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HOUSE BILL NO. 131
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-FOURTH LEGISLATURE - FIRST SESSION
BY THE HOUSE RULES COMMITTEE BY REQUEST OF THE GOVERNOR
Introduced: 3/10/25
Referred: Labor and Commerce, Finance
A BILL
FOR AN ACT ENTITLED
"An Act relating to the licensure of nursing professionals; rel ating to a multistate nurse 1
licensure compact; and providing for an effective date." 2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
* Section 1. AS 08.01.065(c) is amended to read: 4
(c) Except as provided in (f) - (l) [(f) - (k)] of this section, the department shall 5
establish fee levels under (a) of this section so that the tota l amount of fees collected 6
for an occupation approximately equals the actual regulatory co sts for the occupation. 7
The department shall annually re view each fee level to determin e whether the 8
regulatory costs of each occupation are approximately equal to fee collections related 9
to that occupation. If the review indicates that an occupation' s fee collections and 10
regulatory costs are not approxima tely equal, the department sh all calculate fee 11
adjustments and adopt regulations under (a) of this section to implement the 12
adjustments. In January of each year, the department shall repo rt on all fee levels and 13
revisions for the previous year under this subsection to the of fice of management and 14
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budget. If a board regulates an occupation covered by this chap ter, the department 1
shall consider the board's recommendations concerning the occup ation's fee levels and 2
regulatory costs before revising fee schedules to comply with t his subsection. In this 3
subsection, "regulatory costs" means costs of the department th at are attributable to 4
regulation of an occupation plus 5
(1) all expenses of the board that regulates the occupation if the board 6
regulates only one occupation; 7
(2) the expenses of a board that are attributable to the occupation if the 8
board regulates more than one occupation. 9
* Sec. 2. AS 08.01.065 is amended by adding a new subsection to read: 10
(l) Notwithstanding (c) of this section, the department shall establish fee levels 11
under (a) of this section so tha t the total amount of fees coll ected by the Board of 12
Nursing for issuing a single-state license to practice register ed, practical, or advanced 13
practice registered nursing is a pproximately equal to the total regulatory costs to the 14
department and the Board of Nursing for each of those license t ypes. The department 15
shall establish fees for issuing a multistate license to practi ce registered or practical 16
nursing equal to double the fee set for the single-state versio n of that license type. In 17
this subsection, "single-state license" and "multistate license" have the meanings given 18
in AS 08.68.500. 19
* Sec. 3. AS 08.02.130(j)(1), as amended by sec. 2, ch. 44, SLA 2024, is amended to read: 20
(1) "health care provider" means 21
(A) an audiologist or speech-language pathologist licensed 22
under AS 08.11; a behavior analyst licensed under AS 08.15; a c hiropractor 23
licensed under AS 08.20; a professi onal or associate counselor licensed under 24
AS 08.29; a dental hygienist licensed under AS 08.32; a dentist licensed under 25
AS 08.36; a dietitian or nutritionist licensed under AS 08.38; a naturopath 26
licensed under AS 08.45; a marital and family therapist license d under 27
AS 08.63; a physician licensed under AS 08.64; a podiatrist, os teopath, or 28
physician assistant licensed under AS 08.64; a direct-entry mid wife certified 29
under AS 08.65; a nurse licensed or privileged to practice under AS 08.68; a 30
dispensing optician licensed under AS 08.71; an optometrist lic ensed under 31
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AS 08.72; a pharmacist licensed under AS 08.80; a physical ther apist or 1
occupational therapist licensed under AS 08.84; a psychologist or 2
psychological associate license d under AS 08.86; or a social wo rker licensed 3
under AS 08.95; 4
(B) a physician licensed in another state; or 5
(C) a member of a multidisciplinary care team who is licensed 6
in another state. 7
* Sec. 4. AS 08.11.120(b) is amended to read: 8
(b) Notwithstanding the provisions of this chapter, 9
( 1 ) a n u r s e l i c e n s e d or privileged to practice under AS 08.68 may 10
perform hearing sensitivity evaluations; 11
(2) an individual licensed as a hearing aid dealer under AS 08 .55 may 12
deal in hearing aids; 13
(3) an individual holding a class A certificate issued by the Conference 14
of Executives of American Schools of the Deaf may teach the hearing impaired; 15
(4) an individual may engage in the testing of hearing as part o f a 16
hearing conservation program that complies with the regulations of the Occupational 17
Safety and Health Administration of the federal government if t he individual is 18
certified to do the testing by a state or federal agency accept able to the Occupational 19
Safety and Health Administration; 20
(5) an individual may perform hearing screening under AS 47.20 .310 21
if authorized to do so under a protocol adopted under AS 47.20. 310(e) by the 22
Department of Health. 23
* Sec. 5. AS 08.68.100(a) is amended to read: 24
(a) The board shall 25
(1) adopt regulations necessary t o implement this chapter, inc luding 26
regulations 27
(A) pertaining to practice as an advanced practice registered 28
nurse, including requirements fo r an advanced practice register ed nurse to 29
practice as a certified registered nurse anesthetist, certified clinical nurse 30
specialist, certified nurse practitioner, or certified nurse mi dwife; regulations 31
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f o r a n a d v a n c e d p r a c t i c e r e g i s t e r e d n u r s e w h o h o l d s a v a l i d f e deral Drug 1
Enforcement Administration registration number must address tra ining in pain 2
management and opioid use and addiction; 3
(B) necessary to impleme nt AS 08.68.331 - 08.68.336 relating 4
to certified nurse aides in orde r t o p r o t e c t t h e h e a l t h , s a f e t y, and welfare of 5
clients served by nurse aides; 6
(C) pertaining to retired nurse status; 7
(D) establishing criteria for approval of practical nurse 8
education programs that are not a ccredited by a national nursin g accrediting 9
body; 10
(E) establishing guidelines for rendering a diagnosis, providi ng 11
treatment, or prescribing, dispen sing, or administering a presc ription drug to a 12
person without conducting a physical examination under AS 08.68 .710; the 13
guidelines must include a nationally recognized model policy fo r standards of 14
c a r e o f a p a t i e n t w h o i s a t a d i f f e r e n t l o c a t i o n t h a n t h e a d v a nced practice 15
registered nurse; 16
(2) approve curricula and adopt standards for basic education programs 17
that prepare persons for licensing under AS 08.68.190; 18
(3) provide for surveys of the basic nursing education program s in the 19
state at the times it considers necessary; 20
(4) approve education programs th at meet the requirements of t his 21
chapter and of the board, and deny, revoke, or suspend approval of education 22
programs for failure to meet the requirements; 23
(5) examine, license, and renew the licenses of qualified applicants; 24
(6) prescribe requirements for competence before a former regi stered, 25
advanced practice registered, or licensed practical nurse may r esume the practice of 26
nursing under this chapter; 27
(7) define by regulation the qualifications and duties of the executive 28
administrator and delegate authority to the executive administr ator that is necessary to 29
conduct board business; 30
(8) develop reasonable and uniform standards for nursing practice; 31
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(9) publish advisory opinions regarding whether nursing practi ce 1
procedures or policies comply with acceptable standards of nursing practice as defined 2
under this chapter; 3
(10) require applicants under this chapter to submit fingerprints and the 4
fees required by the Department of Public Safety under AS 12.62 .160 for criminal 5
justice information and a national criminal history record chec k; the department shall 6
submit the fingerprints and fees to the Department of Public Sa fety for a report of 7
criminal justice information under AS 12.62 and a national crim inal history record 8
check under AS 12.62.400; 9
(11) require that a licensed advanced practice registered nurse who has 10
a federal Drug Enforcement Administration registration number r egister with the 11
controlled substance prescription database under AS 17.30.200(n); 12
(12) implement the Multistate Nurse Licensure Compact entered 13
into under AS 08.68.500, including ad opting any regulations nec essary to 14
implement the compact. 15
* Sec. 6. AS 08.68.160 is amended to read: 16
Sec. 08.68.160. License or practi ce privilege required. A person practicing 17
or offering to practice registered, advanced practice registere d, or practical nursing in 18
the state shall submit evidence of qualification to practice an d shall be licensed or 19
privileged to practice under this chapter. 20
* Sec. 7. AS 08.68.170(c) is amended to read: 21
(c) An applicant for a license to practice advanced practice r egistered nursing 22
shall submit to the board, on form s and in the manner prescribed by the board, written 23
evidence, verified by oath, that the applicant 24
(1) is licensed or privileged to practice as a registered nurse in the 25
state; and 26
(2) has successfully completed an advanced practice registered nurse 27
education program that meets the criteria established by the bo ard under 28
AS 08.68.100. 29
* Sec. 8. AS 08.68.220 is amended to read: 30
Sec. 08.68.220. Fees. The Department of Commerce, Community, and 31
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Economic Development shall set fees under AS 08.01.065 for each of the following: 1
(1) registered nursing: 2
(A) application; 3
(B) license by examination; 4
(C) license by endorsement; 5
(D) license renewal; 6
(E) temporary permit; 7
(F) multistate licensure privilege; 8
(2) practical nursing: 9
(A) application; 10
(B) license by examination; 11
(C) license by endorsement; 12
(D) license renewal; 13
(E) temporary permit; 14
(F) multistate licensure privilege; 15
(3) advanced practice registered nursing: 16
(A) application; 17
(B) license by certification examination; 18
(C) license by endorsement; 19
(D) license renewal; 20
(E) temporary permit. 21
* Sec. 9. AS 08.68.270 is amended to read: 22
Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 23
may deny, suspend, or revoke the license or practice privilege of a person who 24
(1) has obtained or attempted to obtain a license to practice nursing by 25
fraud or deceit; 26
(2) has been convicted of a felony or other crime if the felon y or other 27
crime is substantially related to the qualifications, functions, or duties of the licensee; 28
(3) habitually abuses alcoholic beverages, or illegally uses c ontrolled 29
substances; 30
(4) has impersonated a registered, advanced practice registere d, or 31
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practical nurse; 1
(5) has intentionally or negligently engaged in conduct that h as 2
resulted in a significant risk to the health or safety of a client or in injury to a client; 3
(6) practices or attempts to practice nursing while afflicted with 4
physical or mental illness, deterioration, or disability that i nterferes with the 5
individual's performance of nursing functions; 6
(7) is guilty of unprofessional conduct as defined by regulati ons 7
adopted by the board; 8
(8) has wilfully or repeatedly violated a provision of this ch apter or 9
regulations adopted under this chapter or AS 08.01; 10
(9) is professionally incompetent; 11
(10) denies care or treatment t o a patient or person seeking a ssistance 12
if the sole reason for the denial is the failure or refusal of the patient or person seeking 13
assistance to agree to arbitrate as provided in AS 09.55.535(a); 14
(11) has prescribed or dispensed an opioid in excess of the ma ximum 15
dosage authorized under AS 08.68.705; or 16
(12) has procured, sold, prescribed, or dispensed drugs in violation of a 17
law, regardless of whether there has been a criminal action or harm to the patient. 18
* Sec. 10. AS 08.68.275(a) is amended to read: 19
(a) The board may take the following disciplinary actions sing ly or in 20
combination: 21
(1) permanently revoke a license , practice privilege, or permit to 22
practice; 23
(2) suspend a license or practice privilege for a stated period of time; 24
(3) censure a licensee; 25
(4) issue a letter of reprimand; 26
(5) impose limitations or conditi ons on the professional pract ice of a 27
licensee; 28
(6) impose peer review; 29
(7) impose professional education requirements until a satisfa ctory 30
degree of skill has been attained in those aspects of professio nal practice determined 31
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by the board to need improvement; 1
(8) impose probation and require the licensee to report regula rly to the 2
board upon matters involving the basis for the probation; 3
(9) accept a voluntary surrender of a license. 4
* Sec. 11. AS 08.68.275(c) is amended to read: 5
(c) The board may summarily suspend a license or practice privilege before 6
final hearing or during the app eals process if the board finds that the licensee or 7
holder of the practice privilege poses a clear and immediate danger to the public 8
health and safety. A person whose license is suspended under this section is entitled to 9
a hearing conducted by the office of administrative hearings (A S 44.64.010) within 10
seven days after the effective date of the order. If, after a h earing, the board upholds 11
the suspension, the licensee may appeal the suspension to a cou rt of competent 12
jurisdiction. 13
* Sec. 12. AS 08.68.275(d) is amended to read: 14
( d ) T h e b o a r d m a y r e i n s t a t e a l i c e n s e or practice privilege that has been 15
suspended or revoked if the board finds, after a hearing, that the applicant is able to 16
practice with skill and safety. 17
* Sec. 13. AS 08.68.277(a) is amended to read: 18
(a) An employer of a nurse licensed or privileged to practice under this 19
chapter or a nurse aide certifie d under this chapter practicing within the scope of that 20
license, privilege, or certification that discharge s or suspends a nurse or nurse aide or 21
conditions or restricts the practice of a nurse or nurse aide s hall, within seven working 22
days after the action, report to the board the name and address of the person and the 23
reason for the action. An employer shall report to the board th e name and address of a 24
nurse or nurse aide who resigns while under investigation by th e employer. The 25
requirement of an employer to r eport under this section applies o n ly to a d is c h a rg e , 26
suspension, or restriction of pr actice that is based on a groun d allowing action by the 27
board under AS 08.68.270 or 08.68.334 or for conduct prohibited under AS 08.68.340. 28
* Sec. 14. AS 08.68.278 is amended to read: 29
Sec. 08.68.278. Immunity for certain reports to the board. A person who, in 30
good faith, reports information to the board relating to allege d incidents of 31
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incompetent, unprofessional, or unlawful conduct of a nurse lic ensed or privileged to 1
practice under this chapter, a nurse aide certified under this chapter, or an employer of 2
a nurse licensed or privileged to practice under this chapter or a nurse aide certified 3
under this chapter who reports t o the board the information req uired under 4
AS 08.68.277 is not liable in a civil action for damages result ing from the reporting of 5
the information. 6
* Sec. 15. AS 08.68 is amended by adding a new section to read: 7
Article 5A. Multistate Nurse Licensure Compact. 8
Sec. 08.68.500. Compact enacted. The Multistate Nurse Licensure Compact 9
as contained in this section is e nacted into law and entered in to on behalf of the state 10
with all other states and jurisdictions legally joining it in a form substantially as 11
follows: 12
ARTICLE I 13
Findings and Declaration of Purpose 14
(a) The legislature finds that: 15
(1) The health and safety of the public are affected by the degree of 16
compliance with and the effectiveness of enforcement activities related to state nurse 17
licensure laws; 18
(2) Violations of nurse licensure and other laws regulating th e practice 19
of nursing may result in injury or harm to the public; 20
(3) The expanded mobility of nurses and the use of advanced 21
communication technologies as part of our nation's health care delivery system require 22
greater coordination and coopera tion among states in the areas of nurse licensure and 23
regulation; 24
(4) New practice modalities and technology make compliance wit h 25
individual state nurse licensure laws difficult and complex; 26
(5) The current system of dupli cative licensure for nurses practicing in 27
multiple states is cumbersome and redundant for both nurses and states; and 28
(6) Uniformity of nurse licensu re requirements throughout the states 29
promotes public safety and public health benefits. 30
(b) The general purposes of this Compact are to: 31
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(1) Facilitate the states' res ponsibility to protect the publi c's health and 1
safety; 2
(2) Ensure and encourage the cooperation of party states in the areas of 3
nurse licensure and regulation; 4
(3) Facilitate the exchange of information between party state s in the 5
areas of nurse regulation, investigation and adverse actions; 6
(4) Promote compliance with the laws governing the practice of 7
nursing in each jurisdiction; 8
(5) Invest all party states with the authority to hold a nurse accountable 9
for meeting all state practice laws in the state in which the patient is located at the time 10
care is rendered through the mutual recognition of party state licenses; 11
(6) Decrease redundancies in the consideration and issuance of nurse 12
licenses; and 13
(7) Provide opportunities for in terstate practice by nurses wh o meet 14
uniform licensure requirements. 15
ARTICLE II 16
Definitions 17
As used in this compact, unless the context clearly requires a different construction, 18
(1) "Adverse action" means any administrative, civil, equitabl e or 19
criminal action permitted by a state's laws which is imposed by a licensing board or 20
other authority against a nurse, including actions against an i ndividual's license or 21
multistate licensure privilege such as revocation, suspension, probation, monitoring of 22
the licensee, limitation on the licensee's practice, or any oth er encumbrance on 23
licensure affecting a nurse's authorization to practice, includ ing issuance of a cease 24
and desist action. 25
(2) "Alternative program" means a non-disciplinary monitoring 26
program approved by a licensing board. 27
(3) "Coordinated licensure infor mation system" means an integr ated 28
process for collecting, storing and sharing information on nurs e licensure and 29
enforcement activities related to nurse licensure laws that is administered by a 30
nonprofit organization composed of and controlled by licensing boards. 31
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(4) "Current significant investigative information" means: 1
(A) Investigative information that a licensing board, after a 2
preliminary inquiry that includes notification and an opportuni ty for the nurse 3
to respond, if required by state law, has reason to believe is not groundless and, 4
if proved true, would indicate more than a minor infraction; or 5
(B) Investigative information that indicates that the nurse 6
represents an immediate threat t o public health and safety rega rdless of 7
whether the nurse has been notified and had an opportunity to respond. 8
(5) "Encumbrance" means a revocation or suspension of, or any 9
limitation on, the full and unrestric ted practice of nursing im posed by a licensing 10
board. 11
(6) "Home state" means the party state which is the nurse's pr imary 12
state of residence. 13
(7) "Licensing board" means a party state's regulatory body 14
responsible for issuing nurse licenses. 15
(8) "Multistate license" means a license to practice as a regi stered or a 16
licensed practical/vocational nur se (LPN/VN) issued by a home s tate licensing board 17
that authorizes the licensed nur se to practice in all party sta tes under a multistate 18
licensure privilege. 19
(9) "Multistate licensure privilege" means a legal authorizati on 20
associated with a multistate license permitting the practice of n u r s i n g a s e i t h e r a 21
registered nurse (RN) or LPN/VN in a remote state. 22
(10) "Nurse" means RN or LPN/VN, as those terms are defined by 23
each party state's practice laws. 24
(11) "Party state" means any state that has adopted this Compact. 25
(12) "Remote state" means a party state, other than the home state. 26
(13) "Single-state license" means a nurse license issued by a party state 27
that authorizes practice only within the issuing state and does not include a multistate 28
licensure privilege to practice in any other party state. 29
(14) "State" means a state, territory or possession of the Uni ted States 30
and the District of Columbia. 31
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(15) "State practice laws" means a party state's laws, rules a nd 1
regulations that govern the prac tice of nursing, define the sco pe of nursing practice, 2
and create the methods and grounds for imposing discipline. "St ate practice laws" do 3
not include requirements necessa ry to obtain and retain a licen se, except for 4
qualifications or requirements of the home state. 5
ARTICLE III 6
General Provisions and Jurisdiction 7
(a) A multistate license to practice registered or licensed pr actical/vocational 8
nursing issued by a home state to a resident in that state will be recognized by each 9
party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed 10
practical/vocational nurse (LP N/VN), under a multistate licensu re privilege, in each 11
party state. 12
( b ) A s t a t e m u s t i m p l e m e n t p r o c e d u r e s f o r c o n s i d e r i n g t h e c r i minal history 13
records of applicants for initial multistate license or licensu re by endorsement. Such 14
procedures shall include the sub mission of fingerprints or othe r biometric-based 15
information by applicants for the purpose of obtaining an appli cant's criminal history 16
record information from the Federal Bureau of Investigation and t h e a g e n c y 17
responsible for retaining that state's criminal records. 18
(c) Each party state shall require the following for an applic ant to obtain or 19
retain a multistate license in the home state: 20
(1) Meets the home state's qualifications for licensure or ren ewal of 21
licensure, as well as, all other applicable state laws; 22
(2) Has graduated or is eligible to graduate from a licensing board-23
approved RN or LPN/VN prelicensu re education program; or has gr aduated from a 24
foreign RN or LPN/VN prelicensure education program that (a) ha s been approved by 25
the authorized accrediting body in the applicable country and ( b) has been verified by 26
an independent credentials review agency to be comparable to a licensing board-27
approved prelicensure education program; 28
(3) Has, if a graduate of a foreign prelicensure education pro gram not 29
taught in English or if English is not the individual's native language, successfully 30
passed an English proficiency exa mination that includes the com ponents of reading, 31
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speaking, writing and listening; 1
( 4 ) H a s s u c c e s s f u l l y p a s s e d a n N C L E X - R N o r N C L E X - P N 2
Examination or recognized predecessor, as applicable; 3
(5) Is eligible for or holds an active, unencumbered license; 4
(6) Has submitted, in connection with an application for initi al 5
licensure or licensure by endorsement, fingerprints or other bi ometric data for the 6
purpose of obtaining criminal history record information from t he Federal Bureau of 7
Investigation and the agency responsible for retaining that state's criminal records; 8
(7) Has not been convicted or found guilty, or has entered int o an 9
agreed disposition, of a felony offense under applicable state or federal criminal law; 10
(8) Has not been convicted or found guilty, or has entered int o an 11
agreed disposition, of a misdemeanor offense related to the pra ctice of nursing as 12
determined on a case-by-case basis; 13
(9) Is not currently enrolled in an alternative program; 14
(10) Is subject to self-disclos ure requirements regarding curr ent 15
participation in an alternative program; and 16
(11) Has a valid United States Social Security number. 17
(d) All party states shall be authorized, in accordance with e xisting state due 18
process law, to take adverse action against a nurse's multistat e licensure privilege such 19
as revocation, suspension, probati on or any other action that a ffects a nurse's 20
authorization to practice under a multistate licensure privileg e, including cease and 21
desist actions. If a party sta te takes such action, it shall pr omptly notify the 22
administrator of the coordinated licensure information system. The administrator of 23
the coordinated licensure infor mation system shall promptly not ify the home state of 24
any such actions by remote states. 25
(e) A nurse practicing in a party state must comply with the s tate practice laws 26
of the state in which the client is located at the time service is provided. The practice 27
of nursing is not limited to patient care, but shall include al l nursing practice as 28
defined by the state practice laws of the party state in which the client is located. The 29
practice of nursing in a party state under a multistate licensu re privilege will subject a 30
nurse to the jurisdiction of the licensing board, the courts an d the laws of the party 31
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state in which the client is located at the time service is provided. 1
(f) Individuals not residing in a party state shall continue t o be able to apply 2
for a party state's single-sta te license as provided under the laws of each party state. 3
However, the single-state license granted to these individuals will not be recognized as 4
granting the privilege to practice nursing in any other party s tate. Nothing in this 5
Compact shall affect the requirements established by a party state for the issuance of a 6
single-state license. 7
(g) Any nurse holding a home state multistate license, on the effective date of 8
this Compact, may retain and renew the multistate license issue d by the nurse's then-9
current home state, provided that: 10
(1) A nurse, who changes primary state of residence after this 11
Compact's effective date, must meet all applicable Article III. c. requirements to obtain 12
a multistate license from a new home state. 13
(2) A nurse who fails to satisfy the multistate licensure requirements in 14
Article III.c. due to a disqualifying event occurring after thi s Compact's effective date 15
shall be ineligible to retain or renew a multistate license, an d the nurse's multistate 16
license shall be revoked or deactivated in accordance with applicable rules adopted by 17
the Interstate Commission of Nurse Licensure Compact Administra tors 18
("Commission"). 19
ARTICLE IV 20
Applications for Licensure in a Party State 21
(a) Upon application for a multistate license, the licensing board in the issuing 22
party state shall ascertain, thr ough the coordinated licensure information system, 23
whether the applicant has ever held, or is the holder of, a lic ense issued by any other 24
state, whether there are any encumbrances on any license or mul tistate licensure 25
privilege held by the applicant, whether any adverse action has been taken against any 26
license or multistate licensure privilege held by the applicant and whether the 27
applicant is currently participating in an alternative program. 28
(b) A nurse may hold a multistate license, issued by the home state, in only 29
one party state at a time. 30
(c) If a nurse changes primary state of residence by moving between two party 31
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states, the nurse must apply fo r licensure in the new home stat e, and the multistate 1
license issued by the prior home state will be deactivated in a ccordance with 2
applicable rules adopted by the Commission. 3
( 1 ) T h e n u r s e m a y a p p l y f o r l i c e n s u r e i n a d v a n c e o f a c h a n g e in 4
primary state of residence. 5
(2) A multistate license shall not be issued by the new home s tate until 6
the nurse provides satisfactory evidence of a change in primary state of residence to 7
the new home state and satisfies all applicable requirements to obtain a multistate 8
license from the new home state. 9
(d) If a nurse changes primary state of residence by moving fr om a party state 10
to a non-party state, the multistate license issued by the prio r home state will convert 11
to a single-state license, valid only in the former home state. 12
ARTICLE V 13
Additional Authorities Invested in Party State Licensing Boards 14
(a) In addition to the other pow ers conferred by state law, a licensing board 15
shall have the authority to: 16
(1) Take adverse action against a nurse's multistate licensure privilege 17
to practice within that party state. 18
(A) Only the home state shall have the power to take adverse 19
action against a nurse's license issued by the home state. 20
(B) For purposes of taking a dverse action, the home state 21
licensing board shall give the same priority and effect to repo rted conduct 22
received from a remote state as it would if such conduct had oc curred within 23
the home state. In so doing, the home state shall apply its own state laws to 24
determine appropriate action. 25
(2) Issue cease and desist ord ers or impose an encumbrance on a 26
nurse's authority to practice within that party state. 27
(3) Complete any pending invest igations of a nurse who changes 28
primary state of residence during the course of such investigat ions. The licensing 29
board shall also have the author ity to take appropriate action( s) and shall promptly 30
report the conclusions of such investigations to the administra tor of the coordinated 31
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licensure information system. Th e administrator of the coordina ted licensure 1
information system shall promptly notify the new home state of any such actions. 2
(4) Issue subpoenas for both hearings and investigations that require 3
the attendance and testimony of witnesses, as well as, the prod uction of evidence. 4
Subpoenas issued by a licensing b oard in a party state for the attendance and 5
testimony of witnesses or the p roduction of evidence from anoth er party state shall be 6
enforced in the latter state by any court of competent jurisdic tion, according to the 7
practice and procedure of that court applicable to subpoenas is sued in proceedings 8
pending before it. The issuing au thority shall pay any witness fees, travel expenses, 9
mileage and other fees required by the service statutes of the state in which the 10
witnesses or evidence are located. 11
(5) Obtain and submit, for each nurse licensure applicant, fin gerprint 12
or other biometric-based information to the Federal Bureau of I nvestigation for 13
criminal background checks, receive the results of the Federal Bureau of Investigation 14
record search on criminal background checks and use the results in making licensure 15
decisions. 16
(6) If otherwise permitted by state law, recover from the affe cted nurse 17
the costs of investigations and disposition of cases resulting from any adverse action 18
taken against that nurse. 19
(7) Take adverse action based on the factual findings of the r emote 20
state, provided that the licensi n g b o a r d f o l l o w s i t s o w n p r o c e dures for taking such 21
adverse action. 22
(b) If adverse action is taken by the home state against a nur se's multistate 23
license, the nurse's multistate licensure privilege to practice in all other party states 24
shall be deactivated until all encumbrances have been removed f rom the multistate 25
license. All home state disciplinary orders that impose adverse action against a nurse's 26
multistate license shall include a statement that the nurse's m ultistate licensure 27
privilege is deactivated in all party states during the pendenc y of the order. Nothing in 28
this Compact shall override a party state's decision that parti cipation in an alternative 29
program may be used in lieu of adverse action. The home state l icensing board shall 30
deactivate the multistate licensure privilege under the multist ate license of any nurse 31
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for the duration of the nurse's participation in an alternative program. 1
ARTICLE VI 2
Coordinated Licensure Information System and Exchange of Information 3
(a) All party states shall participate in a coordinated licens ure information 4
system of all licensed registered nurses (RNs) and licensed pra ctical/vocational nurses 5
(LPNs/VNs). This system will include information on the licensu re and disciplinary 6
history of each nurse, as submitted by party states, to assist in the coordination of 7
nurse licensure and enforcement efforts. 8
(b) The Commission, in consultation with the administrator of the coordinated 9
licensure information system, sh all formulate necessary and pro per procedures for the 10
identification, collection and exchange of information under this Compact. 11
(c) All licensing boards shall promptly report to the coordina ted licensure 12
information system any adverse action, any current significant investigative 13
information, denials of applica tions (with the reasons for such denials) and nurse 14
participation in alternative pr ograms known to the licensing bo ard regardless of 15
whether such participation is deemed nonpublic or confidential under state law. 16
(d) Current significant investigative information and participation in nonpublic 17
or confidential alternative programs shall be transmitted throu gh the coordinated 18
licensure information system only to party state licensing boards. 19
(e) Notwithstanding any other provision of law, all party state licensing boards 20
contributing information to the coordinated licensure informati on system may 21
designate information that may not be shared with non-party sta tes or disclosed to 22
other entities or individuals without the express permission of the contributing state. 23
(f) Any personally identifiable information obtained from the coordinated 24
licensure information system by a party state licensing board s hall not be shared with 25
non-party states or disclosed to other entities or individuals except to the extent 26
permitted by the laws of the party state contributing the information. 27
(g) Any information contributed to the coordinated licensure i nformation 28
system that is subsequently required to be expunged by the laws of the party state 29
contributing that information shall also be expunged from the c oordinated licensure 30
information system. 31
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(h) The Compact administrator of each party state shall furnis h a uniform data 1
set to the Compact administrator of each other party state, whi ch shall include, at a 2
minimum: 3
(1) Identifying information; 4
(2) Licensure data; 5
(3) Information related to alternative program participation; and 6
(4) Other information that may facilitate the administration o f this 7
Compact, as determined by Commission rules. 8
(i) The Compact administrator o f a party state shall provide a ll investigative 9
documents and information requested by another party state. 10
ARTICLE VII 11
Establishment of the Interstate Commission of Nurse Licensure Compact Administrators 12
(a) The party states hereby create and establish a joint publi c entity known as 13
the Interstate Commission of Nurse Licensure Compact Administrators. 14
(1) The Commission is an instrumentality of the party states. 15
(2) Venue is proper, and judicial proceedings by or against th e 16
Commission shall be brought solely and exclusively, in a court of competent 17
jurisdiction where the principal office of the Commission is lo cated. The Commission 18
may waive venue and jurisdictional defenses to the extent it ad opts or consents to 19
participate in alternative dispute resolution proceedings. 20
(3) Nothing in this Compact shall be construed to be a waiver of 21
sovereign immunity. 22
(b) Membership, Voting and Meetings 23
(1) Each party state shall have and be limited to one administ rator. The 24
head of the state licensing board or designee shall be the administrator of this Compact 25
for each party state. Any administrator may be removed or suspe nded from office as 26
provided by the law of the state from which the Administrator i s appointed. Any 27
vacancy occurring in the Commission shall be filled in accordance with the laws of the 28
party state in which the vacancy exists. 29
(2) Each administrator shall be entitled to one (1) vote with regard to 30
the promulgation of rules and cr eation of bylaws and shall othe rwise have an 31
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opportunity to participate in the business and affairs of the C ommission. An 1
administrator shall vote in person or by such other means as pr ovided in the bylaws. 2
The bylaws may provide for an administrator's participation in meetings by telephone 3
or other means of communication. 4
(3) The Commission shall meet at least once during each calend ar 5
year. Additional meetings shall be held as set forth in the byl aws or rules of the 6
commission. 7
(4) All meetings shall be open to the public, and public notic e of 8
meetings shall be given in the sa me manner as required under th e rulemaking 9
provisions in Article VIII. 10
(5) The Commission may convene in a closed, nonpublic meeting if 11
the Commission must discuss: 12
(A) Noncompliance of a party s tate with its obligations under 13
this Compact; 14
(B) The employment, compens ation, discipline or other 15
personnel matters, practices or pr ocedures related to specific employees or 16
other matters related to the Co mmission's internal personnel pr actices and 17
procedures; 18
(C) Current, threatened or reasonably anticipated litigation; 19
(D) Negotiation of contracts for the purchase or sale of goods , 20
services or real estate; 21
(E) Accusing any person of a crime or formally censuring any 22
person; 23
(F) Disclosure of trade secrets or commercial or financial 24
information that is privileged or confidential; 25
(G) Disclosure of information of a personal nature where 26
disclosure would constitute a clearly unwarranted invasion of personal privacy; 27
(H) Disclosure of investigatory records compiled for law 28
enforcement purposes; 29
(I) Disclosure of information related to any reports prepared by 30
or on behalf of the Commission fo r the purpose of investigation of compliance 31
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with this Compact; or 1
(J) Matters specifically exempted from disclosure by federal o r 2
state statute. 3
(6) If a meeting, or portion of a meeting, is closed pursuant to this 4
provision, the Commission's legal counsel or designee shall cer tify that the meeting 5
may be closed and shall reference each relevant exempting provi sion. The 6
Commission shall keep minutes that fully and clearly describe a ll matters discussed in 7
a meeting and shall provide a full and accurate summary of acti ons taken, and the 8
reasons therefor, including a description of the views expresse d. All documents 9
considered in connection with an action shall be identified in such minutes. All 10
minutes and documents of a closed meeting shall remain under se al, subject to release 11
by a majority vote of the Commission or order of a court of competent jurisdiction. 12
(c) The Commission shall, by a majority vote of the administra tors, prescribe 13
bylaws or rules to govern its conduct as may be necessary or ap propriate to carry out 14
the purposes and exercise the powers of this Compact, including but not limited to: 15
(1) Establishing the fiscal year of the Commission; 16
(2) Providing reasonable standards and procedures: 17
(A) For the establishment and meetings of other committees; 18
and 19
(B) Governing any general or specific delegation of any 20
authority or function of the Commission; 21
(3) Providing reasonable procedures for calling and conducting 22
meetings of the Commission, ensu ring reasonable advance notice of all meetings and 23
providing an opportunity for attenda nce of such meetings by int erested parties, with 24
enumerated exceptions designed to protect the public's interest , the privacy of 25
individuals, and proprietary inf ormation, including trade secre ts. The Commission 26
may meet in closed session only after a majority of the adminis trators vote to close a 27
meeting in whole or in part. As soon as practicable, the Commission must make public 28
a copy of the vote to close the meeting revealing the vote of e ach administrator, with 29
no proxy votes allowed; 30
(4) Establishing the titles, duties and authority and reasonab le 31
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procedures for the election of the officers of the Commission; 1
(5) Providing reasonable standa rds and procedures for the 2
establishment of the personnel po licies and programs of the Com mission. 3
Notwithstanding any civil service or other similar laws of any party state, the bylaws 4
shall exclusively govern the personnel policies and programs of the Commission; and 5
(6) Providing a mechanism for winding up the operations of the 6
Commission and the equitable disposition of any surplus funds t hat may exist after the 7
termination of this Compact after the payment or reserving of a l l o f i t s d e b t s a n d 8
obligations; 9
(d) The Commission shall publish its bylaws and rules, and any amendments 10
thereto, in a convenient form on the website of the Commission. 11
(e) The Commission shall maintain its financial records in accordance with the 12
bylaws. 13
(f) The Commission shall meet and take such actions as are consistent with the 14
provisions of this Compact and the bylaws. 15
(g) The Commission shall have the following powers: 16
(1) To promulgate uniform rules to facilitate and coordinate 17
implementation and administration of this Compact. The rules shall have the force and 18
effect of law and shall be binding in all party states; 19
(2) To bring and prosecute legal proceedings or actions in the name of 20
the Commission, provided that the standing of any licensing boa rd to sue or be sued 21
under applicable law shall not be affected; 22
(3) To purchase and maintain insurance and bonds; 23
(4) To borrow, accept or contract for services of personnel, i ncluding, 24
but not limited to, employees of a party state or nonprofit organizations; 25
(5) To cooperate with other or ganizations that administer stat e 26
compacts related to the regulation of nursing, including but no t limited to sharing 27
administrative or staff expenses, office space or other resources; 28
(6) To hire employees, elect o r appoint officers, fix compensa tion, 29
define duties, grant such indi viduals appropriate authority to carry out the purposes of 30
this Compact, and to establish the Commission's personnel polic ies and programs 31
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relating to conflicts of intere st, qualifications of personnel and other related personnel 1
matters; 2
(7) To accept any and all appr opriate donations, grants and gi fts of 3
money, equipment, supplies, materials and services, and to rece ive, utilize and dispose 4
of the same; provided that at all times the Commission shall av oid any appearance of 5
impropriety or conflict of interest; 6
(8) To lease, purchase, accept appropriate gifts or donations of, or 7
otherwise to own, hold, improve or use, any property, whether real, personal or mixed; 8
provided that at all times the Commission shall avoid any appearance of impropriety; 9
(9) To sell, convey, mortgage, pledge, lease, exchange, abando n or 10
otherwise dispose of any property, whether real, personal or mixed; 11
(10) To establish a budget and make expenditures; 12
(11) To borrow money; 13
(12) To appoint committees, including advisory committees comp rised 14
of administrators, state nursing regulators, state legislators or their representatives, and 15
consumer representatives, and other such interested persons; 16
(13) To provide and receive in formation from, and to cooperate with, 17
law enforcement agencies; 18
(14) To adopt and use an official seal; and 19
(15) To perform such other f unctions as may be necessary or 20
appropriate to achieve the purpos es of this Compact consistent with the state 21
regulation of nurse licensure and practice. 22
(h) Financing of the Commission 23
(1) The Commission shall pay, or provide for the payment of, t he 24
reasonable expenses of its establishment, organization and ongoing activities. 25
(2) The Commission may also levy on and collect an annual 26
assessment from each party state to cover the cost of its opera tions, activities and staff 27
in its annual budget as approved each year. The aggregate annua l assessment amount, 28
if any, shall be allocated based upon a formula to be determine d by the Commission, 29
which shall promulgate a rule that is binding upon all party states. 30
(3) The Commission shall not incur obligations of any kind pri or to 31
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securing the funds adequate to m eet the same; nor shall the Com mission pledge the 1
credit of any of the party states, except by, and with the authority of, such party state. 2
(4) The Commission shall keep accurate accounts of all receipt s and 3
disbursements. The receipts and disbursements of the Commission shall be subject to 4
the audit and accounting procedures established under its bylaw s. However, all 5
receipts and disbursements of funds handled by the Commission s hall be audited 6
yearly by a certified or licensed public accountant, and the re port of the audit shall be 7
included in and become part of the annual report of the Commission. 8
(i) Qualified Immunity, Defense and Indemnification 9
(1) The administrators, officers, executive director, employee s and 10
representatives of the Commission shall be immune from suit and liability, either 11
personally or in their official capacity, for any claim for dam age to or loss of property 12
or personal injury or other civil liability caused by or arisin g out of any actual or 13
alleged act, error or omission th at occurred, or that the person against whom the claim 14
is made had a reasonable basis for believing occurred, within t he scope of 15
Commission employment, duties or responsibilities; provided tha t nothing in this 16
paragraph shall be construed to protect any such person from su it or liability for any 17
damage, loss, injury or liability caused by the intentional, wi llful or wanton 18
misconduct of that person. 19
(2) The Commission shall defend any administrator, officer, ex ecutive 20
director, employee or representative of the Commission in any c ivil action seeking to 21
impose liability arising out of any actual or alleged act, error or omission that occurred 22
within the scope of Commission em ployment, duties or responsibi lities, or that the 23
person against whom the claim is made had a reasonable basis fo r believing occurred 24
within the scope of Commission em ployment, duties or responsibi lities; provided that 25
nothing herein shall be construed to prohibit that person from retaining his or her own 26
counsel; and provided further th at the actual or alleged act, e rror or omission did not 27
result from that person's intentional, willful or wanton misconduct. 28
(3) The Commission shall inde mnify and hold harmless any 29
administrator, officer, executive director, employee or represe ntative of the 30
Commission for the amount of any settlement or judgment obtaine d against that 31
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person arising out of any actual or alleged act, error or omiss ion that occurred within 1
the scope of Commission employm ent, duties or responsibilities, or that such person 2
had a reasonable basis for believing occurred within the scope of Commission 3
employment, duties or responsibilities, provided that the actua l or alleged act, error or 4
omission did not result from the intentional, willful or wanton misconduct of that 5
person. 6
ARTICLE VIII 7
Rulemaking 8
(a) The Commission shall exerci se its rulemaking powers pursua nt to the 9
criteria set forth in this Artic le and the rules adopted thereu nder. Rules and 10
amendments shall become binding a s of the date specified in eac h rule or amendment 11
and shall have the same force and effect as provisions of this Compact. 12
(b) Rules or amendments to the rules shall be adopted at a reg ular or special 13
meeting of the Commission. 14
(c) Prior to promulgation and a doption of a final rule or rule s by the 15
Commission, and at least sixty (60) days in advance of the meet ing at which the rule 16
will be considered and voted upon, the Commission shall file a notice of proposed 17
rulemaking: 18
(1) On the website of the Commission; and 19
(2) On the website of each licensing board or the publication in which 20
each state would otherwise publish proposed rules. 21
(d) The notice of proposed rulemaking shall include: 22
(1) The proposed time, date and location of the meeting in whi ch the 23
rule will be considered and voted upon; 24
(2) The text of the proposed rule or amendment, and the reason for the 25
proposed rule; 26
(3) A request for comments on the proposed rule from any inter ested 27
person; and 28
(4) The manner in which interes ted persons may submit notice t o the 29
Commission of their intention to attend the public hearing and any written comments. 30
(e) Prior to adoption of a proposed rule, the Commission shall allow persons 31
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to submit written data, facts, opinions and arguments, which shall be made available to 1
the public. 2
(f) The Commission shall grant an opportunity for a public hea ring before it 3
adopts a rule or amendment. 4
(g) The Commission shall publis h the place, time and date of t he scheduled 5
public hearing. 6
(1) Hearings shall be conducted in a manner providing each per son 7
who wishes to comment a fair a nd reasonable opportunity to comm ent orally or in 8
writing. All hearings will be recorded, and a copy will be made available upon request. 9
(2) Nothing in this section shall be construed as requiring a separate 10
hearing on each rule. Rules may be grouped for the convenience of the Commission at 11
hearings required by this section. 12
(h) If no one appears at the public hearing, the Commission ma y proceed with 13
promulgation of the proposed rule. 14
(i) Following the scheduled hearing date, or by the close of b usiness on the 15
scheduled hearing date if the hearing was not held, the Commiss ion shall consider all 16
written and oral comments received. 17
(j) The Commission shall, by majority vote of all administrato rs, take final 18
action on the proposed rule and sh all determine the effective d ate of the rule, if any, 19
based on the rulemaking record and the full text of the rule. 20
(k) Upon determination that an emergency exists, the Commissio n may 21
consider and adopt an emergency rule without prior notice, oppo rtunity for comment 22
or hearing, provided that the usual rulemaking procedures provi ded in this Compact 23
and in this section shall be ret roactively applied to the rule as soon as reasonably 24
possible, in no event later than ninety (90) days after the eff ective date of the rule. For 25
the purposes of this provision, an emergency rule is one that m ust be adopted 26
immediately in order to: 27
(1) Meet an imminent threat to public health, safety or welfare; 28
(2) Prevent a loss of Commission or party state funds; or 29
(3) Meet a deadline for the promulgation of an administrative rule that 30
is required by federal law or rule. 31
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(l) The Commission may direct rev isions to a previously adopted rule or 1
amendment for purposes of correcting typographical errors, erro rs in format, errors in 2
consistency or grammatical errors. Public notice of any revisio ns shall be posted on 3
the website of the Commission. The revision shall be subject to challenge by any 4
person for a period of thirty (30) days after posting. The revi sion may be challenged 5
only on grounds that the revision results in a material change to a rule. A challeng e 6
shall be made in writing, and delivered to the Commission, prio r to the end of the 7
notice period. If no challenge is made, the revision will take effect without further 8
action. If the revision is challe nged, the revision may not tak e effect without the 9
approval of the Commission. 10
ARTICLE IX 11
Oversight, Dispute Resolution and Enforcement 12
(a) Oversight 13
(1) Each party state shall enforce this Compact and take all a ctions 14
necessary and appropriate to effectuate this Compact's purposes and intent. 15
(2) The Commission shall be entitled to receive service of pro cess in 16
any proceeding that may affect the powers, responsibilities or actions of the 17
Commission, and shall have standing to intervene in such a proc eeding for all 18
purposes. Failure to provide service of process in such proceed ing to the Commission 19
shall render a judgment or order void as to the Commission, thi s Compact or 20
promulgated rules. 21
(b) Default, Technical Assistance and Termination 22
(1) If the Commission determines that a party state has defaul ted in the 23
performance of its obligations or responsibilities under this C ompact or the 24
promulgated rules, the Commission shall: 25
(A) Provide written notice to the defaulting state and other 26
party states of the nature of the default, the proposed means o f curing the 27
default or any other action to be taken by the Commission; and 28
(B) Provide remedial training and specific technical assistanc e 29
regarding the default. 30
(2) If a state in default fails to cure the default, the defau lting state's 31
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membership in this Compact may be terminated upon an affirmative vote of a majority 1
of the administrators, and all rights, privileges and benefits conferred by this Compact 2
may be terminated on the effectiv e date of termination. A cure of the default does not 3
relieve the offending state of obligations or liabilities incur red during the period of 4
default. 5
(3) Termination of membership in this Compact shall be imposed only 6
after all other means of securing compliance have been exhauste d. Notice of intent to 7
suspend or terminate shall be given by the Commission to the go vernor of the 8
defaulting state and to the executive officer of the defaulting state's licensing board 9
and each of the party states. 10
(4) A state whose membership in this Compact has been terminat ed is 11
responsible for all assessments , obligations and liabilities in curred through the 12
effective date of termination, in cluding obligations that exten d beyond the effective 13
date of termination. 14
(5) The Commission shall not bear any costs related to a state that is 15
found to be in default or whose membership in this Compact has been terminated 16
unless agreed upon in writing between the Commission and the defaulting state. 17
(6) The defaulting state may appeal the action of the Commissi on by 18
petitioning the U.S. District Court for the District of Columbia or the federal district in 19
which the Commission has its principal offices. The prevailing party shall be awarded 20
all costs of such litigation, including reasonable attorneys' fees. 21
(c) Dispute Resolution 22
(1) Upon request by a party stat e, the Commission shall attemp t to 23
resolve disputes related to the Compact that arise among party states and between 24
party and non-party states. 25
(2) The Commission shall promulgate a rule providing for both 26
mediation and binding dispute resolution for disputes, as appropriate. 27
(3) In the event the Commission cannot resolve disputes among party 28
states arising under this Compact: 29
(A) The party states may submit the issues in dispute to an 30
arbitration panel, which will be comprised of individuals appoi nted by the 31
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Compact administrator in each of the affected party states and an individual 1
mutually agreed upon by the Compact administrators of all the p arty states 2
involved in the dispute. 3
(B) The decision of a majority of the arbitrators shall be fin al 4
and binding. 5
(d) Enforcement 6
(1) The Commission, in the reasonable exercise of its discreti on, shall 7
enforce the provisions and rules of this Compact. 8
(2) By majority vote, the Commission may initiate legal action in the 9
U.S. District Court for the District of Columbia or the federal district in which the 10
Commission has its principal offices against a party state that is in default to enforce 11
compliance with the provisions of this Compact and its promulga ted rules and bylaws. 12
The relief sought may include both injunctive relief and damages. In the event judicial 13
enforcement is necessary, the prevailing party shall be awarded all costs of such 14
litigation, including reasonable attorneys' fees. 15
(3) The remedies herein shall not be the exclusive remedies of t h e 16
Commission. The Commission may pursue any other remedies availa ble under federal 17
or state law. 18
ARTICLE X 19
Effective Date, Withdrawal and Amendment 20
(a) This Compact shall become effective and binding on the ear lier of the date 21
of legislative enactment of this Compact into law by no less than twenty-six (26) states 22
or December 31, 2018. All party stat es to this Compact, that al so were parties to the 23
prior Nurse Licensure Compact, superseded by this Compact, ("Prior Compact"), shall 24
be deemed to have withdrawn from said Prior Compact within six (6) months after the 25
effective date of this Compact. 26
(b) Each party state to this Compact shall continue to recogni z e a n u r s e ' s 27
multistate licensure privilege to practice in that party state issued under the Prior 28
Compact until such party state has withdrawn from the Prior Compact. 29
(c) Any party state may withdraw from this Compact by enacting a statute 30
repealing the same. A party state's withdrawal shall not take effect until six (6) months 31
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after enactment of the repealing statute. 1
(d) A party state's withdrawal or termination shall not affect the continuing 2
requirement of the withdrawing or terminated state's licensing board to report adverse 3
actions and significant investigations occurring prior to the e ffective date of such 4
withdrawal or termination. 5
(e) Nothing contained in this Compact shall be construed to in validate or 6
prevent any nurse licensure agreement or other cooperative arra ngement between a 7
party state and a non-party state that is made in accordance wi th the other provisions 8
of this Compact. 9
(f) This Compact may be amended by the party states. No amendm ent to this 10
Compact shall become effective and binding upon the party states unless and until it is 11
enacted into the laws of all party states. 12
(g) Representatives of non-part y states to this Compact shall be invited to 13
participate in the activities of the Commission, on a nonvoting basis, prior to the 14
adoption of this Compact by all states. 15
ARTICLE XI 16
Construction and Severability 17
This Compact shall be liberally c o n s t r u e d s o a s t o e f f e c t u a t e the purposes 18
thereof. The provisions of this C ompact shall be severable, and if any phrase, clause, 19
sentence or provision of this Co mpact is declared to be contrar y to the constitution of 20
any party state or of the United States, or if the applicabilit y thereof to any 21
government, agency, person or circumstance is held invalid, the validity of the 22
remainder of this Compact and the applicability thereof to any government, agency, 23
person or circumstance shall not be affected thereby. If this C ompact shall be held to 24
be contrary to the constitution of any party state, this Compac t shall remain in full 25
force and effect as to the remaining party states and in full f orce and effect as to the 26
party state affected as to all severable matters. 27
* Sec. 16. AS 08.68.800(a) is amended to read: 28
(a) This chapter does not apply to 29
(1) a qualified nurse licensed in another state employed by th e United 30
States government or a bureau, or agency, or division of the United States government 31
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while in the discharge of official duties; 1
(2) nursing service given temporarily in the event of a public 2
emergency, epidemic, or disaster; 3
(3) the practice of nursing by a student enrolled in a nursing education 4
program accredited by the board when the practice is in connect ion with the student's 5
course of study; 6
(4) the practice of nursing by an individual enrolled in an ap proved 7
program or course of study approved by the board to satisfy the requirements of 8
AS 08.68.251; 9
(5) the practice of nursing by a nurse licensed in another sta te, except 10
for a nurse holding a multistate license under AS 08.68.500, w h o e n g a g e s i n 11
nursing education or nursing consultation activities, if these activities and contact with 12
clients do not exceed 20 working days within a licensing period; or 13
(6) the practice of nursing by a nurse licensed in another sta te, except 14
for a nurse holding a mul tistate license under AS 08.68.500, whose employment 15
responsibilities include transportin g patients into, out of, or through this state; 16
however, this exception is valid for a period not to exceed 48 hours for each transport. 17
* Sec. 17. AS 08.68.805 is amended to read: 18
Sec. 08.68.805. Delegation of nursing functions. A registered, advanced 19
practice registered, or practical nurse licensed or privileged to practice under this 20
chapter may delegate nursing duties to other persons, including unlicensed assistive 21
personnel, under regulations adopted by the board. A person to whom the nursing 22
duties are delegated may perform the delegated duties without a license or certificate 23
under this chapter if the person meets the applicable requireme nts established by the 24
board. 25
* Sec. 18. AS 09.55.560(2) is amended to read: 26
(2) "health care provider" means an acupuncturist licensed und er 27
AS 08.06; an audiologist or speech-language pathologist license d under AS 08.11; a 28
chiropractor licensed under AS 08.20; a dental hygienist licens ed under AS 08.32; a 29
dentist licensed under AS 08.36; a nurse licensed or privileged to practice under 30
AS 08.68; a dispensing optician licensed under AS 08.71; a natu ropath licensed under 31
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AS 08.45; an optometrist license d under AS 08.72; a pharmacist licensed under 1
AS 08.80; a physical therapist or occupational therapist licens ed under AS 08.84; a 2
physician or physician assistant licensed under AS 08.64; a pod iatrist; a psychologist 3
and a psychological associate licensed under AS 08.86; a hospit al as defined in 4
AS 47.32.900, including a governmentally owned or operated hosp ital; an employee 5
of a health care provider acting within the course and scope of employment; an 6
ambulatory surgical facility a nd other organizations whose prim ary purpose is the 7
delivery of health care, including a health maintenance organiz ation, individual 8
practice association, integrated d elivery system, preferred pro vider organization or 9
arrangement, and a physical hospital organization; 10
* Sec. 19. AS 09.65.095(c)(1) is amended to read: 11
(1) "health care provider" means a nurse licensed or privileged to 12
practice under AS 08.68, a physician licensed under AS 08.64, and a per son certified 13
by a hospital as competent to take blood samples; 14
* Sec. 20. AS 18.20.095(e)(2) is amended to read: 15
(2) "licensed staff member" means a person who is employed by the 16
hospital to provide direct patie nt care and who is licensed , [OR] certified , or 17
privileged to practice in the state as a physician or physician assistant under 18
AS 08.64, direct-entry midwife under AS 08.65, nurse or nurse a ide under AS 08.68, 19
or physical therapist or occupational therapist under AS 08.84; 20
* Sec. 21. AS 18.20.499(3) is amended to read: 21
(3) "nurse" means an individual licensed or privileged to practice 22
registered nursing or practical nursing under AS 08.68 who prov ides nursing services 23
through direct patient care or c linical services and includes a nurse manager when 24
delivering in-hospital patient care; 25
* Sec. 22. AS 18.23.070(3) is amended to read: 26
(3) "health care provider" means an acupuncturist licensed und er 27
AS 08.06; a chiropractor licensed under AS 08.20; a dental hygi enist licensed under 28
AS 08.32; a dentist licensed under AS 08.36; a nurse licensed or privileged to 29
practice under AS 08.68; a dispensing optician licensed under AS 08.71; a n 30
optometrist licensed under AS 08.72; a pharmacist licensed unde r AS 08.80; a 31
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physical therapist or occupati onal therapist licensed under AS 08.84; a physician 1
licensed under AS 08.64; a podiatrist; a psychologist and a psy chological associate 2
licensed under AS 08.86; a hospital as defined in AS 47.32.900, including a 3
governmentally owned or operated hospital; and an employee of a health care provider 4
acting within the course and scope of employment; 5
* Sec. 23. AS 47.07.045(b) is amended to read: 6
(b) Before the department may terminate payment for services pr ovided under 7
(a) of this section 8
(1) the recipient must have had an annual assessment to determ ine 9
whether the recipient continues to meet the standards under (a) of this section; 10
(2) the annual assessment must have been reviewed by an indepe ndent 11
qualified health care professiona l under contract with the depa rtment; for purposes of 12
this paragraph, "independent qualified health care professional" means, 13
(A) for a waiver based on in tellectual or developmental 14
disability, a person who is qualified under 42 C.F.R. 483.430 a s a qualified 15
intellectual disability professional; 16
( B ) f o r o t h e r a l l o w a b l e w a i v e r s , a r e g i s t e r e d o r a d v a n c e d 17
practice registered nurse licensed or privileged to practice under AS 08.68 18
who is qualified to assess children with complex medical condit ions, older 19
Alaskans, and adults with physical disabilities for medical ass istance waivers; 20
and 21
(3) the annual assessment must find that the recipient's condi tion has 22
materially improved since the previous assessment; for purposes of this paragraph, 23
"materially improved" means that a recipient who has previously qualified for a 24
waiver for 25
(A) a child with complex medical conditions, no longer needs 26
technical assistance for a life-threatening condition, and is e xpected to be 27
placed in a skilled nursing facility for less than 30 days each year; 28
(B) intellectual or developmental disability, no longer needs the 29
level of care provided by an intermediate care facility for per sons with 30
intellectual and developmental disabilities either because the qualifying 31
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diagnosis has changed or the recipient is able to demonstrate t he ability to 1
function in a home setting without the need for waiver services; or 2
(C) an older Alaskan or adult with a physical disability, no 3
longer has a functional limitation or cognitive impairment that would result in 4
the need for nursing home placement, and is able to demonstrate the ability to 5
function in a home setting without the need for waiver services. 6
* Sec. 24. AS 47.33.020(d) is amended to read: 7
(d) An assisted living home may provide intermittent nursing s ervices to a 8
resident who does not require 24- hour nursing services and supe rvision. Intermittent 9
nursing services may be provided only by a nurse licensed or privileged to practice 10
under AS 08.68 or by a person to whom a nursing task has been d elegated under (e) of 11
this section. 12
* Sec. 25. AS 47.33.020(e) is amended to read: 13
(e) A person who is on the staff of an assisted living home an d who is not a 14
nurse licensed or privileged to practice under AS 08.68 may perform a nursing task 15
in that home if 16
(1) the authority to perform that nursing task is delegated to that person 17
by a nurse licensed or privileged to practice under AS 08.68; and 18
(2) that nursing task is specified in regulations adopted by the Board of 19
Nursing as a task that may be delegated. 20
* Sec. 26. AS 47.33.020(f) is amended to read: 21
(f) A resident who needs skilled nursing care may, with the co nsent of the 22
assisted living home, arrange for that care to be provided in t he home by a nurse 23
licensed or privileged to practice under AS 08.68 if that arrangement does not 24
interfere with the services provided to other residents. 25
* Sec. 27. AS 47.33.020(g) is amended to read: 26
(g) As part of a plan to avoid transfer of a resident from the home for medical 27
reasons, the home may provide, through the services of a nurse who is licensed or 28
privileged to practice under AS 08.68, 24-hour skilled nursing care to the resident for 29
not more than 45 consecutive days. 30
* Sec. 28. AS 47.33.020(h) is amended to read: 31
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(h) If a resident has receive d 24-hour skilled nursing care fo r the 45-day limit 1
set by (g) of this section, the resident or the resident's repr esentative may elect to have 2
the resident remain in the home without continuation of 24-hour skilled nursing care if 3
the home agrees to retain the resident after 4
(1) the home and either the res ident or the resident's represe ntative 5
have consulted with the resident's physician; 6
(2) the home and either the resident or the resident's represe ntative 7
have discussed the consequences and risks involved in the elect ion to remain in the 8
home; and 9
(3) the portion of the resident's assisted living plan that re lates to 10
health-related services has been revised to provide for the res ident's health-related 11
needs without the use of 24-hour skilled nursing care, and the revised plan has been 12
reviewed by a registered or advanced practice registered nurse licensed or privileged 13
to practice under AS 08.68 or by the resident's attending physician. 14
* Sec. 29. AS 47.33.230(c) is amended to read: 15
(c) If the assisted living home provides or arranges for the provision of health-16
related services to a resident, the home shall ensure that a 17
(1) registered or advanced practice registered nurse licensed or 18
privileged to practice under AS 08.68 reviews the portion of an assisted living plan 19
that describes how the resident's need for health-related services will be met; and 20
(2) physician's statement about the resident is included in the plan. 21
* Sec. 30. The uncodified law of the State of Alaska is amended by adding a new section to 22
read: 23
TRANSITION: REGULATIONS. The Department of Commerce, Community, and 24
Economic Development and the Board of Nursing may proceed to ad opt regulations to 25
implement this Act. The regul ations take effect under AS 44.62 (Administrative Procedure 26
Act) but not before the effective date of the law implemented by the regulation. 27
* Sec. 31. Section 30 of this Act takes effect immediately under AS 01.10.070(c). 28
* Sec. 32. Except as provided in sec. 31 of this Act, this Act takes effect July 1, 2026. 29