SLS 18RS-318 ORIGINAL 2018 Regular Session SENATE BILL NO. 202 BY SENATOR PEACOCK NURSES. Provides relative to the Nurse Licensure Compact. (gov sig) 1 AN ACT 2 To enact Part V of Chapter 11 of Title 37 of the Louisiana Revised Statutes of 1950, to be 3 comprised of R.S. 37:1018 through 1020, relative to the Nurse Licensure Compact; 4 to provide for enactment of the model language required to participate in the 5 compact; to provide for appointment of an administrator; to provide for enforcement 6 and rulemaking authority; to provide for an effective date; and to provide for related 7 matters. 8 Be it enacted by the Legislature of Louisiana: 9 Section 1. Part V of Chapter 11 of Title 37 of the Louisiana Revised Statutes of 10 1950, comprised of R.S. 37:1018 through 1020, is hereby enacted to read as follows: 11 PART V. NURSE LICENSURE COMP ACT 12 §1018. Nurse Licensure Compact; adoption 13 The Nurse Licensure Compact is hereby recognized and enacted into law 14 and entered into by this state with all states legally joining therein in the form 15 substantially as follows: 16 NURSE LICENSURE COMP ACT 17 ARTICLE I. Findings and Declaration of Purpose Page 1 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 (a) The party states find that: 2 (1) The health and safety of the public are affected by the degree of 3 compliance with and the effectiveness of enforcement activities related to state 4 nurse licensure laws. 5 (2) Violations of nurse licensure and other laws regulating the practice 6 of nursing may result in injury or harm to the public. 7 (3) The expanded mobility of nurses and the use of advanced 8 communication technologies as part of our nation's health care delivery system 9 require greater coordination and cooperation among states in the areas of nurse 10 licensure and regulation. 11 (4) New practice modalities and technology make compliance with 12 individual state nurse licensure laws difficult and complex. 13 (5) The current system of duplicative licensure for nurses practicing in 14 multiple states is cumbersome and redundant for both nurses and states. 15 (6) Uniformity of nurse licensure requirements throughout the states 16 promotes public safety and public health benefits. 17 (b) The general purposes of this compact are to: 18 (1) Facilitate the states' responsibility to protect the public's health and 19 safety. 20 (2) Ensure and encourage the cooperation of party states in the areas of 21 nurse licensure and regulation. 22 (3) Facilitate the exchange of information between party states in the 23 areas of nurse regulation, investigation, and adverse actions. 24 (4) Promote compliance with the laws governing the practice of nursing 25 in each jurisdiction. 26 (5) Invest all party states with the authority to hold a nurse accountable 27 for meeting all state practice laws in the state in which the patient is located at 28 the time care is rendered through the mutual recognition of party state licenses. 29 (6) Decrease redundancies in the consideration and issuance of nurse Page 2 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 licenses. 2 (7) Provide opportunities for interstate practice by nurses who meet 3 uniform licensure requirements. 4 ARTICLE II. Definitions 5 As used in this compact: 6 (a) "Adverse action" means any administrative, civil, equitable, or 7 criminal action permitted by a state's laws which is imposed by a licensing 8 board or other authority against a nurse, including actions against an 9 individual's license or multistate licensure privilege such as revocation, 10 suspension, probation, monitoring of the licensee, limitation on the licensee's 11 practice, or any other encumbrance on licensure affecting a nurse's 12 authorization to practice, including issuance of a cease and desist action. 13 (b) "Alternative program" means a nondisciplinary monitoring program 14 approved by a licensing board. 15 (c) "Coordinated licensure information system" means an integrated 16 process for collecting, storing, and sharing information on nurse licensure and 17 enforcement activities related to nurse licensure laws that is administered by a 18 nonprofit organization composed of and controlled by licensing boards. 19 (d) "Current significant investigative information" means: 20 (1) Investigative information that a licensing board, after a preliminary 21 inquiry that includes notification and an opportunity for the nurse to respond, 22 if required by state law, has reason to believe is not groundless and, if proved 23 true, would indicate more than a minor infraction; or 24 (2) Investigative information that indicates that the nurse represents an 25 immediate threat to public health and safety regardless of whether the nurse 26 has been notified and had an opportunity to respond. 27 (e) "Encumbrance" means a revocation or suspension of, or any 28 limitation on, the full and unrestricted practice of nursing imposed by a 29 licensing board. Page 3 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 (f) "Home state" means the party state which is the nurse's primary state 2 of residence. 3 (g) "Licensing board" means a party state's regulatory body responsible 4 for issuing nurse licenses. 5 (h) "Multistate license" means a license to practice as a registered or a 6 licensed practical/vocational nurse (LPN/VN) issued by a home state licensing 7 board that authorizes the licensed nurse to practice in all party states under a 8 multistate licensure privilege. 9 (i) "Multistate licensure privilege" means a legal authorization 10 associated with a multistate license permitting the practice of nursing as either 11 a registered nurse (RN) or LPN/VN in a remote state. 12 (j) "Nurse" means RN or LPN/VN, as those terms are defined by each 13 party state's practice laws. 14 (k) "Party state" means any state that has adopted this compact. 15 (l) "Remote state" means a party state other than the home state. 16 (m) "Single-state license" means a nurse license issued by a party state 17 that authorizes practice only within the issuing state and does not include a 18 multistate licensure privilege to practice in any other party state. 19 (n) "State" means a state, territory, or possession of the United States 20 and the District of Columbia. 21 (o) "State practice laws" means a party state's laws, rules, and 22 regulations that govern the practice of nursing, define the scope of nursing 23 practice, and create the methods and grounds for imposing discipline. "State 24 practice laws" do not include requirements necessary to obtain and retain a 25 license, except for qualifications or requirements of the home state. 26 ARTICLE III. General Provisions and Jurisdiction 27 (a) A multistate license to practice registered or licensed 28 practical/vocational nursing issued by a home state to a resident in that state 29 will be recognized by each party state as authorizing a nurse to practice as a Page 4 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 registered nurse (RN) or as a licensed practical/vocational nurse (LPN/VN), 2 under a multistate licensure privilege, in each party state. 3 (b) A state must implement procedures for considering the criminal 4 history records of applicants for initial multistate license or licensure by 5 endorsement. Such procedures shall include the submission of fingerprints or 6 other biometric-based information by applicants for the purpose of obtaining 7 an applicant's criminal history record information from the Federal Bureau of 8 Investigation and the agency responsible for retaining that state's criminal 9 records. 10 (c) Each party state shall require the following for an applicant to obtain 11 or retain a multistate license in the home state: 12 (1) Meets the home state's qualifications for licensure or renewal of 13 licensure, as well as, all other applicable state laws. 14 (2)(i) Has graduated or is eligible to graduate from a licensing 15 board-approved RN or LPN/VN prelicensure education program; or 16 (ii) Has graduated from a foreign RN or LPN/VN prelicensure education 17 program that (a) has been approved by the authorized accrediting body in the 18 applicable country and (b) has been verified by an independent credentials 19 review agency to be comparable to a licensing board-approved prelicensure 20 education program. 21 (3) Has, if a graduate of a foreign prelicensure education program not 22 taught in English or if English is not the individual's native language, 23 successfully passed an English proficiency examination that includes the 24 components of reading, speaking, writing, and listening. 25 (4) Has successfully passed an NCLEX-RN® or NCLEX-PN® 26 examination or recognized predecessor, as applicable. 27 (5) Is eligible for or holds an active, unencumbered license. 28 (6) Has submitted, in connection with an application for initial licensure 29 or licensure by endorsement, fingerprints or other biometric data for the Page 5 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 purpose of obtaining criminal history record information from the Federal 2 Bureau of Investigation and the agency responsible for retaining that state's 3 criminal records. 4 (7) Has not been convicted or found guilty, or has entered into an agreed 5 disposition, of a felony offense under applicable state or federal criminal law. 6 (8) Has not been convicted or found guilty, or has entered into an agreed 7 disposition, of a misdemeanor offense related to the practice of nursing as 8 determined on a case-by-case basis. 9 (9) Is not currently enrolled in an alternative program. 10 (10) Is subject to self-disclosure requirements regarding current 11 participation in an alternative program. 12 (11) Has a valid United States Social Security number. 13 (d) All party states shall be authorized, in accordance with existing state 14 due process law, to take adverse action against a nurse's multistate licensure 15 privilege such as revocation, suspension, probation, or any other action that 16 affects a nurse's authorization to practice under a multistate licensure privilege, 17 including cease and desist actions. If a party state takes such action, it shall 18 promptly notify the administrator of the coordinated licensure information 19 system. The administrator of the coordinated licensure information system shall 20 promptly notify the home state of any such actions by remote states. 21 (e) A nurse practicing in a party state must comply with the state 22 practice laws of the state in which the client is located at the time service is 23 provided. The practice of nursing is not limited to patient care, but shall include 24 all nursing practice as defined by the state practice laws of the party state in 25 which the client is located. The practice of nursing in a party state under a 26 multistate licensure privilege will subject a nurse to the jurisdiction of the 27 licensing board, the courts, and the laws of the party state in which the client is 28 located at the time service is provided. 29 (f) Individuals not residing in a party state shall continue to be able to Page 6 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 apply for a party state's single-state license as provided under the laws of each 2 party state. However, the single-state license granted to these individuals will 3 not be recognized as granting the privilege to practice nursing in any other 4 party state. Nothing in this compact shall affect the requirements established by 5 a party state for the issuance of a single-state license. 6 (g) Any nurse holding a home state multistate license, on the effective 7 date of this compact, may retain and renew the multistate license issued by the 8 nurse's then-current home state, provided that: 9 (1) A nurse, who changes primary state of residence after this compact's 10 effective date, must meet all applicable Article III.c. requirements to obtain a 11 multistate license from a new home state. 12 (2) A nurse who fails to satisfy the multistate licensure requirements in 13 Article III.c. due to a disqualifying event occurring after this compact's effective 14 date shall be ineligible to retain or renew a multistate license, and the nurse's 15 multistate license shall be revoked or deactivated in accordance with applicable 16 rules adopted by the Interstate Commission of Nurse Licensure Compact 17 Administrators ("commission"). 18 ARTICLE IV. Applications for Licensure in a Party State 19 (a) Upon application for a multistate license, the licensing board in the 20 issuing party state shall ascertain, through the coordinated licensure 21 information system, whether the applicant has ever held, or is the holder of, a 22 license issued by any other state, whether there are any encumbrances on any 23 license or multistate licensure privilege held by the applicant, whether any 24 adverse action has been taken against any license or multistate licensure 25 privilege held by the applicant and whether the applicant is currently 26 participating in an alternative program. 27 (b) A nurse may hold a multistate license, issued by the home state, in 28 only one party state at a time. 29 (c) If a nurse changes primary state of residence by moving between two Page 7 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 party states, the nurse must apply for licensure in the new home state, and the 2 multistate license issued by the prior home state will be deactivated in 3 accordance with applicable rules adopted by the commission. 4 (1) The nurse may apply for licensure in advance of a change in primary 5 state of residence. 6 (2) A multistate license shall not be issued by the new home state until 7 the nurse provides satisfactory evidence of a change in primary state of 8 residence to the new home state and satisfies all applicable requirements to 9 obtain a multistate license from the new home state. 10 (d) If a nurse changes primary state of residence by moving from a party 11 state to a nonparty state, the multistate license issued by the prior home state 12 will convert to a single-state license, valid only in the former home state. 13 ARTICLE V. Additional Authorities Invested in Party State Licensing Boards 14 (a) In addition to the other powers conferred by state law, a licensing 15 board shall have the authority to: 16 (1) Take adverse action against a nurse's multistate licensure privilege 17 to practice within that party state. 18 (i) Only the home state shall have the power to take adverse action 19 against a nurse's license issued by the home state. 20 (ii) For purposes of taking adverse action, the home state licensing board 21 shall give the same priority and effect to reported conduct received from a 22 remote state as it would if such conduct had occurred within the home state. In 23 so doing, the home state shall apply its own state laws to determine appropriate 24 action. 25 (2) Issue cease and desist orders or impose an encumbrance on a nurse's 26 authority to practice within that party state. 27 (3) Complete any pending investigations of a nurse who changes primary 28 state of residence during the course of such investigations. The licensing board 29 shall also have the authority to take appropriate action(s) and shall promptly Page 8 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 report the conclusions of such investigations to the administrator of the 2 coordinated licensure information system. The administrator of the coordinated 3 licensure information system shall promptly notify the new home state of any 4 such actions. 5 (4) Issue subpoenas for both hearings and investigations that require the 6 attendance and testimony of witnesses, as well as, the production of evidence. 7 Subpoenas issued by a licensing board in a party state for the attendance and 8 testimony of witnesses or the production of evidence from another party state 9 shall be enforced in the latter state by any court of competent jurisdiction, 10 according to the practice and procedure of that court applicable to subpoenas 11 issued in proceedings pending before it. The issuing authority shall pay any 12 witness fees, travel expenses, mileage, and other fees required by the service 13 statutes of the state in which the witnesses or evidence are located. 14 (5) Obtain and submit, for each nurse licensure applicant, fingerprint, 15 or other biometric-based information to the Federal Bureau of Investigation for 16 criminal background checks, receive the results of the Federal Bureau of 17 Investigation record search on criminal background checks and use the results 18 in making licensure decisions. 19 (6) If otherwise permitted by state law, recover from the affected nurse 20 the costs of investigations and disposition of cases resulting from any adverse 21 action taken against that nurse. 22 (7) Take adverse action based on the factual findings of the remote state, 23 provided that the licensing board follows its own procedures for taking such 24 adverse action. 25 (b) If adverse action is taken by the home state against a nurse's 26 multistate license, the nurse's multistate licensure privilege to practice in all 27 other party states shall be deactivated until all encumbrances have been 28 removed from the multistate license. All home state disciplinary orders that 29 impose adverse action against a nurse's multistate license shall include a Page 9 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 statement that the nurse's multistate licensure privilege is deactivated in all 2 party states during the pendency of the order. 3 (c) Nothing in this compact shall override a party state's decision that 4 participation in an alternative program may be used in lieu of adverse action. 5 The home state licensing board shall deactivate the multistate licensure 6 privilege under the multistate license of any nurse for the duration of the 7 nurse's participation in an alternative program. 8 ARTICLE VI. Coordinated Licensure Information System and 9 Exchange of Information 10 (a) All party states shall participate in a coordinated licensure 11 information system of all licensed registered nurses (RNs) and licensed 12 practical/vocational nurses (LPNs/VNs). This system will include information 13 on the licensure and disciplinary history of each nurse, as submitted by party 14 states, to assist in the coordination of nurse licensure and enforcement efforts. 15 (b) The commission, in consultation with the administrator of the 16 coordinated licensure information system, shall formulate necessary and proper 17 procedures for the identification, collection, and exchange of information under 18 this compact. 19 (c) All licensing boards shall promptly report to the coordinated 20 licensure information system any adverse action, any current significant 21 investigative information, denials of applications (with the reasons for such 22 denials), and nurse participation in alternative programs known to the licensing 23 board regardless of whether such participation is deemed nonpublic or 24 confidential under state law. 25 (d) Current significant investigative information and participation in 26 nonpublic or confidential alternative programs shall be transmitted through the 27 coordinated licensure information system only to party state licensing boards. 28 (e) Notwithstanding any other provision of law, all party state licensing 29 boards contributing information to the coordinated licensure information Page 10 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 system may designate information that may not be shared with nonparty states 2 or disclosed to other entities or individuals without the express permission of the 3 contributing state. 4 (f) Any personally identifiable information obtained from the 5 coordinated licensure information system by a party state licensing board shall 6 not be shared with nonparty states or disclosed to other entities or individuals 7 except to the extent permitted by the laws of the party state contributing the 8 information. 9 (g) Any information contributed to the coordinated licensure 10 information system that is subsequently required to be expunged by the laws of 11 the party state contributing that information shall also be expunged from the 12 coordinated licensure information system. 13 (h) The compact administrator of each party state shall furnish a 14 uniform data set to the compact administrator of each other party state, which 15 shall include, at a minimum: 16 (1) Identifying information; 17 (2) Licensure data; 18 (3) Information related to alternative program participation; and 19 (4) Other information that may facilitate the administration of this 20 compact, as determined by commission rules. 21 (i) The compact administrator of a party state shall provide all 22 investigative documents and information requested by another party state. 23 ARTICLE VII. Establishment of the Interstate Commission 24 of Nurse Licensure Compact Administrators 25 (a) The party states hereby create and establish a joint public entity 26 known as the Interstate Commission of Nurse Licensure Compact 27 Administrators. 28 (1) The commission is an instrumentality of the party states. 29 (2) Venue is proper, and judicial proceedings by or against the Page 11 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 commission shall be brought solely and exclusively, in a court of competent 2 jurisdiction where the principal office of the commission is located. The 3 commission may waive venue and jurisdictional defenses to the extent it adopts 4 or consents to participate in alternative dispute resolution proceedings. 5 (3) Nothing in this compact shall be construed to be a waiver of sovereign 6 immunity. 7 (b) Membership, Voting, and Meetings 8 (1) Each party state shall have and be limited to one administrator. The 9 head of the state licensing board or designee shall be the administrator of this 10 compact for each party state. Any administrator may be removed or suspended 11 from office as provided by the law of the state from which the administrator is 12 appointed. Any vacancy occurring in the commission shall be filled in 13 accordance with the laws of the party state in which the vacancy exists. 14 (2) Each administrator shall be entitled to one vote with regard to the 15 promulgation of rules and creation of bylaws and shall otherwise have an 16 opportunity to participate in the business and affairs of the commission. An 17 administrator shall vote in person or by such other means as provided in the 18 bylaws. The bylaws may provide for an administrator's participation in 19 meetings by telephone or other means of communication. 20 (3) The commission shall meet at least once during each calendar year. 21 Additional meetings shall be held as set forth in the bylaws or rules of the 22 commission. 23 (4) All meetings shall be open to the public, and public notice of meetings 24 shall be given in the same manner as required under the rulemaking provisions 25 in Article VIII. 26 (5) The commission may convene in a closed, nonpublic meeting if the 27 commission must discuss: 28 (i) Noncompliance of a party state with its obligations under this 29 compact. Page 12 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 (ii) The employment, compensation, discipline, or other personnel 2 matters, practices or procedures related to specific employees or other matters 3 related to the commission's internal personnel practices and procedures. 4 (iii) Current, threatened, or reasonably anticipated litigation. 5 (iv) Negotiation of contracts for the purchase or sale of goods, services, 6 or real estate. 7 (v) Accusing any person of a crime or formally censuring any person. 8 (vi) Disclosure of trade secrets or commercial or financial information 9 that is privileged or confidential. 10 (vii) Disclosure of information of a personal nature where disclosure 11 would constitute a clearly unwarranted invasion of personal privacy. 12 (viii) Disclosure of investigatory records compiled for law enforcement 13 purposes. 14 (ix) Disclosure of information related to any reports prepared by or on 15 behalf of the commission for the purpose of investigation of compliance with 16 this compact. 17 (x) Matters specifically exempted from disclosure by federal or state 18 statute. 19 (6) If a meeting, or portion of a meeting, is closed pursuant to this 20 provision, the commission's legal counsel or designee shall certify that the 21 meeting may be closed and shall reference each relevant exempting provision. 22 The commission shall keep minutes that fully and clearly describe all matters 23 discussed in a meeting and shall provide a full and accurate summary of actions 24 taken, and the reasons therefor, including a description of the views expressed. 25 All documents considered in connection with an action shall be identified in 26 such minutes. All minutes and documents of a closed meeting shall remain 27 under seal, subject to release by a majority vote of the commission or order of 28 a court of competent jurisdiction. 29 (c) The commission shall, by a majority vote of the administrators, Page 13 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 prescribe bylaws or rules to govern its conduct as may be necessary or 2 appropriate to carry out the purposes and exercise the powers of this compact, 3 including but not limited to: 4 (1) Establishing the fiscal year of the commission. 5 (2) Providing reasonable standards and procedures. 6 (i) For the establishment and meetings of other committees. 7 (ii) Governing any general or specific delegation of any authority or 8 function of the commission. 9 (3) Providing reasonable procedures for calling and conducting meetings 10 of the commission, ensuring reasonable advance notice of all meetings, and 11 providing an opportunity for attendance of such meetings by interested parties, 12 with enumerated exceptions designed to protect the public's interest, the 13 privacy of individuals, and proprietary information, including trade secrets. 14 The commission may meet in closed session only after a majority of the 15 administrators vote to close a meeting in whole or in part. As soon as 16 practicable, the commission must make public a copy of the vote to close the 17 meeting, revealing the vote of each administrator, with no proxy votes allowed. 18 (4) Establishing the titles, duties and authority, and reasonable 19 procedures for the election of the officers of the commission. 20 (5) Providing reasonable standards and procedures for the establishment 21 of the personnel policies and programs of the commission. Notwithstanding any 22 civil service or other similar laws of any party state, the bylaws shall exclusively 23 govern the personnel policies and programs of the commission. 24 (6) Providing a mechanism for winding up the operations of the 25 commission and the equitable disposition of any surplus funds that may exist 26 after the termination of this compact after the payment or reserving of all of its 27 debts and obligations. 28 (d) The commission shall publish its bylaws and rules, and any 29 amendments thereto, in a convenient form on the website of the commission. Page 14 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 (e) The commission shall maintain its financial records in accordance 2 with the bylaws. 3 (f) The commission shall meet and take such actions as are consistent 4 with the provisions of this compact and the bylaws. 5 (g) The commission shall have the following powers: 6 (1) To promulgate uniform rules to facilitate and coordinate 7 implementation and administration of this compact. The rules shall have the 8 force and effect of law and shall be binding in all party states. 9 (2) To bring and prosecute legal proceedings or actions in the name of 10 the commission, provided that the standing of any licensing board to sue or be 11 sued under applicable law shall not be affected. 12 (3) To purchase and maintain insurance and bonds. 13 (4) To borrow, accept, or contract for services of personnel, including 14 but not limited to employees of a party state or nonprofit organizations. 15 (5) To cooperate with other organizations that administer state compacts 16 related to the regulation of nursing, including but not limited to sharing 17 administrative or staff expenses, office space, or other resources. 18 (6) To hire employees, elect or appoint officers, fix compensation, define 19 duties, grant such individuals appropriate authority to carry out the purposes 20 of this compact, and to establish the commission's personnel policies and 21 programs relating to conflicts of interest, qualifications of personnel, and other 22 related personnel matters. 23 (7) To accept any and all appropriate donations, grants, and gifts of 24 money, equipment, supplies, materials and services, and to receive, utilize, and 25 dispose of the same; provided that at all times the commission shall avoid any 26 appearance of impropriety or conflict of interest. 27 (8) To lease, purchase, accept appropriate gifts or donations of, or 28 otherwise to own, hold, improve, or use, any property, whether real, personal, 29 or mixed; provided that at all times the commission shall avoid any appearance Page 15 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 of impropriety. 2 (9) To sell, convey, mortgage, pledge, lease, exchange, abandon, or 3 otherwise dispose of any property, whether real, personal, or mixed. 4 (10) To establish a budget and make expenditures. 5 (11) To borrow money. 6 (12) To appoint committees, including advisory committees comprised 7 of administrators, state nursing regulators, state legislators or their 8 representatives, and consumer representatives, and other such interested 9 persons. 10 (13) To provide and receive information from, and to cooperate with, law 11 enforcement agencies. 12 (14) To adopt and use an official seal. 13 (15) To perform such other functions as may be necessary or appropriate 14 to achieve the purposes of this compact consistent with the state regulation of 15 nurse licensure and practice. 16 (h) Financing of the commission 17 (1) The commission shall pay, or provide for the payment of, the 18 reasonable expenses of its establishment, organization, and ongoing activities. 19 (2) The commission may also levy on and collect an annual assessment 20 from each party state to cover the cost of its operations, activities, and staff in 21 its annual budget as approved each year. The aggregate annual assessment 22 amount, if any, shall be allocated based upon a formula to be determined by the 23 commission, which shall promulgate a rule that is binding upon all party states. 24 (3) The commission shall not incur obligations of any kind prior to 25 securing the funds adequate to meet the same; nor shall the commission pledge 26 the credit of any of the party states, except by, and with the authority of, such 27 party state. 28 (4) The commission shall keep accurate accounts of all receipts and 29 disbursements. The receipts and disbursements of the commission shall be Page 16 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 subject to the audit and accounting procedures established under its bylaws. 2 However, all receipts and disbursements of funds handled by the commission 3 shall be audited yearly by a certified or licensed public accountant, and the 4 report of the audit shall be included in and become part of the annual report of 5 the commission. 6 (i) Qualified immunity, defense, and indemnification 7 (1) The administrators, officers, executive director, employees and 8 representatives of the commission shall be immune from suit and liability, either 9 personally or in their official capacity, for any claim for damage to or loss of 10 property or personal injury or other civil liability caused by or arising out of 11 any actual or alleged act, error, or omission that occurred, or that the person 12 against whom the claim is made had a reasonable basis for believing occurred, 13 within the scope of commission employment, duties or responsibilities; provided 14 that nothing in this paragraph shall be construed to protect any such person 15 from suit or liability for any damage, loss, injury, or liability caused by the 16 intentional, willful, or wanton misconduct of that person. 17 (2) The commission shall defend any administrator, officer, executive 18 director, employee, or representative of the commission in any civil action 19 seeking to impose liability arising out of any actual or alleged act, error, or 20 omission that occurred within the scope of commission employment, duties, or 21 responsibilities, or that the person against whom the claim is made had a 22 reasonable basis for believing occurred within the scope of commission 23 employment, duties or responsibilities; provided that nothing herein shall be 24 construed to prohibit that person from retaining his or her own counsel; and 25 provided further that the actual or alleged act, error, or omission did not result 26 from that person's intentional, willful, or wanton misconduct. 27 (3) The commission shall indemnify and hold harmless any 28 administrator, officer, executive director, employee, or representative of the 29 commission for the amount of any settlement or judgment obtained against that Page 17 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 person arising out of any actual or alleged act, error, or omission that occurred 2 within the scope of commission employment, duties, or responsibilities, or that 3 such person had a reasonable basis for believing occurred within the scope of 4 commission employment, duties, or responsibilities, provided that the actual or 5 alleged act, error, or omission did not result from the intentional, willful, or 6 wanton misconduct of that person. 7 ARTICLE VIII. Rulemaking 8 (a) The commission shall exercise its rulemaking powers pursuant to the 9 criteria set forth in this Article and the rules adopted thereunder. Rules and 10 amendments shall become binding as of the date specified in each rule or 11 amendment and shall have the same force and effect as provisions of this 12 compact. 13 (b) Rules or amendments to the rules shall be adopted at a regular or 14 special meeting of the commission. 15 (c) Prior to promulgation and adoption of a final rule or rules by the 16 commission, and at least sixty days in advance of the meeting at which the rule 17 will be considered and voted upon, the commission shall file a notice of 18 proposed rulemaking: 19 (1) On the website of the commission. 20 (2) On the website of each licensing board or the publication in which 21 each state would otherwise publish proposed rules. 22 (d) The notice of proposed rulemaking shall include: 23 (1) The proposed time, date, and location of the meeting in which the rule 24 will be considered and voted upon. 25 (2) The text of the proposed rule or amendment, and the reason for the 26 proposed rule. 27 (3) A request for comments on the proposed rule from any interested 28 person. 29 (4) The manner in which interested persons may submit notice to the Page 18 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 commission of their intention to attend the public hearing and any written 2 comments. 3 (e) Prior to adoption of a proposed rule, the commission shall allow 4 persons to submit written data, facts, opinions, and arguments, which shall be 5 made available to the public. 6 (f) The commission shall grant an opportunity for a public hearing 7 before it adopts a rule or amendment. 8 (g) The commission shall publish the place, time, and date of the 9 scheduled public hearing. 10 (1) Hearings shall be conducted in a manner providing each person who 11 wishes to comment a fair and reasonable opportunity to comment orally or in 12 writing. All hearings will be recorded, and a copy will be made available upon 13 request. 14 (2) Nothing in this Section shall be construed as requiring a separate 15 hearing on each rule. Rules may be grouped for the convenience of the 16 commission at hearings required by this Section. 17 (h) If no one appears at the public hearing, the commission may proceed 18 with promulgation of the proposed rule. 19 (i) Following the scheduled hearing date, or by the close of business on 20 the scheduled hearing date if the hearing was not held, the commission shall 21 consider all written and oral comments received. 22 (j) The commission shall, by majority vote of all administrators, take 23 final action on the proposed rule and shall determine the effective date of the 24 rule, if any, based on the rulemaking record and the full text of the rule. 25 (k) Upon determination that an emergency exists, the commission may 26 consider and adopt an emergency rule without prior notice, opportunity for 27 comment or hearing, provided that the usual rulemaking procedures provided 28 in this compact and in this Section shall be retroactively applied to the rule as 29 soon as reasonably possible, in no event later than ninety days after the effective Page 19 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 date of the rule. For the purposes of this provision, an emergency rule is one 2 that must be adopted immediately in order to: 3 (1) Meet an imminent threat to public health, safety or welfare. 4 (2) Prevent a loss of commission or party state funds. 5 (3) Meet a deadline for the promulgation of an administrative rule that 6 is required by federal law or rule. 7 (l) The commission may direct revisions to a previously adopted rule or 8 amendment for purposes of correcting typographical errors, errors in format, 9 errors in consistency, or grammatical errors. Public notice of any revisions shall 10 be posted on the website of the commission. The revision shall be subject to 11 challenge by any person for a period of thirty days after posting. The revision 12 may be challenged only on grounds that the revision results in a material change 13 to a rule. A challenge shall be made in writing, and delivered to the commission, 14 prior to the end of the notice period. If no challenge is made, the revision will 15 take effect without further action. If the revision is challenged, the revision may 16 not take effect without the approval of the commission. 17 ARTICLE IX. Oversight, Dispute Resolution, and Enforcement 18 (a) Oversight 19 (1) Each party state shall enforce this compact and take all actions 20 necessary and appropriate to effectuate this compact's purposes and intent. 21 (2) The commission shall be entitled to receive service of process in any 22 proceeding that may affect the powers, responsibilities, or actions of the 23 commission, and shall have standing to intervene in such a proceeding for all 24 purposes. Failure to provide service of process in such proceeding to the 25 commission shall render a judgment or order void as to the commission, this 26 compact, or promulgated rules. 27 (b) Default, technical assistance, and termination 28 (1) If the commission determines that a party state has defaulted in the 29 performance of its obligations or responsibilities under this compact or the Page 20 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 promulgated rules, the commission shall: 2 (i) Provide written notice to the defaulting state and other party states 3 of the nature of the default, the proposed means of curing the default, or any 4 other action to be taken by the commission. 5 (ii) Provide remedial training and specific technical assistance regarding 6 the default. 7 (2) If a state in default fails to cure the default, the defaulting state's 8 membership in this compact may be terminated upon an affirmative vote of a 9 majority of the administrators, and all rights, privileges, and benefits conferred 10 by this compact may be terminated on the effective date of termination. A cure 11 of the default does not relieve the offending state of obligations or liabilities 12 incurred during the period of default. 13 (3) Termination of membership in this compact shall be imposed only 14 after all other means of securing compliance have been exhausted. Notice of 15 intent to suspend or terminate shall be given by the commission to the governor 16 of the defaulting state and to the executive officer of the defaulting state's 17 licensing board and each of the party states. 18 (4) A state whose membership in this compact has been terminated is 19 responsible for all assessments, obligations, and liabilities incurred through the 20 effective date of termination, including obligations that extend beyond the 21 effective date of termination. 22 (5) The commission shall not bear any costs related to a state that is 23 found to be in default or whose membership in this compact has been 24 terminated unless agreed upon in writing between the commission and the 25 defaulting state. 26 (6) The defaulting state may appeal the action of the commission by 27 petitioning the United States District Court for the District of Columbia or the 28 federal district in which the commission has its principal offices. The prevailing 29 party shall be awarded all costs of such litigation, including reasonable Page 21 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 attorneys' fees. 2 (c) Dispute resolution 3 (1) Upon request by a party state, the commission shall attempt to 4 resolve disputes related to the compact that arise among party states and 5 between party and nonparty states. 6 (2) The commission shall promulgate a rule providing for both mediation 7 and binding dispute resolution for disputes, as appropriate. 8 (3) In the event the commission cannot resolve disputes among party 9 states arising under this compact: 10 (i) The party states may submit the issues in dispute to an arbitration 11 panel, which will be comprised of individuals appointed by the compact 12 administrator in each of the affected party states and an individual mutually 13 agreed upon by the compact administrators of all the party states involved in 14 the dispute. 15 (ii) The decision of a majority of the arbitrators shall be final and 16 binding. 17 (d) Enforcement 18 (1) The commission, in the reasonable exercise of its discretion, shall 19 enforce the provisions and rules of this compact. 20 (2) By majority vote, the commission may initiate legal action in the 21 United States District Court for the District of Columbia or the federal district 22 in which the commission has its principal offices against a party state that is in 23 default to enforce compliance with the provisions of this compact and its 24 promulgated rules and bylaws. The relief sought may include both injunctive 25 relief and damages. In the event judicial enforcement is necessary, the 26 prevailing party shall be awarded all costs of such litigation, including 27 reasonable attorney fees. 28 (3) The remedies herein shall not be the exclusive remedies of the 29 commission. The commission may pursue any other remedies available under Page 22 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 federal or state law. 2 ARTICLE X. Effective Date, Withdrawal, and Amendment 3 (a) This compact shall become effective and binding on the earlier of the 4 date of legislative enactment of this compact into law by no less than twenty-six 5 states or December 31, 2018. All party states to this compact, that also were 6 parties to the prior Nurse Licensure Compact, superseded by this compact, 7 (prior compact), shall be deemed to have withdrawn from said prior compact 8 within six months after the effective date of this compact. 9 (b) Each party state to this compact shall continue to recognize a nurse's 10 multistate licensure privilege to practice in that party state issued under the 11 prior compact until such party state has withdrawn from the prior compact. 12 (c) Any party state may withdraw from this compact by enacting a 13 statute repealing the same. A party state's withdrawal shall not take effect until 14 six months after enactment of the repealing statute. 15 (d) A party state's withdrawal or termination shall not affect the 16 continuing requirement of the withdrawing or terminated state's licensing 17 board to report adverse actions and significant investigations occurring prior 18 to the effective date of such withdrawal or termination. 19 (e) Nothing contained in this compact shall be construed to invalidate or 20 prevent any nurse licensure agreement or other cooperative arrangement 21 between a party state and a nonparty state that is made in accordance with the 22 other provisions of this compact. 23 (f) This compact may be amended by the party states. No amendment to 24 this compact shall become effective and binding upon the party states unless 25 and until it is enacted into the laws of all party states. 26 (g) Representatives of nonparty states to this compact shall be invited to 27 participate in the activities of the commission, on a nonvoting basis, prior to the 28 adoption of this compact by all states. 29 ARTICLE XI. Construction and Severability Page 23 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 This compact shall be liberally construed so as to effectuate the purposes 2 thereof. The provisions of this compact shall be severable, and if any phrase, 3 clause, sentence, or provision of this compact is declared to be contrary to the 4 constitution of any party state or of the United States, or if the applicability 5 thereof to any government, agency, person, or circumstance is held invalid, the 6 validity of the remainder of this compact and the applicability thereof to any 7 government, agency, person, or circumstance shall not be affected thereby. If 8 this compact shall be held to be contrary to the constitution of any party state, 9 this compact shall remain in full force and effect as to the remaining party 10 states and in full force and effect as to the party state affected as to all severable 11 matters. 12 §1019. Nurse Licensure Compact Administrator 13 (A) The nurse licensure compact administrator for this state shall be 14 appointed by the governor to serve as the single state designee on the Interstate 15 Commission of Nurse Licensure Compact Administrators. 16 (B) The administrator shall be a current board member or the executive 17 director of the Louisiana State Board of Nursing for two years beginning in the 18 year of enactment of this Part and shall rotate every two years thereafter with 19 an appointment of a current board member or the executive director of the 20 Louisiana State Board of Practical Nurse Examiners. 21 §1020. Implementation; rulemaking 22 The Louisiana State Board of Nursing and the Louisiana State Board of 23 Practical Nurse Examiners shall: 24 (1) Ensure application and enforcement of the nurse licensure compact 25 as it applies to their respective licensees and licensees from compact states 26 performing nursing services under each board's respective practice act. 27 (2) Promulgate rules and regulations necessary to implement the 28 provisions of this Part in accordance with the Administrative Procedure Act. 29 Section 2. This Act shall become effective upon signature by the governor or, if not Page 24 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 202 SLS 18RS-318 ORIGINAL 1 signed by the governor, upon expiration of the time for bills to become law without signature 2 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If 3 vetoed by the governor and subsequently approved by the legislature, this Act shall become 4 effective on the day following such approval. The original instrument and the following digest, which constitutes no part of the legislative instrument, were prepared by Christine Arbo Peck. DIGEST SB 202 Original 2018 Regular Session Peacock Proposed law enacts the nurse licensure compact. Proposed law allows Louisiana to join a multi-state compact for nurses to obtain multi-state license privileges to practice in participating compact states to decrease redundancies in the consideration and issuance of nursing licenses and provide opportunity for interstate practice by nurses who meet the uniform licensure requirements. Proposed law provides that each participating state to the compact adopt similar requirements for criminal background checks, licensure, and education. Proposed law requires verification of licensure information through the coordinated information system and exchange of information regarding discipline and adverse actions by all participating states. Proposed law requires a nurse leaving his home state to practice in a participating state to comply with the laws of the participating state. Proposed law provides for a home state license and process for changing home state and location of primary residence. Proposed law provides that the home state is responsible for taking adverse action against nurses in violation of practice act requirements, including deactivation of multi-state licensure privileges. Proposed law establishes the Interstate Commission and grants each participating state a single seat on the commission. Proposed law provides for gubernatorial appointment, based on a two year rotation, of an appointee from the Louisiana State Board of Nursing and the Louisiana State Board of Practical Nurse Examiners. Proposed law provides for enforcement and rulemaking authority. Effective upon signature of the governor or lapse of time for gubernatorial action. (Adds R.S. 37:1018-1020) Page 25 of 25 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions.