Session of 2025
HOUSE BILL No. 2266
By Committee on Health and Human Services
Requested by Representative Beuhler on behalf of the Kansas Chamber of
Commerce
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AN ACT concerning health and healthcare; relating to advanced practice
registered nurses; enacting the advanced practice registered nurses
compact to provide interstate practice privileges.
Be it enacted by the Legislature of the State of Kansas:
Section 1. This section shall be known and may be cited as the
advanced practice registered nurse compact.
ARTICLE 1—FINDINGS AND DECLARATION OF PURPOSE
(a) The party states find that:
(1) The health and safety of the public are affected by the degree of
compliance with advanced practice registered nurse (APRN) licensure
requirements and the effectiveness of enforcement activities related to
state APRN licensure laws;
(2) violations of APRN licensure and other laws regulating the
practice of nursing may result in injury or harm to the public;
(3) the expanded mobility of APRNs and the use of advanced
communication and intervention technologies as part of our nation's
healthcare delivery system require greater coordination and cooperation
among states in the areas of APRN licensure and regulation;
(4) new practice modalities and technology make compliance with
individual state APRN licensure laws difficult and complex;
(5) the current system of duplicative APRN licensure for APRNs
practicing in multiple states is cumbersome and redundant for healthcare
delivery systems, payors, state licensing boards, regulators and APRNs;
and
(6) uniformity of APRN licensure requirements throughout the states
promotes public safety and public health benefits and provides a
mechanism to increase access to care.
(b) The general purposes of this compact are to:
(1) Facilitate the states' responsibility to protect the public's health
and safety;
(2) ensure and encourage the cooperation of party states in the areas
of APRN licensure and regulation, including promotion of uniform
licensure requirements;
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(3) facilitate the exchange of information between party states in the
areas of APRN regulation, investigation and adverse actions;
(4) promote compliance with laws governing APRN practice in each
jurisdiction;
(5) invest all party states with the authority to hold an APRN
accountable for meeting all state practice laws in the state in which the
patient is located at the time care is rendered through the mutual
recognition of party state privileges to practice;
(6) decrease redundancies in the consideration and issuance of APRN
licenses; and
(7) provide opportunities for interstate practice by APRNs who meet
uniform licensure requirements.
ARTICLE 2—DEFINITIONS
As used in this compact:
(a) "Advanced practice registered nurse" or "APRN" means a
registered nurse who has gained additional specialized knowledge, skills
and experience through a program of study recognized or defined by the
interstate commission of APRN compact administrators (commission), and
who is licensed to perform advanced nursing practice. An advanced
practice registered nurse is licensed in an APRN role that is congruent with
an APRN educational program, certification and commission rules.
(b) "Adverse action" means any administrative, civil, equitable or
criminal action permitted by a state's laws that is imposed by a licensing
board or other authority against an APRN, including actions against an
individual's license or multistate licensure privilege such as revocation,
suspension, probation, monitoring of the licensee, limitation on the
licensee's practice or any other encumbrance on licensure affecting an
APRN's authorization to practice, including the issuance of a cease and
desist action.
(c) "Alternative program" means a non-disciplinary monitoring
program approved by a licensing board.
(d) "APRN licensure" means the regulatory mechanism used by a
party state to grant legal authority to practice as an APRN.
(e) "APRN uniform licensure requirements" means the minimum
uniform licensure, education and examination requirements set forth in
article 3(b) of this compact.
(f) "Coordinated licensure information system" means an integrated
process for collecting, storing and sharing information on APRN licensure
and enforcement activities related to APRN licensure laws that is
administered by a nonprofit organization, composed of and controlled by
licensing boards.
(g) "Current significant investigatory information" means
investigative information that:
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(1) A licensing board, after a preliminary inquiry that includes
notification and an opportunity for the APRN to respond, if required by
state law, has reason to believe is not groundless and, if proved true, would
indicate more than a minor infraction; or
(2) indicates that the APRN represents an immediate threat to public
health and safety regardless of whether the APRN has been notified and
had an opportunity to respond.
(h) "Encumbrance" means a revocation or suspension of, or any
limitation on, the full and unrestricted practice of nursing imposed by a
licensing board in connection with a disciplinary proceeding.
(i) "Home state" means the party state that is the APRN's primary
state of residence.
(j) "Licensing board" means a party state's regulatory body
responsible for regulating the practice of advanced practice registered
nursing.
(k) "Multistate license" means an APRN license to practice as an
APRN issued by a home state licensing board that authorizes the APRN to
practice as an APRN in all party states under a multistate licensure
privilege, in the same role and population focus as the APRN is licensed in
the home state.
(l) "Multistate licensure privilege" means a legal authorization
associated with an APRN multistate license that permits an APRN to
practice as an APRN in a remote state, in the same role and population
focus as the APRN is licensed in the home state.
(m) "Non-controlled prescription drug" means a device or drug that is
not a controlled substance and is prohibited under state or federal law from
being dispensed without a prescription. The term includes a device or drug
that bears or is required to bear the legend "Caution: federal law prohibits
dispensing without prescription" or "prescription only" or other legend that
complies with federal law.
(n) "Party state" means any state that has adopted this compact.
(o) "Population focus" means one of the six population foci of family
and individual across the lifespan, adult-gerontology, pediatrics, neonatal,
women's health and gender-related and psychiatric-mental health.
(p) "Prescriptive authority" means the legal authority to prescribe
medications and devices as defined by party state laws.
(q) "Remote state" means a party state that is not the home state.
(r) "Role" means one of the four recognized roles of certified
registered nurse anesthetists (CRNA), certified nurse-midwives (CNM),
clinical nurse specialists (CNS) and certified nurse practitioners (CNP).
(s) "Single-state license" means an APRN license issued by a party
state that authorizes practice only within the issuing state and does not
include a multistate licensure privilege to practice in any other party state.
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(t) "State" means a state, territory or possession of the United States
and the District of Columbia.
(u) "State practice laws" means a party state's laws, rules and
regulations that govern APRN practice, define the scope of advanced
nursing practice and create the methods and grounds for imposing
discipline except that prescriptive authority shall be treated in accordance
with article 3(f) and article 3(g) of this compact. "State practice laws"
does not include:
(1) A party state's laws, rules and regulations requiring supervision or
collaboration with a healthcare professional, except for laws, rules and
regulations regarding prescribing controlled substances; or
(2) the requirements necessary to obtain and retain an APRN license,
except for qualifications or requirements of the home state.
ARTICLE 3—GENERAL PROVISIONS AND JURISDICTION
(a) A state shall implement procedures for considering the criminal
history records of applicants for initial APRN licensure or APRN licensure
by endorsement. Such procedures shall include the submission of
fingerprints or other biometric-based information by APRN applicants for
the purpose of obtaining an applicant's criminal history record information
from the federal bureau of investigation and the agency responsible for
retaining that state's criminal records.
(b) Each party state shall require an applicant to satisfy the following
APRN uniform licensure requirements to obtain or retain a multistate
license in the home state:
(1) Meets the home state's qualifications for licensure or renewal of
licensure, as well as, all other applicable state laws;
(2)(A) has completed an accredited graduate-level education program
that prepares the applicant for one of the four recognized roles and
population foci; or
(B) has completed a foreign APRN education program for one of the
four recognized roles and population foci that:
(i) has been approved by the authorized accrediting body in the
applicable country; and
(ii) has been verified by an independent credentials review agency to
be comparable to a licensing board-approved APRN education program;
(3) has, if a graduate of a foreign APRN education program not
taught in English or if English is not the individual's native language,
successfully passed an English proficiency examination that includes the
components of reading, speaking, writing and listening;
(4) has successfully passed a national certification examination that
measures APRN, role and population-focused competencies and maintains
continued competence as evidenced by recertification in the role and
population focus through the national certification program;
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(5) holds an active, unencumbered license as a registered nurse and
an active, unencumbered authorization to practice as an APRN;
(6) has successfully passed an NCLEX-RN examination or
recognized predecessor, as applicable;
(7) has practiced for at least 2,080 hours as an APRN in a role and
population focus congruent with the applicant's education and training. For
purposes of this section, practice shall not include hours obtained as part of
enrollment in an APRN education program;
(8) has submitted, in connection with an application for initial
licensure or licensure by endorsement, fingerprints or other biometric data
for the purpose of obtaining criminal history record information from the
federal bureau of investigation and the agency responsible for retaining
that state or, if applicable, foreign country's criminal records;
(9) has not been convicted or found guilty, or has entered into an
agreed disposition, of a felony offense under applicable state, federal or
foreign criminal law;
(10) has not been convicted or found guilty, or has entered into an
agreed disposition, of a misdemeanor offense related to the practice of
nursing as determined by factors set forth in rules adopted by the
commission;
(11) is not currently enrolled in an alternative program;
(12) is subject to self-disclosure requirements regarding current
participation in an alternative program; and
(13) has a valid United States social security number.
(c) An APRN issued a multistate license shall be licensed in an
approved role and at least one approved population focus.
(d) An APRN multistate license issued by a home state to a resident
in that state will be recognized by each party state as authorizing the
APRN to practice as an APRN in each party state, under a multistate
licensure privilege, in the same role and population focus as the APRN is
licensed in the home state.
(e) Nothing in this compact shall affect the requirements established
by a party state for the issuance of a single-state license, except that an
individual may apply for a single-state license, instead of a multistate
license, even if otherwise qualified for the multistate license. However, the
failure of such an individual to affirmatively opt for a single state license
may result in the issuance of a multistate license.
(f) Issuance of an APRN multistate license shall include prescriptive
authority for noncontrolled prescription drugs.
(g) For each state in which an APRN seeks authority to prescribe
controlled substances, the APRN shall satisfy all requirements imposed by
such state in granting or renewing such authority.
(h) An APRN issued a multistate license is authorized to assume
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responsibility and accountability for patient care independent of any
supervisory or collaborative relationship. This authority may be exercised
in the home state and in any remote state where the APRN exercises a
multistate licensure privilege.
(i) All party states shall be authorized, in accordance with state due
process laws, to take adverse action against an APRN's multistate licensure
privilege such as revocation, suspension, probation or any other action that
affects an APRN's authorization to practice under a multistate licensure
privilege, including cease and desist actions. If a party state takes such
action, it shall promptly notify the administrator of the coordinated
licensure information system. The administrator of the coordinated
licensure information system shall promptly notify the home state of any
such actions by remote states.
(j) Except as otherwise expressly provided in this compact, an APRN
practicing in a party state shall comply with the state practice laws of the
state where the client is located at the time service is provided. APRN
practice is not limited to patient care, but shall include all advanced
nursing practice as defined by the state practice laws of the party state
where the client is located. APRN practice in a party state under a
multistate licensure privilege will subject the APRN to the jurisdiction of
the licensing board, the courts, and the laws of the party state where the
client is located at the time service is provided.
(k) Except as otherwise expressly provided in this compact, this
compact does not affect additional requirements imposed by states for
advanced practice registered nursing. However, a multistate licensure
privilege to practice registered nursing granted by a party state shall be
recognized by other party states as satisfying any state law requirement for
registered nurse licensure as a precondition for authorization to practice as
an APRN in that state.
(l) Individuals not residing in a party state shall continue to be able to
apply for a party state's single-state APRN license as provided under the
laws of each party state. However, the single-state license granted to these
individuals will not be recognized as granting the privilege to practice as
an APRN in any other party state.
ARTICLE 4—APPLICATIONS FOR APRN LICENSURE IN A PARTY
STATE
(a) Upon application for an APRN multistate license, the licensing
board in the issuing party state shall ascertain, through the coordinated
licensure information system, whether the applicant has ever held or is the
holder of a licensed practical or vocational nursing license, a registered
nursing license or an advanced practice registered nursing license issued
by any other state, whether there are any encumbrances on any license or
multistate licensure privilege held by the applicant, whether any adverse
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action has been taken against any license or multistate licensure privilege
held by the applicant and whether the applicant is currently participating in
an alternative program.
(b) An APRN may hold a multistate APRN license, issued by the
home state, in only one party state at a time.
(c) If an APRN changes primary state of residence by moving
between two party states, the APRN shall apply for APRN licensure in the
new home state, and the multistate license issued by the prior home state
shall be deactivated in accordance with applicable commission rules.
(1) The APRN may apply for licensure in advance of a change in
primary state of residence.
(2) A multistate APRN license shall not be issued by the new home
state until the APRN provides satisfactory evidence of a change in primary
state of residence to the new home state and satisfies all applicable
requirements to obtain a multistate APRN license from the new home
state.
(d) If an APRN changes primary state of residence by moving from a
party state to a non-party state, the APRN multistate license issued by the
prior home state will convert to a single-state license, valid only in the
former home state.
ARTICLE 5—ADDITIONAL AUTHORITIES INVESTED IN PARTY
STATE LICENSING BOARDS
(a) In addition to the other powers conferred by state law, a licensing
board shall have the authority to:
(1) Take adverse action against an APRN's multistate licensure
privilege to practice within that party state.
(A) Only the home state shall have power to take adverse action
against an APRN's license issued by the home state.
(B) For purposes of taking adverse action, the home state licensing
board shall give the same priority and effect to reported conduct that
occurred outside of the home state as it would if such conduct had
occurred within the home state. In so doing, the home state shall apply its
own state laws to determine appropriate action.
(2) Issue cease and desist orders or impose an encumbrance on an
APRN's authority to practice within that party state.
(3) Complete any pending investigations of an APRN who changes
primary state of residence during the course of such investigations. The
licensing board shall also have the authority to take appropriate action and
shall promptly report the conclusions of such investigations to the
administrator of the coordinated licensure information system. The
administrator of the coordinated licensure information system shall
promptly notify the new home state of any such actions.
(4) Issue subpoenas for both hearings and investigations that require
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the attendance and testimony of witnesses, as well as, the production of
evidence. Subpoenas issued by a party state licensing board for the
attendance and testimony of witnesses or the production of evidence from
another party state shall be enforced in the latter state by any court of
competent jurisdiction, according to that court's practice and procedure in
considering subpoenas issued in its own proceedings. The issuing licensing
board shall pay any witness fees, travel expenses, mileage and other fees
required by the service statutes of the state where the witnesses or
evidence are located.
(5) Obtain and submit, for an APRN licensure applicant, fingerprints
or other biometric-based information to the federal bureau of investigation
for criminal background checks, receive the results of the federal bureau of
investigation record search on criminal background checks and use the
results in making licensure decisions.
(6) If otherwise permitted by state law, recover from the affected
APRN the costs of investigations and disposition of cases resulting from
any adverse action taken against that APRN.
(7) Take adverse action based on the factual findings of another party
state, provided that the licensing board follows its own procedures for
taking such adverse action.
(b) If adverse action is taken by a home state against an APRN's
multistate licensure, the privilege to practice in all other party states under
a multistate licensure privilege shall be deactivated until all encumbrances
have been removed from the APRN's multistate license. All home state
disciplinary orders that impose adverse action against an APRN's
multistate license shall include a statement that the APRN's multistate
licensure privilege is deactivated in all party states during the pendency of
the order.
(c) Nothing in this compact shall override a party state's decision that
participation in an alternative program may be used in lieu of adverse
action. The home state licensing board shall deactivate the multistate
licensure privilege under the multistate license of any APRN for the
duration of the APRN's participation in an alternative program.
ARTICLE 6—COORDIANTED LICENSURE INFORMATION
SYSTEM AND EXCHANGE OF INFORMATION
(a) All party states shall participate in a coordinated licensure
information system of all APRNs, licensed registered nurses, licensed
practical nurses and vocational nurses. This system shall include
information on the licensure and disciplinary history of each APRN, as
submitted by party states, to assist in the coordinated administration of
APRN licensure and enforcement efforts.
(b) The commission, in consultation with the administrator of the
coordinated licensure information system, shall formulate necessary and
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proper procedures for the identification, collection and exchange of
information under this compact.
(c) All licensing boards shall promptly report to the coordinated
licensure information system any adverse action, any current significant
investigative information, denials of applications, with the reasons for such
denials, and APRN participation in alternative programs known to the
licensing board regardless of whether such participation is deemed
nonpublic or confidential under state law.
(d) Notwithstanding any other provision of law, all party state
licensing boards contributing information to the coordinated licensure
information system shall designate information that shall not be shared
with non-party states or disclosed to other entities or individuals without
the express permission of the contributing state.
(e) Any personally identifiable information obtained from the
coordinated licensure information system by a party state licensing board
shall not be shared with non-party states or disclosed to other entities or
individuals except to the extent permitted by the laws of the party state
contributing the information.
(f) Any information contributed to the coordinated licensure
information system that is subsequently required to be expunged by the
laws of the party state contributing the information shall be removed from
the coordinated licensure information system.
(g) The compact administrator of each party state shall furnish a
uniform data set to the compact administrator of each other party state,
which shall include, at a minimum:
(1) Identifying information;
(2) licensure data;
(3) information related to alternative program participation
information; and
(4) other information that may facilitate the administration of this
compact, as determined by commission rules.
(h) The compact administrator of a party state shall provide all
investigative documents and information requested by another party state.
ARTICLE 7—ESTABLISHMENT OF THE INTERSTATE
COMMISSION OF APRN COMPACT ADMINISTRATORS
(a) The party states hereby create and establish a joint public agency
known as the interstate commission of APRN compact administrators.
(1) The commission is an instrumentality of the party states.
(2) Venue is proper and judicial proceedings by or against the
commission shall be brought solely and exclusively in a court of
competent jurisdiction where the principal office of the commission is
located. The commission may waive venue and jurisdictional defenses to
the extent it adopts or consents to participate in alternative dispute
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resolution proceedings.
(3) Nothing in this compact shall be construed to be a waiver of
sovereign immunity.
(b) Membership, voting and meetings.
(1) Each party state shall have and be limited to one administrator.
The head of the state licensing board or designee shall be the administrator
of this compact for each party state. Any administrator may be removed or
suspended from office as provided by the law of the state from which the
administrator is appointed. Any vacancy occurring in the commission shall
be filled in accordance with the laws of the party state where the vacancy
exists.
(2) Each administrator shall be entitled to one vote with regard to the
promulgation of rules and creation of bylaws and shall otherwise have an
opportunity to participate in the business and affairs of the commission. An
administrator shall vote in person or by such other means as provided in
the bylaws. The bylaws may provide for an administrator's participation in
meetings by telephone or other means of communication.
(3) The commission shall meet at least once during each calendar
year. Additional meetings shall be held as set forth in the bylaws or rules
of the commission.
(4) All meetings shall be open to the public, and public notice of
meetings shall be given in the same manner as required under the
rulemaking provisions in article 8.
(5) The commission may convene in a closed, non-public meeting if
the commission shall discuss:
(A) Noncompliance of a party state with its obligations under this
compact;
(B) the employment, compensation, discipline or other personnel
matters, practices or procedures related to specific employees or other
matters related to the commission's internal personnel practices and
procedures;
(C) current, threatened or reasonably anticipated litigation;
(D) negotiation of contracts for the purchase or sale of goods,
services or real estate;
(E) accusing any person of a crime or formally censuring any person;
(F) disclosure of trade secrets or commercial or financial information
that is privileged or confidential;
(G) disclosure of information of a personal nature where disclosure
would constitute a clearly unwarranted invasion of personal privacy;
(H) disclosure of investigatory records compiled for law enforcement
purposes;
(I) disclosure of information related to any reports prepared by or on
behalf of the commission for the purpose of investigation of compliance
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with this compact; or
(J) matters specifically exempted from disclosure by federal or state
statute.
(6) If a meeting, or portion of a meeting, is closed pursuant to this
provision, the commission's legal counsel or designee shall certify that the
meeting may be closed and shall reference each relevant exempting
provision. The commission shall keep minutes that fully and clearly
describe all matters discussed in a meeting and shall provide a full and
accurate summary of actions taken, and the reasons therefor, including a
description of the views expressed. All documents considered in
connection with an action shall be identified in such minutes. All minutes
and documents of a closed meeting shall remain under seal, subject to
release by a majority vote of the commission or order of a court of
competent jurisdiction.
(c) The commission shall, by a majority vote of the administrators,
prescribe bylaws or rules to govern its conduct as may be necessary or
appropriate to carry out the purposes and exercise the powers of this
compact, including but not limited to:
(1) Establishing the fiscal year of the commission;
(2) providing reasonable standards and procedures:
(A) For the establishment and meetings of other committees; and
(B) governing any general or specific delegation of any authority or
function of the commission;
(3) providing reasonable procedures for calling and conducting
meetings of the commission, ensuring reasonable advance notice of all
meetings and providing an opportunity for attendance of such meetings by
interested parties, with enumerated exceptions designed to protect the
public's interest, the privacy of individuals, and proprietary information,
including trade secrets. The commission may meet in closed session only
after a majority of the administrators vote to close a meeting in whole or in
part. As soon as practicable, the commission shall make public a copy of
the vote to close the meeting revealing the vote of each administrator, with
no proxy votes allowed;
(4) establishing the titles, duties and authority and reasonable
procedures for the election of the officers of the commission;
(5) providing reasonable standards and procedures for the
establishment of the personnel policies and programs of the commission.
Notwithstanding any civil service or other similar laws of any party state,
the bylaws shall exclusively govern the personnel policies and programs of
the commission; and
(6) providing a mechanism for winding up the operations of the
commission and the equitable disposition of any surplus funds that may
exist after the termination of this compact after the payment or reserving
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of all of its debts and obligations.
(d) The commission shall publish its bylaws and rules, and any
amendments thereto, in a convenient form on the website of the
commission.
(e) The commission shall maintain its financial records in accordance
with the bylaws.
(f) The commission shall meet and take such actions as are consistent
with the provisions of this compact and the bylaws.
(g) The commission shall have the following powers to:
(1) Promulgate uniform rules to facilitate and coordinate
implementation and administration of this compact. The rules shall have
the force and effect of law and shall be binding in all party states;
(2) bring and prosecute legal proceedings or actions in the name of
the commission, provided that the standing of any licensing board to sue or
be sued under applicable law shall not be affected;
(3) purchase and maintain insurance and bonds;
(4) borrow, accept or contract for services of personnel, including, but
not limited to, employees of a party state or nonprofit organizations;
(5) cooperate with other organizations that administer state compacts
related to the regulation of nursing, including, but not limited to, sharing
administrative or staff expenses, office space or other resources;
(6) hire employees, elect or appoint officers, fix compensation, define
duties, grant such individuals appropriate authority to carry out the
purposes of this compact and to establish the commission's personnel
policies and programs relating to conflicts of interest, qualifications of
personnel and other related personnel matters;
(7) accept any and all appropriate donations, grants and gifts of
money, equipment, supplies, materials and services, and to receive, utilize
and dispose of the same. At all times the commission shall strive to avoid
any appearance of impropriety or conflict of interest;
(8) lease, purchase, accept appropriate gifts or donations of, or
otherwise to own, hold, improve or use, any property, whether real,
personal or mixed. At all times the commission shall strive to avoid any
appearance of impropriety;
(9) sell, convey, mortgage, pledge, lease, exchange, abandon or
otherwise dispose of any property, whether real, personal or mixed;
(10) establish a budget and make expenditures;
(11) borrow money;
(12) appoint committees, including advisory committees comprised
of administrators, state nursing regulators, state legislators or their
representatives, and consumer representatives, and other such interested
persons;
(13) issue advisory opinions;
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(14) provide and receive information from, and to cooperate with, law
enforcement agencies;
(15) adopt and use an official seal; and
(16) perform such other functions as may be necessary or appropriate
to achieve the purposes of this compact consistent with the state regulation
of APRN licensure and practice.
(h) Financing of the commission.
(1) The commission shall pay, or provide for the payment of, the
reasonable expenses of its establishment, organization and ongoing
activities.
(2) The commission may also levy on and collect an annual
assessment from each party state to cover the cost of its operations,
activities and staff in its annual budget as approved each year. The
aggregate annual assessment amount, if any, shall be allocated based upon
a formula to be determined by the commission, which shall promulgate a
rule that is binding upon all party states.
(3) The commission shall not incur obligations of any kind prior to
securing the funds adequate to meet the same; nor shall the commission
pledge the credit of any of the party states, except by, and with the
authority of, such party state.
(4) The commission shall keep accurate accounts of all receipts and
disbursements. The receipts and disbursements of the commission shall be
subject to the audit and accounting procedures established under its
bylaws. However, all receipts and disbursements of funds handled by the
commission shall by audited yearly by a certified or licensed public
accountant, and the report of the audit shall be included in and become
part of the annual report of the commission.
(i) Qualified immunity, defense and indemnification.
(1) The administrators, officers, executive director, employees and
representatives of the commission shall be immune from suit and liability,
either personally or in their official capacity, for any claim for damage to
or loss of property or personal injury or other civil liability caused by or
arising out of any actual or alleged act, error or omission that occurred, or
that the person against whom the claim is made had a reasonable basis for
believing occurred, within the scope of commission employment, duties or
responsibilities. Nothing in this paragraph shall be construed to protect any
such person from suit or liability for any damage, loss, injury or liability
caused by the intentional, willful or wanton misconduct of that person.
(2) The commission shall defend any administrator, officer, executive
director, employee or representative of the commission in any civil action
seeking to impose liability arising out of any actual or alleged act, error or
omission that occurred within the scope of commission employment,
duties or responsibilities, or that the person against whom the claim is
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made had a reasonable basis for believing occurred within the scope of
commission employment, duties or responsibilities. Nothing in this
paragraph shall be construed to prohibit that person from retaining their
own counsel, provided that the actual or alleged act, error or omission did
not result from that person's intentional, willful or wanton misconduct.
(3) The commission shall indemnify and hold harmless any
administrator, officer, executive director, employee or representative of the
commission for the amount of any settlement or judgment obtained against
that person arising out of any actual or alleged act, error or omission that
occurred within the scope of commission employment, duties or
responsibilities, or that such person had a reasonable basis for believing
occurred within the scope of commission employment, duties or
responsibilities, provided that the actual or alleged act, error or omission
did not result from the intentional, willful or wanton misconduct of that
person.
ARTICLE 8—RULEMAKING
(a) The commission shall exercise its rulemaking powers pursuant to
the criteria set forth in this article and the rules adopted thereunder. Rules
and amendments shall become binding as of the date specified in each rule
or amendment and shall have the same force and effect as provisions of
this compact.
(b) Rules or amendments to the rules shall be adopted at a regular or
special meeting of the commission.
(c) Prior to promulgation and adoption of a final rule or rules by the
commission, and at least 60 days in advance of the meeting at which the
rule will be considered and voted upon, the commission shall file a notice
of proposed rulemaking on the website of:
(1) The commission; and
(2) each licensing board or the publication where each state would
otherwise publish proposed rules.
(d) The notice of proposed rulemaking shall include:
(1) The proposed time, date and location of the meeting where the
rule will be considered and voted upon;
(2) the text of the proposed rule or amendment and the reason for the
proposed rule;
(3) a request for comments on the proposed rule from any interested
person; and
(4) the manner in which interested persons may submit notice to the
commission of their intention to attend the public hearing and any written
comments.
(e) Prior to adoption of a proposed rule, the commission shall allow
persons to submit written data, facts, opinions and arguments, which shall
be made available to the public.
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(f) The commission shall grant an opportunity for a public hearing
before it adopts a rule or amendment.
(g) The commission shall publish the place, time, and date of the
scheduled public hearing.
(1) Hearings shall be conducted in a manner providing each person
who wishes to comment a fair and reasonable opportunity to comment
orally or in writing. All hearings shalll be recorded and a copy will be
made available upon request.
(2) Nothing in this section shall be construed as requiring a separate
hearing on each rule. Rules may be grouped for the convenience of the
commission at hearings required by this section.
(h) If no one appears at the public hearing, the commission may
proceed with promulgation of the proposed rule.
(i) Following the scheduled hearing date, or by the close of business
on the scheduled hearing date if the hearing was not held, the commission
shall consider all written and oral comments received.
(j) The commission shall, by majority vote of all administrators, take
final action on the proposed rule and shall determine the effective date of
the rule, if any, based on the rulemaking record and the full text of the rule.
(k) Upon determination that an emergency exists, the commission
may consider and adopt an emergency rule without prior notice,
opportunity for comment or hearing, provided that the usual rulemaking
procedures provided in this compact and in this section shall be
retroactively applied to the rule as soon as reasonably possible, in no event
later than 90 days after the effective date of the rule. For the purposes of
this provision, an emergency rule is one that shall be adopted immediately
in order to:
(1) Meet an imminent threat to public health, safety or welfare;
(2) prevent a loss of commission or party state funds; or
(3) meet a deadline for the promulgation of an administrative rule that
is established by federal law or rule.
(l) The commission may direct revisions to a previously adopted rule
or amendment for purposes of correcting typographical errors, errors in
format, errors in consistency or grammatical errors. Public notice of any
revisions shall be posted on the website of the commission. The revision
shall be subject to challenge by any person for a period of 30 days after
posting. The revision may be challenged only on grounds that the revision
results in a material change to a rule. A challenge shall be made in writing,
and delivered to the commission, prior to the end of the notice period. If
no challenge is made, the revision shalll take effect without further action.
If the revision is challenged, the revision may not take effect without the
approval of the commission.
ARTICLE 9—OVERSIGHT, DISPUTE RESOLUTION AND
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ENFORCEMENT
(a) Oversight.
(1) Each party state shall enforce this compact and take all actions
necessary and appropriate to effectuate this compact's purposes and intent.
(2) The commission shall be entitled to receive service of process in
any proceeding that may affect the powers, responsibilities or actions of
the commission, and shall have standing to intervene in such a proceeding
for all purposes. Failure to provide service of process to the commission
shall render a judgment or order void as to the commission, this compact
or promulgated rules.
(b) Default, technical assistance and termination.
(1) If the commission determines that a party state has defaulted in
the performance of its obligations or responsibilities under this compact or
the promulgated rules, the commission shall:
(A) Provide written notice to the defaulting state and other party
states of the nature of the default, the proposed means of curing the default
or any other action to be taken by the commission; and
(B) provide remedial training and specific technical assistance
regarding the default.
(2) If a state in default fails to cure the default, the defaulting state's
membership in this compact may be terminated upon an affirmative vote
of a majority of the administrators, and all rights, privileges and benefits
conferred by this compact may be terminated on the effective date of
termination. A cure of the default does not relieve the offending state of
obligations or liabilities incurred during the period of default.
(3) Termination of membership in this compact shall be imposed only
after all other means of securing compliance have been exhausted. Notice
of intent to suspend or terminate shall be given by the commission to the
governor of the defaulting state and to the executive officer of the
defaulting state's licensing board, the defaulting state's licensing board,
and each of the party states.
(4) A state whose membership in this compact has been terminated is
responsible for all assessments, obligations and liabilities incurred through
the effective date of termination, including obligations that extend beyond
the effective date of termination.
(5) The commission shall not bear any costs related to a state that is
found to be in default or whose membership in this compact has been
terminated, unless agreed upon in writing between the commission and the
defaulting state.
(6) The defaulting state may appeal the action of the commission by
petitioning the United States district court for the District of Columbia or
the federal district where the commission has its principal offices. The
prevailing party shall be awarded all costs of such litigation, including
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reasonable attorney fees.
(c) Dispute resolution.
(1) Upon request by a party state, the commission shall attempt to
resolve disputes related to the compact that arise among party states and
between party and non-party states.
(2) The commission shall promulgate a rule providing for both
mediation and binding dispute resolution for disputes, as appropriate.
(3) In the event the commission cannot resolve disputes among party
states arising under this compact:
(A) The party states may submit the issues in dispute to an arbitration
panel, which shall be comprised of individuals appointed by the compact
administrator in each of the affected party states and an individual
mutually agreed upon by the compact administrators of all the party states
involved in the dispute.
(B) The decision of a majority of the arbitrators shall be final and
binding.
(d) Enforcement.
(1) The commission, in the reasonable exercise of its discretion, shall
enforce the provisions and rules of this compact.
(2) By majority vote, the commission may initiate legal action in the
United States district court for the District of Columbia or the federal
district where the commission has its principal offices against a party state
that is in default to enforce compliance with the provisions of this compact
and its promulgated rules and bylaws. The relief sought may include both
injunctive relief and damages. In the event judicial enforcement is
necessary, the prevailing party shall be awarded all costs of such litigation,
including reasonable attorney fees.
(3) The remedies herein shall not be the exclusive remedies of the
commission. The commission may pursue any other remedies available
under federal or state law.
ARTICLE 10—EFFECTIVE DATE, WITHDRAWAL AND
AMENDMENT
(a) This compact shall come into limited effect at such time as this
compact has been enacted into law in seven party states for the sole
purpose of establishing and convening the commission to adopt rules
relating to its operation.
(b) Any state that joins this compact subsequent to the commission's
initial adoption of the APRN uniform licensure requirements shall be
subject to all rules that have been previously adopted by the commission.
(c) Any party state may withdraw from this compact by enacting a
statute repealing the same. A party state's withdrawal shall not take effect
until six months after enactment of the repealing statute.
(d) A party state's withdrawal or termination shall not affect the
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continuing requirement of the withdrawing or terminated state's licensing
board to report adverse actions and significant investigations occurring
prior to the effective date of such withdrawal or termination.
(e) Nothing contained in this compact shall be construed to invalidate
or prevent any APRN licensure agreement or other cooperative
arrangement between a party state and a non-party state that does not
conflict with the provisions of this compact.
(f) This compact may be amended by the party states. No amendment
to this compact shall become effective and binding upon any party state
until it is enacted into the laws of all party states.
(g) Representatives of non-party states to this compact shall be
invited to participate in the activities of the commission, on a nonvoting
basis, prior to the adoption of this compact by all states.
ARTICLE 11—CONSTRUCTION AND SEVERABILITY
This compact shall be liberally construed so as to effectuate the
purposes thereof. The provisions of this compact shall be severable, and if
any phrase, clause, sentence or provision of this compact is declared to be
contrary to the constitution of any party state or of the United States, or if
the applicability thereof to any government, agency, person or
circumstance is held invalid, the validity of the remainder of this compact
and the applicability thereof to any government, agency, person or
circumstance shall not be affected thereby. If this compact shall be held to
be contrary to the constitution of any party state, this compact shall remain
in full force and effect as to the remaining party states and in full force and
effect as to the party state affected as to all severable matters.
Sec. 2. This act shall take effect and be in force from and after its
publication in the statute book.
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