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314.470 Nurse Licensure Compact.
The Nurse Licensure Compact is hereby enacted and entered into with all other
jurisdictions that legally join in the compact, which is, in form, substantially as follows:
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 healthcare 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; and
5.
The current system of duplicative licensure for nurses practicing in multiple
states is cumbersome and redundant to both nurses and states.
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; and
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.
ARTICLE II
Definitions
As used in this Compact:
a.
"Adverse action" means a home or remote state action;
b.
"Alternative program" means a voluntary, non-disciplinary monitoring program
approved by a nurse 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, which is administered by a non-profit
organization composed of and controlled by state nurse licensing boards;
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
"Current significant investigative information" means 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
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;
"Home state" means the party state which is the nurse's primary state of residence;
"Home state action" means any administrative, civil, equitable, or criminal action
permitted by the home state's laws which are imposed on a nurse by the home state's
licensing board or other authority, including actions against an individual's license
such as: revocation, suspension, probation, or any other action which affects a
nurse's authorization to practice;
"Licensing board" means a party state's regulatory body responsible for issuing
nurse licenses;
"Multistate licensure privilege" means current, official authority from a remote state
permitting the practice of nursing as either a registered nurse or a licensed
practical/vocational nurse in such party state. All party states have the authority, in
accordance with existing state due process law, to take actions against the nurse's
privilege such as: revocation, suspension, probation, or any other action which
affects a nurse's authorization to practice;
"Nurse" means a registered nurse or licensed practical/vocational nurse, as those
terms are defined by each party's state practice laws;
"Party state" means any state that has adopted this Compact;
"Remote state" means a party state, other than the home state, where the patient is
located at the time nursing care is provided or, in the case of the practice of nursing
not involving a patient, in such party state where the recipient of nursing practice is
located;
"Remote state action" means any administrative, civil, equitable, or criminal action
permitted by a remote state's laws which are imposed on a nurse by the remote
state's licensing board or other authority including actions against an individual's
multistate licensure privilege to practice in the remote state, and cease and desist
and other injunctive or equitable orders issued by remote states or the licensing
boards thereof;
"State" means a state, territory, or possession of the United States, the District of
Columbia or the Commonwealth of Puerto Rico;
"State practice laws" means those individual party's state laws and regulations that
govern the practice of nursing, define the scope of nursing practice, and create the
methods and grounds for imposing discipline; and
"State practice laws" does not include the initial qualifications for licensure or
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 license to practice registered nursing issued by a home state to a resident in that
state will be recognized by each party state as authorizing a multistate licensure
privilege to practice as a registered nurse in such party state. A license to practice
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 multistate licensure
privilege to practice as a licensed practical/vocational nurse in such party state. In
order to obtain or retain a license, an applicant must meet the home state's
qualifications for licensure and license renewal as well as all other applicable state
laws.
b.
Party states may, in accordance with state due process laws, limit or revoke the
multistate licensure privilege of any nurse to practice in their state and may take any
other actions under their applicable state laws necessary to protect the health and
safety of their citizens. 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.
c.
Every nurse practicing in a party state must comply with the state practice laws of
the state in which the patient is located at the time care is rendered. In addition, the
practice of nursing is not limited to patient care, but shall include all nursing
practice as defined by the state practice laws of a party state. The practice of nursing
will subject a nurse to the jurisdiction of the nurse licensing board and the courts, as
well as the laws, in that party state.
d.
This Compact does not affect additional requirements imposed by states for
advanced practice registered nursing. However, a multistate licensure privilege to
practice registered nursing granted by a party state shall be recognized by other
party states as a license to practice registered nursing if one is required by state law
as a precondition for qualifying for advanced practice registered nurse
authorization.
e.
Individuals not residing in a party state shall continue to be able to apply for nurse
licensure as provided for under the laws of each party state. However, the license
granted to these individuals will not be recognized as granting the privilege to
practice nursing in any other party state unless explicitly agreed to by that party
state.
ARTICLE IV
Applications for Licensure in a Party State
a.
Upon application for a license, the licensing board in a 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 restrictions on the multistate licensure privilege, and whether any other adverse
action by any state has been taken against the license.
b.
A nurse in a party state shall hold licensure in only one party state at a time, issued
by the home state.
c.
A nurse who intends to change primary state of residence may apply for licensure in
the new home state in advance of such change. However, new licenses will not be
issued by a party state until after a nurse provides evidence of change in primary
state of residence satisfactory to the new home state's licensing board.
d.
When a nurse changes primary state of residence by:
1.
Moving between two party states, and obtains a license from the new home
state, the license from the former home state is no longer valid;
2.
Moving from a non-party state to a party state, and obtains a license from the
new home state, the individual state license issued by the non-party state is not
affected and will remain in full force if so provided by the laws of the nonparty state; and
3.
Moving from a party state to a non-party state, the license issued by the prior
home state converts to an individual state license, valid only in the former
home state, without the multistate licensure privilege to practice in other party
states.
ARTICLE V
Adverse Actions
In addition to the General Provisions described in Article III, the following provisions
apply:
a.
The licensing board of a remote state shall promptly report to the administrator of
the coordinated licensure information system any remote state actions including the
factual and legal basis for such action, if known. The licensing board of a remote
state shall also promptly report any significant current investigative information yet
to result in a remote state action. The administrator of the coordinated licensure
information system shall promptly notify the home state of any such reports.
b.
The licensing board of a party state shall have the authority to complete any pending
investigations for a nurse who changes primary state of residence during the course
of such investigations. It 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.
c.
A remote state may take adverse action affecting the multistate licensure privilege
to practice within that party state. However, only the home state shall have the
power to impose adverse action against the license issued by the home state.
d.
For purposes of imposing adverse action, the licensing board of the home state 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, it shall
apply its own state laws to determine appropriate action.
e.
The home state may take adverse action based on the factual findings of the remote
state, so long as each state follows its own procedures for imposing such adverse
action.
f.
Nothing in this Compact shall override a party state's decision that participation in
an alternative program may be used in lieu of licensure action and that such
participation shall remain non-public if required by the party state's laws. Party
states must require nurses who enter any alternative programs to agree not to
practice in any other party state during the term of the alternative program without
prior authorization from such other party state.
ARTICLE VI
Additional Authorities Invested in Party State Nurse Licensing Boards
Notwithstanding any other powers, party state nurse licensing boards shall have the
authority to:
a.
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;
b.
Issue subpoenas for both hearings and investigations which require the attendance
and testimony of witnesses, and the production of evidence. Subpoenas issued by a
nurse licensing board in a party state for the attendance and testimony of witnesses,
and/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 where the witnesses
and/or evidence are located;
c.
Issue cease and desist orders to limit or revoke a nurse's authority to practice in their
state; and
d.
Promulgate uniform rules and regulations as provided for in Article VIIIc.
ARTICLE VII
Coordinated Licensure Information System
a.
All party states shall participate in a cooperative effort to create a coordinated
database of all licensed registered nurses and licensed practical/vocational nurses.
This system will include information on the licensure and disciplinary history of
each nurse, as contributed by party states, to assist in the coordination of nurse
licensure and enforcement efforts.
b.
Notwithstanding any other provision of law, all party states' licensing boards shall
promptly report adverse actions, actions against multistate licensure privileges, any
current significant investigative information yet to result in adverse action, denials
of applications, and the reasons for such denials, to the coordinated licensure
information system.
c.
Current significant investigative information shall be transmitted through the
coordinated licensure information system only to party state licensing boards.
d.
Notwithstanding any other provision of law, all party states' 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.
e.
Any personally identifiable information obtained by a party state's licensing board
from the coordinated licensure information system may not be shared with nonparty states or disclosed to other entities or individuals except to the extent
permitted by the laws of the party state contributing the information.
f.
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.
g.
The Compact administrators, acting jointly with each other and 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.
ARTICLE VIII
Compact Administration and Interchange of Information
a.
The head of the nurse licensing board, or his/her designee, of each party state shall
be the administrator of this Compact for his/her state.
b.
The Compact administrator of each party state shall furnish to the Compact
administrator of each other party state any information and documents including,
but not limited to, a uniform data set of investigations, identifying information,
licensure data, and disclosable alternative program participation information to
facilitate the administration of this Compact.
c.
Compact administrators shall have the authority to develop uniform rules to
facilitate and coordinate implementation of this Compact. These uniform rules shall
be adopted by party states, under the authority invested under Article VId.
ARTICLE IX
Immunity
No party state or the officers or employees or agents of a party state's nurse licensing
board who acts in accordance with the provisions of this Compact shall be liable on
account of any act or omission in good faith while engaged in the performance of their
duties under this Compact. Good faith in this article shall not include willful misconduct,
gross negligence, or recklessness.
ARTICLE X
Entry into Force, Withdrawal, and Amendment
a.
This Compact shall enter into force and become effective as to any state when it has
been enacted into the laws of that state. Any party state may withdraw from this
Compact by enacting a statute repealing the same, but no such withdrawal shall take
effect until six months after the withdrawing state has given notice of the
withdrawal to the executive heads of all other party states.
b.
No withdrawal shall affect the validity or applicability by the licensing boards of
states remaining party to the Compact of any report of adverse action occurring
prior to the withdrawal.
c.
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.
d.
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.
ARTICLE XI
Construction and Severability
a.
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 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
contrary to the constitution of any state party thereto, the 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.
b.
In the event party states find a need for settling disputes arising under this Compact:
1.
The party states may submit the issues in dispute to an arbitration panel which
will be composed of an individual appointed by the Compact administrator in
the home state; an individual appointed by the Compact administrator in the
remote state(s) involved; and an individual mutually agreed upon by the
Compact administrators of all the party states involved in the dispute.
The decision of a majority of the arbitrators shall be final and binding.
Effective: June 1, 2007
History: Created 2006 Ky. Acts ch. 86, sec. 1, effective June 1, 2007.
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