Nurse Licensure Compact.

WORKING DRAFT
2007
STATE OF
WYOMING
07LSO-0269

SENATE FILE
NO.
SF0081

Nurse
L
icensure
C
ompact.

Sponsored by:
Senator(s) Meier and Scott and Representative(s) Harvey and Mercer

A BILL

for

AN ACT relating to
the Nurse Licensure Compact; directing the governor to enter into a compact
with other states to allow nurses licensed in one compact state to exercise a multistate licensure privilege in other states that are party to the compact; approving and specifying terms of the compact; providing conforming amendments;
and providing for an effective date.

Be It Enacted by the Legislature of the State of
Wyoming
:

Section 1.
W.S. 33
‑
21
‑
201 and 33
‑
21
‑
202 are created to read:

ARTICLE 2
NURSE LICENSURE COMPACT

33
‑
21
‑
201.

Short title.

This
article
shall be known and may be cited as the "Nurse Licensure Compact".

33
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21
‑
202.

Compact approved and ratified.

The
Wyoming
legislature
hereby approves and ratifies
,
and the governor shall enter into a compact on behalf of the state of
Wyoming
with any of the
states of the
United States
or other jurisdictions legally joining therein
,
in the form substantially as follows:

ARTICLE I
Declaration and Purpose

(a)

The party states find that:

(i)

The health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws;

(ii)

Violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public;

(iii)

The expanded mobility of nurses and the use of advanced communication technologies as part of our nation's healthcare delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation;

(iv)

New practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex;

(v)

The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant to both nurses and states.

(b)

The general purposes of this
c
ompact are to:

(i)

Facilitate the states' responsibility to protect the public's health and safety;

(ii)

Ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation;

(iii)

Facilitate the exchange of information between party states in the areas of nurse regulation, investigation and adverse actions;

(iv)

Promote compliance with the laws governing the practice of nursing in each jurisdiction;

(v)

Invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses.

ARTICLE II
Definitions

(a)

As used in this
c
ompact:

(i)

"Adverse action" means a home or remote state action
;

(ii)

"Alternative program" means a voluntary, nondisciplinary monitoring program approved by a nurse licensing board
;

(iii)

"Coordinated licensure information system" means an integrated process for collecting, storing and sharing information on nurse licensure and enforcement activities related to nurse licensure laws, which is administered by a nonprofit organization composed of and controlled by state nurse licensing boards
;

(iv)

"Current significant investigative information" means:

(A)

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

(B)

Investigative information that indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and had an opportunity to respond.

(v)

"Home state" means the party state that is the nurse's primary state of residence
;

(vi)

"Home state action" means any administrative, civil, equitable or criminal action permitted by the home state's laws that is 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
;

(vii)

"Licensing board" means a party state's regulatory body responsible for issuing nurse licenses
;

(viii)

"Multistate licensure privilege" means current, official authority from a remote state permitting the practice of nursing as either a registered nurse or a licensed practical/vocational nurse in such party state. All party states have the authority, in accordance with existing state due process law, to take actions against the nurse's privilege such as: Revocation, suspension, probation or any other action that affects a nurse's authorization to practice
;

(ix)

"Nurse" means a registered nurse or licensed practical/vocational nurse, as those terms are defined by each party's state practice laws
;

(x)

"Party state" means any state that has adopted this
c
ompact
;

(xi)

"Remote state" means a party state, other than the home state:

(A)

Where the patient is located at the time nursing care is provided; or

(B)

In the case of the practice of nursing not involving a patient, in such party state where the recipient of nursing practice is located.

(xii)

"Remote state action" means:

(A)

Any administrative, civil, equitable or criminal action permitted by a remote state's laws that is imposed on a nurse by the remote state's licensing board or other authority, including actions against an individual's multistate licensure privilege to practice in the remote state; and

(B)

Cease and desist and other injunctive or equitable orders issued by remote states or the licensing boards thereof.

(xiii)

"State" means a state, territory or possession of the
United States
, the
District of Columbia
or the
Commonwealth
of
Puerto Rico
;

(xiv)

"State practice laws" means those individual party's state laws and regulations that govern the practice of nursing, define the scope of nursing practice and create the methods and grounds for imposing discipline
;

(xv)

"State practice laws" does not include the initial qualifications for licensure or requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.

ARTICLE III
General Provisions and Jurisdiction

(a)

A license to practice registered nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a multistate licensure privilege to practice as a registered nurse in such party state. A license to practice licensed practical/vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a multistate licensure privilege to practice as a licensed practical/vocational nurse in such party state. In order to obtain or retain a license, an applicant must meet the home state's qualifications for licensure and license renewal as well as all other applicable state laws.

(b)

Party states may, in accordance with state due process laws, limit or revoke the multistate licensure privilege of any nurse to practice in their state and may take any other actions under their applicable state laws necessary to protect the health and safety of their citizens. If a party state takes such action, it shall promptly notify the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states.

(c)

Every nurse practicing in a party state must comply with the state practice laws of the state in which the patient is located at the time care is rendered. In addition, the practice of nursing is not limited to patient care, but shall include all nursing practice as defined by the state practice laws of a party state. The practice of nursing will subject a nurse to the jurisdiction of the nurse licensing board and the courts, as well as the laws, in that party state.

(d)

This
c
ompact does not affect additional requirements imposed by states for advanced practice registered nursing. However, a multistate licensure privilege to practice registered nursing granted by a party state shall be recognized by other party states as a license to practice registered nursing if one is required by state law as a precondition for qualifying for advanced practice
registered nurse authorization.

(e)

Individuals not residing in a party state shall continue to be able to apply for nurse licensure as provided for under the laws of each party state. However, the license granted to these individuals will not be recognized as granting the privilege to practice nursing in any other party state unless explicitly agreed to by that party state.

ARTICLE IV
Applications for Licensure in a
Party

State

(a)

Upon application for a license, the licensing board in a party state shall ascertain, through the coordinated licensure information system, whether the applicant has ever held, or is the holder of, a license issued by any other state, whether there are any restrictions on the multistate licensure privilege, and whether any other adverse action by any state has been taken against the license.

(b)

A nurse in a party state shall hold licensure in only one
(1)
party state at a time, issued by the home state.

(c)

A nurse who intends to change primary state of residence may apply for licensure in the new home state in advance of such change. However, new licenses will not be issued by a party state until after a nurse provides evidence of change in primary state of residence satisfactory to the new home state's licensing board.

(d)

When a nurse changes primary state of residence by:

(i)

Moving between two
(2)
party states, and obtains a license from the new home state, the license from the former home state is no longer valid;

(ii)

Moving from a nonparty state to a party state, and obtains a license from the new home state, the individual state license issued by the nonparty state is not affected and will remain in full force if so provided by the laws of the nonparty state;

(iii)

Moving from a party state to a nonparty state, the license issued by the prior home state converts to an individual state license, valid only in the former home state, without the multistate licensure privilege to practice in other party states.

ARTICLE V
Adverse Actions

In addition to the General Provisions described in Article III, the following provisions apply:

(a)

The licensing board of a remote state shall promptly report to the administrator of the coordinated licensure information system any remote state actions, including the factual and legal basis for such action, if known. The licensing board of a remote state shall also promptly report any significant current investigative information yet to result in a remote state action. The administrator of the coordinated licensure information system shall promptly notify the home state of any such reports.

(b)

The licensing board of a party state shall have the authority to complete any pending investigations for a nurse who changes primary state of residence during the course of such investigations. It shall also have the authority to take appropriate action and shall promptly report the conclusions of such investigations to the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the new home state of any such actions.

(c)

A remote state may take adverse action affecting the multistate licensure privilege to practice within that party state. However, only the home state shall have the power to impose adverse action against the license issued by the home state.

(d)

For purposes of imposing adverse action, the licensing board of the home state shall give the same priority and effect to reported conduct received from a remote state as it would if such conduct had occurred within the home state. In so doing, it shall apply its own state laws to determine appropriate action.

(e)

The home state may take adverse action based on the factual findings of the remote state, so long as each state follows its own procedures for imposing such adverse action.

(f)

Nothing in this
c
ompact shall override a party state's decision that participation in an alternative program may be used in lieu of licensure action and that such participation shall remain nonpublic if required by the party state's laws. Party states must require nurses who enter any alternative programs to agree not to practice in any other party state during the term of the alternative program without prior authorization from such other party state.

ARTICLE VI
Additional Authorities Invested in

Party

State
Nurse
Licensing

Boards

(a)

Notwithstanding any other powers, party state nurse licensing boards shall have the authority to:

(i)

If otherwise permitted by state law, recover from the affected nurse the costs of investigations and disposition of cases resulting from any adverse action taken against that nurse;

(ii)

Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses and the production of evidence.

Subpoenas issued by a nurse licensing board in a party state for the attendance and testimony of witnesses, or the production of evidence from another party state shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state where the witnesses or evidence are located;

(iii)

Issue cease and desist orders to limit or revoke a nurse's authority to practice in their state;

(iv)

Promulgate uniform rules and regulations as provided for in Article VIII (c).

ARTICLE VII
Coordinated Licensure Information System

(a)

All party states shall participate in a cooperative effort to create a coordinated data base of all licensed registered nurses and licensed practical/vocational nurses. This system will include information on the licensure and disciplinary history of each nurse, as contributed by party states, to assist in the coordination of nurse licensure and enforcement efforts.

(b)

Notwithstanding any other provision of law, all party states' licensing boards shall promptly report adverse actions, actions against multistate licensure privileges, any current significant investigative information yet to result in adverse action, denials of applications and the reasons for such denials to the coordinated licensure information system.

(c)

Current significant investigative information shall be transmitted through the coordinated licensure information system only to party state licensing boards.

(d)

Notwithstanding any other provision of law, all party states' licensing boards contributing information to the coordinated licensure information system may designate information that may not be shared with nonparty states or disclosed to other entities or individuals without the express permission of the contributing state.

(e)

Any personally identifiable information obtained by a party state's licensing board from the coordinated licensure information system may not be shared with nonparty states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information.

(f)

Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing that information, shall also be expunged from the coordinated licensure information system.

(g)

The
c
ompact administrators, acting jointly with each other and in consultation with the administrator of the coordinated licensure information system, shall formulate necessary and proper procedures for the identification, collection and exchange of information under this
c
ompact.

ARTICLE VIII
Compact Administration and Interchange of Information

(a)

The head of the nurse licensing board, or his designee, of each party state shall be the administrator of this
c
ompact for his state.

(b)

The
c
ompact administrator of each party state shall furnish to the
c
ompact administrator of each other party state any information and documents including, but not limited to, a uniform data set of investigations, identifying information, licensure data and disclosable alternative program participation information to facilitate the administration of this
c
ompact.

(c)

Compact administrators shall have the authority to develop uniform rules to facilitate and coordinate implementation of this
c
ompact.

These uniform rules shall be adopted by party states, under the authority invested under Article VI
(a)(iv)
.

ARTICLE IX
Immunity

No party state or the officers, employees or agents of a party state's nurse licensing board who act in accordance with the provisions of this
c
ompact shall be liable on account of any act or omission in good faith while engaged in the performance of their duties under this
c
ompact. Good faith in this article shall not include willful misconduct, gross negligence or recklessness.

ARTICLE X
Entry into Force, Withdrawal and

Amendment

(a)

This
c
ompact shall enter into force and become effective as to any state when it has been enacted into the laws of that state. Any party state may withdraw from this
c
ompact by enacting a statute repealing the same, but no such withdrawal shall take effect until six
(6)
months after the withdrawing state has given notice of the withdrawal to the executive heads of all other party states.

(b)

No withdrawal shall affect the validity or applicability by the licensing boards of states remaining party to the
c
ompact of any report of adverse action occurring prior to the withdrawal.

(c)

Nothing contained in this
c
ompact shall be construed to invalidate or prevent any nurse licensure agreement or other cooperative arrangement between a party state and a nonparty state that is made in accordance with the other provisions of this
c
ompact.

(d)

This
c
ompact may be amended by the party states. No amendment to this
c
ompact shall become effective and binding upon the party states unless and until it is enacted into the laws of all party states.

ARTICLE XI
Construction and Severability

(a)

This
c
ompact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this
c
ompact shall be severable and if any phrase, clause, sentence or provision of this
c
ompact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this
c
ompact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby. If this
c
ompact shall be held contrary to the constitution of any state party, the
c
ompact shall remain in full force and effect as to the remaining party states and in full force and effect as to the party state affected as to all severable matters.

(b)

In the event party states find a need for settling disputes arising under this
c
ompact:

(i)

The party states may submit the issues in dispute to an arbitration panel that will be comprised of an individual appointed by the
c
ompact administrator in the home state; an individual appointed by the
c
ompact administrator in the remote state or states involved; and an individual mutually agreed upon by the
c
ompact administrators of all the party states involved in the dispute
;

(ii)

The decision of a majority of the arbitrators shall be final and binding.

Section 2.
W.S. 33
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21
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122 by creating a new subsection (f), 33
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21
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134(a), 33
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135, 33
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145(a)(i) and (iii), 33
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146(a)(vii) and 33
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154(a) by creating a new paragraph (x) are amended to read:

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122.

Board of nursing; powers and duties.

(f)

The board shall administer the provisions of the Nurse Licensure Compact pursuant to W.S. 33
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21
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202. Before recognizing a nurse license from another state that is party to the Nurse Licensure Compact, the board shall determine that the qualifications for a nursing license in the remote state are substantially equivalent to, or more stringent than, the minimum qualifications for issuance of a Wyoming license under this act.

33
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134.

Registered professional nurse; use of R.N.; advanced practice registered nurse; use of A.P.R.N.

(a)

Any person who holds a license to practice as a registered professional nurse in this
state
, or
who holds a license in another state and is practicing in this state pursuant to W.S. 33
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21
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202,
shall have the right to use the title "Registered Nurse" and the abbreviation "R.N." No other person shall assume this title or use this abbreviation or any words, letters, signs or devices to indicate that the person using same is a registered professional nurse.

33
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135.

Licensed practical nurse; use of L.P.N.

Any person who holds a license to practice as a licensed practical nurse in this state
, or
who holds a license in another state and is practicing in this state pursuant to W.S. 33
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21
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202,

shall have the right to use the title "Licensed Practical Nurse" and the abbreviation "L.P.N." No other person shall assume this title or use this abbreviation or any words, letters, signs or devices to indicate that the person using same is a licensed practical nurse.

33
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145.

Violations; penalties.

(a)

No person shall:

(i)

Engage in the practice of nursing as defined in this act without a valid, current license or temporary permit, except as otherwise permitted under this act
or the Nurse Licensure Compact
;

(iii)

Use any words, abbreviations, figures, letters, titles, signs, cards or devices tending to imply that the person is a registered nurse, licensed practical nurse or advanced practice registered nurse unless the person is duly licensed as a registered nurse, licensed practical nurse, or recognized as an advanced practice registered nurse under this act
, or
holds a license in another state and is practicing in this state pursuant to W.S. 33
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21
‑
202
;

33
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21
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146.

Disciplining licensees; grounds.

(a)

The board of nursing may refuse to issue or renew, or may suspend or revoke the license, certificate or temporary permit of any person, or to otherwise discipline a licensee, upon proof that the person:

(vii)

Has practiced nursing within this state without a valid current license or temporary permit or as otherwise permitted under this act

or the Nurse Licensure Compact
;

33
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21
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154.

Exemptions.

(a)

No provisions in this act prohibit:

(x)

The practice of any nurse who holds a license in another state and is practicing in this state pursuant to W.S. 33
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21
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202.

Section 3.
This act is effect
ive July 1, 2007.

(END)

1
SF0081