2005 Texas Occupations Code CHAPTER 304. NURSE LICENSURE COMPACT

OCCUPATIONS CODE

CHAPTER 304. NURSE LICENSURE COMPACT


	§ 304.001. NURSE LICENSURE COMPACT.  The Nurse Licensure 
Compact is enacted and entered into with all other jurisdictions 
that legally join in the compact, which is as follows:

NURSE LICENSURE COMPACT

ARTICLE 1. 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 licensing laws;
		(2)  violations of nurse licensing 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 licensing and regulation;
		(4)  new practice modalities and technology make 
compliance with each state nurse licensing laws difficult and 
complex;  and
		(5)  the current system of the duplicative licensing of 
nurses practicing in multiple states is cumbersome and redundant to 
both nurses and the states.
	(b)  The general purposes of this compact are to:                              
		(1)  facilitate the states' responsibilities to protect 
the public's health and safety;
		(2)  ensure and encourage the cooperation of party 
states in the areas of nurse licensing and regulation;
		(3)  facilitate the exchange of information between 
party states in the areas of nurse regulation, investigation, and 
adverse action;
		(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 provided through 
the mutual recognition of party state licenses.
	In this compact:                                                               

ARTICLE 2. DEFINITIONS
		(a)  "Adverse action" means a home or remote state 
action.                  
		(b)  "Alternative program" means a voluntary, 
nondisciplinary 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 licensing and enforcement activities related 
to nurse licensing laws, which is administered by a nonprofit 
organization composed of and controlled by state nurse 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 a 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)  "Home state" means the party state that is the 
nurse's primary state of residence.
		(f)  "Home state action" means any administrative, 
civil, equitable, or criminal action permitted by the home state's 
laws that 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 that affects a nurse's authorization to practice.
		(g)  "Licensing board" means a party state's regulatory 
body responsible for issuing nurse licenses.
		(h)  "Multistate licensing privilege" means current, 
official authority from a remote state permitting the practice of 
nursing as a registered nurse, licensed practical nurse, or 
licensed vocational nurse in the party state.  All party states have 
the authority, in accordance with existing state due process laws, 
to take actions against the nurse's privilege, including 
revocation, suspension, probation, or any other action that affects 
a nurse's authorization to practice.
		(i)  "Nurse" means a registered nurse, licensed 
practical nurse, or licensed vocational nurse as those terms are 
defined by each party state's practice laws.
		(j)  "Party state" means any state that has enacted 
this compact.           
		(k)  "Remote state" means a party state, other than the 
home state, in which:
			(1)  a patient is located at the time nursing care 
is provided;  or        
			(2)  in the case of the practice of nursing not 
involving a patient, the recipient of nursing practice is located.
		(l)  "Remote state action" means:                                             
			(1)  an administrative, civil, equitable, or 
criminal action permitted by a remote state's laws that are imposed 
on a nurse by the remote state's licensing board or other authority, 
including an action against an individual's multistate licensing 
privilege to practice in the remote state;  and
			(2)  a cease and desist order and other injunctive 
or equitable orders issued by remote states or the licensing boards 
of remote states.
		(m)  "State" means a state, territory, possession of 
the United States, the District of Columbia, or the Commonwealth of 
Puerto Rico.
		(n)  "State practice laws" means a party state's laws 
and regulations that govern the practice of nursing, define the 
scope of nursing practice, and create the methods and grounds for 
imposing discipline.  The term does not include the initial 
qualifications for licensing or requirements necessary to obtain 
and retain a license, except for qualifications or requirements of 
the home state.

ARTICLE 3. 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 licensing privilege to 
practice as a registered nurse in the party state.  A license to 
practice licensed practical nursing or licensed vocational nursing 
issued by a home state to a resident in that state will be 
recognized by each party state as authorizing a multistate 
licensing privilege to practice as a licensed practical nurse or 
vocational nurse in the party state.  To obtain or retain a license, 
an applicant must meet the home state's qualifications for a 
license and license renewal as well as all other applicable state 
laws.
	(b)  A party state may, in accordance with state due process 
laws, limit or revoke the multistate licensing privilege of any 
nurse to practice in the party state and may take any other 
necessary actions under the party state's applicable laws to 
protect the health and safety of the party state's citizens.  If a 
party state takes this action, the party state 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)  A 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 provided.  The practice of nursing includes patient 
care and all nursing practice defined by the party state's practice 
laws.  The practice of nursing will subject a nurse to the 
jurisdiction of the nurse licensing board, the courts, and the laws 
of the party state.
	(d)  This compact does not affect additional requirements 
imposed by states for advanced practice registered nursing.  
However, a multistate licensing privilege to practice registered 
nursing granted by a party state shall be recognized by another 
party state as a license to practice registered nursing if the 
state's law requires the license as a precondition for qualifying 
for advanced practice registered nurse authorization.
	(e)  Individuals not residing in a party state may apply for 
a nurse license under the laws of a 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 4. APPLICATION FOR LICENSE IN A PARTY STATE
	(a)  Once an application for a license is submitted, the 
licensing board in a party state shall ascertain, through the 
coordinated licensure information system, whether:
		(1)  the applicant has held or is the holder of a 
license issued by another state;
		(2)  a restriction exists on the multistate licensing 
privilege;  and       
		(3)  any other adverse action by any state has been 
taken against the license.
	(b)  A nurse in a party state shall hold a license that is 
issued by the home state in only one party state at a time.
	(c)  A nurse who intends to change the nurse's primary state 
of residence may apply for a license in the new home state in 
advance of the change.  However, a new license will not be issued by 
a party state until a nurse provides satisfactory evidence to the 
new home state's licensing board of a change in the nurse's primary 
state of residence.
	(d)  When a nurse changes the nurse's primary state of 
residence by moving from:
		(1)  a party state to another party state and obtains a 
license from the new home state, the license from the former home 
state is no longer valid;
		(2)  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 remains in full 
force if provided by the laws of the non-party state;  and
		(3)  a party state to a non-party state, the license 
issued by the prior home state converts to a state license valid 
only in the former home state and does not entitle the nurse to the 
multistate licensing privilege to practice in other party states.

ARTICLE 5. ADVERSE ACTIONS
	(a)  The licensing board of a remote state shall promptly 
report to the administrator of the coordinated licensure 
information system a remote state action and the factual and legal 
basis for the action, if known.  The licensing board of a remote 
state shall 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 these reports.
	(b)  The licensing board of a party state shall have the 
authority to complete a pending investigation of a nurse who 
changes the nurse's primary state of residence during the course of 
the investigation and to take appropriate action.  The licensing 
board shall promptly report the conclusions of the 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 action.
	(c)  A remote state may take adverse action affecting the 
multistate licensing privilege to practice in that party state.  
However, only the home state has 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 to conduct 
occurring in the home state.  In so doing, the licensing board shall 
apply its state laws to determine appropriate action.
	(e)  The home state may take adverse action based on the 
factual findings of the remote state only if each state follows its 
own procedures for imposing the adverse action.
	(f)  This compact does not affect a party state's decision 
that participation in an alternative program may be used instead of 
licensing action and that the participation shall remain non-public 
if required by the party state's laws.  Party states must require a 
nurse who enters an alternative program to agree not to practice in 
any other party state during the term of the alternative program 
without prior authorization from the other party state.

ARTICLE 6. ADDITIONAL AUTHORITIES OF PARTY STATE NURSE LICENSING 
BOARDS
	(a)  Notwithstanding any other powers, party state nurse 
licensing boards have the authority to:
		(1)  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 the nurse;
		(2)  issue subpoenas for hearings and investigations 
that require the attendance and testimony of witnesses and the 
production of evidence;
		(3)  issue a cease and desist order to limit or revoke a 
nurse's authority to practice in the state;  and
		(4)  adopt uniform rules as provided under Article 8(c) 
of this compact.    
	(b)  A subpoena issued by a nurse 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 non-issuing party state by a court of competent jurisdiction 
in accordance with the practice and procedure applicable to 
subpoenas issued in proceedings pending before the court.  The 
issuing authority shall pay any witness fees, travel expenses, 
mileage, and other fees required by the service statutes of the 
state in which a witness or evidence is located.

ARTICLE 7. COORDINATED LICENSURE INFORMATION SYSTEM
	(a)  All party states shall participate in a cooperative 
effort to create a coordinated database of all licensed registered 
nurses, licensed practical nurses, and licensed vocational nurses.  
This system will include information on the licensing and 
disciplinary history of each nurse, as contributed by party states, 
to assist in the coordination of nurse licensing and enforcement 
efforts.
	(b)  Notwithstanding any other provision of law, all party 
states' licensing boards shall promptly report to the coordinated 
licensure information system adverse actions, actions against 
multistate licensing privileges, any current significant 
investigative information yet to result in adverse action, and 
denials of applications and the reasons for the denials.
	(c)  Current significant investigative information shall be 
transmitted only to party state licensing boards through the 
coordinated licensure information system.
	(d)  Notwithstanding any other provision of law, all party 
states' licensing boards that contribute 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 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.
	(f)  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 be 
expunged from the coordinated licensure information system.
	(g)  Each compact administrator shall act jointly and in 
consultation with the administrator of the coordinated licensure 
information system to formulate necessary and proper procedures for 
the identification, collection, and exchange of information under 
this compact.

ARTICLE 8. COMPACT ADMINISTRATION AND EXCHANGE OF INFORMATION
	(a)  The presiding officer of the nurse licensing board of a 
party state or the presiding officer's designee shall be the 
administrator of this compact for the state.
	(b)  The compact administrator of each party state shall 
furnish to the compact administrator of each other party state 
information and documents including a uniform data set of 
investigations, identifying information, licensing data, and 
disclosable alternative program participation information to 
facilitate the administration of this compact.
	(c)  Compact administrators have the authority to develop 
uniform rules to facilitate and coordinate implementation of this 
compact.  The uniform rules shall be adopted by party states under 
Article 6(a)(4) of this compact. 
	A party state or an officer, employee, or agent of a party 
state's nurse licensing board who acts in accordance with the 
provisions of this compact is not liable for any good faith act or 
omission that occurs while the person is performing the person's 
duties under this compact.  Good faith in this article does not 
include wilful misconduct, gross negligence, or recklessness.

ARTICLE 9. IMMUNITY

ARTICLE 10. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT
	(a)  This compact enters into force and takes effect for a 
state when the state enacts this compact as law.  A party state may 
withdraw from the compact by enacting a statute repealing the 
compact, but a withdrawal takes effect six months after the date the 
withdrawing state gives 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)  This compact does not invalidate or prevent any nurse 
licensing 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.  An 
amendment to this compact is not effective or binding on the party 
states unless and until all party states enact the amendment into 
the law of each state.

ARTICLE 11. CONSTRUCTION AND SEVERABILITY
	(a)  This compact shall be liberally construed to effectuate 
the compact's purposes.
	(b)  This compact is severable.  If a phrase, clause, 
sentence, or provision of this compact is declared to be contrary to 
the constitution of a party state or the United States or the 
applicability of this compact to a government, agency, person, or 
circumstance is held invalid, the validity and applicability of the 
remainder of the compact to a government, agency, person, or 
circumstance is not affected.  If this compact is held to be 
contrary to the constitution of a party state, the compact remains 
in full force and effect for the other party states and in full 
force and effect for the party state affected for all severable 
matters.
	(c)  If the party states need to settle a dispute under the 
compact the party states may submit the issues in dispute to an 
arbitration panel comprised of:
		(A)  an individual appointed by the compact 
administrator in the home state;
		(B)  an individual appointed by the compact 
administrator in each remote state involved;  and
		(C)  an individual mutually agreed upon by the compact 
administrators of each party state involved in the dispute.
	(d)  The decision of a majority of the arbitrators shall be 
final and binding.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.


	§ 304.002. ADMINISTRATION OF COMPACT.  The executive 
director of the Board of Nurse Examiners is the Nurse Licensure 
Compact administrator for this state.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.022, eff. 
Feb. 1, 2004.


	§ 304.003. RULES.  The Board of Nurse Examiners may adopt 
rules necessary to implement this chapter.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.023, eff. 
Feb. 1, 2004.


	§ 304.004. GENERAL PROVISIONS.  (a) The terms "nurse," 
"registered nurse," and "vocational nurse" include nurses licensed 
as registered nurses or vocational nurses by a state that is a party 
to the Nurse Licensure Compact.
	(b)  Unless the context indicates otherwise or doing so would 
be inconsistent with the Nurse Licensure Compact, nurses practicing 
in this state under a license issued by a state that is a party to 
the Nurse Licensure Compact have the same rights and obligations as 
imposed by the laws of this state on license holders of the Board of 
Nurse Examiners.
	(c)  The Board of Nurse Examiners has the authority to 
determine whether a right or obligation imposed on license holders 
applies to nurses practicing in this state under a license issued by 
a state that is a party to the Nurse Licensure Compact unless that 
determination is inconsistent with the Nurse Licensure Compact.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.024, eff. 
Feb. 1, 2004.


	§ 304.005. ENFORCEMENT.  The Board of Nurse Examiners is 
the state agency responsible for taking action against registered 
and vocational nurses practicing in this state under a license 
issued by a state that is a party to the Nurse Licensure Compact as 
authorized by the Nurse Licensure Compact.  The action shall be 
taken in accordance with the same procedures for taking action 
against registered and vocational nurses licensed by this state.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.025, eff. 
Feb. 1, 2004.


	§ 304.006. INFORMATION MAINTAINED UNDER COMPACT.  (a) On 
request and payment of a reasonable fee, the Board of Nurse 
Examiners shall provide a registered or vocational nurse licensed 
by this state with a copy of information regarding the nurse 
maintained by the coordinated licensure information system under 
Article 7 of the Nurse Licensure Compact.
	(b)  A board is not obligated to provide information not 
available to the board or information that is not available to the 
nurse under the laws of the state contributing the information to 
the coordinated licensure information system.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.026, eff. 
Feb. 1, 2004.


	§ 304.007. ACCESS TO PRACTICE-RELATED 
INFORMATION.  Practice-related information provided by the Board 
of Nurse Examiners to registered or vocational nurses licensed by 
this state shall be made available by the board on request and at a 
reasonable cost to nurses practicing in this state under a license 
issued by a state that is a party to the Nurse Licensure Compact.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.027, eff. 
Feb. 1, 2004.


	§ 304.008. DISCLOSURE OF PERSONAL INFORMATION.  (a) In 
reporting information to the coordinated licensure information 
system under Article 7 of the Nurse Licensure Compact, the Board of 
Nurse Examiners may disclose personally identifiable information 
about the nurse, including social security number.
	(b)  The coordinated licensure information system may not 
share personally identifiable information with a state not a party 
to the compact unless the state agrees not to disclose that 
information to other persons.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.028, eff. 
Feb. 1, 2004.


	§ 304.009. WITHDRAWAL FROM COMPACT.  (a) The governor may 
withdraw this state from the Nurse Licensure Compact if the Board of 
Nurse Examiners notifies the governor that a state that is party to 
the compact changed, after January 1, 1999, the state's 
requirements for licensing a nurse and that the state's 
requirements, as changed, are substantially lower than the 
requirements for licensing a nurse in this state.
	(b)  The governor may completely withdraw this state from the 
Nurse Licensure Compact or may limit withdrawal to the application 
of the compact to registered nurses or vocational nurses.

Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept. 
1, 2001.  Amended by Acts 2003, 78th Leg., ch. 553, § 2.029, eff. 
Feb. 1, 2004.