Alaska 2025-2026 Regular Session

Alaska Senate Bill SB124 Compare Versions

Only one version of the bill is available at this time.

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2	2	SB0124A -1- SB 124
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11	11	SENATE BILL NO. 124
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13	13	IN THE LEGISLATURE OF THE STATE OF ALASKA
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15	15	THIRTY-FOURTH LEGISLATURE - FIRST SESSION
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17	17	BY THE SENATE RULES COMMITTEE BY REQUEST OF THE GOVERNOR
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19	19	Introduced: 3/10/25
20	20	Referred: Labor and Commerce, Finance
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22	22
23	23	A BILL
24	24
25	25	FOR AN ACT ENTITLED
26	26
27	27	"An Act relating to the licensure of nursing professionals; relating to a multistate nurse 1
28	28	licensure compact; and providing for an effective date." 2
29	29	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
30	30	* Section 1. AS 08.01.065(c) is amended to read: 4
31	31	(c) Except as provided in (f) - (l) [(f) - (k)] of this section, the department shall
32	32	5
33	33	establish fee levels under (a) of this section so that the total amount of fees collected 6
34	34	for an occupation approximately equals the actual regulatory costs for the occupation. 7
35	35	The department shall annually review each fee level to determine whether the 8
36	36	regulatory costs of each occupation are approximately equal to fee collections related 9
37	37	to that occupation. If the review indicates that an occupation's fee collections and 10
38	38	regulatory costs are not approximately equal, the department shall calculate fee 11
39	39	adjustments and adopt regulations under (a) of this section to implement the 12
40	40	adjustments. In January of each year, the department shall report on all fee levels and 13
41	41	revisions for the previous year under this subsection to the office of management and 14 34-GS1160\A
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45	45	budget. If a board regulates an occupation covered by this chapter, the department 1
46	46	shall consider the board's recommendations concerning the occupation's fee levels and 2
47	47	regulatory costs before revising fee schedules to comply with this subsection. In this 3
48	48	subsection, "regulatory costs" means costs of the department that are attributable to 4
49	49	regulation of an occupation plus 5
50	50	(1) all expenses of the board that regulates the occupation if the board 6
51	51	regulates only one occupation; 7
52	52	(2) the expenses of a board that are attributable to the occupation if the 8
53	53	board regulates more than one occupation. 9
54	54	* Sec. 2. AS 08.01.065 is amended by adding a new subsection to read: 10
55	55	(l) Notwithstanding (c) of this section, the department shall establish fee levels 11
56	56	under (a) of this section so that the total amount of fees collected by the Board of 12
57	57	Nursing for issuing a single-state license to practice registered, practical, or advanced 13
58	58	practice registered nursing is approximately equal to the total regulatory costs to the 14
59	59	department and the Board of Nursing for each of those license types. The department 15
60	60	shall establish fees for issuing a multistate license to practice registered or practical 16
61	61	nursing equal to double the fee set for the single-state version of that license type. In 17
62	62	this subsection, "single-state license" and "multistate license" have the meanings given 18
63	63	in AS 08.68.500. 19
64	64	* Sec. 3. AS 08.02.130(j)(1), as amended by sec. 2, ch. 44, SLA 2024, is amended to read: 20
65	65	(1) "health care provider" means 21
66	66	(A) an audiologist or speech-language pathologist licensed 22
67	67	under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 23
68	68	licensed under AS 08.20; a professional or associate counselor licensed under 24
69	69	AS 08.29; a dental hygienist licensed under AS 08.32; a dentist licensed under 25
70	70	AS 08.36; a dietitian or nutritionist licensed under AS 08.38; a naturopath 26
71	71	licensed under AS 08.45; a marital and family therapist licensed under 27
72	72	AS 08.63; a physician licensed under AS 08.64; a podiatrist, osteopath, or 28
73	73	physician assistant licensed under AS 08.64; a direct-entry midwife certified 29
74	74	under AS 08.65; a nurse licensed or privileged to practice under AS 08.68; a 30
75	75	dispensing optician licensed under AS 08.71; an optometrist licensed under 31 34-GS1160\A
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79	79	AS 08.72; a pharmacist licensed under AS 08.80; a physical therapist or 1
80	80	occupational therapist licensed under AS 08.84; a psychologist or 2
81	81	psychological associate licensed under AS 08.86; or a social worker licensed 3
82	82	under AS 08.95; 4
83	83	(B) a physician licensed in another state; or 5
84	84	(C) a member of a multidisciplinary care team who is licensed 6
85	85	in another state. 7
86	86	* Sec. 4. AS 08.11.120(b) is amended to read: 8
87	87	(b) Notwithstanding the provisions of this chapter, 9
88	88	(1) a nurse licensed or privileged to practice under AS 08.68 may 10
89	89	perform hearing sensitivity evaluations; 11
90	90	(2) an individual licensed as a hearing aid dealer under AS 08.55 may 12
91	91	deal in hearing aids; 13
92	92	(3) an individual holding a class A certificate issued by the Conference 14
93	93	of Executives of American Schools of the Deaf may teach the hearing impaired; 15
94	94	(4) an individual may engage in the testing of hearing as part of a 16
95	95	hearing conservation program that complies with the regulations of the Occupational 17
96	96	Safety and Health Administration of the federal government if the individual is 18
97	97	certified to do the testing by a state or federal agency acceptable to the Occupational 19
98	98	Safety and Health Administration; 20
99	99	(5) an individual may perform hearing screening under AS 47.20.310 21
100	100	if authorized to do so under a protocol adopted under AS 47.20.310(e) by the 22
101	101	Department of Health. 23
102	102	* Sec. 5. AS 08.68.100(a) is amended to read: 24
103	103	(a) The board shall 25
104	104	(1) adopt regulations necessary to implement this chapter, including 26
105	105	regulations 27
106	106	(A) pertaining to practice as an advanced practice registered 28
107	107	nurse, including requirements for an advanced practice registered nurse to 29
108	108	practice as a certified registered nurse anesthetist, certified clinical nurse 30
109	109	specialist, certified nurse practitioner, or certified nurse midwife; regulations 31 34-GS1160\A
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113	113	for an advanced practice registered nurse who holds a valid federal Drug 1
114	114	Enforcement Administration registration number must address training in pain 2
115	115	management and opioid use and addiction; 3
116	116	(B) necessary to implement AS 08.68.331 - 08.68.336 relating 4
117	117	to certified nurse aides in order to protect the health, safety, and welfare of 5
118	118	clients served by nurse aides; 6
119	119	(C) pertaining to retired nurse status; 7
120	120	(D) establishing criteria for approval of practical nurse 8
121	121	education programs that are not accredited by a national nursing accrediting 9
122	122	body; 10
123	123	(E) establishing guidelines for rendering a diagnosis, providing 11
124	124	treatment, or prescribing, dispensing, or administering a prescription drug to a 12
125	125	person without conducting a physical examination under AS 08.68.710; the 13
126	126	guidelines must include a nationally recognized model policy for standards of 14
127	127	care of a patient who is at a different location than the advanced practice 15
128	128	registered nurse; 16
129	129	(2) approve curricula and adopt standards for basic education programs 17
130	130	that prepare persons for licensing under AS 08.68.190; 18
131	131	(3) provide for surveys of the basic nursing education programs in the 19
132	132	state at the times it considers necessary; 20
133	133	(4) approve education programs that meet the requirements of this 21
134	134	chapter and of the board, and deny, revoke, or suspend approval of education 22
135	135	programs for failure to meet the requirements; 23
136	136	(5) examine, license, and renew the licenses of qualified applicants; 24
137	137	(6) prescribe requirements for competence before a former registered, 25
138	138	advanced practice registered, or licensed practical nurse may resume the practice of 26
139	139	nursing under this chapter; 27
140	140	(7) define by regulation the qualifications and duties of the executive 28
141	141	administrator and delegate authority to the executive administrator that is necessary to 29
142	142	conduct board business; 30
143	143	(8) develop reasonable and uniform standards for nursing practice; 31 34-GS1160\A
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147	147	(9) publish advisory opinions regarding whether nursing practice 1
148	148	procedures or policies comply with acceptable standards of nursing practice as defined 2
149	149	under this chapter; 3
150	150	(10) require applicants under this chapter to submit fingerprints and the 4
151	151	fees required by the Department of Public Safety under AS 12.62.160 for criminal 5
152	152	justice information and a national criminal history record check; the department shall 6
153	153	submit the fingerprints and fees to the Department of Public Safety for a report of 7
154	154	criminal justice information under AS 12.62 and a national criminal history record 8
155	155	check under AS 12.62.400; 9
156	156	(11) require that a licensed advanced practice registered nurse who has 10
157	157	a federal Drug Enforcement Administration registration number register with the 11
158	158	controlled substance prescription database under AS 17.30.200(n); 12
159	159	(12) implement the Multistate Nurse Licensure Compact entered 13
160	160	into under AS 08.68.500, including adopting any regulations necessary to 14
161	161	implement the compact. 15
162	162	* Sec. 6. AS 08.68.160 is amended to read: 16
163	163	Sec. 08.68.160. License or practice privilege required. A person practicing 17
164	164	or offering to practice registered, advanced practice registered, or practical nursing in 18
165	165	the state shall submit evidence of qualification to practice and shall be licensed or 19
166	166	privileged to practice under this chapter. 20
167	167	* Sec. 7. AS 08.68.170(c) is amended to read: 21
168	168	(c) An applicant for a license to practice advanced practice registered nursing 22
169	169	shall submit to the board, on forms and in the manner prescribed by the board, written 23
170	170	evidence, verified by oath, that the applicant 24
171	171	(1) is licensed or privileged to practice as a registered nurse in the 25
172	172	state; and 26
173	173	(2) has successfully completed an advanced practice registered nurse 27
174	174	education program that meets the criteria established by the board under 28
175	175	AS 08.68.100. 29
176	176	* Sec. 8. AS 08.68.220 is amended to read: 30
177	177	Sec. 08.68.220. Fees. The Department of Commerce, Community, and 31 34-GS1160\A
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181	181	Economic Development shall set fees under AS 08.01.065 for each of the following: 1
182	182	(1) registered nursing: 2
183	183	(A) application; 3
184	184	(B) license by examination; 4
185	185	(C) license by endorsement; 5
186	186	(D) license renewal; 6
187	187	(E) temporary permit; 7
188	188	(F) multistate licensure privilege; 8
189	189	(2) practical nursing: 9
190	190	(A) application; 10
191	191	(B) license by examination; 11
192	192	(C) license by endorsement; 12
193	193	(D) license renewal; 13
194	194	(E) temporary permit; 14
195	195	(F) multistate licensure privilege; 15
196	196	(3) advanced practice registered nursing: 16
197	197	(A) application; 17
198	198	(B) license by certification examination; 18
199	199	(C) license by endorsement; 19
200	200	(D) license renewal; 20
201	201	(E) temporary permit. 21
202	202	* Sec. 9. AS 08.68.270 is amended to read: 22
203	203	Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 23
204	204	may deny, suspend, or revoke the license or practice privilege of a person who 24
205	205	(1) has obtained or attempted to obtain a license to practice nursing by 25
206	206	fraud or deceit; 26
207	207	(2) has been convicted of a felony or other crime if the felony or other 27
208	208	crime is substantially related to the qualifications, functions, or duties of the licensee; 28
209	209	(3) habitually abuses alcoholic beverages, or illegally uses controlled 29
210	210	substances; 30
211	211	(4) has impersonated a registered, advanced practice registered, or 31 34-GS1160\A
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215	215	practical nurse; 1
216	216	(5) has intentionally or negligently engaged in conduct that has 2
217	217	resulted in a significant risk to the health or safety of a client or in injury to a client; 3
218	218	(6) practices or attempts to practice nursing while afflicted with 4
219	219	physical or mental illness, deterioration, or disability that interferes with the 5
220	220	individual's performance of nursing functions; 6
221	221	(7) is guilty of unprofessional conduct as defined by regulations 7
222	222	adopted by the board; 8
223	223	(8) has wilfully or repeatedly violated a provision of this chapter or 9
224	224	regulations adopted under this chapter or AS 08.01; 10
225	225	(9) is professionally incompetent; 11
226	226	(10) denies care or treatment to a patient or person seeking assistance 12
227	227	if the sole reason for the denial is the failure or refusal of the patient or person seeking 13
228	228	assistance to agree to arbitrate as provided in AS 09.55.535(a); 14
229	229	(11) has prescribed or dispensed an opioid in excess of the maximum 15
230	230	dosage authorized under AS 08.68.705; or 16
231	231	(12) has procured, sold, prescribed, or dispensed drugs in violation of a 17
232	232	law, regardless of whether there has been a criminal action or harm to the patient. 18
233	233	* Sec. 10. AS 08.68.275(a) is amended to read: 19
234	234	(a) The board may take the following disciplinary actions singly or in 20
235	235	combination: 21
236	236	(1) permanently revoke a license, practice privilege, or permit to 22
237	237	practice; 23
238	238	(2) suspend a license or practice privilege for a stated period of time; 24
239	239	(3) censure a licensee; 25
240	240	(4) issue a letter of reprimand; 26
241	241	(5) impose limitations or conditions on the professional practice of a 27
242	242	licensee; 28
243	243	(6) impose peer review; 29
244	244	(7) impose professional education requirements until a satisfactory 30
245	245	degree of skill has been attained in those aspects of professional practice determined 31 34-GS1160\A
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249	249	by the board to need improvement; 1
250	250	(8) impose probation and require the licensee to report regularly to the 2
251	251	board upon matters involving the basis for the probation; 3
252	252	(9) accept a voluntary surrender of a license. 4
253	253	* Sec. 11. AS 08.68.275(c) is amended to read: 5
254	254	(c) The board may summarily suspend a license or practice privilege before 6
255	255	final hearing or during the appeals process if the board finds that the licensee or 7
256	256	holder of the practice privilege poses a clear and immediate danger to the public 8
257	257	health and safety. A person whose license is suspended under this section is entitled to 9
258	258	a hearing conducted by the office of administrative hearings (AS 44.64.010) within 10
259	259	seven days after the effective date of the order. If, after a hearing, the board upholds 11
260	260	the suspension, the licensee may appeal the suspension to a court of competent 12
261	261	jurisdiction. 13
262	262	* Sec. 12. AS 08.68.275(d) is amended to read: 14
263	263	(d) The board may reinstate a license or practice privilege that has been 15
264	264	suspended or revoked if the board finds, after a hearing, that the applicant is able to 16
265	265	practice with skill and safety. 17
266	266	* Sec. 13. AS 08.68.277(a) is amended to read: 18
267	267	(a) An employer of a nurse licensed or privileged to practice under this 19
268	268	chapter or a nurse aide certified under this chapter practicing within the scope of that 20
269	269	license, privilege, or certification that discharges or suspends a nurse or nurse aide or 21
270	270	conditions or restricts the practice of a nurse or nurse aide shall, within seven working 22
271	271	days after the action, report to the board the name and address of the person and the 23
272	272	reason for the action. An employer shall report to the board the name and address of a 24
273	273	nurse or nurse aide who resigns while under investigation by the employer. The 25
274	274	requirement of an employer to report under this section applies only to a discharge, 26
275	275	suspension, or restriction of practice that is based on a ground allowing action by the 27
276	276	board under AS 08.68.270 or 08.68.334 or for conduct prohibited under AS 08.68.340. 28
277	277	* Sec. 14. AS 08.68.278 is amended to read: 29
278	278	Sec. 08.68.278. Immunity for certain reports to the board. A person who, in 30
279	279	good faith, reports information to the board relating to alleged incidents of 31 34-GS1160\A
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283	283	incompetent, unprofessional, or unlawful conduct of a nurse licensed or privileged to 1
284	284	practice under this chapter, a nurse aide certified under this chapter, or an employer of 2
285	285	a nurse licensed or privileged to practice under this chapter or a nurse aide certified 3
286	286	under this chapter who reports to the board the information required under 4
287	287	AS 08.68.277 is not liable in a civil action for damages resulting from the reporting of 5
288	288	the information. 6
289	289	* Sec. 15. AS 08.68 is amended by adding a new section to read: 7
290	290	Article 5A. Multistate Nurse Licensure Compact. 8
291	291	Sec. 08.68.500. Compact enacted. The Multistate Nurse Licensure Compact 9
292	292	as contained in this section is enacted into law and entered into on behalf of the state 10
293	293	with all other states and jurisdictions legally joining it in a form substantially as 11
294	294	follows: 12
295	295	ARTICLE I 13
296	296	Findings and Declaration of Purpose 14
297	297	(a) The legislature finds that: 15
298	298	(1) The health and safety of the public are affected by the degree of 16
299	299	compliance with and the effectiveness of enforcement activities related to state nurse 17
300	300	licensure laws; 18
301	301	(2) Violations of nurse licensure and other laws regulating the practice 19
302	302	of nursing may result in injury or harm to the public; 20
303	303	(3) The expanded mobility of nurses and the use of advanced 21
304	304	communication technologies as part of our nation's health care delivery system require 22
305	305	greater coordination and cooperation among states in the areas of nurse licensure and 23
306	306	regulation; 24
307	307	(4) New practice modalities and technology make compliance with 25
308	308	individual state nurse licensure laws difficult and complex; 26
309	309	(5) The current system of duplicative licensure for nurses practicing in 27
310	310	multiple states is cumbersome and redundant for both nurses and states; and 28
311	311	(6) Uniformity of nurse licensure requirements throughout the states 29
312	312	promotes public safety and public health benefits. 30
313	313	(b) The general purposes of this Compact are to: 31 34-GS1160\A
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317	317	(1) Facilitate the states' responsibility to protect the public's health and 1
318	318	safety; 2
319	319	(2) Ensure and encourage the cooperation of party states in the areas of 3
320	320	nurse licensure and regulation; 4
321	321	(3) Facilitate the exchange of information between party states in the 5
322	322	areas of nurse regulation, investigation and adverse actions; 6
323	323	(4) Promote compliance with the laws governing the practice of 7
324	324	nursing in each jurisdiction; 8
325	325	(5) Invest all party states with the authority to hold a nurse accountable 9
326	326	for meeting all state practice laws in the state in which the patient is located at the time 10
327	327	care is rendered through the mutual recognition of party state licenses; 11
328	328	(6) Decrease redundancies in the consideration and issuance of nurse 12
329	329	licenses; and 13
330	330	(7) Provide opportunities for interstate practice by nurses who meet 14
331	331	uniform licensure requirements. 15
332	332	ARTICLE II 16
333	333	Definitions 17
334	334	As used in this compact, unless the context clearly requires a different construction, 18
335	335	(1) "Adverse action" means any administrative, civil, equitable or 19
336	336	criminal action permitted by a state's laws which is imposed by a licensing board or 20
337	337	other authority against a nurse, including actions against an individual's license or 21
338	338	multistate licensure privilege such as revocation, suspension, probation, monitoring of 22
339	339	the licensee, limitation on the licensee's practice, or any other encumbrance on 23
340	340	licensure affecting a nurse's authorization to practice, including issuance of a cease 24
341	341	and desist action. 25
342	342	(2) "Alternative program" means a non-disciplinary monitoring 26
343	343	program approved by a licensing board. 27
344	344	(3) "Coordinated licensure information system" means an integrated 28
345	345	process for collecting, storing and sharing information on nurse licensure and 29
346	346	enforcement activities related to nurse licensure laws that is administered by a 30
347	347	nonprofit organization composed of and controlled by licensing boards. 31 34-GS1160\A
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351	351	(4) "Current significant investigative information" means: 1
352	352	(A) Investigative information that a licensing board, after a 2
353	353	preliminary inquiry that includes notification and an opportunity for the nurse 3
354	354	to respond, if required by state law, has reason to believe is not groundless and, 4
355	355	if proved true, would indicate more than a minor infraction; or 5
356	356	(B) Investigative information that indicates that the nurse 6
357	357	represents an immediate threat to public health and safety regardless of 7
358	358	whether the nurse has been notified and had an opportunity to respond. 8
359	359	(5) "Encumbrance" means a revocation or suspension of, or any 9
360	360	limitation on, the full and unrestricted practice of nursing imposed by a licensing 10
361	361	board. 11
362	362	(6) "Home state" means the party state which is the nurse's primary 12
363	363	state of residence. 13
364	364	(7) "Licensing board" means a party state's regulatory body 14
365	365	responsible for issuing nurse licenses. 15
366	366	(8) "Multistate license" means a license to practice as a registered or a 16
367	367	licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board 17
368	368	that authorizes the licensed nurse to practice in all party states under a multistate 18
369	369	licensure privilege. 19
370	370	(9) "Multistate licensure privilege" means a legal authorization 20
371	371	associated with a multistate license permitting the practice of nursing as either a 21
372	372	registered nurse (RN) or LPN/VN in a remote state. 22
373	373	(10) "Nurse" means RN or LPN/VN, as those terms are defined by 23
374	374	each party state's practice laws. 24
375	375	(11) "Party state" means any state that has adopted this Compact. 25
376	376	(12) "Remote state" means a party state, other than the home state. 26
377	377	(13) "Single-state license" means a nurse license issued by a party state 27
378	378	that authorizes practice only within the issuing state and does not include a multistate 28
379	379	licensure privilege to practice in any other party state. 29
380	380	(14) "State" means a state, territory or possession of the United States 30
381	381	and the District of Columbia. 31 34-GS1160\A
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385	385	(15) "State practice laws" means a party state's laws, rules and 1
386	386	regulations that govern the practice of nursing, define the scope of nursing practice, 2
387	387	and create the methods and grounds for imposing discipline. "State practice laws" do 3
388	388	not include requirements necessary to obtain and retain a license, except for 4
389	389	qualifications or requirements of the home state. 5
390	390	ARTICLE III 6
391	391	General Provisions and Jurisdiction 7
392	392	(a) A multistate license to practice registered or licensed practical/vocational 8
393	393	nursing issued by a home state to a resident in that state will be recognized by each 9
394	394	party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed 10
395	395	practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each 11
396	396	party state. 12
397	397	(b) A state must implement procedures for considering the criminal history 13
398	398	records of applicants for initial multistate license or licensure by endorsement. Such 14
399	399	procedures shall include the submission of fingerprints or other biometric-based 15
400	400	information by applicants for the purpose of obtaining an applicant's criminal history 16
401	401	record information from the Federal Bureau of Investigation and the agency 17
402	402	responsible for retaining that state's criminal records. 18
403	403	(c) Each party state shall require the following for an applicant to obtain or 19
404	404	retain a multistate license in the home state: 20
405	405	(1) Meets the home state's qualifications for licensure or renewal of 21
406	406	licensure, as well as, all other applicable state laws; 22
407	407	(2) Has graduated or is eligible to graduate from a licensing board-23
408	408	approved RN or LPN/VN prelicensure education program; or has graduated from a 24
409	409	foreign RN or LPN/VN prelicensure education program that (a) has been approved by 25
410	410	the authorized accrediting body in the applicable country and (b) has been verified by 26
411	411	an independent credentials review agency to be comparable to a licensing board-27
412	412	approved prelicensure education program; 28
413	413	(3) Has, if a graduate of a foreign prelicensure education program not 29
414	414	taught in English or if English is not the individual's native language, successfully 30
415	415	passed an English proficiency examination that includes the components of reading, 31 34-GS1160\A
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419	419	speaking, writing and listening; 1
420	420	(4) Has successfully passed an NCLEX-RN or NCLEX-PN 2
421	421	Examination or recognized predecessor, as applicable; 3
422	422	(5) Is eligible for or holds an active, unencumbered license; 4
423	423	(6) Has submitted, in connection with an application for initial 5
424	424	licensure or licensure by endorsement, fingerprints or other biometric data for the 6
425	425	purpose of obtaining criminal history record information from the Federal Bureau of 7
426	426	Investigation and the agency responsible for retaining that state's criminal records; 8
427	427	(7) Has not been convicted or found guilty, or has entered into an 9
428	428	agreed disposition, of a felony offense under applicable state or federal criminal law; 10
429	429	(8) Has not been convicted or found guilty, or has entered into an 11
430	430	agreed disposition, of a misdemeanor offense related to the practice of nursing as 12
431	431	determined on a case-by-case basis; 13
432	432	(9) Is not currently enrolled in an alternative program; 14
433	433	(10) Is subject to self-disclosure requirements regarding current 15
434	434	participation in an alternative program; and 16
435	435	(11) Has a valid United States Social Security number. 17
436	436	(d) All party states shall be authorized, in accordance with existing state due 18
437	437	process law, to take adverse action against a nurse's multistate licensure privilege such 19
438	438	as revocation, suspension, probation or any other action that affects a nurse's 20
439	439	authorization to practice under a multistate licensure privilege, including cease and 21
440	440	desist actions. If a party state takes such action, it shall promptly notify the 22
441	441	administrator of the coordinated licensure information system. The administrator of 23
442	442	the coordinated licensure information system shall promptly notify the home state of 24
443	443	any such actions by remote states. 25
444	444	(e) A nurse practicing in a party state must comply with the state practice laws 26
445	445	of the state in which the client is located at the time service is provided. The practice 27
446	446	of nursing is not limited to patient care, but shall include all nursing practice as 28
447	447	defined by the state practice laws of the party state in which the client is located. The 29
448	448	practice of nursing in a party state under a multistate licensure privilege will subject a 30
449	449	nurse to the jurisdiction of the licensing board, the courts and the laws of the party 31 34-GS1160\A
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452	452
453	453	state in which the client is located at the time service is provided. 1
454	454	(f) Individuals not residing in a party state shall continue to be able to apply 2
455	455	for a party state's single-state license as provided under the laws of each party state. 3
456	456	However, the single-state license granted to these individuals will not be recognized as 4
457	457	granting the privilege to practice nursing in any other party state. Nothing in this 5
458	458	Compact shall affect the requirements established by a party state for the issuance of a 6
459	459	single-state license. 7
460	460	(g) Any nurse holding a home state multistate license, on the effective date of 8
461	461	this Compact, may retain and renew the multistate license issued by the nurse's then-9
462	462	current home state, provided that: 10
463	463	(1) A nurse, who changes primary state of residence after this 11
464	464	Compact's effective date, must meet all applicable Article III.c. requirements to obtain 12
465	465	a multistate license from a new home state. 13
466	466	(2) A nurse who fails to satisfy the multistate licensure requirements in 14
467	467	Article III.c. due to a disqualifying event occurring after this Compact's effective date 15
468	468	shall be ineligible to retain or renew a multistate license, and the nurse's multistate 16
469	469	license shall be revoked or deactivated in accordance with applicable rules adopted by 17
470	470	the Interstate Commission of Nurse Licensure Compact Administrators 18
471	471	("Commission"). 19
472	472	ARTICLE IV 20
473	473	Applications for Licensure in a Party State 21
474	474	(a) Upon application for a multistate license, the licensing board in the issuing 22
475	475	party state shall ascertain, through the coordinated licensure information system, 23
476	476	whether the applicant has ever held, or is the holder of, a license issued by any other 24
477	477	state, whether there are any encumbrances on any license or multistate licensure 25
478	478	privilege held by the applicant, whether any adverse action has been taken against any 26
479	479	license or multistate licensure privilege held by the applicant and whether the 27
480	480	applicant is currently participating in an alternative program. 28
481	481	(b) A nurse may hold a multistate license, issued by the home state, in only 29
482	482	one party state at a time. 30
483	483	(c) If a nurse changes primary state of residence by moving between two party 31 34-GS1160\A
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486	486
487	487	states, the nurse must apply for licensure in the new home state, and the multistate 1
488	488	license issued by the prior home state will be deactivated in accordance with 2
489	489	applicable rules adopted by the Commission. 3
490	490	(1) The nurse may apply for licensure in advance of a change in 4
491	491	primary state of residence. 5
492	492	(2) A multistate license shall not be issued by the new home state until 6
493	493	the nurse provides satisfactory evidence of a change in primary state of residence to 7
494	494	the new home state and satisfies all applicable requirements to obtain a multistate 8
495	495	license from the new home state. 9
496	496	(d) If a nurse changes primary state of residence by moving from a party state 10
497	497	to a non-party state, the multistate license issued by the prior home state will convert 11
498	498	to a single-state license, valid only in the former home state. 12
499	499	ARTICLE V 13
500	500	Additional Authorities Invested in Party State Licensing Boards 14
501	501	(a) In addition to the other powers conferred by state law, a licensing board 15
502	502	shall have the authority to: 16
503	503	(1) Take adverse action against a nurse's multistate licensure privilege 17
504	504	to practice within that party state. 18
505	505	(A) Only the home state shall have the power to take adverse 19
506	506	action against a nurse's license issued by the home state. 20
507	507	(B) For purposes of taking adverse action, the home state 21
508	508	licensing board shall give the same priority and effect to reported conduct 22
509	509	received from a remote state as it would if such conduct had occurred within 23
510	510	the home state. In so doing, the home state shall apply its own state laws to 24
511	511	determine appropriate action. 25
512	512	(2) Issue cease and desist orders or impose an encumbrance on a 26
513	513	nurse's authority to practice within that party state. 27
514	514	(3) Complete any pending investigations of a nurse who changes 28
515	515	primary state of residence during the course of such investigations. The licensing 29
516	516	board shall also have the authority to take appropriate action(s) and shall promptly 30
517	517	report the conclusions of such investigations to the administrator of the coordinated 31 34-GS1160\A
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521	521	licensure information system. The administrator of the coordinated licensure 1
522	522	information system shall promptly notify the new home state of any such actions. 2
523	523	(4) Issue subpoenas for both hearings and investigations that require 3
524	524	the attendance and testimony of witnesses, as well as, the production of evidence. 4
525	525	Subpoenas issued by a licensing board in a party state for the attendance and 5
526	526	testimony of witnesses or the production of evidence from another party state shall be 6
527	527	enforced in the latter state by any court of competent jurisdiction, according to the 7
528	528	practice and procedure of that court applicable to subpoenas issued in proceedings 8
529	529	pending before it. The issuing authority shall pay any witness fees, travel expenses, 9
530	530	mileage and other fees required by the service statutes of the state in which the 10
531	531	witnesses or evidence are located. 11
532	532	(5) Obtain and submit, for each nurse licensure applicant, fingerprint 12
533	533	or other biometric-based information to the Federal Bureau of Investigation for 13
534	534	criminal background checks, receive the results of the Federal Bureau of Investigation 14
535	535	record search on criminal background checks and use the results in making licensure 15
536	536	decisions. 16
537	537	(6) If otherwise permitted by state law, recover from the affected nurse 17
538	538	the costs of investigations and disposition of cases resulting from any adverse action 18
539	539	taken against that nurse. 19
540	540	(7) Take adverse action based on the factual findings of the remote 20
541	541	state, provided that the licensing board follows its own procedures for taking such 21
542	542	adverse action. 22
543	543	(b) If adverse action is taken by the home state against a nurse's multistate 23
544	544	license, the nurse's multistate licensure privilege to practice in all other party states 24
545	545	shall be deactivated until all encumbrances have been removed from the multistate 25
546	546	license. All home state disciplinary orders that impose adverse action against a nurse's 26
547	547	multistate license shall include a statement that the nurse's multistate licensure 27
548	548	privilege is deactivated in all party states during the pendency of the order. Nothing in 28
549	549	this Compact shall override a party state's decision that participation in an alternative 29
550	550	program may be used in lieu of adverse action. The home state licensing board shall 30
551	551	deactivate the multistate licensure privilege under the multistate license of any nurse 31 34-GS1160\A
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554	554
555	555	for the duration of the nurse's participation in an alternative program. 1
556	556	ARTICLE VI 2
557	557	Coordinated Licensure Information System and Exchange of Information 3
558	558	(a) All party states shall participate in a coordinated licensure information 4
559	559	system of all licensed registered nurses (RNs) and licensed practical/vocational nurses 5
560	560	(LPNs/VNs). This system will include information on the licensure and disciplinary 6
561	561	history of each nurse, as submitted by party states, to assist in the coordination of 7
562	562	nurse licensure and enforcement efforts. 8
563	563	(b) The Commission, in consultation with the administrator of the coordinated 9
564	564	licensure information system, shall formulate necessary and proper procedures for the 10
565	565	identification, collection and exchange of information under this Compact. 11
566	566	(c) All licensing boards shall promptly report to the coordinated licensure 12
567	567	information system any adverse action, any current significant investigative 13
568	568	information, denials of applications (with the reasons for such denials) and nurse 14
569	569	participation in alternative programs known to the licensing board regardless of 15
570	570	whether such participation is deemed nonpublic or confidential under state law. 16
571	571	(d) Current significant investigative information and participation in nonpublic 17
572	572	or confidential alternative programs shall be transmitted through the coordinated 18
573	573	licensure information system only to party state licensing boards. 19
574	574	(e) Notwithstanding any other provision of law, all party state licensing boards 20
575	575	contributing information to the coordinated licensure information system may 21
576	576	designate information that may not be shared with non-party states or disclosed to 22
577	577	other entities or individuals without the express permission of the contributing state. 23
578	578	(f) Any personally identifiable information obtained from the coordinated 24
579	579	licensure information system by a party state licensing board shall not be shared with 25
580	580	non-party states or disclosed to other entities or individuals except to the extent 26
581	581	permitted by the laws of the party state contributing the information. 27
582	582	(g) Any information contributed to the coordinated licensure i
583	583	nformation 28
584	584	system that is subsequently required to be expunged by the laws of the party state 29
585	585	contributing that information shall also be expunged from the coordinated licensure 30
586	586	information system. 31 34-GS1160\A
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589	589
590	590	(h) The Compact administrator of each party state shall furnish a uniform data 1
591	591	set to the Compact administrator of each other party state, which shall include, at a 2
592	592	minimum: 3
593	593	(1) Identifying information; 4
594	594	(2) Licensure data; 5
595	595	(3) Information related to alternative program participation; and 6
596	596	(4) Other information that may facilitate the administration of this 7
597	597	Compact, as determined by Commission rules. 8
598	598	(i) The Compact administrator of a party state shall provide all investigative 9
599	599	documents and information requested by another party state. 10
600	600	ARTICLE VII 11
601	601	Establishment of the Interstate Commission of Nurse Licensure Compact Administrators 12
602	602	(a) The party states hereby create and establish a joint public entity known as 13
603	603	the Interstate Commission of Nurse Licensure Compact Administrators. 14
604	604	(1) The Commission is an instrumentality of the party states. 15
605	605	(2) Venue is proper, and judicial proceedings by or against the 16
606	606	Commission shall be brought solely and exclusively, in a court of competent 17
607	607	jurisdiction where the principal office of the Commission is located. The Commission 18
608	608	may waive venue and jurisdictional defenses to the extent it adopts or consents to 19
609	609	participate in alternative dispute resolution proceedings. 20
610	610	(3) Nothing in this Compact shall be construed to be a waiver of 21
611	611	sovereign immunity. 22
612	612	(b) Membership, Voting and Meetings 23
613	613	(1) Each party state shall have and be limited to one administrator. The 24
614	614	head of the state licensing board or designee shall be the administrator of this Compact 25
615	615	for each party state. Any administrator may be removed or suspended from office as 26
616	616	provided by the law of the state from which the Administrator is appointed. Any 27
617	617	vacancy occurring in the Commission shall be filled in accordance with the laws of the 28
618	618	party state in which the vacancy exists. 29
619	619	(2) Each administrator shall be entitled to one (1) vote with regard to 30
620	620	the promulgation of rules and creation of bylaws and shall otherwise have an 31 34-GS1160\A
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623	623
624	624	opportunity to participate in the business and affairs of the Commission. An 1
625	625	administrator shall vote in person or by such other means as provided in the bylaws. 2
626	626	The bylaws may provide for an administrator's participation in meetings by telephone 3
627	627	or other means of communication. 4
628	628	(3) The Commission shall meet at least once during each calendar 5
629	629	year. Additional meetings shall be held as set forth in the bylaws or rules of the 6
630	630	commission. 7
631	631	(4) All meetings shall be open to the public, and public notice of 8
632	632	meetings shall be given in the same manner as required under the rulemaking 9
633	633	provisions in Article VIII. 10
634	634	(5) The Commission may convene in a closed, nonpublic meeting if 11
635	635	the Commission must discuss: 12
636	636	(A) Noncompliance of a party state with its obligations under 13
637	637	this Compact; 14
638	638	(B) The employment, compensation, discipline or other 15
639	639	personnel matters, practices or procedures related to specific employees or 16
640	640	other matters related to the Commission's internal personnel practices and 17
641	641	procedures; 18
642	642	(C) Current, threatened or reasonably anticipated litigation; 19
643	643	(D) Negotiation of contracts for the purchase or sale of goods, 20
644	644	services or real estate; 21
645	645	(E) Accusing any person of a crime or formally censuring any 22
646	646	person; 23
647	647	(F) Disclosure of trade secrets or commercial or financial 24
648	648	information that is privileged or confidential; 25
649	649	(G) Disclosure of information of a personal nature where 26
650	650	disclosure would constitute a clearly unwarranted invasion of personal privacy; 27
651	651	(H) Disclosure of investigatory records compiled for law 28
652	652	enforcement purposes; 29
653	653	(I) Disclosure of information related to any reports prepared by 30
654	654	or on behalf of the Commission for the purpose of investigation of compliance 31 34-GS1160\A
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657	657
658	658	with this Compact; or 1
659	659	(J) Matters specifically exempted from disclosure by federal or 2
660	660	state statute. 3
661	661	(6) If a meeting, or portion of a meeting, is closed pursuant to this 4
662	662	provision, the Commission's legal counsel or designee shall certify that the meeting 5
663	663	may be closed and shall reference each relevant exempting provision. The 6
664	664	Commission shall keep minutes that fully and clearly describe all matters discussed in 7
665	665	a meeting and shall provide a full and accurate summary of actions taken, and the 8
666	666	reasons therefor, including a description of the views expressed. All documents 9
667	667	considered in connection with an action shall be identified in such minutes. All 10
668	668	minutes and documents of a closed meeting shall remain under seal, subject to release 11
669	669	by a majority vote of the Commission or order of a court of competent jurisdiction. 12
670	670	(c) The Commission shall, by a majority vote of the administrators, prescribe 13
671	671	bylaws or rules to govern its conduct as may be necessary or appropriate to carry out 14
672	672	the purposes and exercise the powers of this Compact, including but not limited to: 15
673	673	(1) Establishing the fiscal year of the Commission; 16
674	674	(2) Providing reasonable standards and procedures: 17
675	675	(A) For the establishment and meetings of other committees; 18
676	676	and 19
677	677	(B) Governing any general or specific delegation of any 20
678	678	authority or function of the Commission; 21
679	679	(3) Providing reasonable procedures for calling and conducting 22
680	680	meetings of the Commission, ensuring reasonable advance notice of all meetings and 23
681	681	providing an opportunity for attendance of such meetings by interested parties, with 24
682	682	enumerated exceptions designed to protect the public's interest, the privacy of 25
683	683	individuals, and proprietary information, including trade secrets. The Commission 26
684	684	may meet in closed session only after a majority of the administrators vote to close a 27
685	685	meeting in whole or in part. As soon as practicable, the Commission must make public 28
686	686	a copy of the vote to close the meeting revealing the vote of each administrator, with 29
687	687	no proxy votes allowed; 30
688	688	(4) Establishing the titles, duties and authority and reasonable 31 34-GS1160\A
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690	690	New Text Underlined [DELETED TEXT BRACKETED]
691	691
692	692	procedures for the election of the officers of the Commission; 1
693	693	(5) Providing reasonable standards and procedures for the 2
694	694	establishment of the personnel policies and programs of the Commission. 3
695	695	Notwithstanding any civil service or other similar laws of any party state, the bylaws 4
696	696	shall exclusively govern the personnel policies and programs of the Commission; and 5
697	697	(6) Providing a mechanism for winding up the operations of the 6
698	698	Commission and the equitable disposition of any surplus funds that may exist after the 7
699	699	termination of this Compact after the payment or reserving of all of its debts and 8
700	700	obligations; 9
701	701	(d) The Commission shall publish its bylaws and rules, and any amendments 10
702	702	thereto, in a convenient form on the website of the Commission. 11
703	703	(e) The Commission shall maintain its financial records in accordance with the 12
704	704	bylaws. 13
705	705	(f) The Commission shall meet and take such actions as are consistent with the 14
706	706	provisions of this Compact and the bylaws. 15
707	707	(g) The Commission shall have the following powers: 16
708	708	(1) To promulgate uniform rules to facilitate and coordinate 17
709	709	implementation and administration of this Compact. The rules shall have the force and 18
710	710	effect of law and shall be binding in all party states; 19
711	711	(2) To bring and prosecute legal proceedings or actions in the name of 20
712	712	the Commission, provided that the standing of any licensing board to sue or be sued 21
713	713	under applicable law shall not be affected; 22
714	714	(3) To purchase and maintain insurance and bonds; 23
715	715	(4) To borrow, accept or contract for services of personnel, including, 24
716	716	but not limited to, employees of a party state or nonprofit organizations; 25
717	717	(5) To cooperate with other organizations that administer state 26
718	718	compacts related to the regulation of nursing, including but not limited to sharing 27
719	719	administrative or staff expenses, office space or other resources; 28
720	720	(6) To hire employees, elect or appoint officers, fix compensation, 29
721	721	define duties, grant such individuals appropriate authority to carry out the purposes of 30
722	722	this Compact, and to establish the Commission's personnel polic
723	723	ies and programs 31 34-GS1160\A
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726	726
727	727	relating to conflicts of interest, qualifications of personnel and other related personnel 1
728	728	matters; 2
729	729	(7) To accept any and all appropriate donations, grants and gifts of 3
730	730	money, equipment, supplies, materials and services, and to receive, utilize and dispose 4
731	731	of the same; provided that at all times the Commission shall avoid any appearance of 5
732	732	impropriety or conflict of interest; 6
733	733	(8) To lease, purchase, accept appropriate gifts or donations of, or 7
734	734	otherwise to own, hold, improve or use, any property, whether real, personal or mixed; 8
735	735	provided that at all times the Commission shall avoid any appearance of impropriety; 9
736	736	(9) To sell, convey, mortgage, pledge, lease, exchange, abandon or 10
737	737	otherwise dispose of any property, whether real, personal or mixed; 11
738	738	(10) To establish a budget and make expenditures; 12
739	739	(11) To borrow money; 13
740	740	(12) To appoint committees, including advisory committees comprised 14
741	741	of administrators, state nursing regulators, state legislators or their representatives, and 15
742	742	consumer representatives, and other such interested persons; 16
743	743	(13) To provide and receive information from, and to cooperate with, 17
744	744	law enforcement agencies; 18
745	745	(14) To adopt and use an official seal; and 19
746	746	(15) To perform such other functions as may be necessary or 20
747	747	appropriate to achieve the purposes of this Compact consistent with the state 21
748	748	regulation of nurse licensure and practice. 22
749	749	(h) Financing of the Commission 23
750	750	(1) The Commission shall pay, or provide for the payment of, the 24
751	751	reasonable expenses of its establishment, organization and ongoing activities. 25
752	752	(2) The Commission may also levy on and collect an annual 26
753	753	assessment from each party state to cover the cost of its operations, activities and staff 27
754	754	in its annual budget as approved each year. The aggregate annual assessment amount, 28
755	755	if any, shall be allocated based upon a formula to be determined by the Commission, 29
756	756	which shall promulgate a rule that is binding upon all party states. 30
757	757	(3) The Commission shall not incur obligations of any kind prior to 31 34-GS1160\A
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761	761	securing the funds adequate to meet the same; nor shall the Commission pledge the 1
762	762	credit of any of the party states, except by, and with the authority of, such party state. 2
763	763	(4) The Commission shall keep accurate accounts of all receipts and 3
764	764	disbursements. The receipts and disbursements of the Commission shall be subject to 4
765	765	the audit and accounting procedures established under its bylaws. However, all 5
766	766	receipts and disbursements of funds handled by the Commission shall be audited 6
767	767	yearly by a certified or licensed public accountant, and the report of the audit shall be 7
768	768	included in and become part of the annual report of the Commission. 8
769	769	(i) Qualified Immunity, Defense and Indemnification 9
770	770	(1) The administrators, officers, executive director, employees and 10
771	771	representatives of the Commission shall be immune from suit and liability, either 11
772	772	personally or in their official capacity, for any claim for damage to or loss of property 12
773	773	or personal injury or other civil liability caused by or arising out of any actual or 13
774	774	alleged act, error or omission that occurred, or that the person against whom the claim 14
775	775	is made had a reasonable basis for believing occurred, within the scope of 15
776	776	Commission employment, duties or responsibilities; provided that nothing in this 16
777	777	paragraph shall be construed to protect any such person from suit or liability for any 17
778	778	damage, loss, injury or liability caused by the intentional, willful or wanton 18
779	779	misconduct of that person. 19
780	780	(2) The Commission shall defend any administrator, officer, executive 20
781	781	director, employee or representative of the Commission in any civil action seeking to 21
782	782	impose liability arising out of any actual or alleged act, error or omission that occurred 22
783	783	within the scope of Commission employment, duties or responsibilities, or that the 23
784	784	person against whom the claim is made had a reasonable basis for believing occurred 24
785	785	within the scope of Commission employment, duties or responsibilities; provided that 25
786	786	nothing herein shall be construed to prohibit that person from retaining his or her own 26
787	787	counsel; and provided further that the actual or alleged act, error or omission did not 27
788	788	result from that person's intentional, willful or wanton misconduct. 28
789	789	(3) The Commission shall indemnify and hold harmless any 29
790	790	administrator, officer, executive director, employee or representative of the 30
791	791	Commission for the amount of any settlement or judgment obtaine
792	792	d against that 31 34-GS1160\A
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795	795
796	796	person arising out of any actual or alleged act, error or omission that occurred within 1
797	797	the scope of Commission employment, duties or responsibilities, or that such person 2
798	798	had a reasonable basis for believing occurred within the scope of Commission 3
799	799	employment, duties or responsibilities, provided that the actual or alleged act, error or 4
800	800	omission did not result from the intentional, willful or wanton misconduct of that 5
801	801	person. 6
802	802	ARTICLE VIII 7
803	803	Rulemaking 8
804	804	(a) The Commission shall exercise its rulemaking powers pursuant to the 9
805	805	criteria set forth in this Article and the rules adopted thereunder. Rules and 10
806	806	amendments shall become binding as of the date specified in each rule or amendment 11
807	807	and shall have the same force and effect as provisions of this Compact. 12
808	808	(b) Rules or amendments to the rules shall be adopted at a regular or special 13
809	809	meeting of the Commission. 14
810	810	(c) Prior to promulgation and adoption of a final rule or rules by the 15
811	811	Commission, and at least sixty (60) days in advance of the meeting at which the rule 16
812	812	will be considered and voted upon, the Commission shall file a notice of proposed 17
813	813	rulemaking: 18
814	814	(1) On the website of the Commission; and 19
815	815	(2) On the website of each licensing board or the publication in which 20
816	816	each state would otherwise publish proposed rules. 21
817	817	(d) The notice of proposed rulemaking shall include: 22
818	818	(1) The proposed time, date and location of the meeting in which the 23
819	819	rule will be considered and voted upon; 24
820	820	(2) The text of the proposed rule or amendment, and the reason for the 25
821	821	proposed rule; 26
822	822	(3) A request for comments on the proposed rule from any interested 27
823	823	person; and 28
824	824	(4) The manner in which interested persons may submit notice to the 29
825	825	Commission of their intention to attend the public hearing and any written comments. 30
826	826	(e) Prior to adoption of a proposed rule, the Commission shall allow persons 31 34-GS1160\A
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829	829
830	830	to submit written data, facts, opinions and arguments, which shall be made available to 1
831	831	the public. 2
832	832	(f) The Commission shall grant an opportunity for a public hearing before it 3
833	833	adopts a rule or amendment. 4
834	834	(g) The Commission shall publish the place, time and date of the scheduled 5
835	835	public hearing. 6
836	836	(1) Hearings shall be conducted in a manner providing each person 7
837	837	who wishes to comment a fair and reasonable opportunity to comment orally or in 8
838	838	writing. All hearings will be recorded, and a copy will be made available upon request. 9
839	839	(2) Nothing in this section shall be construed as requiring a separate 10
840	840	hearing on each rule. Rules may be grouped for the convenience of the Commission at 11
841	841	hearings required by this section. 12
842	842	(h) If no one appears at the public hearing, the Commission may proceed with 13
843	843	promulgation of the proposed rule. 14
844	844	(i) Following the scheduled hearing date, or by the close of business on the 15
845	845	scheduled hearing date if the hearing was not held, the Commission shall consider all 16
846	846	written and oral comments received. 17
847	847	(j) The Commission shall, by majority vote of all administrators, take final 18
848	848	action on the proposed rule and shall determine the effective date of the rule, if any, 19
849	849	based on the rulemaking record and the full text of the rule. 20
850	850	(k) Upon determination that an emergency exists, the Commission may 21
851	851	consider and adopt an emergency rule without prior notice, opportunity for comment 22
852	852	or hearing, provided that the usual rulemaking procedures provided in this Compact 23
853	853	and in this section shall be retroactively applied to the rule as soon as reasonably 24
854	854	possible, in no event later than ninety (90) days after the effective date of the rule. For 25
855	855	the purposes of this provision, an emergency rule is one that must be adopted 26
856	856	immediately in order to: 27
857	857	(1) Meet an imminent threat to public health, safety or welfare; 28
858	858	(2) Prevent a loss of Commission or party state funds; or 29
859	859	(3) Meet a deadline for the promulgation of an administrative rule that 30
860	860	is required by federal law or rule. 31 34-GS1160\A
861	861	SB 124 -26- SB0124A
862	862	New Text Underlined [DELETED TEXT BRACKETED]
863	863
864	864	(l) The Commission may direct revisions to a previously adopted rule or 1
865	865	amendment for purposes of correcting typographical errors, errors in format, errors in 2
866	866	consistency or grammatical errors. Public notice of any revisions shall be posted on 3
867	867	the website of the Commission. The revision shall be subject to challenge by any 4
868	868	person for a period of thirty (30) days after posting. The revision may be challenged 5
869	869	only on grounds that the revision results in a material change to a rule. A challenge 6
870	870	shall be made in writing, and delivered to the Commission, prior to the end of the 7
871	871	notice period. If no challenge is made, the revision will take effect without further 8
872	872	action. If the revision is challenged, the revision may not take effect without the 9
873	873	approval of the Commission. 10
874	874	ARTICLE IX 11
875	875	Oversight, Dispute Resolution and Enforcement 12
876	876	(a) Oversight 13
877	877	(1) Each party state shall enforce this Compact and take all actions 14
878	878	necessary and appropriate to effectuate this Compact's purposes and intent. 15
879	879	(2) The Commission shall be entitled to receive service of process in 16
880	880	any proceeding that may affect the powers, responsibilities or actions of the 17
881	881	Commission, and shall have standing to intervene in such a proceeding for all 18
882	882	purposes. Failure to provide service of process in such proceeding to the Commission 19
883	883	shall render a judgment or order void as to the Commission, this Compact or 20
884	884	promulgated rules. 21
885	885	(b) Default, Technical Assistance and Termination 22
886	886	(1) If the Commission determines that a party state has defaulted in the 23
887	887	performance of its obligations or responsibilities under this Compact or the 24
888	888	promulgated rules, the Commission shall: 25
889	889	(A) Provide written notice to the defaulting state and other 26
890	890	party states of the nature of the default, the proposed means of curing the 27
891	891	default or any other action to be taken by the Commission; and 28
892	892	(B) Provide remedial training and specific technical assistance 29
893	893	regarding the default. 30
894	894	(2) If a state in default fails to cure the default, the defaulting state's 31 34-GS1160\A
895	895	SB0124A -27- SB 124
896	896	New Text Underlined [DELETED TEXT BRACKETED]
897	897
898	898	membership in this Compact may be terminated upon an affirmative vote of a majority 1
899	899	of the administrators, and all rights, privileges and benefits conferred by this Compact 2
900	900	may be terminated on the effective date of termination. A cure of the default does not 3
901	901	relieve the offending state of obligations or liabilities incurred during the period of 4
902	902	default. 5
903	903	(3) Termination of membership in this Compact shall be imposed only 6
904	904	after all other means of securing compliance have been exhausted. Notice of intent to 7
905	905	suspend or terminate shall be given by the Commission to the governor of the 8
906	906	defaulting state and to the executive officer of the defaulting state's licensing board 9
907	907	and each of the party states. 10
908	908	(4) A state whose membership in this Compact has been terminated is 11
909	909	responsible for all assessments, obligations and liabilities incurred through the 12
910	910	effective date of termination, including obligations that extend beyond the effective 13
911	911	date of termination. 14
912	912	(5) The Commission shall not bear any costs related to a state that is 15
913	913	found to be in default or whose membership in this Compact has been terminated 16
914	914	unless agreed upon in writing between the Commission and the defaulting state. 17
915	915	(6) The defaulting state may appeal the action of the Commission by 18
916	916	petitioning the U.S. District Court for the District of Columbia or the federal district in 19
917	917	which the Commission has its principal offices. The prevailing party shall be awarded 20
918	918	all costs of such litigation, including reasonable attorneys' fees. 21
919	919	(c) Dispute Resolution 22
920	920	(1) Upon request by a party state, the Commission shall attempt to 23
921	921	resolve disputes related to the Compact that arise among party states and between 24
922	922	party and non-party states. 25
923	923	(2) The Commission shall promulgate a rule providing for both 26
924	924	mediation and binding dispute resolution for disputes, as appropriate. 27
925	925	(3) In the event the Commission cannot resolve disputes among party 28
926	926	states arising under this Compact: 29
927	927	(A) The party states may submit the issues in dispute to an 30
928	928	arbitration panel, which will be comprised of individuals appointed by the 31 34-GS1160\A
929	929	SB 124 -28- SB0124A
930	930	New Text Underlined [DELETED TEXT BRACKETED]
931	931
932	932	Compact administrator in each of the affected party states and an individual 1
933	933	mutually agreed upon by the Compact administrators of all the party states 2
934	934	involved in the dispute. 3
935	935	(B) The decision of a majority of the arbitrators shall be final 4
936	936	and binding. 5
937	937	(d) Enforcement 6
938	938	(1) The Commission, in the reasonable exercise of its discretion, shall 7
939	939	enforce the provisions and rules of this Compact. 8
940	940	(2) By majority vote, the Commission may initiate legal action in the 9
941	941	U.S. District Court for the District of Columbia or the federal district in which the 10
942	942	Commission has its principal offices against a party state that is in default to enforce 11
943	943	compliance with the provisions of this Compact and its promulgated rules and bylaws. 12
944	944	The relief sought may include both injunctive relief and damages. In the event judicial 13
945	945	enforcement is necessary, the prevailing party shall be awarded all costs of such 14
946	946	litigation, including reasonable attorneys' fees. 15
947	947	(3) The remedies herein shall not be the exclusive remedies of the 16
948	948	Commission. The Commission may pursue any other remedies available under federal 17
949	949	or state law. 18
950	950	ARTICLE X 19
951	951	Effective Date, Withdrawal and Amendment 20
952	952	(a) This Compact shall become effective and binding on the earlier of the date 21
953	953	of legislative enactment of this Compact into law by no less than twenty-six (26) states 22
954	954	or December 31, 2018. All party states to this Compact, that also were parties to the 23
955	955	prior Nurse Licensure Compact, superseded by this Compact, ("Prior Compact"), shall 24
956	956	be deemed to have withdrawn from said Prior Compact within six (6) months after the 25
957	957	effective date of this Compact. 26
958	958	(b) Each party state to this Compact shall continue to recognize a nurse's 27
959	959	multistate licensure privilege to practice in that party state issued under the Prior 28
960	960	Compact until such party state has withdrawn from the Prior Compact. 29
961	961	(c) Any party state may withdraw from this Compact by enacting a statute 30
962	962	repealing the same. A party state's withdrawal shall not take effect until six (6) months 31 34-GS1160\A
963	963	SB0124A -29- SB 124
964	964	New Text Underlined [DELETED TEXT BRACKETED]
965	965
966	966	after enactment of the repealing statute. 1
967	967	(d) A party state's withdrawal or termination shall not affect the continuing 2
968	968	requirement of the withdrawing or terminated state's licensing board to report adverse 3
969	969	actions and significant investigations occurring prior to the effective date of such 4
970	970	withdrawal or termination. 5
971	971	(e) Nothing contained in this Compact shall be construed to invalidate or 6
972	972	prevent any nurse licensure agreement or other cooperative arrangement between a 7
973	973	party state and a non-party state that is made in accordance with the other provisions 8
974	974	of this Compact. 9
975	975	(f) This Compact may be amended by the party states. No amendment to this 10
976	976	Compact shall become effective and binding upon the party states unless and until it is 11
977	977	enacted into the laws of all party states. 12
978	978	(g) Representatives of non-party states to this Compact shall be invited to 13
979	979	participate in the activities of the Commission, on a nonvoting basis, prior to the 14
980	980	adoption of this Compact by all states. 15
981	981	ARTICLE XI 16
982	982	Construction and Severability 17
983	983	This Compact shall be liberally construed so as to effectuate the purposes 18
984	984	thereof. The provisions of this Compact shall be severable, and if any phrase, clause, 19
985	985	sentence or provision of this Compact is declared to be contrary to the constitution of 20
986	986	any party state or of the United States, or if the applicability thereof to any 21
987	987	government, agency, person or circumstance is held invalid, the validity of the 22
988	988	remainder of this Compact and the applicability thereof to any government, agency, 23
989	989	person or circumstance shall not be affected thereby. If this Compact shall be held to 24
990	990	be contrary to the constitution of any party state, this Compact shall remain in full 25
991	991	force and effect as to the remaining party states and in full force and effect as to the 26
992	992	party state affected as to all severable matters. 27
993	993	* Sec. 16. AS 08.68.800(a) is amended to read: 28
994	994	(a) This chapter does not apply to 29
995	995	(1) a qualified nurse licensed in another state employed by the United 30
996	996	States government or a bureau, or agency, or division of the United States government 31 34-GS1160\A
997	997	SB 124 -30- SB0124A
998	998	New Text Underlined [DELETED TEXT BRACKETED]
999	999
1000	1000	while in the discharge of official duties; 1
1001	1001	(2) nursing service given temporarily in the event of a public 2
1002	1002	emergency, epidemic, or disaster; 3
1003	1003	(3) the practice of nursing by a student enrolled in a nursing education 4
1004	1004	program accredited by the board when the practice is in connection with the student's 5
1005	1005	course of study; 6
1006	1006	(4) the practice of nursing by an individual enrolled in an approved 7
1007	1007	program or course of study approved by the board to satisfy the requirements of 8
1008	1008	AS 08.68.251; 9
1009	1009	(5) the practice of nursing by a nurse licensed in another state, except 10
1010	1010	for a nurse holding a multistate license under AS 08.68.500, who engages in 11
1011	1011	nursing education or nursing consultation activities, if these activities and contact with 12
1012	1012	clients do not exceed 20 working days within a licensing period; or 13
1013	1013	(6) the practice of nursing by a nurse licensed in another state, except 14
1014	1014	for a nurse holding a multistate license under AS 08.68.500, whose employment 15
1015	1015	responsibilities include transporting patients into, out of, or through this state; 16
1016	1016	however, this exception is valid for a period not to exceed 48 hours for each transport. 17
1017	1017	* Sec. 17. AS 08.68.805 is amended to read: 18
1018	1018	Sec. 08.68.805. Delegation of nursing functions. A registered, advanced 19
1019	1019	practice registered, or practical nurse licensed or privileged to practice under this 20
1020	1020	chapter may delegate nursing duties to other persons, including unlicensed assistive 21
1021	1021	personnel, under regulations adopted by the board. A person to whom the nursing 22
1022	1022	duties are delegated may perform the delegated duties without a license or certificate 23
1023	1023	under this chapter if the person meets the applicable requirements established by the 24
1024	1024	board. 25
1025	1025	* Sec. 18. AS 09.55.560(2) is amended to read: 26
1026	1026	(2) "health care provider" means an acupuncturist licensed under 27
1027	1027	AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 28
1028	1028	chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a 29
1029	1029	dentist licensed under AS 08.36; a nurse licensed or privileged to practice under 30
1030	1030	AS 08.68; a dispensing optician licensed under AS 08.71; a naturopath licensed under 31 34-GS1160\A
1031	1031	SB0124A -31- SB 124
1032	1032	New Text Underlined [DELETED TEXT BRACKETED]
1033	1033
1034	1034	AS 08.45; an optometrist licensed under AS 08.72; a pharmacist licensed under 1
1035	1035	AS 08.80; a physical therapist or occupational therapist licensed under AS 08.84; a 2
1036	1036	physician or physician assistant licensed under AS 08.64; a podiatrist; a psychologist 3
1037	1037	and a psychological associate licensed under AS 08.86; a hospital as defined in 4
1038	1038	AS 47.32.900, including a governmentally owned or operated hospital; an employee 5
1039	1039	of a health care provider acting within the course and scope of employment; an 6
1040	1040	ambulatory surgical facility and other organizations whose primary purpose is the 7
1041	1041	delivery of health care, including a health maintenance organization, individual 8
1042	1042	practice association, integrated delivery system, preferred provider organization or 9
1043	1043	arrangement, and a physical hospital organization; 10
1044	1044	* Sec. 19. AS 09.65.095(c)(1) is amended to read: 11
1045	1045	(1) "health care provider" means a nurse licensed or privileged to 12
1046	1046	practice under AS 08.68, a physician licensed under AS 08.64, and a person certified 13
1047	1047	by a hospital as competent to take blood samples; 14
1048	1048	* Sec. 20. AS 18.20.095(e)(2) is amended to read: 15
1049	1049	(2) "licensed staff member" means a person who is employed by the 16
1050	1050	hospital to provide direct patient care and who is licensed, [OR] certified, or 17
1051	1051	privileged to practice in the state as a physician or physician assistant under 18
1052	1052	AS 08.64, direct-entry midwife under AS 08.65, nurse or nurse aide under AS 08.68, 19
1053	1053	or physical therapist or occupational therapist under AS 08.84; 20
1054	1054	* Sec. 21. AS 18.20.499(3) is amended to read: 21
1055	1055	(3) "nurse" means an individual licensed or privileged to practice 22
1056	1056	registered nursing or practical nursing under AS 08.68 who provides nursing services 23
1057	1057	through direct patient care or clinical services and includes a nurse manager when 24
1058	1058	delivering in-hospital patient care; 25
1059	1059	* Sec. 22. AS 18.23.070(3) is amended to read: 26
1060	1060	(3) "health care provider" means an acupuncturist licensed under 27
1061	1061	AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist licensed under 28
1062	1062	AS 08.32; a dentist licensed under AS 08.36; a nurse licensed or privileged to 29
1063	1063	practice under AS 08.68; a dispensing optician licensed under AS 08.71; an 30
1064	1064	optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 31 34-GS1160\A
1065	1065	SB 124 -32- SB0124A
1066	1066	New Text Underlined [DELETED TEXT BRACKETED]
1067	1067
1068	1068	physical therapist or occupational therapist licensed under AS 08.84; a physician 1
1069	1069	licensed under AS 08.64; a podiatrist; a psychologist and a psychological associate 2
1070	1070	licensed under AS 08.86; a hospital as defined in AS 47.32.900, including a 3
1071	1071	governmentally owned or operated hospital; and an employee of a health care provider 4
1072	1072	acting within the course and scope of employment; 5
1073	1073	* Sec. 23. AS 47.07.045(b) is amended to read: 6
1074	1074	(b) Before the department may terminate payment for services provided under 7
1075	1075	(a) of this section 8
1076	1076	(1) the recipient must have had an annual assessment to determine 9
1077	1077	whether the recipient continues to meet the standards under (a) of this section; 10
1078	1078	(2) the annual assessment must have been reviewed by an independent 11
1079	1079	qualified health care professional under contract with the department; for purposes of 12
1080	1080	this paragraph, "independent qualified health care professional" means, 13
1081	1081	(A) for a waiver based on intellectual or developmental 14
1082	1082	disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 15
1083	1083	intellectual disability professional; 16
1084	1084	(B) for other allowable waivers, a registered or advanced 17
1085	1085	practice registered nurse licensed or privileged to practice under AS 08.68 18
1086	1086	who is qualified to assess children with complex medical conditions, older 19
1087	1087	Alaskans, and adults with physical disabilities for medical assistance waivers; 20
1088	1088	and 21
1089	1089	(3) the annual assessment must find that the recipient's condition has 22
1090	1090	materially improved since the previous assessment; for purposes of this paragraph, 23
1091	1091	"materially improved" means that a recipient who has previously qualified for a 24
1092	1092	waiver for 25
1093	1093	(A) a child with complex medical conditions, no longer needs 26
1094	1094	technical assistance for a life-threatening condition, and is expected to be 27
1095	1095	placed in a skilled nursing facility for less than 30 days each year; 28
1096	1096	(B) intellectual or developmental disability, no longer needs the 29
1097	1097	level of care provided by an intermediate care facility for persons with 30
1098	1098	intellectual and developmental disabilities either because the qualifying 31 34-GS1160\A
1099	1099	SB0124A -33- SB 124
1100	1100	New Text Underlined [DELETED TEXT BRACKETED]
1101	1101
1102	1102	diagnosis has changed or the recipient is able to demonstrate the ability to 1
1103	1103	function in a home setting without the need for waiver services; or 2
1104	1104	(C) an older Alaskan or adult with a physical disability, no 3
1105	1105	longer has a functional limitation or cognitive impairment that would result in 4
1106	1106	the need for nursing home placement, and is able to demonstrate the ability to 5
1107	1107	function in a home setting without the need for waiver services. 6
1108	1108	* Sec. 24. AS 47.33.020(d) is amended to read: 7
1109	1109	(d) An assisted living home may provide intermittent nursing services to a 8
1110	1110	resident who does not require 24-hour nursing services and supervision. Intermittent 9
1111	1111	nursing services may be provided only by a nurse licensed or privileged to practice 10
1112	1112	under AS 08.68 or by a person to whom a nursing task has been delegated under (e) of 11
1113	1113	this section. 12
1114	1114	* Sec. 25. AS 47.33.020(e) is amended to read: 13
1115	1115	(e) A person who is on the staff of an assisted living home and who is not a 14
1116	1116	nurse licensed or privileged to practice under AS 08.68 may perform a nursing task 15
1117	1117	in that home if 16
1118	1118	(1) the authority to perform that nursing task is delegated to that person 17
1119	1119	by a nurse licensed or privileged to practice under AS 08.68; and 18
1120	1120	(2) that nursing task is specified in regulations adopted by the Board of 19
1121	1121	Nursing as a task that may be delegated. 20
1122	1122	* Sec. 26. AS 47.33.020(f) is amended to read: 21
1123	1123	(f) A resident who needs skilled nursing care may, with the consent of the 22
1124	1124	assisted living home, arrange for that care to be provided in the home by a nurse 23
1125	1125	licensed or privileged to practice under AS 08.68 if that arrangement does not 24
1126	1126	interfere with the services provided to other residents. 25
1127	1127	* Sec. 27. AS 47.33.020(g) is amended to read: 26
1128	1128	(g) As part of a plan to avoid transfer of a resident from the home for medical 27
1129	1129	reasons, the home may provide, through the services of a nurse who is licensed or 28
1130	1130	privileged to practice under AS 08.68, 24-hour skilled nursing care to the resident for 29
1131	1131	not more than 45 consecutive days. 30
1132	1132	* Sec. 28. AS 47.33.020(h) is amended to read: 31 34-GS1160\A
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1135	1135
1136	1136	(h) If a resident has received 24-hour skilled nursing care for the 45-day limit 1
1137	1137	set by (g) of this section, the resident or the resident's representative may elect to have 2
1138	1138	the resident remain in the home without continuation of 24-hour skilled nursing care if 3
1139	1139	the home agrees to retain the resident after 4
1140	1140	(1) the home and either the resident or the resident's representative 5
1141	1141	have consulted with the resident's physician; 6
1142	1142	(2) the home and either the resident or the resident's representative 7
1143	1143	have discussed the consequences and risks involved in the election to remain in the 8
1144	1144	home; and 9
1145	1145	(3) the portion of the resident's assisted living plan that relates to 10
1146	1146	health-related services has been revised to provide for the resident's health-related 11
1147	1147	needs without the use of 24-hour skilled nursing care, and the revised plan has been 12
1148	1148	reviewed by a registered or advanced practice registered nurse licensed or privileged 13
1149	1149	to practice under AS 08.68 or by the resident's attending physician. 14
1150	1150	* Sec. 29. AS 47.33.230(c) is amended to read: 15
1151	1151	(c) If the assisted living home provides or arranges for the provision of health-16
1152	1152	related services to a resident, the home shall ensure that a 17
1153	1153	(1) registered or advanced practice registered nurse licensed or 18
1154	1154	privileged to practice under AS 08.68 reviews the portion of an assisted living plan 19
1155	1155	that describes how the resident's need for health-related services will be met; and 20
1156	1156	(2) physician's statement about the resident is included in the plan. 21
1157	1157	* Sec. 30. The uncodified law of the State of Alaska is amended by adding a new section to 22
1158	1158	read: 23
1159	1159	TRANSITION: REGULATIONS. The Department of Commerce, Community, and 24
1160	1160	Economic Development and the Board of Nursing may proceed to adopt regulations to 25
1161	1161	implement this Act. The regulations take effect under AS 44.62 (Administrative Procedure 26
1162	1162	Act) but not before the effective date of the law implemented by the regulation. 27
1163	1163	* Sec. 31. Section 30 of this Act takes effect immediately under AS 01.10.070(c). 28
1164	1164	* Sec. 32. Except as provided in sec. 31 of this Act, this Act takes effect July 1, 2026. 29