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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; relating 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 total amount of fees collected 6
for an occupation approximately equals the actual regulatory costs for the occupation. 7
The department shall annually review each fee level to determine 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 approximately equal, the department shall 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 report on all fee levels and 13
revisions for the previous year under this subsection to the office of management and 14 34-GH1160\A
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budget. If a board regulates an occupation covered by this chapter, the department 1
shall consider the board's recommendations concerning the occupation's fee levels and 2
regulatory costs before revising fee schedules to comply with this subsection. In this 3
subsection, "regulatory costs" means costs of the department that 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 that the total amount of fees collected by the Board of 12
Nursing for issuing a single-state license to practice registered, practical, or advanced 13
practice registered nursing is approximately equal to the total regulatory costs to the 14
department and the Board of Nursing for each of those license types. The department 15
shall establish fees for issuing a multistate license to practice registered or practical 16
nursing equal to double the fee set for the single-state version 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 chiropractor 23
licensed under AS 08.20; a professional 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 licensed under 27
AS 08.63; a physician licensed under AS 08.64; a podiatrist, osteopath, or 28
physician assistant licensed under AS 08.64; a direct-entry midwife 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 licensed under 31 34-GH1160\A
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AS 08.72; a pharmacist licensed under AS 08.80; a physical therapist or 1
occupational therapist licensed under AS 08.84; a psychologist or 2
psychological associate licensed under AS 08.86; or a social worker 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 nurse licensed 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 of a 16
hearing conservation program that complies with the regulations of the Occupational 17
Safety and Health Administration of the federal government if the individual is 18
certified to do the testing by a state or federal agency acceptable 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 to implement this chapter, including 26
regulations 27
(A) pertaining to practice as an advanced practice registered 28
nurse, including requirements for an advanced practice registered nurse to 29
practice as a certified registered nurse anesthetist, certified clinical nurse 30
specialist, certified nurse practitioner, or certified nurse midwife; regulations 31 34-GH1160\A
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for an advanced practice registered nurse who holds a valid federal Drug 1
Enforcement Administration registration number must address training in pain 2
management and opioid use and addiction; 3
(B) necessary to implement AS 08.68.331 - 08.68.336 relating 4
to certified nurse aides in order to protect the health, safety, 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 accredited by a national nursing accrediting 9
body; 10
(E) establishing guidelines for rendering a diagnosis, providing 11
treatment, or prescribing, dispensing, or administering a prescription 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 for standards of 14
care of a patient who is at a different location than the advanced 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 programs in the 19
state at the times it considers necessary; 20
(4) approve education programs that meet the requirements of this 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 registered, 25
advanced practice registered, or licensed practical nurse may resume 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 administrator that is necessary to 29
conduct board business; 30
(8) develop reasonable and uniform standards for nursing practice; 31 34-GH1160\A
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(9) publish advisory opinions regarding whether nursing practice 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 check; the department shall 6
submit the fingerprints and fees to the Department of Public Safety for a report of 7
criminal justice information under AS 12.62 and a national criminal 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 register 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 adopting any regulations necessary to 14
implement the compact. 15
* Sec. 6. AS 08.68.160 is amended to read: 16
Sec. 08.68.160. License or practice privilege required. A person practicing 17
or offering to practice registered, advanced practice registered, or practical nursing in 18
the state shall submit evidence of qualification to practice and 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 registered nursing 22
shall submit to the board, on forms 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 board 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 34-GH1160\A
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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 felony 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 controlled 29
substances; 30
(4) has impersonated a registered, advanced practice registered, or 31 34-GH1160\A
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practical nurse; 1
(5) has intentionally or negligently engaged in conduct that has 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 interferes with the 5
individual's performance of nursing functions; 6
(7) is guilty of unprofessional conduct as defined by regulations 7
adopted by the board; 8
(8) has wilfully or repeatedly violated a provision of this chapter or 9
regulations adopted under this chapter or AS 08.01; 10
(9) is professionally incompetent; 11
(10) denies care or treatment to a patient or person seeking assistance 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 maximum 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 singly 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 conditions on the professional practice of a 27
licensee; 28
(6) impose peer review; 29
(7) impose professional education requirements until a satisfactory 30
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by the board to need improvement; 1
(8) impose probation and require the licensee to report regularly 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 appeals 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 (AS 44.64.010) within 10
seven days after the effective date of the order. If, after a hearing, the board upholds 11
the suspension, the licensee may appeal the suspension to a court of competent 12
jurisdiction. 13
* Sec. 12. AS 08.68.275(d) is amended to read: 14
(d) The board may reinstate a license 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 certified under this chapter practicing within the scope of that 20
license, privilege, or certification that discharges or suspends a nurse or nurse aide or 21
conditions or restricts the practice of a nurse or nurse aide shall, 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 the name and address of a 24
nurse or nurse aide who resigns while under investigation by the employer. The 25
requirement of an employer to report under this section applies only to a discharge, 26
suspension, or restriction of practice that is based on a ground 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 alleged incidents of 31 34-GH1160\A
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incompetent, unprofessional, or unlawful conduct of a nurse licensed 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 to the board the information required under 4
AS 08.68.277 is not liable in a civil action for damages resulting 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 enacted into law and entered into 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 the 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 cooperation among states in the areas of nurse licensure and 23
regulation; 24
(4) New practice modalities and technology make compliance with 25
individual state nurse licensure laws difficult and complex; 26
(5) The current system of duplicative licensure for nurses practicing in 27
multiple states is cumbersome and redundant for both nurses and states; and 28
(6) Uniformity of nurse licensure requirements throughout the states 29
promotes public safety and public health benefits. 30
(b) The general purposes of this Compact are to: 31 34-GH1160\A
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(1) Facilitate the states' responsibility to protect the public'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 states 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 interstate practice by nurses who 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, equitable 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 individual'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 other encumbrance on 23
licensure affecting a nurse's authorization to practice, including 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 information system" means an integrated 28
process for collecting, storing and sharing information on nurse 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 34-GH1160\A
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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 opportunity 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 to public health and safety regardless 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 unrestricted practice of nursing imposed by a licensing 10
board. 11
(6) "Home state" means the party state which is the nurse's primary 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 registered or a 16
licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board 17
that authorizes the licensed nurse to practice in all party states under a multistate 18
licensure privilege. 19
(9) "Multistate licensure privilege" means a legal authorization 20
associated with a multistate license permitting the practice of nursing as either 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 United States 30
and the District of Columbia. 31 34-GH1160\A
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(15) "State practice laws" means a party state's laws, rules and 1
regulations that govern the practice of nursing, define the scope of nursing practice, 2
and create the methods and grounds for imposing discipline. "State practice laws" do 3
not include requirements necessary to obtain and retain a license, 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 practical/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 (LPN/VN), under a multistate licensure privilege, in each 11
party state. 12
(b) A state must implement procedures for considering the criminal history 13
records of applicants for initial multistate license or licensure by endorsement. Such 14
procedures shall include the submission of fingerprints or other biometric-based 15
information by applicants for the purpose of obtaining an applicant's criminal history 16
record information from the Federal Bureau of Investigation and the agency 17
responsible for retaining that state's criminal records. 18
(c) Each party state shall require the following for an applicant to obtain or 19
retain a multistate license in the home state: 20
(1) Meets the home state's qualifications for licensure or renewal 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 prelicensure education program; or has graduated from a 24
foreign RN or LPN/VN prelicensure education program that (a) has 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 program not 29
taught in English or if English is not the individual's native language, successfully 30
passed an English proficiency examination that includes the components of reading, 31 34-GH1160\A
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speaking, writing and listening; 1
(4) Has successfully passed an NCLEX-RN or NCLEX-PN 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 initial 5
licensure or licensure by endorsement, fingerprints or other biometric data for the 6
purpose of obtaining criminal history record information from the 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 into 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 into an 11
agreed disposition, of a misdemeanor offense related to the practice 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-disclosure requirements regarding current 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 existing state due 18
process law, to take adverse action against a nurse's multistate licensure privilege such 19
as revocation, suspension, probation or any other action that affects a nurse's 20
authorization to practice under a multistate licensure privilege, including cease and 21
desist actions. If a party state takes such action, it shall promptly notify the 22
administrator of the coordinated licensure information system. The administrator of 23
the coordinated licensure information system shall promptly notify the home state of 24
any such actions by remote states. 25
(e) A nurse practicing in a party state must comply with the state 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 all 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 licensure privilege will subject a 30
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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 to be able to apply 2
for a party state's single-state 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 state. 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 issued 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 this Compact's effective date 15
shall be ineligible to retain or renew a multistate license, and 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 Administrators 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, through the coordinated licensure information system, 23
whether the applicant has ever held, or is the holder of, a license issued by any other 24
state, whether there are any encumbrances on any license or multistate 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 34-GH1160\A
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states, the nurse must apply for licensure in the new home state, and the multistate 1
license issued by the prior home state will be deactivated in accordance with 2
applicable rules adopted by the Commission. 3
(1) The nurse may apply for licensure in advance of a change in 4
primary state of residence. 5
(2) A multistate license shall not be issued by the new home state 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 from a party state 10
to a non-party state, the multistate license issued by the prior 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 powers 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 adverse action, the home state 21
licensing board shall give the same priority and effect to reported conduct 22
received from a remote state as it would if such conduct had occurred 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 orders or impose an encumbrance on a 26
nurse's authority to practice within that party state. 27
(3) Complete any pending investigations of a nurse who changes 28
primary state of residence during the course of such investigations. The licensing 29
board shall also have the authority to take appropriate action(s) and shall promptly 30
report the conclusions of such investigations to the administrator of the coordinated 31 34-GH1160\A
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licensure information system. The administrator of the coordinated 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 production of evidence. 4
Subpoenas issued by a licensing board in a party state for the attendance and 5
testimony of witnesses or the production of evidence from another party state shall be 6
enforced in the latter state by any court of competent jurisdiction, according to the 7
practice and procedure of that court applicable to subpoenas issued in proceedings 8
pending before it. The issuing authority 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, fingerprint 12
or other biometric-based information to the Federal Bureau of Investigation 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 affected 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 remote 20
state, provided that the licensing board follows its own procedures for taking such 21
adverse action. 22
(b) If adverse action is taken by the home state against a nurse'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 from 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 multistate licensure 27
privilege is deactivated in all party states during the pendency of the order. Nothing in 28
this Compact shall override a party state's decision that participation in an alternative 29
program may be used in lieu of adverse action. The home state licensing board shall 30
deactivate the multistate licensure privilege under the multistate license of any nurse 31 34-GH1160\A
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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 licensure information 4
system of all licensed registered nurses (RNs) and licensed practical/vocational nurses 5
(LPNs/VNs). This system will include information on the licensure 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, shall formulate necessary and proper procedures for the 10
identification, collection and exchange of information under this Compact. 11
(c) All licensing boards shall promptly report to the coordinated licensure 12
information system any adverse action, any current significant investigative 13
information, denials of applications (with the reasons for such denials) and nurse 14
participation in alternative programs known to the licensing board 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 through 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 information system may 21
designate information that may not be shared with non-party states 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 shall 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 coordinated licensure 30
information system. 31 34-GH1160\A
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(h) The Compact administrator of each party state shall furnish a uniform data 1
set to the Compact administrator of each other party state, which 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 of this 7
Compact, as determined by Commission rules. 8
(i) The Compact administrator of a party state shall provide all 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 public 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 the 16
Commission shall be brought solely and exclusively, in a court of competent 17
jurisdiction where the principal office of the Commission is located. The Commission 18
may waive venue and jurisdictional defenses to the extent it adopts 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 administrator. 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 suspended from office as 26
provided by the law of the state from which the Administrator is 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 creation of bylaws and shall otherwise have an 31 34-GH1160\A
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opportunity to participate in the business and affairs of the Commission. An 1
administrator shall vote in person or by such other means as provided 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 calendar 5
year. Additional meetings shall be held as set forth in the bylaws or rules of the 6
commission. 7
(4) All meetings shall be open to the public, and public notice of 8
meetings shall be given in the same manner as required under the 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 state with its obligations under 13
this Compact; 14
(B) The employment, compensation, discipline or other 15
personnel matters, practices or procedures related to specific employees or 16
other matters related to the Commission's internal personnel practices 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 for the purpose of investigation of compliance 31 34-GH1160\A
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with this Compact; or 1
(J) Matters specifically exempted from disclosure by federal or 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 certify that the meeting 5
may be closed and shall reference each relevant exempting provision. The 6
Commission shall keep minutes that fully and clearly describe all matters discussed in 7
a meeting and shall provide a full and accurate summary of actions taken, and the 8
reasons therefor, including a description of the views expressed. 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 seal, 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 administrators, prescribe 13
bylaws or rules to govern its conduct as may be necessary or appropriate 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, ensuring reasonable advance notice of all meetings and 23
providing an opportunity for attendance of such meetings by interested parties, with 24
enumerated exceptions designed to protect the public's interest, the privacy of 25
individuals, and proprietary information, including trade secrets. The Commission 26
may meet in closed session only after a majority of the administrators 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 each administrator, with 29
no proxy votes allowed; 30
(4) Establishing the titles, duties and authority and reasonable 31 34-GH1160\A
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procedures for the election of the officers of the Commission; 1
(5) Providing reasonable standards and procedures for the 2
establishment of the personnel policies and programs of the Commission. 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 that may exist after the 7
termination of this Compact after the payment or reserving of all of its debts and 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 board 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, including, 24
but not limited to, employees of a party state or nonprofit organizations; 25
(5) To cooperate with other organizations that administer state 26
compacts related to the regulation of nursing, including but not limited to sharing 27
administrative or staff expenses, office space or other resources; 28
(6) To hire employees, elect or appoint officers, fix compensation, 29
define duties, grant such individuals appropriate authority to carry out the purposes of 30
this Compact, and to establish the Commission's personnel polic
ies and programs 31 34-GH1160\A
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relating to conflicts of interest, qualifications of personnel and other related personnel 1
matters; 2
(7) To accept any and all appropriate donations, grants and gifts of 3
money, equipment, supplies, materials and services, and to receive, utilize and dispose 4
of the same; provided that at all times the Commission shall avoid 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, abandon 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 comprised 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 information 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 functions as may be necessary or 20
appropriate to achieve the purposes 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, the 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 operations, activities and staff 27
in its annual budget as approved each year. The aggregate annual assessment amount, 28
if any, shall be allocated based upon a formula to be determined 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 prior to 31 34-GH1160\A
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securing the funds adequate to meet the same; nor shall the Commission 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 receipts and 3
disbursements. The receipts and disbursements of the Commission shall be subject to 4
the audit and accounting procedures established under its bylaws. However, all 5
receipts and disbursements of funds handled by the Commission shall be audited 6
yearly by a certified or licensed public accountant, and the report 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, employees 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 damage to or loss of property 12
or personal injury or other civil liability caused by or arising out of any actual or 13
alleged act, error or omission that occurred, or that the person against whom the claim 14
is made had a reasonable basis for believing occurred, within the scope of 15
Commission employment, duties or responsibilities; provided that nothing in this 16
paragraph shall be construed to protect any such person from suit or liability for any 17
damage, loss, injury or liability caused by the intentional, willful or wanton 18
misconduct of that person. 19
(2) The Commission shall defend any administrator, officer, executive 20
director, employee or representative of the Commission in any civil 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 employment, duties or responsibilities, or that the 23
person against whom the claim is made had a reasonable basis for believing occurred 24
within the scope of Commission employment, duties or responsibilities; provided that 25
nothing herein shall be construed to prohibit that person from retaining his or her own 26
counsel; and provided further that the actual or alleged act, error or omission did not 27
result from that person's intentional, willful or wanton misconduct. 28
(3) The Commission shall indemnify and hold harmless any 29
administrator, officer, executive director, employee or representative of the 30
Commission for the amount of any settlement or judgment obtaine
d against that 31 34-GH1160\A
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person arising out of any actual or alleged act, error or omission that occurred within 1
the scope of Commission employment, 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 actual 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 exercise its rulemaking powers pursuant to the 9
criteria set forth in this Article and the rules adopted thereunder. Rules and 10
amendments shall become binding as of the date specified in each 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 regular or special 13
meeting of the Commission. 14
(c) Prior to promulgation and adoption of a final rule or rules by the 15
Commission, and at least sixty (60) days in advance of the meeting 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 which 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 interested 27
person; and 28
(4) The manner in which interested persons may submit notice to 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 34-GH1160\A
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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 hearing before it 3
adopts a rule or amendment. 4
(g) The Commission shall publish the place, time and date of the scheduled 5
public hearing. 6
(1) Hearings shall be conducted in a manner providing each person 7
who wishes to comment a fair and reasonable opportunity to comment 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 may proceed with 13
promulgation of the proposed rule. 14
(i) Following the scheduled hearing date, or by the close of business on the 15
scheduled hearing date if the hearing was not held, the Commission shall consider all 16
written and oral comments received. 17
(j) The Commission shall, by majority vote of all administrators, take final 18
action on the proposed rule and shall determine the effective date 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 Commission may 21
consider and adopt an emergency rule without prior notice, opportunity for comment 22
or hearing, provided that the usual rulemaking procedures provided in this Compact 23
and in this section shall be retroactively applied to the rule as soon as reasonably 24
possible, in no event later than ninety (90) days after the effective date of the rule. For 25
the purposes of this provision, an emergency rule is one that must 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 34-GH1160\A
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(l) The Commission may direct revisions to a previously adopted rule or 1
amendment for purposes of correcting typographical errors, errors in format, errors in 2
consistency or grammatical errors. Public notice of any revisions 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 revision may be challenged 5
only on grounds that the revision results in a material change to a rule. A challenge 6
shall be made in writing, and delivered to the Commission, prior 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 challenged, the revision may not take 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 actions 14
necessary and appropriate to effectuate this Compact's purposes and intent. 15
(2) The Commission shall be entitled to receive service of process 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 proceeding for all 18
purposes. Failure to provide service of process in such proceeding to the Commission 19
shall render a judgment or order void as to the Commission, this Compact or 20
promulgated rules. 21
(b) Default, Technical Assistance and Termination 22
(1) If the Commission determines that a party state has defaulted in the 23
performance of its obligations or responsibilities under this Compact 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 of curing the 27
default or any other action to be taken by the Commission; and 28
(B) Provide remedial training and specific technical assistance 29
regarding the default. 30
(2) If a state in default fails to cure the default, the defaulting state's 31 34-GH1160\A
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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 effective date of termination. A cure of the default does not 3
relieve the offending state of obligations or liabilities incurred 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 exhausted. Notice of intent to 7
suspend or terminate shall be given by the Commission to the governor 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 terminated is 11
responsible for all assessments, obligations and liabilities incurred through the 12
effective date of termination, including obligations that extend 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 Commission 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 state, the Commission shall attempt 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 appointed by the 31 34-GH1160\A
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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 party states 2
involved in the dispute. 3
(B) The decision of a majority of the arbitrators shall be final 4
and binding. 5
(d) Enforcement 6
(1) The Commission, in the reasonable exercise of its discretion, 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 promulgated 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 the 16
Commission. The Commission may pursue any other remedies available 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 earlier 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 states to this Compact, that also 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 recognize a nurse'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 34-GH1160\A
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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 effective date of such 4
withdrawal or termination. 5
(e) Nothing contained in this Compact shall be construed to invalidate or 6
prevent any nurse licensure agreement or other cooperative arrangement between a 7
party state and a non-party state that is made in accordance with the other provisions 8
of this Compact. 9
(f) This Compact may be amended by the party states. No amendment 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-party 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 construed so as to effectuate the purposes 18
thereof. The provisions of this Compact shall be severable, and if any phrase, clause, 19
sentence or provision of this Compact is declared to be contrary to the constitution of 20
any party state or of the United States, or if the applicability 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 Compact shall be held to 24
be contrary to the constitution of any party state, this Compact shall remain in full 25
force and effect as to the remaining party states and in full force 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 the United 30
States government or a bureau, or agency, or division of the United States government 31 34-GH1160\A
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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 connection with the student's 5
course of study; 6
(4) the practice of nursing by an individual enrolled in an approved 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 state, except 10
for a nurse holding a multistate license under AS 08.68.500, who engages in 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 state, except 14
for a nurse holding a multistate license under AS 08.68.500, whose employment 15
responsibilities include transporting 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 requirements 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 under 27
AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 28
chiropractor licensed under AS 08.20; a dental hygienist licensed 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 naturopath licensed under 31 34-GH1160\A
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AS 08.45; an optometrist licensed under AS 08.72; a pharmacist licensed under 1
AS 08.80; a physical therapist or occupational therapist licensed under AS 08.84; a 2
physician or physician assistant licensed under AS 08.64; a podiatrist; a psychologist 3
and a psychological associate licensed under AS 08.86; a hospital as defined in 4
AS 47.32.900, including a governmentally owned or operated hospital; an employee 5
of a health care provider acting within the course and scope of employment; an 6
ambulatory surgical facility and other organizations whose primary purpose is the 7
delivery of health care, including a health maintenance organization, individual 8
practice association, integrated delivery system, preferred provider 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 person 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 patient 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 aide 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 provides nursing services 23
through direct patient care or clinical 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 under 27
AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist 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; an 30
optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 31 34-GH1160\A
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physical therapist or occupational therapist licensed under AS 08.84; a physician 1
licensed under AS 08.64; a podiatrist; a psychologist and a psychological 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 provided under 7
(a) of this section 8
(1) the recipient must have had an annual assessment to determine 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 independent 11
qualified health care professional under contract with the department; for purposes of 12
this paragraph, "independent qualified health care professional" means, 13
(A) for a waiver based on intellectual or developmental 14
disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 15
intellectual disability professional; 16
(B) for other allowable waivers, a registered or advanced 17
practice registered nurse licensed or privileged to practice under AS 08.68 18
who is qualified to assess children with complex medical conditions, older 19
Alaskans, and adults with physical disabilities for medical assistance waivers; 20
and 21
(3) the annual assessment must find that the recipient's condition 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 expected 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 persons with 30
intellectual and developmental disabilities either because the qualifying 31 34-GH1160\A
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diagnosis has changed or the recipient is able to demonstrate the 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 services to a 8
resident who does not require 24-hour nursing services and supervision. 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 delegated 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 and 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 consent of the 22
assisted living home, arrange for that care to be provided in the 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 34-GH1160\A
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(h) If a resident has received 24-hour skilled nursing care for the 45-day limit 1
set by (g) of this section, the resident or the resident's representative 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 resident or the resident's representative 5
have consulted with the resident's physician; 6
(2) the home and either the resident or the resident's representative 7
have discussed the consequences and risks involved in the election to remain in the 8
home; and 9
(3) the portion of the resident's assisted living plan that relates to 10
health-related services has been revised to provide for the resident'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 adopt regulations to 25
implement this Act. The regulations 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