered Nurse Compact. The advanced prac-
    10  tice registered nurse compact is hereby enacted  into  law  and  entered
    11  into with all jurisdictions legally joining therein in the form substan-
    12  tially as follows:

    13                                 ARTICLE I.
    14                     Findings and Declaration of Purpose

    15    a. The party states find that:
    16    1.  The  health and safety of the public are affected by the degree of
    17  compliance with APRN licensure requirements  and  the  effectiveness  of
    18  enforcement activities related to state APRN licensure laws;
    19    2. Violations of APRN licensure and other laws regulating the practice
    20  of nursing may result in injury or harm to the public;
    21    3.  The  expanded  mobility  of APRNs and the use of advanced communi-
    22  cation and intervention technologies as part of our nation's health care
    23  delivery system  require  greater  coordination  and  cooperation  among
    24  states in the areas of APRN licensure and regulation;
    25    4.  New  practice modalities and technology make compliance with indi-
    26  vidual state APRN licensure laws difficult and complex;
    27    5. The current system of duplicative APRN licensure for APRNs practic-
    28  ing in multiple states is cumbersome and redundant for healthcare deliv-
    29  ery systems, payors, state licensing boards, regulators and APRNs;
    30    6. Uniformity of APRN licensure  requirements  throughout  the  states
    31  promotes public safety and public health benefits as well as providing a
    32  mechanism to increase access to care.
    33    b. The general purposes of this Compact are to:
    34    1.  Facilitate  the  states'  responsibility  to  protect the public's
    35  health and safety;
    36    2. Ensure and encourage the cooperation of party states in  the  areas
    37  of  APRN licensure and regulation, including promotion of uniform licen-
    38  sure requirements;
    39    3. Facilitate the exchange of information between party states in  the
    40  areas of APRN regulation, investigation and adverse actions;
    41    4.  Promote  compliance  with the laws governing APRN practice in each
    42  jurisdiction;
    43    5. Invest all party states with the authority to hold an APRN account-
    44  able for meeting all state practice laws  in  the  state  in  which  the
    45  patient  is  located  at  the  time  care is rendered through the mutual
    46  recognition of party state privileges to practice;
    47    6. Decrease redundancies in the consideration  and  issuance  of  APRN
    48  licenses; and
    49    7.  Provide  opportunities  for  interstate practice by APRNs who meet
    50  uniform licensure requirements.

        A. 7946                            16

     1                                 ARTICLE II.
     2                                 Definitions

     3    As used in this Compact:
     4    a.  "Advanced  practice registered nurse" or "APRN" means a registered
     5  nurse who has gained additional specialized knowledge, skills and  expe-
     6  rience  through  a  program of study recognized or defined by the Inter-
     7  state Commission of APRN Compact Administrators ("commission"), and  who
     8  is  licensed  to perform advanced nursing practice. An advanced practice
     9  registered nurse is licensed in an APRN role that is congruent  with  an
    10  APRN educational program, certification, and Commission rules.
    11    b.  "Adverse  action"  means  any  administrative, civil, equitable or
    12  criminal action permitted by a  state's  laws  which  is  imposed  by  a
    13  licensing  board  or  other authority against an APRN, including actions
    14  against an individual's license or multistate licensure  privilege  such
    15  as  revocation, suspension, probation, monitoring of the licensee, limi-
    16  tation on the licensee's practice, or any other encumbrance on licensure
    17  affecting an APRN's authorization to practice, including the issuance of
    18  a cease and desist action.
    19    c. "Alternative program" means a non-disciplinary  monitoring  program
    20  approved by a licensing board.
    21    d.  "APRN  licensure"  means  the regulatory mechanism used by a party
    22  state to grant legal authority to practice as an APRN.
    23    e. "APRN uniform licensure requirements"  means  the  minimum  uniform
    24  licensure,  education and examination requirements set forth in subdivi-
    25  sion b of article III of this compact.
    26    f. "Coordinated licensure  information  system"  means  an  integrated
    27  process  for  collecting, storing and sharing information on APRN licen-
    28  sure and enforcement activities related to APRN licensure laws  that  is
    29  administered  by  a nonprofit organization composed of and controlled by
    30  licensing boards.
    31    g. "Current significant investigatory information" means:
    32    1. Investigative information that a licensing board, after a  prelimi-
    33  nary  inquiry that includes notification and an opportunity for the APRN
    34  to respond, if required by state law,  has  reason  to  believe  is  not
    35  groundless and, if proved true, would indicate more than a minor infrac-
    36  tion; or
    37    2.  Investigative  information that indicates that the APRN represents
    38  an immediate threat to public health and safety  regardless  of  whether
    39  the APRN has been notified and had an opportunity to respond.
    40    h.  "Encumbrance"  means a revocation or suspension of, or any limita-
    41  tion on, the full and unrestricted practice  of  nursing  imposed  by  a
    42  licensing board in connection with a disciplinary proceeding.
    43    i. "Home state" means the party state that is the APRN's primary state
    44  of residence.
    45    j. "Licensing board" means a party state's regulatory body responsible
    46  for regulating the practice of advanced practice registered nursing.
    47    k.  "Multistate  license" means an APRN license to practice as an APRN
    48  issued by a home state licensing board that authorizes the APRN to prac-
    49  tice as an APRN in all party states under a multistate licensure  privi-
    50  lege,  in  the same role and population focus as the APRN is licensed in
    51  the home state.
    52    l. "Multistate licensure privilege" means a legal authorization  asso-
    53  ciated  with an APRN multistate license that permits an APRN to practice
    54  as an APRN in a remote state, in the same role and population  focus  as
    55  the APRN is licensed in the home state.

        A. 7946                            17

     1    m.  "Non-controlled  prescription drug" means a device or drug that is
     2  not a controlled substance and is prohibited under state or federal  law
     3  from  being dispensed without a prescription. The term includes a device
     4  or drug that bears or is required to bear the legend  "Caution:  federal
     5  law prohibits dispensing without prescription" or "prescription only" or
     6  other legend that complies with federal law.
     7    n. "Party state" means any state that has adopted this Compact.
     8    o.  "Population  focus"  means  one  of  the  six  population  foci of
     9  family/individual across the  lifespan,  adult-gerontology,  pediatrics,
    10  neonatal, women's health/gender-related and psych/mental health.
    11    p.  "Prescriptive  authority"  means  the legal authority to prescribe
    12  medications and devices as defined by party state laws.
    13    q. "Remote state" means a party state that is not the home state.
    14    r. "Role" means one of the four recognized roles of  certified  regis-
    15  tered  nurse  anesthetists (CRNA), certified nurse-midwives (CNM), clin-
    16  ical nurse specialists (CNS) and certified nurse practitioners (CNP).
    17    s. "Single-state license" means an APRN  license  issued  by  a  party
    18  state  that  authorizes  practice only within the issuing state and does
    19  not include a multistate licensure privilege to practice  in  any  other
    20  party state.
    21    t. "State" means a state, territory or possession of the United States
    22  and the District of Columbia.
    23    u.  "State practice laws" means a party state's laws, rules, and regu-
    24  lations that govern APRN practice, define the scope of advanced  nursing
    25  practice  and  create  the  methods  and grounds for imposing discipline
    26  except that prescriptive authority shall be treated in  accordance  with
    27  subdivisions  f  and  g  of Article III of this Compact. "State practice
    28  laws" does not include:
    29    1. A party state's laws, rules, and regulations requiring  supervision
    30  or collaboration with a healthcare professional, except for laws, rules,
    31  and regulations regarding prescribing controlled substances; and
    32    2.  The  requirements  necessary to obtain and retain an APRN license,
    33  except for qualifications or requirements of the home state.

    34                                ARTICLE III.
    35                     General Provisions and Jurisdiction

    36    a. A state must implement  procedures  for  considering  the  criminal
    37  history  records of applicants for initial APRN licensure or APRN licen-
    38  sure by endorsement. Such procedures shall  include  the  submission  of
    39  fingerprints or other biometric-based information by APRN applicants for
    40  the purpose of obtaining an applicant's criminal history record informa-
    41  tion from the Federal Bureau of Investigation and the agency responsible
    42  for retaining that state's criminal records.
    43    b.  Each party state shall require an applicant to satisfy the follow-
    44  ing APRN uniform licensure requirements to obtain or retain a multistate
    45  license in the home state:
    46    1. Meets the home state's qualifications for licensure or  renewal  of
    47  licensure, as well as, all other applicable state laws;
    48    2.  i.  Has  completed  an accredited graduate-level education program
    49  that prepares the applicant for one of the  four  recognized  roles  and
    50  population foci; or
    51    ii. Has completed a foreign APRN education program for one of the four
    52  recognized  roles  and population foci that (a) has been approved by the
    53  authorized accrediting body in the applicable country and (b)  has  been

        A. 7946                            18

     1  verified by an independent credentials review agency to be comparable to
     2  a licensing board-approved APRN education program;
     3    3.  Has,  if a graduate of a foreign APRN education program not taught
     4  in English or if  English  is  not  the  individual's  native  language,
     5  successfully passed an English proficiency examination that includes the
     6  components of reading, speaking, writing and listening;
     7    4.  Has  successfully passed a national certification examination that
     8  measures APRN, role and population-focused  competencies  and  maintains
     9  continued  competence  as  evidenced  by recertification in the role and
    10  population focus through the national certification program;
    11    5. Holds an active, unencumbered license as a registered nurse and  an
    12  active, unencumbered authorization to practice as an APRN;
    13    6. Has successfully passed an NCLEX-RN examination or recognized pred-
    14  ecessor, as applicable;
    15    7.  Has  practiced  for  at least 2,080 hours as an APRN in a role and
    16  population focus congruent with the applicant's education and  training.
    17  For  purposes of this section, practice shall not include hours obtained
    18  as part of enrollment in an APRN education program;
    19    8. Has submitted, in connection with an application for initial licen-
    20  sure or licensure by endorsement, fingerprints or other  biometric  data
    21  for  the  purpose  of obtaining criminal history record information from
    22  the Federal Bureau of  Investigation  and  the  agency  responsible  for
    23  retaining  that  state  or,  if  applicable,  foreign country's criminal
    24  records;
    25    9. Has not been convicted or found guilty,  or  has  entered  into  an
    26  agreed  disposition, of a felony offense under applicable state, federal
    27  or foreign criminal law;
    28    10. Has not been convicted or found guilty, or  has  entered  into  an
    29  agreed  disposition, of a misdemeanor offense related to the practice of
    30  nursing as determined by factors set  forth  in  rules  adopted  by  the
    31  Commission;
    32    11. Is not currently enrolled in an alternative program;
    33    12.  Is  subject  to  self-disclosure  requirements  regarding current
    34  participation in an alternative program; and
    35    13. Has a valid United States Social Security number.
    36    c. An APRN issued  a  multistate  license  shall  be  licensed  in  an
    37  approved role and at least one approved population focus.
    38    d.  An APRN multistate license issued by a home state to a resident in
    39  that state will be recognized by each party  state  as  authorizing  the
    40  APRN  to  practice  as  an  APRN in each party state, under a multistate
    41  licensure privilege, in the same role and population focus as  the  APRN
    42  is licensed in the home state.
    43    e.  Nothing  in this Compact shall affect the requirements established
    44  by a party state for the issuance of a single-state license, except that
    45  an individual may apply for a single-state license, instead of a  multi-
    46  state  license,  even if otherwise qualified for the multistate license.
    47  However, the failure of such an individual to affirmatively  opt  for  a
    48  single state license may result in the issuance of a multistate license.
    49    f.  Issuance  of an APRN multistate license shall include prescriptive
    50  authority for noncontrolled prescription drugs.
    51    g. For each state in  which  an  APRN  seeks  authority  to  prescribe
    52  controlled  substances,  the APRN shall satisfy all requirements imposed
    53  by such state in granting and/or renewing such authority.
    54    h. An APRN issued a multistate license is authorized to assume respon-
    55  sibility and accountability for patient care independent of any supervi-
    56  sory or collaborative relationship.  This authority may be exercised  in

        A. 7946                            19

     1  the  home  state  and  in any remote state in which the APRN exercises a
     2  multistate licensure privilege.
     3    i.  All party states shall be authorized, in accordance with state due
     4  process laws, to take adverse action against an APRN's multistate licen-
     5  sure privilege such as revocation, suspension, probation  or  any  other
     6  action  that  affects an APRN's authorization to practice under a multi-
     7  state licensure privilege, including cease  and  desist  actions.  If  a
     8  party  state takes such action, it shall promptly notify the administra-
     9  tor of the coordinated licensure information system.  The  administrator
    10  of  the  coordinated  licensure information system shall promptly notify
    11  the home state of any such actions by remote states.
    12    j. Except as otherwise expressly provided in  this  Compact,  an  APRN
    13  practicing  in a party state must comply with the state practice laws of
    14  the state in which  the  client  is  located  at  the  time  service  is
    15  provided.  APRN  practice  is  not  limited  to  patient care, but shall
    16  include all advanced nursing practice as defined by the  state  practice
    17  laws of the party state in which the client is located. APRN practice in
    18  a  party  state  under a multistate licensure privilege will subject the
    19  APRN to the jurisdiction of the licensing board,  the  courts,  and  the
    20  laws  of  the  party  state  in  which the client is located at the time
    21  service is provided.
    22    k. Except as  otherwise  expressly  provided  in  this  Compact,  this
    23  Compact  does  not  affect additional requirements imposed by states for
    24  advanced practice registered nursing.  However, a  multistate  licensure
    25  privilege  to practice registered nursing granted by a party state shall
    26  be recognized by other party states as satisfying any state law require-
    27  ment for registered nurse licensure as a precondition for  authorization
    28  to practice as an APRN in that state.
    29    l. Individuals not residing in a party state shall continue to be able
    30  to apply for a party state's single-state APRN license as provided under
    31  the laws of each party state.  However, the single-state license granted
    32  to these individuals will not be recognized as granting the privilege to
    33  practice as an APRN in any other party state.

    34                                 ARTICLE IV.
    35              Applications for APRN Licensure in a Party State

    36    a.  Upon  application  for  an  APRN multistate license, the licensing
    37  board in the issuing party state shall ascertain,  through  the  coordi-
    38  nated  licensure information system, whether the applicant has ever held
    39  or is the holder of a licensed practical/vocational nursing  license,  a
    40  registered  nursing  license  or  an  advanced practice registered nurse
    41  license issued by any other state, whether there are any encumbrances on
    42  any license or multistate licensure privilege  held  by  the  applicant,
    43  whether  any adverse action has been taken against any license or multi-
    44  state licensure privilege held by the applicant and whether  the  appli-
    45  cant is currently participating in an alternative program.
    46    b.  An  APRN  may  hold  a multistate APRN license, issued by the home
    47  state, in only one party state at a time.
    48    c. If an APRN changes primary state of residence by moving between two
    49  party states, the APRN must apply for APRN licensure  in  the  new  home
    50  state,  and  the multistate license issued by the prior home state shall
    51  be deactivated in accordance with applicable Commission rules.
    52    1. The APRN may apply for licensure in advance of a change in  primary
    53  state of residence.

        A. 7946                            20

     1    2. A multistate APRN license shall not be issued by the new home state
     2  until  the  APRN  provides  satisfactory evidence of a change in primary
     3  state of residence to the new home state and  satisfies  all  applicable
     4  requirements  to  obtain  a  multistate  APRN  license from the new home
     5  state.
     6    d.  If  an  APRN  changes  primary state of residence by moving from a
     7  party state to a non-party state, the APRN multistate license issued  by
     8  the  prior home state will convert to a single-state license, valid only
     9  in the former home state.

    10                                 ARTICLE V.
    11       Additional Authorities Invested in Party State Licensing Boards

    12    a. In addition to the other powers conferred by state law, a licensing
    13  board shall have the authority to:
    14    1. Take adverse action against an APRN's multistate  licensure  privi-
    15  lege to practice within that party state.
    16    i. Only the home state shall have power to take adverse action against
    17  an APRN's license issued by the home state.
    18    ii.  For  purposes  of taking adverse action, the home state licensing
    19  board shall give the same priority and effect to reported  conduct  that
    20  occurred  outside  of  the  home  state  as it would if such conduct had
    21  occurred within the home state. In so doing, the home state shall  apply
    22  its own state laws to determine appropriate action.
    23    2. Issue cease and desist orders or impose an encumbrance on an APRN's
    24  authority to practice within that party state.
    25    3.  Complete any pending investigations of an APRN who changes primary
    26  state of residence during the course of such investigations. The licens-
    27  ing board shall also have the authority to  take  appropriate  action(s)
    28  and  shall promptly report the conclusions of such investigations to the
    29  administrator of  the  coordinated  licensure  information  system.  The
    30  administrator  of  the  coordinated  licensure  information system shall
    31  promptly notify the new home state of any such actions.
    32    4. Issue subpoenas for both hearings and investigations  that  require
    33  the attendance and testimony of witnesses, as well as, the production of
    34  evidence.  Subpoenas  issued  by  a  party state licensing board for the
    35  attendance and testimony of witnesses and/or the production of  evidence
    36  from  another  party  state shall be enforced in the latter state by any
    37  court of competent jurisdiction, according to that court's practice  and
    38  procedure  in  considering  subpoenas issued in its own proceedings. The
    39  issuing licensing board shall pay any  witness  fees,  travel  expenses,
    40  mileage  and other fees required by the service statutes of the state in
    41  which the witnesses and/or evidence are located.
    42    5. Obtain and submit, for an APRN licensure applicant, fingerprints or
    43  other biometric-based information to the Federal Bureau of Investigation
    44  for criminal background checks,  receive  the  results  of  the  Federal
    45  Bureau  of Investigation record search on criminal background checks and
    46  use the results in making licensure decisions.
    47    6. If otherwise permitted by state law, recover from the affected APRN
    48  the costs of investigations and disposition of cases resulting from  any
    49  adverse action taken against that APRN.
    50    7.  Take adverse action based on the factual findings of another party
    51  state, provided that the licensing board follows its own procedures  for
    52  taking such adverse action.
    53    b. If adverse action is taken by a home state against an APRN's multi-
    54  state  licensure,  the  privilege  to practice in all other party states

        A. 7946                            21

     1  under a multistate licensure privilege shall be  deactivated  until  all
     2  encumbrances  have  been removed from the APRN's multistate license. All
     3  home state disciplinary orders that impose  adverse  action  against  an
     4  APRN's  multistate  license  shall  include  a statement that the APRN's
     5  multistate licensure privilege is deactivated in all party states during
     6  the pendency of the order.
     7    c. Nothing in this Compact shall override  a  party  state's  decision
     8  that  participation  in  an  alternative  program may be used in lieu of
     9  adverse action. The home state  licensing  board  shall  deactivate  the
    10  multistate  licensure privilege under the multistate license of any APRN
    11  for the duration of the APRN's participation in an alternative program.

    12                                 ARTICLE VI.
    13    Coordinated Licensure Information System and Exchange of Information

    14    a. All party states  shall  participate  in  a  coordinated  licensure
    15  information system of all APRNs, licensed registered nurses and licensed
    16  practical/vocational nurses. This system will include information on the
    17  licensure  and  disciplinary history of each APRN, as submitted by party
    18  states, to assist in the coordinated administration  of  APRN  licensure
    19  and enforcement efforts.
    20    b. The Commission, in consultation with the administrator of the coor-
    21  dinated  licensure  information  system,  shall  formulate necessary and
    22  proper procedures for the identification,  collection  and  exchange  of
    23  information under this Compact.
    24    c.  All  licensing  boards  shall  promptly  report to the coordinated
    25  licensure information system any adverse action, any current significant
    26  investigative information, denials of applications (with the reasons for
    27  such denials) and APRN participation in alternative  programs  known  to
    28  the  licensing  board regardless of whether such participation is deemed
    29  nonpublic and/or confidential under state law.
    30    d. Notwithstanding any other provision of law, all party state licens-
    31  ing boards contributing information to the coordinated licensure  infor-
    32  mation  system  may  designate  information  that may not be shared with
    33  non-party states or disclosed to other entities or  individuals  without
    34  the express permission of the contributing state.
    35    e.  Any  personally identifiable information obtained from the coordi-
    36  nated licensure information system by  a  party  state  licensing  board
    37  shall not be shared with non-party states or disclosed to other entities
    38  or  individuals  except to the extent permitted by the laws of the party
    39  state contributing the information.
    40    f. Any information contributed to the coordinated  licensure  informa-
    41  tion  system that is subsequently required to be expunged by the laws of
    42  the party state contributing the information shall be removed  from  the
    43  coordinated licensure information system.
    44    g.  The  Compact  administrator  of  each  party state shall furnish a
    45  uniform data set to the Compact administrator of each other party state,
    46  which shall include, at a minimum:
    47    1. Identifying information;
    48    2. Licensure data;
    49    3. Information related to alternative program  participation  informa-
    50  tion; and
    51    4.  Other  information  that may facilitate the administration of this
    52  Compact, as determined by Commission rules.
    53    h. The Compact administrator of a party state shall provide all inves-
    54  tigative documents and information requested by another party state.

        A. 7946                            22

     1                                ARTICLE VII.
     2         Establishment of the Interstate Commission of APRN Compact
     3                               Administrators

     4    a.  The party states hereby create and establish a joint public agency
     5  known as the Interstate Commission of APRN Compact Administrators.
     6    1. The Commission is an instrumentality of the party states.
     7    2. Venue is proper, and judicial proceedings by or against the Commis-
     8  sion shall be brought solely and exclusively, in a  court  of  competent
     9  jurisdiction  where  the  principal office of the Commission is located.
    10  The Commission may waive venue and jurisdictional defenses to the extent
    11  it adopts or consents to participate in alternative  dispute  resolution
    12  proceedings.
    13    3. Nothing in this Compact shall be construed to be a waiver of sover-
    14  eign immunity.
    15    b. Membership, Voting and Meetings.
    16    1.  Each  party  state shall have and be limited to one administrator.
    17  The head of the state licensing board or designee shall be the  adminis-
    18  trator  of  this  Compact for each party state. Any administrator may be
    19  removed or suspended from office as provided by the  law  of  the  state
    20  from  which the administrator is appointed. Any vacancy occurring in the
    21  Commission shall be filled in accordance with  the  laws  of  the  party
    22  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
    25  have an opportunity to participate in the business and  affairs  of  the
    26  Commission. An administrator shall vote in person or by such other means
    27  as provided in the bylaws. The bylaws may provide for an administrator's
    28  participation in meetings by telephone or other means of communication.
    29    3.  The Commission shall meet at least once during each calendar year.
    30  Additional meetings shall be held as set forth in the bylaws or rules of
    31  the commission.
    32    4. All meetings shall be open to the  public,  and  public  notice  of
    33  meetings  shall  be given in the same manner as required under the rule-
    34  making provisions in Article VIII.
    35    5. The Commission may convene in a closed, nonpublic  meeting  if  the
    36  Commission must discuss:
    37    i.  Noncompliance  of  a  party  state with its obligations under this
    38  Compact;
    39    ii.  The  employment,  compensation,  discipline  or  other  personnel
    40  matters,  practices or procedures related to specific employees or other
    41  matters related to the Commission's  internal  personnel  practices  and
    42  procedures;
    43    iii. Current, threatened, or reasonably anticipated litigation;
    44    iv.  Negotiation  of  contracts  for  the  purchase  or sale of goods,
    45  services or real estate;
    46    v. Accusing any person of a crime or formally censuring any person;
    47    vi. Disclosure of trade secrets or commercial or financial information
    48  that is privileged or confidential;
    49    vii. Disclosure of information of a personal nature  where  disclosure
    50  would constitute a clearly unwarranted invasion of personal privacy;
    51    viii. Disclosure of investigatory records compiled for law enforcement
    52  purposes;
    53    ix. Disclosure of information related to any reports prepared by or on
    54  behalf  of the Commission for the purpose of investigation of compliance
    55  with this Compact; or

        A. 7946                            23

     1    x. Matters specifically exempted from disclosure by federal  or  state
     2  statute.
     3    6.  If  a meeting, or portion of a meeting, is closed pursuant to this
     4  provision, the Commission's legal counsel or designee shall certify that
     5  the meeting may be closed and shall reference  each  relevant  exempting
     6  provision.  The  Commission  shall  keep  minutes that fully and clearly
     7  describe all matters discussed in a meeting and shall provide a full and
     8  accurate summary of actions taken, and the reasons therefor, including a
     9  description  of  the  views  expressed.  All  documents  considered   in
    10  connection  with  an  action  shall  be  identified in such minutes. All
    11  minutes and documents of a  closed  meeting  shall  remain  under  seal,
    12  subject  to  release  by a majority vote of the Commission or order of a
    13  court of competent jurisdiction.
    14    c. The Commission shall, by a majority  vote  of  the  administrators,
    15  prescribe  bylaws  or rules to govern its conduct as may be necessary or
    16  appropriate to carry out the purposes and exercise the  powers  of  this
    17  Compact, including but not limited to:
    18    1. Establishing the fiscal year of the Commission;
    19    2. Providing reasonable standards and procedures:
    20    i. For the establishment and meetings of other committees; and
    21    ii.  Governing  any general or specific delegation of any authority or
    22  function of the Commission;
    23    3. Providing reasonable procedures for calling and conducting meetings
    24  of the Commission, ensuring reasonable advance notice  of  all  meetings
    25  and  providing  an opportunity for attendance of such meetings by inter-
    26  ested parties,  with  enumerated  exceptions  designed  to  protect  the
    27  public's  interest, the privacy of individuals, and proprietary informa-
    28  tion, including trade secrets. The Commission may meet in closed session
    29  only after a majority of the administrators vote to close a  meeting  in
    30  whole  or  in  part.  As  soon  as practicable, the Commission must make
    31  public a copy of the vote to close the meeting  revealing  the  vote  of
    32  each administrator, with no proxy votes allowed;
    33    4. Establishing the titles, duties and authority and reasonable proce-
    34  dures for the election of the officers of the Commission;
    35    5. Providing reasonable standards and procedures for the establishment
    36  of  the personnel policies and programs of the Commission. Notwithstand-
    37  ing any civil service or other similar laws  of  any  party  state,  the
    38  bylaws  shall  exclusively govern the personnel policies and programs of
    39  the Commission;
    40    6. Providing a mechanism for winding up the operations of the  Commis-
    41  sion  and  the equitable disposition of any surplus funds that may exist
    42  after the termination of this Compact after the payment and/or reserving
    43  of all of its debts and obligations;
    44    d. The Commission shall publish its bylaws and rules, and  any  amend-
    45  ments thereto, in a convenient form on the website of the Commission;
    46    e.  The  Commission shall maintain its financial records in accordance
    47  with the bylaws; and
    48    f. The Commission shall meet and take such actions as  are  consistent
    49  with the provisions of this Compact and the bylaws.
    50    g. The Commission shall have the following powers:
    51    1.  To promulgate uniform rules to facilitate and coordinate implemen-
    52  tation and administration of this Compact.  The  rules  shall  have  the
    53  force and effect of law and shall be binding in all party states;
    54    2.  To bring and prosecute legal proceedings or actions in the name of
    55  the Commission, provided that the standing of any licensing board to sue
    56  or be sued under applicable law shall not be affected;

        A. 7946                            24

     1    3. To purchase and maintain insurance and bonds;
     2    4.  To borrow, accept or contract for services of personnel, including
     3  but not limited to employees of a party  state  or  nonprofit  organiza-
     4  tions;
     5    5.  To  cooperate  with  other  organizations  that  administer  state
     6  compacts related to the regulation of nursing, including but not limited
     7  to sharing administrative or  staff  expenses,  office  space  or  other
     8  resources;
     9    6.  To  hire  employees,  elect or appoint officers, fix compensation,
    10  define duties, grant such individuals appropriate authority to carry out
    11  the purposes of this Compact, and to establish the Commission's  person-
    12  nel  policies and programs relating to conflicts of interest, qualifica-
    13  tions of personnel and other related personnel matters;
    14    7. To accept any and all appropriate donations, grants  and  gifts  of
    15  money,  equipment,  supplies,  materials  and  services, and to receive,
    16  utilize and dispose of the same; provided that at all times the  Commis-
    17  sion shall strive to avoid any appearance of impropriety and/or conflict
    18  of interest;
    19    8.  To  lease,  purchase, accept appropriate gifts or donations of, or
    20  otherwise to own, hold, improve or  use,  any  property,  whether  real,
    21  personal  or  mixed;  provided  that  at  all times the Commission shall
    22  strive to avoid any appearance of impropriety;
    23    9. To sell convey,  mortgage,  pledge,  lease,  exchange,  abandon  or
    24  otherwise dispose of any property, whether real, personal or mixed;
    25    10. To establish a budget and make expenditures;
    26    11. To borrow money;
    27    12.  To appoint committees, including advisory committees comprised of
    28  administrators, state nursing regulators,  state  legislators  or  their
    29  representatives, and consumer representatives, and other such interested
    30  persons;
    31    13. To issue advisory opinions;
    32    14.  To  provide  and receive information from, and to cooperate with,
    33  law enforcement agencies;
    34    15. To adopt and use an official seal; and
    35    16. To perform such other functions as may be necessary or appropriate
    36  to achieve the purposes of this Compact consistent with the state  regu-
    37  lation of APRN licensure and practice.
    38    h. Financing of the Commission.
    39    1.  The  Commission  shall  pay,  or  provide  for the payment of, the
    40  reasonable expenses  of  its  establishment,  organization  and  ongoing
    41  activities.
    42    2.  The  Commission  may also levy on and collect an annual assessment
    43  from each party state to cover the cost of  its  operations,  activities
    44  and  staff  in  its  annual  budget as approved each year. The aggregate
    45  annual assessment amount, if any, shall be allocated based upon a formu-
    46  la to be determined by the Commission, which  shall  promulgate  a  rule
    47  that is binding upon all party states.
    48    3.  The  Commission  shall  not incur obligations of any kind prior to
    49  securing the funds adequate to meet the same; nor shall  the  Commission
    50  pledge  the  credit  of any of the party states, except by, and with the
    51  authority of, such party state.
    52    4. The Commission shall keep accurate accounts  of  all  receipts  and
    53  disbursements.    The receipts and disbursements of the Commission shall
    54  be subject to the audit and accounting procedures established under  its
    55  bylaws.  However, all receipts and disbursements of funds handled by the
    56  Commission shall by audited yearly by a  certified  or  licensed  public

        A. 7946                            25

     1  accountant,  and the report of the audit shall be included in and become
     2  part of the annual report of the Commission.
     3    i. Qualified Immunity, Defense, and Indemnification.
     4    1.  The  administrators,  officers,  executive director, employees and
     5  representatives of the Commission shall be immune from suit and  liabil-
     6  ity,  either personally or in their official capacity, for any claim for
     7  damage to or loss of property or personal injury or other civil  liabil-
     8  ity  caused  by  or  arising  out of any actual or alleged act, error or
     9  omission that occurred, or that the person against  whom  the  claim  is
    10  made  had a reasonable basis for believing occurred, within the scope of
    11  commission employment, duties or responsibilities; provided that nothing
    12  in this paragraph shall be construed to protect  any  such  person  from
    13  suit  and/or  liability for any damage, loss, injury or liability caused
    14  by the intentional, willful or wanton misconduct of that person.
    15    2. The Commission shall defend any administrator,  officer,  executive
    16  director,  employee  or  representative  of  the Commission in any civil
    17  action seeking to impose liability arising out of any actual or  alleged
    18  act,  error  or  omission  that  occurred within the scope of Commission
    19  employment, duties or responsibilities, or that the person against  whom
    20  the  claim  is made had a reasonable basis for believing occurred within
    21  the scope of Commission employment, duties or responsibilities; provided
    22  that nothing herein shall be construed  to  prohibit  that  person  from
    23  retaining  his  or her own counsel; and provided further that the actual
    24  or alleged act, error or omission did  not  result  from  that  person's
    25  intentional, willful or wanton misconduct.
    26    3. The Commission shall indemnify and hold harmless any administrator,
    27  officer,  executive  director, employee or representative of the Commis-
    28  sion for the amount of any settlement or judgment obtained against  that
    29  person  arising out of any actual or alleged act, error or omission that
    30  occurred within the scope of Commission employment, duties or  responsi-
    31  bilities,  or  that  such  person  had  a reasonable basis for believing
    32  occurred within the scope of Commission employment, duties or  responsi-
    33  bilities, provided that the actual or alleged act, error or omission did
    34  not  result  from  the intentional, willful or wanton misconduct of that
    35  person.

    36                                ARTICLE VIII.
    37                                 Rulemaking

    38    a. The Commission shall exercise its rulemaking powers pursuant to the
    39  criteria set forth in this Article and  the  rules  adopted  thereunder.
    40  Rules  and  amendments  shall become binding as of the date specified in
    41  each rule or amendment and shall have  the  same  force  and  effect  as
    42  provisions of this Compact.
    43    b.  Rules  or amendments to the rules shall be adopted at a regular or
    44  special meeting of the Commission.
    45    c. Prior to promulgation and adoption of a final rule or rules by  the
    46  Commission,  and  at  least sixty (60) days in advance of the meeting at
    47  which the rule will be considered and voted upon, the  Commission  shall
    48  file a notice of proposed rulemaking:
    49    1. On the website of the Commission; and
    50    2.  On the website of each licensing board or the publication in which
    51  each state would otherwise publish proposed rules.
    52    d. The notice of proposed rulemaking shall include:
    53    1. The proposed time, date and location of the meeting  in  which  the
    54  rule will be considered and voted upon;

        A. 7946                            26

     1    2.  The text of the proposed rule or amendment, and the reason for the
     2  proposed rule;
     3    3.  A  request  for  comments on the proposed rule from any interested
     4  person; and
     5    4. The manner in which interested persons may  submit  notice  to  the
     6  Commission of their intention to attend the public hearing and any writ-
     7  ten comments.
     8    e.  Prior  to  adoption of a proposed rule, the Commission shall allow
     9  persons to submit written data, facts,  opinions  and  arguments,  which
    10  shall be made available to the public.
    11    f.  The  Commission  shall  grant  an opportunity for a public hearing
    12  before it adopts a rule or amendment.
    13    g. The Commission shall publish the place, time, and date of the sche-
    14  duled public hearing.
    15    1. Hearings shall be conducted in a manner providing each  person  who
    16  wishes to comment a fair and reasonable opportunity to comment orally or
    17  in  writing.  All  hearings  will  be  recorded, and a copy will be made
    18  available upon request.
    19    2. Nothing in this section shall be construed as requiring a  separate
    20  hearing  on  each  rule. Rules may be grouped for the convenience of the
    21  Commission at hearings required by this section.
    22    h. If no one appears at the public hearing, the Commission may proceed
    23  with promulgation of the proposed rule.
    24    i. Following the scheduled hearing date, or by the close  of  business
    25  on  the  scheduled hearing date if the hearing was not held, the Commis-
    26  sion shall consider all written and oral comments received.
    27    j. The Commission shall, by majority vote of all administrators,  take
    28  final action on the proposed rule and shall determine the effective date
    29  of the rule, if any, based on the rulemaking record and the full text of
    30  the rule.
    31    k.  Upon  determination  that  an emergency exists, the Commission may
    32  consider and adopt an emergency rule without prior  notice,  opportunity
    33  for  comment,  or hearing, provided that the usual rulemaking procedures
    34  provided in this Compact and in  this  section  shall  be  retroactively
    35  applied  to  the  rule as soon as reasonably possible, in no event later
    36  than ninety (90) days after the effective date  of  the  rule.  For  the
    37  purposes  of  this  provision,  an  emergency  rule  is one that must be
    38  adopted immediately in order to:
    39    1. Meet an imminent threat to public health, safety or welfare;
    40    2. Prevent a loss of Commission or party state funds; or
    41    3. Meet a deadline for the promulgation of an administrative rule that
    42  is established by federal law or rule.
    43    l. The Commission may direct revisions to a previously adopted rule or
    44  amendment for purposes of correcting  typographical  errors,  errors  in
    45  format,  errors  in  consistency or grammatical errors. Public notice of
    46  any revisions shall be posted on the  website  of  the  Commission.  The
    47  revision  shall  be  subject  to challenge by any person for a period of
    48  thirty (30) days after posting. The revision may be challenged  only  on
    49  grounds  that  the  revision  results  in a material change to a rule. A
    50  challenge shall be made in writing, and  delivered  to  the  Commission,
    51  prior  to  the  end  of  the notice period. If no challenge is made, the
    52  revision will take effect without further action.  If  the  revision  is
    53  challenged, the revision may not take effect without the approval of the
    54  Commission.

        A. 7946                            27

     1                                 ARTICLE IX.
     2                Oversight, Dispute Resolution and Enforcement

     3    a. Oversight.
     4    1.  Each  party  state shall enforce this Compact and take all actions
     5  necessary and appropriate to  effectuate  this  Compact's  purposes  and
     6  intent.
     7    2.  The  Commission shall be entitled to receive service of process in
     8  any proceeding that may affect the powers, responsibilities  or  actions
     9  of  the  Commission,  and  shall  have  standing  to intervene in such a
    10  proceeding for all purposes. Failure to provide service  of  process  to
    11  the  Commission  shall render a judgment or order void as to the Commis-
    12  sion, this Compact or promulgated rules.
    13    b. Default, Technical Assistance and Termination.
    14    1. If the Commission determines that a party state  has  defaulted  in
    15  the  performance  of  its  obligations  or  responsibilities  under this
    16  Compact or the promulgated rules, the Commission shall:
    17    i. Provide written notice to the  defaulting  state  and  other  party
    18  states  of  the  nature of the default, the proposed means of curing the
    19  default and/or any other action to be taken by the Commission; and
    20    ii.  Provide  remedial  training  and  specific  technical  assistance
    21  regarding the default.
    22    2.  If  a  state  in default fails to cure the default, the defaulting
    23  state's membership in this Compact may be terminated upon an affirmative
    24  vote of a majority of the administrators, and all rights, privileges and
    25  benefits conferred by this Compact may be terminated  on  the  effective
    26  date  of termination. A cure of the default does not relieve the offend-
    27  ing state of obligations or liabilities incurred during  the  period  of
    28  default.
    29    3.  Termination  of  membership  in this Compact shall be imposed only
    30  after all other means of securing compliance have been exhausted. Notice
    31  of intent to suspend or terminate shall be given by  the  Commission  to
    32  the governor of the defaulting state and to the executive officer of the
    33  defaulting  state's  licensing  board,  the defaulting state's licensing
    34  board, and each of the party states.
    35    4. A state whose membership in this Compact  has  been  terminated  is
    36  responsible  for  all  assessments, obligations and liabilities incurred
    37  through the effective date of termination,  including  obligations  that
    38  extend beyond the effective date of termination.
    39    5.  The Commission shall not bear any costs related to a state that is
    40  found to be in default or whose membership  in  this  Compact  has  been
    41  terminated, unless agreed upon in writing between the Commission and the
    42  defaulting state.
    43    6.  The  defaulting  state  may appeal the action of the Commission by
    44  petitioning the U.S. District Court for the District of Columbia or  the
    45  federal  district in which the Commission has its principal offices. The
    46  prevailing party shall be awarded all costs of such litigation,  includ-
    47  ing reasonable attorneys' fees.
    48    c. Dispute Resolution.
    49    1.  Upon  request  by  a  party state, the Commission shall attempt to
    50  resolve disputes related to the Compact that arise  among  party  states
    51  and between party and non-party states.
    52    2. The Commission shall promulgate a rule providing for both mediation
    53  and binding dispute resolution for disputes, as appropriate.
    54    3.  In  the  event  the Commission cannot resolve disputes among party
    55  states arising under this Compact:

        A. 7946                            28

     1    i. The party states may submit the issues in dispute to an arbitration
     2  panel, which will be comprised of individuals appointed by  the  Compact
     3  administrator  in  each  of  the affected party states and an individual
     4  mutually agreed upon by the Compact  administrators  of  all  the  party
     5  states involved in the dispute.
     6    ii.  The  decision of a majority of the arbitrators shall be final and
     7  binding.
     8    d. Enforcement.
     9    1. The Commission, in the reasonable exercise of its discretion, shall
    10  enforce the provisions and rules of this Compact.
    11    2. By majority vote, the Commission may initiate legal action  in  the
    12  United States District Court for the District of Columbia or the federal
    13  district  in  which  the  Commission has its principal offices against a
    14  party state that is in default to enforce compliance with the provisions
    15  of this Compact and its promulgated rules and bylaws. The relief  sought
    16  may  include  both  injunctive relief and damages. In the event judicial
    17  enforcement is necessary, the prevailing  party  shall  be  awarded  all
    18  costs of such litigation, including reasonable attorneys' fees.
    19    3.  The  remedies  herein  shall  not be the exclusive remedies of the
    20  Commission. The Commission may pursue any other remedies available under
    21  federal or state law.

    22                                 ARTICLE X.
    23                  Effective Date, Withdrawal and Amendment

    24    a. This Compact shall come into limited effect at such  time  as  this
    25  Compact has been enacted into law in seven (7) party states for the sole
    26  purpose  of  establishing  and  convening  the Commission to adopt rules
    27  relating to its operation.
    28    b. Any state that joins this Compact subsequent  to  the  Commission's
    29  initial  adoption  of  the  APRN uniform licensure requirements shall be
    30  subject to all rules that have been previously adopted  by  the  Commis-
    31  sion.
    32    c.  Any party state may withdraw from this Compact by enacting a stat-
    33  ute repealing the same. A party state's withdrawal shall not take effect
    34  until six (6) months after enactment of the repealing statute.
    35    d. A party state's withdrawal or  termination  shall  not  affect  the
    36  continuing  requirement of the withdrawing or terminated state's licens-
    37  ing board to  report  adverse  actions  and  significant  investigations
    38  occurring prior to the effective date of such withdrawal or termination.
    39    e.  Nothing contained in this Compact shall be construed to invalidate
    40  or prevent any APRN licensure agreement or other cooperative arrangement
    41  between a party state and a non-party state that does not conflict  with
    42  the provisions of this Compact.
    43    f.  This  Compact  may be amended by the party states. No amendment to
    44  this Compact shall become effective and binding  upon  any  party  state
    45  until it is enacted into the laws of all party states.
    46    g.  Representatives  of  non-party  states  to  this  Compact shall be
    47  invited to participate in the activities of the Commission, on a nonvot-
    48  ing basis, prior to the adoption of this Compact by all states.

    49                                 ARTICLE XI.
    50                        Construction and Severability

    51    This Compact shall be liberally construed  so  as  to  effectuate  the
    52  purposes thereof. The provisions of this Compact shall be severable, and

        A. 7946                            29

     1  if any phrase, clause, sentence or provision of this Compact is declared
     2  to  be  contrary to the constitution of any party state or of the United
     3  States, or if the  applicability  thereof  to  any  government,  agency,
     4  person or circumstance is held invalid, the validity of the remainder of
     5  this  Compact  and  the applicability thereof to any government, agency,
     6  person or circumstance shall not be affected thereby.  If  this  Compact
     7  shall  be  held  to  be contrary to the constitution of any party state,
     8  this Compact shall remain in full force and effect as to  the  remaining
     9  party states and in full force and effect as to the party state affected
    10  as to all severable matters.
    11    §  2.  This  act shall take effect on the ninetieth day after it shall
    12  have become a law.    Effective  immediately,  the  addition,  amendment
    13  and/or repeal of any rule or regulation necessary for the implementation
    14  of  this  act  on  its  effective  date  are  authorized  to be made and
    15  completed on or before such effective date.
    16    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    17  sion, section or part of this act shall be  adjudged  by  any  court  of
    18  competent  jurisdiction  to  be invalid, such judgment shall not affect,
    19  impair, or invalidate the remainder thereof, but shall  be  confined  in
    20  its  operation  to the clause, sentence, paragraph, subdivision, section
    21  or part thereof directly involved in the controversy in which such judg-
    22  ment shall have been rendered. It is hereby declared to be the intent of
    23  the legislature that this act would  have  been  enacted  even  if  such
    24  invalid provisions had not been included herein.
    25    §  3.  This act shall take effect immediately; provided, however, that
    26  the applicable effective date of Parts A through B of this act shall  be
    27  as specifically set forth in the last section of such Parts.
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