Bill Text: MI HB4042 | 2019-2020 | 100th Legislature | Introduced


Bill Title: Health occupations; nurses; nurse licensure compact; enact. Amends sec. 17201 of 1978 PA 368 (MCL 333.17201) & adds secs. 16190, 17225 & 17225a.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2019-06-06 - Referred To Committee On Ways And Means, With Substitute (h-1) [HB4042 Detail]

Download: Michigan-2019-HB4042-Introduced.html

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOUSE BILL No. 4042

 

 

January 15, 2019, Introduced by Reps. Whiteford and Brann and referred to the Committee on Health Policy.

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending section 17201 (MCL 333.17201), as amended by 2016 PA

 

499, and by adding sections 16190, 17225, and 17225a.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 16190. (1) The Nurse Licensure Compact is enacted into

 

law and entered into by this state as a party state with all other

 

jurisdictions that legally join in the Compact, in the form

 

substantially as follows:

 

 

 

NURSE LICENSURE COMPACT

 

ARTICLE I

 

Findings and Declaration of Purpose

 

a. The party states find that:

 

1. The health and safety of the public are affected by the degree


of compliance with and the effectiveness of enforcement activities

 

related to state nurse licensure laws;

 

2. Violations of nurse licensure and other laws regulating the

 

practice of nursing may result in injury or harm to the public;

 

3. The expanded mobility of nurses and the use of advanced

 

communication technologies as part of our nation's health care

 

delivery system require greater coordination and cooperation among

 

states in the areas of nurse licensure and regulation;

 

4. New practice modalities and technology make compliance with

 

individual state nurse licensure laws difficult and complex;

 

5. The current system of duplicative licensure for nurses

 

practicing in multiple states is cumbersome and redundant for both

 

nurses and states; and

 

6. Uniformity of nurse licensure requirements throughout the states

 

promotes public safety and public health benefits.

 

b. The general purposes of this Compact are to:

 

1. Facilitate the states' responsibility to protect the public's

 

health and safety;

 

2. Ensure and encourage the cooperation of party states in the

 

areas of nurse licensure and regulation;

 

3. Facilitate the exchange of information between party states in

 

the areas of nurse regulation, investigation and adverse actions;

 

4. Promote compliance with the laws governing the practice of

 

nursing in each jurisdiction;

 

5. Invest all party states with the authority to hold a nurse

 

accountable for meeting all state practice laws in the state in

 

which the patient is located at the time care is rendered through


the mutual recognition of party state licenses;

 

6. Decrease redundancies in the consideration and issuance of nurse

 

licenses; and

 

7. Provide opportunities for interstate practice by nurses who meet

 

uniform licensure requirements.

 

 

 

ARTICLE II

 

Definitions

 

As used in this Compact:

 

a. "Adverse action" means any administrative, civil, equitable or

 

criminal action permitted by a state's laws which is imposed by a

 

licensing board or other authority against a nurse, including

 

actions against an individual's license or multistate licensure

 

privilege such as revocation, suspension, probation, monitoring of

 

the licensee, limitation on the licensee's practice, or any other

 

encumbrance on licensure affecting a nurse's authorization to

 

practice, including issuance of a cease and desist action.

 

b. "Alternative program" means a non-disciplinary monitoring

 

program approved by a licensing board.

 

c. "Coordinated licensure information system" means an integrated

 

process for collecting, storing and sharing information on nurse

 

licensure and enforcement activities related to nurse licensure

 

laws that is administered by a nonprofit organization composed of

 

and controlled by licensing boards.

 

d. "Current significant investigative information" means:

 

1. Investigative information that a licensing board, after a

 

preliminary inquiry that includes notification and an opportunity

 


for the nurse to respond, if required by state law, has reason to

 

believe is not groundless and, if proved true, would indicate more

 

than a minor infraction; or

 

2. Investigative information that indicates that the nurse

 

represents an immediate threat to public health and safety

 

regardless of whether the nurse has been notified and had an

 

opportunity to respond.

 

e. "Encumbrance" means a revocation or suspension of, or any

 

limitation on, the full and unrestricted practice of nursing

 

imposed by a licensing board.

 

f. "Home state" means the party state which is the nurse's primary

 

state of residence.

 

g. "Licensing board" means a party state's regulatory body

 

responsible for issuing nurse licenses.

 

h. "Multistate license" means a license to practice as a registered

 

or a licensed practical/vocational nurse (LPN/VN) issued by a home

 

state licensing board that authorizes the licensed nurse to

 

practice in all party states under a multistate licensure

 

privilege.

 

i. "Multistate licensure privilege" means a legal authorization

 

associated with a multistate license permitting the practice of

 

nursing as either a registered nurse (RN) or LPN/VN in a remote

 

state.

 

j. "Nurse" means RN or LPN/VN, as those terms are defined by each

 

party state's practice laws.

 

k. "Party state" means any state that has adopted this Compact.

 

l. "Remote state" means a party state, other than the home state.


m. "Single-state license" means a nurse license issued by a party

 

state that authorizes practice only within the issuing state and

 

does not include a multistate licensure privilege to practice in

 

any other party state.

 

n. "State" means a state, territory or possession of the United

 

States and the District of Columbia.

 

o. "State practice laws" means a party state's laws, rules and

 

regulations that govern the practice of nursing, define the scope

 

of nursing practice, and create the methods and grounds for

 

imposing discipline. "State practice laws" do not include

 

requirements necessary to obtain and retain a license, except for

 

qualifications or requirements of the home state.

 

 

 

ARTICLE III

 

General Provisions and Jurisdiction

 

a. A multistate license to practice registered or licensed

 

practical/vocational nursing issued by a home state to a resident

 

in that state will be recognized by each party state as authorizing

 

a nurse to practice as a registered nurse (RN) or as a licensed

 

practical/vocational nurse (LPN/VN), under a multistate licensure

 

privilege, in each party state.

 

b. A state must implement procedures for considering the criminal

 

history records of applicants for initial multistate license or

 

licensure by endorsement. Such procedures shall include the

 

submission of fingerprints or other biometric-based information by

 

applicants for the purpose of obtaining an applicant's criminal

 

history record information from the Federal Bureau of Investigation

 


and the agency responsible for retaining that state's criminal

 

records.

 

c. Each party state shall require the following for an applicant to

 

obtain or retain a multistate license in the home state:

 

1. Meets the home state's qualifications for licensure or renewal

 

of licensure, as well as, all other applicable state laws;

 

2. i. Has graduated or is eligible to graduate from a licensing

 

board-approved RN or LPN/VN prelicensure education program; or

 

ii. Has graduated from a foreign RN or LPN/VN prelicensure

 

education program that (a) has been approved by the authorized

 

accrediting body in the applicable country and (b) has been

 

verified by an independent credentials review agency to be

 

comparable to a licensing board-approved prelicensure education

 

program;

 

3. Has, if a graduate of a foreign prelicensure education program

 

not taught in English or if English is not the individual's native

 

language, successfully passed an English proficiency examination

 

that includes the components of reading, speaking, writing and

 

listening;

 

4. Has successfully passed an NCLEX-RNŽ or NCLEX-PNŽ Examination or

 

recognized predecessor, as applicable;

 

5. Is eligible for or holds an active, unencumbered license;

 

6. Has submitted, in connection with an application for initial

 

licensure or licensure by endorsement, fingerprints or other

 

biometric data for the purpose of obtaining criminal history record

 

information from the Federal Bureau of Investigation and the agency

 

responsible for retaining that state's criminal records;


7. Has not been convicted or found guilty, or has entered into an

 

agreed disposition, of a felony offense under applicable state or

 

federal criminal law;

 

8. Has not been convicted or found guilty, or has entered into an

 

agreed disposition, of a misdemeanor offense related to the

 

practice of nursing as determined on a case-by-case basis;

 

9. Is not currently enrolled in an alternative program;

 

10. Is subject to self-disclosure requirements regarding current

 

participation in an alternative program; and

 

11. Has a valid United States Social Security number.

 

d. All party states shall be authorized, in accordance with

 

existing state due process law, to take adverse action against a

 

nurse's multistate licensure privilege such as revocation,

 

suspension, probation or any other action that affects a nurse's

 

authorization to practice under a multistate licensure privilege,

 

including cease and desist actions. If a party state takes such

 

action, it shall promptly notify the administrator of the

 

coordinated licensure information system. The administrator of the

 

coordinated licensure information system shall promptly notify the

 

home state of any such actions by remote states.

 

e. A nurse practicing in a party state must comply with the state

 

practice laws of the state in which the client is located at the

 

time service is provided. The practice of nursing is not limited to

 

patient care, but shall include all nursing practice as defined by

 

the state practice laws of the party state in which the client is

 

located. The practice of nursing in a party state under a

 

multistate licensure privilege will subject a nurse to the


jurisdiction of the licensing board, the courts and the laws of the

 

party state in which the client is located at the time service is

 

provided.

 

f. Individuals not residing in a party state shall continue to be

 

able to apply for a party state's single-state license as provided

 

under the laws of each party state. However, the single-state

 

license granted to these individuals will not be recognized as

 

granting the privilege to practice nursing in any other party

 

state. Nothing in this Compact shall affect the requirements

 

established by a party state for the issuance of a single-state

 

license.

 

g. Any nurse holding a home state multistate license, on the

 

effective date of this Compact, may retain and renew the multistate

 

license issued by the nurse's then-current home state, provided

 

that:

 

1. A nurse, who changes primary state of residence after this

 

Compact's effective date, must meet all applicable Article III.c.

 

requirements to obtain a multistate license from a new home state.

 

2. A nurse who fails to satisfy the multistate licensure

 

requirements in Article III.c. due to a disqualifying event

 

occurring after this Compact's effective date shall be ineligible

 

to retain or renew a multistate license, and the nurse's multistate

 

license shall be revoked or deactivated in accordance with

 

applicable rules adopted by the Interstate Commission of Nurse

 

Licensure Compact Administrators ("Commission").

 

 

 

ARTICLE IV

 


Applications for Licensure in a Party State

 

a. Upon application for a multistate license, the licensing board

 

in the issuing party state shall ascertain, through the coordinated

 

licensure information system, whether the applicant has ever held,

 

or is the holder of, a license issued by any other state, whether

 

there are any encumbrances on any license or multistate licensure

 

privilege held by the applicant, whether any adverse action has

 

been taken against any license or multistate licensure privilege

 

held by the applicant and whether the applicant is currently

 

participating in an alternative program.

 

b. A nurse may hold a multistate license, issued by the home state,

 

in only one party state at a time.

 

c. If a nurse changes primary state of residence by moving between

 

two party states, the nurse must apply for licensure in the new

 

home state, and the multistate license issued by the prior home

 

state will be deactivated in accordance with applicable rules

 

adopted by the Commission.

 

1. The nurse may apply for licensure in advance of a change in

 

primary state of residence.

 

2. A multistate license shall not be issued by the new home state

 

until the nurse provides satisfactory evidence of a change in

 

primary state of residence to the new home state and satisfies all

 

applicable requirements to obtain a multistate license from the new

 

home state.

 

d. If a nurse changes primary state of residence by moving from a

 

party state to a non-party state, the multistate license issued by

 

the prior home state will convert to a single-state license, valid


only in the former home state.

 

 

 

ARTICLE V

 

Additional Authorities Invested in Party State Licensing Boards

 

a. In addition to the other powers conferred by state law, a

 

licensing board shall have the authority to:

 

1. Take adverse action against a nurse's multistate licensure

 

privilege to practice within that party state.

 

i. Only the home state shall have the power to take adverse action

 

against a nurse's license issued by the home state.

 

ii. For purposes of taking adverse action, the home state licensing

 

board shall give the same priority and effect to reported conduct

 

received from a remote state as it would if such

 

conduct had occurred within the home state. In so doing, the home

 

state shall apply its own state laws to determine appropriate

 

action.

 

2. Issue cease and desist orders or impose an encumbrance on a

 

nurse's authority to practice within that party state.

 

3. Complete any pending investigations of a nurse who changes

 

primary state of residence during the course of such

 

investigations. The licensing board shall also have the authority

 

to take appropriate action(s) and shall promptly report the

 

conclusions of such investigations to the administrator of the

 

coordinated licensure information system. The administrator of the

 

coordinated licensure information system shall promptly notify the

 

new home state of any such actions.

 

4. Issue subpoenas for both hearings and investigations that

 


require the attendance and testimony of witnesses, as well as, the

 

production of evidence. Subpoenas issued by a licensing board in a

 

party state for the attendance and testimony of witnesses or the

 

production of evidence from another party state shall be enforced

 

in the latter state by any court of competent jurisdiction,

 

according to the practice and procedure of that court applicable to

 

subpoenas issued in proceedings pending before it. The issuing

 

authority shall pay any witness fees, travel expenses, mileage and

 

other fees required by the service statutes of the state in which

 

the witnesses or evidence are located.

 

5. Obtain and submit, for each nurse licensure applicant,

 

fingerprint or other biometric-based information to the Federal

 

Bureau of Investigation for criminal background checks, receive the

 

results of the Federal Bureau of Investigation record search on

 

criminal background checks and use the results in making licensure

 

decisions.

 

6. If otherwise permitted by state law, recover from the affected

 

nurse the costs of investigations and disposition of cases

 

resulting from any adverse action taken against that nurse.

 

7. Take adverse action based on the factual findings of the remote

 

state, provided that the licensing board follows its own procedures

 

for taking such adverse action.

 

b. If adverse action is taken by the home state against a nurse's

 

multistate license, the nurse's multistate licensure privilege to

 

practice in all other party states shall be deactivated until all

 

encumbrances have been removed from the multistate license. All

 

home state disciplinary orders that impose adverse action against a


nurse's multistate license shall include a statement that the

 

nurse's multistate licensure privilege is deactivated in all party

 

states during the pendency of the order.

 

c. Nothing in this Compact shall override a party state's decision

 

that participation in an alternative program may be used in lieu of

 

adverse action. The home state licensing board shall deactivate the

 

multistate licensure privilege under the multistate license of any

 

nurse for the duration of the nurse's participation in an

 

alternative program.

 

 

 

ARTICLE VI

 

Coordinated Licensure Information System and Exchange of

 

Information

 

a. All party states shall participate in a coordinated licensure

 

information system of all licensed registered nurses (RNs) and

 

licensed practical/vocational nurses (LPNs/VNs). This system will

 

include information on the licensure and disciplinary history of

 

each nurse, as submitted by party states, to assist in the

 

coordination of nurse licensure and enforcement efforts.

 

b. The Commission, in consultation with the administrator of the

 

coordinated licensure information system, shall formulate necessary

 

and proper procedures for the identification, collection and

 

exchange of information under this Compact.

 

c. All licensing boards shall promptly report to the coordinated

 

licensure information system any adverse action, any current

 

significant investigative information, denials of applications

 

(with the reasons for such denials) and nurse participation in

 


alternative programs known to the licensing board regardless of

 

whether such participation is deemed nonpublic or confidential

 

under state law.

 

d. Current significant investigative information and participation

 

in nonpublic or confidential alternative programs shall be

 

transmitted through the coordinated licensure information system

 

only to party state licensing boards.

 

e. Notwithstanding any other provision of law, all party state

 

licensing boards contributing information to the coordinated

 

licensure information system may designate information that may not

 

be shared with non-party states or disclosed to other entities or

 

individuals without the express permission of the contributing

 

state.

 

f. Any personally identifiable information obtained from the

 

coordinated licensure information system by a party state licensing

 

board shall not be shared with non-party states or disclosed to

 

other entities or individuals except to the extent permitted by the

 

laws of the party state contributing the information.

 

g. Any information contributed to the coordinated licensure

 

information system that is subsequently required to be expunged by

 

the laws of the party state contributing that information shall

 

also be expunged from the coordinated licensure information system.

 

h. The Compact administrator of each party state shall furnish a

 

uniform data set to the Compact administrator of each other party

 

state, which shall include, at a minimum:

 

1. Identifying information;

 

2. Licensure data;


3. Information related to alternative program participation; and

 

4. Other information that may facilitate the administration of this

 

Compact, as determined by Commission rules.

 

i. The Compact administrator of a party state shall provide all

 

investigative documents and information requested by another party

 

state.

 

 

 

ARTICLE VII

 

Establishment of the Interstate Commission of Nurse Licensure

 

Compact Administrators

 

a. The party states hereby create and establish a joint public

 

entity known as the Interstate Commission of Nurse Licensure

 

Compact Administrators.

 

1. The Commission is an instrumentality of the party states.

 

2. Venue is proper, and judicial proceedings by or against the

 

Commission shall be brought solely and exclusively, in a court of

 

competent jurisdiction where the principal office of the Commission

 

is located. The Commission may waive venue and jurisdictional

 

defenses to the extent it adopts or consents to participate in

 

alternative dispute resolution proceedings.

 

3. Nothing in this Compact shall be construed to be a waiver of

 

sovereign immunity.

 

b. Membership, Voting and Meetings

 

1. Each party state shall have and be limited to one administrator.

 

The head of the state licensing board or designee shall be the

 

administrator of this Compact for each party state. Any

 

administrator may be removed or suspended from office as provided

 


by the law of the state from which the Administrator is appointed.

 

Any vacancy occurring in the Commission shall be filled in

 

accordance with the laws of the party state in which the vacancy

 

exists.

 

2. Each administrator shall be entitled to one (1) vote with regard

 

to the promulgation of rules and creation of bylaws and shall

 

otherwise have an opportunity to participate in the business and

 

affairs of the Commission. An administrator shall vote in person or

 

by such other means as provided in the bylaws. The bylaws may

 

provide for an administrator's participation in meetings by

 

telephone or other means of communication.

 

3. The Commission shall meet at least once during each calendar

 

year. Additional meetings shall be held as set forth in the bylaws

 

or rules of the commission.

 

4. All meetings shall be open to the public, and public notice of

 

meetings shall be given in the same manner as required under the

 

rulemaking provisions in Article VIII.

 

5. The Commission may convene in a closed, nonpublic meeting if the

 

Commission must discuss:

 

i. Noncompliance of a party state with its obligations under this

 

Compact;

 

ii. The employment, compensation, discipline or other personnel

 

matters, practices or procedures related to specific employees or

 

other matters related to the Commission's internal personnel

 

practices and procedures;

 

iii. Current, threatened or reasonably anticipated litigation;

 

iv. Negotiation of contracts for the purchase or sale of goods,


services or real estate;

 

v. Accusing any person of a crime or formally censuring any person;

 

vi. Disclosure of trade secrets or commercial or financial

 

information that is privileged or confidential;

 

vii. Disclosure of information of a personal nature where

 

disclosure would constitute a clearly unwarranted invasion of

 

personal privacy;

 

viii. Disclosure of investigatory records compiled for law

 

enforcement purposes;

 

ix. Disclosure of information related to any reports prepared by or

 

on behalf of the Commission for the purpose of investigation of

 

compliance with this Compact; or

 

x. Matters specifically exempted from disclosure by federal or

 

state statute.

 

6. If a meeting, or portion of a meeting, is closed pursuant to

 

this provision, the Commission's legal counsel or designee shall

 

certify that the meeting may be closed and shall reference each

 

relevant exempting provision. The Commission shall keep minutes

 

that fully and clearly describe all matters discussed in a meeting

 

and shall provide a full and accurate summary of actions taken, and

 

the reasons therefor, including a description of the views

 

expressed. All documents considered in connection with an action

 

shall be identified in such minutes. All minutes and documents of a

 

closed meeting shall remain under seal, subject to release by a

 

majority vote of the Commission or order of a court of competent

 

jurisdiction.

 

c. The Commission shall, by a majority vote of the administrators,


prescribe bylaws or rules to govern its conduct as may be necessary

 

or appropriate to carry out the purposes and exercise the powers of

 

this Compact, including but not limited to:

 

1. Establishing the fiscal year of the Commission;

 

2. Providing reasonable standards and procedures:

 

i. For the establishment and meetings of other committees; and

 

ii. Governing any general or specific delegation of any authority

 

or function of the Commission;

 

3. Providing reasonable procedures for calling and conducting

 

meetings of the Commission, ensuring reasonable advance notice of

 

all meetings and providing an opportunity for attendance of such

 

meetings by interested parties, with enumerated exceptions designed

 

to protect the public's interest, the privacy of individuals, and

 

proprietary information, including trade secrets. The Commission

 

may meet in closed session only after a majority of the

 

administrators vote to close a meeting in whole or in part. As soon

 

as practicable, the Commission must make public a copy of the vote

 

to close the meeting revealing the vote of each administrator, with

 

no proxy votes allowed;

 

4. Establishing the titles, duties and authority and reasonable

 

procedures for the election of the officers of the Commission;

 

5. Providing reasonable standards and procedures for the

 

establishment of the personnel policies and programs of the

 

Commission. Notwithstanding any civil service or other similar laws

 

of any party state, the bylaws shall exclusively govern the

 

personnel policies and programs of the Commission; and

 

6. Providing a mechanism for winding up the operations of the


Commission and the equitable disposition of any surplus funds that

 

may exist after the termination of this Compact after the payment

 

or reserving of all of its debts and obligations;

 

d. The Commission shall publish its bylaws and rules, and any

 

amendments thereto, in a convenient form on the website of the

 

Commission.

 

e. The Commission shall maintain its financial records in

 

accordance with the bylaws.

 

f. The Commission shall meet and take such actions as are

 

consistent with the provisions of this Compact and the bylaws.

 

g. The Commission shall have the following powers:

 

1. To promulgate uniform rules to facilitate and coordinate

 

implementation and administration of this Compact. The rules shall

 

have the force and effect of law and shall be binding in all party

 

states;

 

2. To bring and prosecute legal proceedings or actions in the name

 

of the Commission, provided that the standing of any licensing

 

board to sue or be sued under applicable law shall not be affected;

 

3. To purchase and maintain insurance and bonds;

 

4. To borrow, accept or contract for services of personnel,

 

including, but not limited to, employees of a party state or

 

nonprofit organizations;

 

5. To cooperate with other organizations that administer state

 

compacts related to the regulation of nursing, including but not

 

limited to sharing administrative or staff expenses, office space

 

or other resources;

 

6. To hire employees, elect or appoint officers, fix compensation,


define duties, grant such individuals appropriate authority to

 

carry out the purposes of this Compact, and to establish the

 

Commission's personnel policies and programs relating to conflicts

 

of interest, qualifications of personnel and other related

 

personnel matters;

 

7. To accept any and all appropriate donations, grants and gifts of

 

money, equipment, supplies, materials and services, and to receive,

 

utilize and dispose of the same; provided that at all times the

 

Commission shall avoid any appearance of impropriety or conflict of

 

interest;

 

8. To lease, purchase, accept appropriate gifts or donations of, or

 

otherwise to own, hold, improve or use, any property, whether real,

 

personal or mixed; provided that at all times the Commission shall

 

avoid any appearance of impropriety;

 

9. To sell, convey, mortgage, pledge, lease, exchange, abandon or

 

otherwise dispose of any property, whether real, personal or mixed;

 

10. To establish a budget and make expenditures;

 

11. To borrow money;

 

12. To appoint committees, including advisory committees comprised

 

of administrators, state nursing regulators, state legislators or

 

their representatives, and consumer representatives, and other such

 

interested persons;

 

13. To provide and receive information from, and to cooperate with,

 

law enforcement agencies;

 

14. To adopt and use an official seal; and

 

15. To perform such other functions as may be necessary or

 

appropriate to achieve the purposes of this Compact consistent with


the state regulation of nurse licensure and practice.

 

h. Financing of the Commission

 

1. The Commission shall pay, or provide for the payment of, the

 

reasonable expenses of its establishment, organization and ongoing

 

activities.

 

2. The Commission may also levy on and collect an annual assessment

 

from each party state to cover the cost of its operations,

 

activities and staff in its annual budget as approved each year.

 

The aggregate annual assessment amount, if any, shall be allocated

 

based upon a formula to be determined by the Commission, which

 

shall promulgate a rule that is binding upon all party states.

 

3. The Commission shall not incur obligations of any kind prior to

 

securing the funds adequate to meet the same; nor shall the

 

Commission pledge the credit of any of the party states, except by,

 

and with the authority of, such party state.

 

4. The Commission shall keep accurate accounts of all receipts and

 

disbursements. The receipts and disbursements of the Commission

 

shall be subject to the audit and accounting procedures established

 

under its bylaws. However, all receipts and disbursements of funds

 

handled by the Commission shall be audited yearly by a certified or

 

licensed public accountant, and the report of the audit shall be

 

included in and become part of the annual report of the Commission.

 

i. Qualified Immunity, Defense and Indemnification

 

1. The administrators, officers, executive director, employees and

 

representatives of the Commission shall be immune from suit and

 

liability, either personally or in their official capacity, for any

 

claim for damage to or loss of property or personal injury or other


civil liability caused by or arising out of any actual or alleged

 

act, error or omission that occurred, or that the person against

 

whom the claim is made had a reasonable basis for believing

 

occurred, within the scope of Commission employment, duties or

 

responsibilities; provided that nothing in this paragraph shall be

 

construed to protect any such person from suit or liability for any

 

damage, loss, injury or liability caused by the intentional,

 

willful or wanton misconduct of that person.

 

2. The Commission shall defend any administrator, officer,

 

executive director, employee or representative of the Commission in

 

any civil action seeking to impose liability arising out of any

 

actual or alleged act, error or omission that occurred within the

 

scope of Commission employment, duties or responsibilities, or that

 

the person against whom the claim is made had a reasonable basis

 

for believing occurred within the scope of Commission employment,

 

duties or responsibilities; provided that nothing herein shall be

 

construed to prohibit that person from retaining his or her own

 

counsel; and provided further that the actual or alleged act, error

 

or omission did not result from that person's intentional, willful

 

or wanton misconduct.

 

3. The Commission shall indemnify and hold harmless any

 

administrator, officer, executive director, employee or

 

representative of the Commission for the amount of any settlement

 

or judgment obtained against that person arising out of any actual

 

or alleged act, error or omission that occurred within the scope of

 

Commission employment, duties or responsibilities, or that such

 

person had a reasonable basis for believing occurred within the


scope of Commission employment, duties or responsibilities,

 

provided that the actual or alleged act, error or omission did not

 

result from the intentional, willful or wanton misconduct of that

 

person.

 

 

 

ARTICLE VIII

 

Rulemaking

 

a. The Commission shall exercise its rulemaking powers pursuant to

 

the criteria set forth in this Article and the rules adopted

 

thereunder. Rules and amendments shall become binding as of the

 

date specified in each rule or amendment and shall have the same

 

force and effect as provisions of this Compact.

 

b. Rules or amendments to the rules shall be adopted at a regular

 

or special meeting of the Commission.

 

c. Prior to promulgation and adoption of a final rule or rules by

 

the Commission, and at least sixty (60) days in advance of the

 

meeting at which the rule will be considered and voted upon, the

 

Commission shall file a notice of proposed rulemaking:

 

1. On the website of the Commission; and

 

2. On the website of each licensing board or the publication in

 

which each state would otherwise publish proposed rules.

 

d. The notice of proposed rulemaking shall include:

 

1. The proposed time, date and location of the meeting in which the

 

rule will be considered and voted upon;

 

2. The text of the proposed rule or amendment, and the reason for

 

the proposed rule;

 

3. A request for comments on the proposed rule from any interested

 


person; and

 

4. The manner in which interested persons may submit notice to the

 

Commission of their intention to attend the public hearing and any

 

written comments.

 

e. Prior to adoption of a proposed rule, the Commission shall allow

 

persons to submit written data, facts, opinions and arguments,

 

which shall be made available to the public.

 

f. The Commission shall grant an opportunity for a public hearing

 

before it adopts a rule or amendment.

 

g. The Commission shall publish the place, time and date of the

 

scheduled public hearing.

 

1. Hearings shall be conducted in a manner providing each person

 

who wishes to comment a fair and reasonable opportunity to comment

 

orally or in writing. All hearings will be recorded, and a copy

 

will be made available upon request.

 

2. Nothing in this section shall be construed as requiring a

 

separate hearing on each rule. Rules may be grouped for the

 

convenience of the Commission at hearings required by this section.

 

h. If no one appears at the public hearing, the Commission may

 

proceed with promulgation of the proposed rule.

 

i. Following the scheduled hearing date, or by the close of

 

business on the scheduled hearing date if the hearing was not held,

 

the Commission shall consider all written and oral comments

 

received.

 

j. The Commission shall, by majority vote of all administrators,

 

take final action on the proposed rule and shall determine the

 

effective date of the rule, if any, based on the rulemaking record


and the full text of the rule.

 

k. Upon determination that an emergency exists, the Commission may

 

consider and adopt an emergency rule without prior notice,

 

opportunity for comment or hearing, provided that the usual

 

rulemaking procedures provided in this Compact and in this section

 

shall be retroactively applied to the rule as soon as reasonably

 

possible, in no event later than ninety (90) days after the

 

effective date of the rule. For the purposes of this provision, an

 

emergency rule is one that must be adopted immediately in order to:

 

1. Meet an imminent threat to public health, safety or welfare;

 

2. Prevent a loss of Commission or party state funds; or

 

3. Meet a deadline for the promulgation of an administrative rule

 

that is required by federal law or rule.

 

l. The Commission may direct revisions to a previously adopted rule

 

or amendment for purposes of correcting typographical errors,

 

errors in format, errors in consistency or grammatical errors.

 

Public notice of any revisions shall be posted on the website of

 

the Commission. The revision shall be subject to challenge by any

 

person for a period of thirty (30) days after posting. The revision

 

may be challenged only on grounds that the revision results in a

 

material change to a rule. A challenge shall

 

be made in writing, and delivered to the Commission, prior to the

 

end of the notice period. If no challenge is made, the revision

 

will take effect without further action. If the revision is

 

challenged, the revision may not take effect without the approval

 

of the Commission.

 

 

 


ARTICLE IX

 

Oversight, Dispute Resolution and Enforcement

 

a. Oversight

 

1. Each party state shall enforce this Compact and take all actions

 

necessary and appropriate to effectuate this Compact's purposes and

 

intent.

 

2. The Commission shall be entitled to receive service of process

 

in any proceeding that may affect the powers, responsibilities or

 

actions of the Commission, and shall have standing to intervene in

 

such a proceeding for all purposes. Failure to provide service of

 

process in such proceeding to the Commission shall render a

 

judgment or order void as to the Commission, this Compact or

 

promulgated rules.

 

b. Default, Technical Assistance and Termination

 

1. If the Commission determines that a party state has defaulted in

 

the performance of its obligations or responsibilities under this

 

Compact or the promulgated rules, the Commission shall:

 

i. Provide written notice to the defaulting state and other party

 

states of the nature of the default, the proposed means of curing

 

the default or any other action to be taken by the Commission; and

 

ii. Provide remedial training and specific technical assistance

 

regarding the default.

 

2. If a state in default fails to cure the default, the defaulting

 

state's membership in this Compact may be terminated upon an

 

affirmative vote of a majority of the administrators, and all

 

rights, privileges and benefits conferred by this Compact may be

 

terminated on the effective date of termination. A cure of the


default does not relieve the offending state of obligations or

 

liabilities incurred during the period of default.

 

3. Termination of membership in this Compact shall be imposed only

 

after all other means of securing compliance have been exhausted.

 

Notice of intent to suspend or terminate shall be

 

given by the Commission to the governor of the defaulting state and

 

to the executive officer of the defaulting state's licensing board

 

and each of the party states.

 

4. A state whose membership in this Compact has been terminated is

 

responsible for all assessments, obligations and liabilities

 

incurred through the effective date of termination, including

 

obligations that extend beyond the effective date of termination.

 

5. The Commission shall not bear any costs related to a state that

 

is found to be in default or whose membership in this Compact has

 

been terminated unless agreed upon in writing between the

 

Commission and the defaulting state.

 

6. The defaulting state may appeal the action of the Commission by

 

petitioning the U.S. District Court for the District of Columbia or

 

the federal district in which the Commission has its principal

 

offices. The prevailing party shall be awarded all costs of such

 

litigation, including reasonable attorneys' fees.

 

c. Dispute Resolution

 

1. Upon request by a party state, the Commission shall attempt to

 

resolve disputes related to the Compact that arise among party

 

states and between party and non-party states.

 

2. The Commission shall promulgate a rule providing for both

 

mediation and binding dispute resolution for disputes, as


appropriate.

 

3. In the event the Commission cannot resolve disputes among party

 

states arising under this Compact:

 

i. The party states may submit the issues in dispute to an

 

arbitration panel, which will be comprised of individuals appointed

 

by the Compact administrator in each of the affected party states

 

and an individual mutually agreed upon by the Compact

 

administrators of all the party states involved in the dispute.

 

ii. The decision of a majority of the arbitrators shall be final

 

and binding.

 

d. Enforcement

 

1. The Commission, in the reasonable exercise of its discretion,

 

shall enforce the provisions and rules of this Compact.

 

2. By majority vote, the Commission may initiate legal action in

 

the U.S. District Court for the District of Columbia or the federal

 

district in which the Commission has its principal offices against

 

a party state that is in default to enforce compliance with the

 

provisions of this Compact and its promulgated rules and bylaws.

 

The relief sought may include both injunctive relief and damages.

 

In the event judicial enforcement is necessary, the prevailing

 

party shall be awarded all costs of such litigation, including

 

reasonable attorneys' fees.

 

3. The remedies herein shall not be the exclusive remedies of the

 

Commission. The Commission may pursue any other remedies available

 

under federal or state law.

 

 

 

ARTICLE X

 


Effective Date, Withdrawal and Amendment

 

a. This Compact shall become effective and binding on the earlier

 

of the date of legislative enactment of this Compact into law by no

 

less than twenty-six (26) states or December 31, 2018. All party

 

states to this Compact, that also were parties to the prior Nurse

 

Licensure Compact, superseded by this Compact, ("Prior Compact"),

 

shall be deemed to have withdrawn from said Prior Compact within

 

six (6) months after the effective date of this Compact.

 

b. Each party state to this Compact shall continue to recognize a

 

nurse's multistate licensure privilege to practice in that party

 

state issued under the Prior Compact until such party state has

 

withdrawn from the Prior Compact.

 

c. Any party state may withdraw from this Compact by enacting a

 

statute repealing the same. A party state's withdrawal shall not

 

take effect until six (6) months after enactment of the repealing

 

statute.

 

d. A party state's withdrawal or termination shall not affect the

 

continuing requirement of the withdrawing or terminated state's

 

licensing board to report adverse actions and significant

 

investigations occurring prior to the effective date of such

 

withdrawal or termination.

 

e. Nothing contained in this Compact shall be construed to

 

invalidate or prevent any nurse licensure agreement or other

 

cooperative arrangement between a party state and a non-party state

 

that is made in accordance with the other provisions of this

 

Compact.

 

f. This Compact may be amended by the party states. No amendment to


this Compact shall become effective and binding upon the party

 

states unless and until it is enacted into the laws of all party

 

states.

 

g. Representatives of non-party states to this Compact shall be

 

invited to participate in the activities of the Commission, on a

 

nonvoting basis, prior to the adoption of this Compact by all

 

states.

 

 

 

ARTICLE XI

 

Construction and Severability

 

This Compact shall be liberally construed so as to effectuate the

 

purposes thereof. The provisions of this Compact shall be

 

severable, and if any phrase, clause, sentence or provision of this

 

Compact is declared to be contrary to the constitution of any party

 

state or of the United States, or if the applicability thereof to

 

any government, agency, person or circumstance is held invalid, the

 

validity of the remainder of this Compact and the applicability

 

thereof to any government, agency, person or circumstance shall not

 

be affected thereby. If this Compact shall be held to be contrary

 

to the constitution of any party state, this Compact shall remain

 

in full force and effect as to the remaining party states and in

 

full force and effect as to the party state affected as to all

 

severable matters.

 

     (2) Subsection (1) shall be known as the "Nurse Licensure

 

Compact".

 

     Sec. 17201. (1) As used in this part:

 

     (a) "Advanced practice registered nurse" or "a.p.r.n." means a

 


registered professional nurse who has been granted a specialty

 

certification under section 17210 in 1 of the following health

 

profession specialty fields:

 

     (i) Nurse midwifery.

 

     (ii) Nurse practitioner.

 

     (iii) Clinical nurse specialist.

 

     (b) "Nurse licensure compact" means the nurse licensure

 

compact as enacted in section 16190.

 

     (c) (b) "Physician" means a physician who is licensed under

 

part 170 or part 175.

 

     (d) (c) "Practice of nursing" means the systematic application

 

of substantial specialized knowledge and skill, derived from the

 

biological, physical, and behavioral sciences, to the care,

 

treatment, counsel, and health teaching of individuals who are

 

experiencing changes in the normal health processes or who require

 

assistance in the maintenance of health and the prevention or

 

management of illness, injury, or disability.

 

     (e) (d) "Practice of nursing as a licensed practical nurse" or

 

"l.p.n." means the practice of nursing based on less comprehensive

 

knowledge and skill than that required of a registered professional

 

nurse and performed under the supervision of a registered

 

professional nurse, physician, or dentist.

 

     (f) (e) "Registered professional nurse" or "r.n." means an

 

individual who is licensed under this part article or authorized

 

under section 17225 to engage in the practice of nursing which and

 

whose scope of practice includes the teaching, direction, and

 

supervision of less skilled personnel in the performance of


delegated nursing activities.

 

     (2) In addition to the definitions in this part, article 1

 

contains general definitions and principles of construction

 

applicable to all articles in the code and part 161 contains

 

definitions applicable to this part.

 

     Sec. 17225. (1) An individual who holds a multistate license

 

to practice registered nursing under the nurse licensure compact is

 

authorized to engage in the practice of nursing under this article.

 

     (2) For purposes of this article, including the obligations of

 

an individual who is licensed as a registered professional nurse,

 

an individual who holds a multistate license to practice registered

 

nursing under the nurse licensure compact is considered a

 

registered professional nurse who is licensed under this part.

 

     Sec. 17225a. (1) An individual who holds a multistate license

 

to practice licensed practical/vocational nursing under the nurse

 

licensure compact is authorized to engage in the practice of

 

nursing as a licensed practical nurse under this article.

 

     (2) For purposes of this article, including the obligations of

 

an individual who is licensed as a licensed practical nurse, an

 

individual who holds a multistate license to practice licensed

 

practical/vocational nursing under the nurse licensure compact is

 

considered a licensed practical nurse who is licensed under this

 

part.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.

feedback