Texas 2017 - 85th Regular

Texas Senate Bill SB305 Compare Versions

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

Old	New	Differences
1	1	85R6362 JG-D
2	2	By: Hinojosa, et al. S.B. No. 305
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the continuation and functions of the Texas Board of
8	8	Nursing and to the regulation of the practice of nursing.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 301.003, Occupations Code, is amended to
11	11	read as follows:
12	12	Sec. 301.003. APPLICATION OF SUNSET ACT. The Texas Board of
13	13	Nursing is subject to Chapter 325, Government Code (Texas Sunset
14	14	Act). Unless continued in existence as provided by that chapter,
15	15	the board is abolished September 1, 2029 [2017].
16	16	SECTION 2. Section 301.059, Occupations Code, is amended by
17	17	amending Subsection (b) and adding Subsection (d) to read as
18	18	follows:
19	19	(b) The training program must provide the person with
20	20	information regarding:
21	21	(1) the law governing [legislation that created the
22	22	board and] the board's operations;
23	23	(2) the programs, functions, rules, and budget of the
24	24	board;
25	25	(3) the scope of and limitations on the board's
26	26	rulemaking authority;
27	27	(4) [(2)] the results of the most recent formal audit
28	28	of the board;
29	29	(5) [(3)] the requirements of:
30	30	(A) laws relating to open meetings, public
31	31	information, administrative procedure, and disclosing conflicts of
32	32	interest; and
33	33	(B) other laws applicable to members of the board
34	34	in performing their duties; and
35	35	(6) [(4)] any applicable ethics policies adopted by
36	36	the board or the Texas Ethics Commission.
37	37	(d) The executive director of the board shall create a
38	38	training manual that includes the information required by
39	39	Subsection (b). The executive director shall distribute a copy of
40	40	the training manual annually to each board member. On receipt of
41	41	the training manual, each board member shall sign and submit to the
42	42	executive director a statement acknowledging receipt of the
43	43	training manual.
44	44	SECTION 3. Section 301.157, Occupations Code, is amended by
45	45	amending Subsections (d-4), (d-8), (d-9), and (d-11) and adding
46	46	Subsection (d-12) to read as follows:
47	47	(d-4) The board may recognize and accept as approved under
48	48	this section a school of nursing or educational program operated in
49	49	another state and approved by a state board of nursing or other
50	50	regulatory body of that state. The board shall adopt rules [develop
51	51	policies] to ensure that the other state's standards are
52	52	substantially equivalent to the board's standards. The board by
53	53	rule shall develop a process for students enrolled in a school of
54	54	nursing or educational program operated in another state that does
55	55	not meet standards substantially equivalent to the board's
56	56	standards to apply for an initial license under this chapter.
57	57	(d-8) For purposes of Subsection (d-4), a nursing program
58	58	is considered to meet standards substantially equivalent to the
59	59	board's standards if the program:
60	60	(1) is part of an institution of higher education
61	61	located outside this state that is approved by the appropriate
62	62	regulatory authorities of that state;
63	63	(2) holds regional accreditation by an accrediting
64	64	body recognized by the United States secretary of education and the
65	65	Council for Higher Education Accreditation;
66	66	(3) holds specialty accreditation by an accrediting
67	67	body recognized by the United States secretary of education and the
68	68	Council for Higher Education Accreditation, including the National
69	69	League for Nursing Accrediting Commission;
70	70	(4) requires program applicants to be a licensed
71	71	practical or vocational nurse, a military service corpsman, or a
72	72	paramedic, or to hold a college degree in a clinically oriented
73	73	health care field with demonstrated experience providing direct
74	74	patient care; and
75	75	(5) graduates students who:
76	76	(A) achieve faculty-determined program outcomes,
77	77	including passing criterion-referenced examinations of nursing
78	78	knowledge essential to beginning a registered nursing practice and
79	79	transitioning to the role of registered nurse;
80	80	(B) pass a criterion-referenced summative
81	81	performance examination developed by faculty subject matter
82	82	experts that measures clinical competencies essential to beginning
83	83	a registered nursing practice and that meets nationally recognized
84	84	standards for educational testing, including the educational
85	85	testing standards of the American Educational Research
86	86	Association, the American Psychological Association, and the
87	87	National Council on Measurement in Education; and
88	88	(C) pass the National Council Licensure
89	89	Examination for Registered Nurses at a rate equivalent to the
90	90	board's required passage rate for students of approved in-state
91	91	programs.
92	92	(d-9) A graduate of a clinical competency assessment
93	93	program operated in another state and approved by a state board of
94	94	nursing or other regulatory body of another state is eligible to
95	95	apply for an initial license under this chapter if:
96	96	(1) [the board allowed graduates of the program to
97	97	apply for an initial license under this chapter continuously during
98	98	the 10-year period preceding January 1, 2007;
99	99	[(2)] the program does not make any substantial
100	100	changes in the length or content of its clinical competency
101	101	assessment without the board's approval; and
102	102	(2) [(3)] the program remains in good standing with
103	103	the state board of nursing or other regulatory body in the other
104	104	state[; and
105	105	[(4) the program participates in the research study
106	106	under Section 105.008, Health and Safety Code].
107	107	(d-11) If a clinical competency assessment program operated
108	108	in another state graduates students who pass the National Council
109	109	Licensure Examination for Registered Nurses at a rate lower than
110	110	the board's required passage rate for graduating students of
111	111	approved in-state programs, not later than May 31 of the next school
112	112	year the program shall:
113	113	(1) for the first year the student passage rate is
114	114	lower than the board's required passage rate for students of
115	115	approved in-state programs, complete and submit to the board for
116	116	review and comment a self-study of the program in accordance with
117	117	the board's guidelines;
118	118	(2) for the second consecutive year the student
119	119	passage rate is lower than the board's required passage rate for
120	120	students of approved in-state programs, allow the board to conduct
121	121	a desk review to evaluate the program using the criteria typically
122	122	used in an on-site visit and make recommendations to improve the
123	123	program; and
124	124	(3) for the third consecutive year the student passage
125	125	rate is lower than the board's required passage rate for students of
126	126	approved in-state programs, provide notice on the program's
127	127	Internet website that prospective students of the program may need
128	128	to complete additional requirements to apply for an initial license
129	129	in this state because the program has failed to meet the board's
130	130	standards related to the required passage rate on the National
131	131	Council Licensure Examination for Registered Nurses [Subsections
132	132	(d-8), (d-9), (d-10), and (d-11) expire December 31, 2017. As part
133	133	of the first review conducted under Section 301.003 after September
134	134	1, 2009, the Sunset Advisory Commission shall:
135	135	[(1) recommend whether Subsections (d-8) and (d-9)
136	136	should be extended; and
137	137	[(2) recommend any changes to Subsections (d-8) and
138	138	(d-9) relating to the eligibility for a license of graduates of a
139	139	clinical competency assessment program operated in another state].
140	140	(d-12) A clinical competency assessment program operated in
141	141	another state is not considered to meet standards substantially
142	142	equivalent to the board's standards if the program fails to meet the
143	143	applicable requirements under Subsection (d-11) or if the program's
144	144	graduating student passage rate on the National Council Licensure
145	145	Examination for Registered Nurses is lower than the board's
146	146	required passage rate for graduating students of approved in-state
147	147	programs for four consecutive years. A student enrolled in a
148	148	program described by this subsection before December 31 of the
149	149	fourth consecutive year is eligible to apply for an initial license
150	150	under this chapter. The program shall notify a student who enrolls
151	151	in the program after December 31 of the fourth consecutive year that
152	152	the student is required to complete additional requirements
153	153	established by the board under Subsection (d-4) to apply for an
154	154	initial license under this chapter.
155	155	SECTION 4. Section 301.252, Occupations Code, is amended by
156	156	amending Subsection (a) and adding Subsection (a-2) to read as
157	157	follows:
158	158	(a) Each applicant for a registered nurse license or a
159	159	vocational nurse license must submit to the board a sworn
160	160	application that demonstrates the applicant's qualifications under
161	161	this chapter, accompanied by evidence that the applicant:
162	162	(1) has good professional character related to the
163	163	practice of nursing;
164	164	(2) has successfully completed a program of
165	165	professional or vocational nursing education approved under
166	166	Section 301.157(d); and
167	167	(3) has passed the jurisprudence examination approved
168	168	by the board as provided by Subsection (a-1).
169	169	(a-2) An applicant who provides satisfactory evidence that
170	170	the applicant has not committed a violation of this chapter or a
171	171	rule adopted under this chapter is considered to have good
172	172	professional character related to the practice of nursing. A
173	173	determination by the board that an applicant does not have good
174	174	professional character related to the practice of nursing must be
175	175	based on a showing by the board of a clear and rational connection
176	176	between a violation of this chapter or a rule adopted under this
177	177	chapter and the applicant's ability to effectively practice
178	178	nursing.
179	179	SECTION 5. Section 301.257, Occupations Code, is amended by
180	180	adding Subsections (l) and (m) to read as follows:
181	181	(l) The board may require in a declaratory order under this
182	182	section that a person begin participation in a peer assistance
183	183	program at the time of receipt of an initial license under this
184	184	chapter. The board shall notify the person that, on issuance of the
185	185	person's initial license, the person may request reevaluation of
186	186	the person's required participation in the peer assistance program.
187	187	(m) The board by rule shall develop a process to determine
188	188	whether a person should continue to be required to participate in a
189	189	peer assistance program. In making the determination, the board
190	190	shall:
191	191	(1) review the person's criminal history record
192	192	information and, if applicable, determine whether participation in
193	193	the program is warranted based on the time that has elapsed since
194	194	the conviction or end of community supervision;
195	195	(2) reevaluate or require a contractor administering a
196	196	peer assistance program to reevaluate the treatment plan or the
197	197	time the person is required to participate in the peer assistance
198	198	program based on the person's individualized needs; and
199	199	(3) authorize, as appropriate, a waiver of peer
200	200	assistance program completion if the board is satisfied the person
201	201	has achieved a satisfactory period of treatment or documented
202	202	sobriety, as defined by board rules, and continued participation is
203	203	not necessary.
204	204	SECTION 6. Subchapter H, Chapter 301, Occupations Code, is
205	205	amended by adding Section 301.355 to read as follows:
206	206	Sec. 301.355. DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)
207	207	An advanced practice registered nurse authorized to prescribe or
208	208	order a drug or device may not prescribe a drug listed in Subsection
209	209	(b) to a patient unless the advanced practice registered nurse has
210	210	reviewed the patient's prescription history by accessing the
211	211	prescription information submitted to the Texas State Board of
212	212	Pharmacy as authorized by Section 481.076(a)(5), Health and Safety
213	213	Code.
214	214	(b) Subsection (a) applies only to the prescribing of:
215	215	(1) opioids;
216	216	(2) benzodiazepines;
217	217	(3) barbiturates; or
218	218	(4) carisoprodol.
219	219	(c) Failure by an advanced practice registered nurse to
220	220	comply with the requirements of this section is grounds for
221	221	disciplinary action under Section 301.452.
222	222	SECTION 7. Section 301.4106, Occupations Code, is amended
223	223	to read as follows:
224	224	Sec. 301.4106. PEER ASSISTANCE PROGRAMS. The board by rule
225	225	shall develop guidelines to:
226	226	(1) outline the roles and responsibilities of the
227	227	board and a peer assistance program established or approved by the
228	228	board under Chapter 467, Health and Safety Code;
229	229	(2) outline the process for a peer assistance program
230	230	to refer to the board complaints alleging a violation of the
231	231	practice of nursing;
232	232	(3) establish requirements for successfully
233	233	completing a peer assistance program and for notification of the
234	234	board of the successful completion by a nurse the board has ordered
235	235	to attend or referred to the program; [and]
236	236	(4) establish a clear procedure based on meaningful
237	237	performance goals for evaluating the success of a peer assistance
238	238	program established or approved by the board under Chapter 467,
239	239	Health and Safety Code;
240	240	(5) establish individualized requirements for
241	241	participants in a peer assistance program, including the duration
242	242	of participation in a peer assistance program for substance use,
243	243	based on the individual's diagnosis and needs; and
244	244	(6) ensure that participation requirements and
245	245	treatment plans for peer assistance program participants who are
246	246	referred to peer assistance for similar reasons are administered
247	247	consistently.
248	248	SECTION 8. Section 301.452, Occupations Code, is amended by
249	249	amending Subsection (b) and adding Subsection (e) to read as
250	250	follows:
251	251	(b) A person is subject to denial of a license or to
252	252	disciplinary action under this subchapter for:
253	253	(1) a violation of this chapter, a rule or regulation
254	254	not inconsistent with this chapter, or an order issued under this
255	255	chapter;
256	256	(2) fraud or deceit in procuring or attempting to
257	257	procure a license to practice professional nursing or vocational
258	258	nursing;
259	259	(3) a conviction for, or placement on deferred
260	260	adjudication community supervision or deferred disposition for, a
261	261	felony or for a misdemeanor involving moral turpitude;
262	262	(4) conduct that results in the revocation of
263	263	probation imposed because of conviction for a felony or for a
264	264	misdemeanor involving moral turpitude;
265	265	(5) use of a nursing license, diploma, or permit, or
266	266	the transcript of such a document, that has been fraudulently
267	267	purchased, issued, counterfeited, or materially altered;
268	268	(6) impersonating or acting as a proxy for another
269	269	person in the licensing examination required under Section 301.253
270	270	or 301.255;
271	271	(7) directly or indirectly aiding or abetting an
272	272	unlicensed person in connection with the unauthorized practice of
273	273	nursing;
274	274	(8) revocation, suspension, or denial of, or any other
275	275	action relating to, the person's license or privilege to practice
276	276	nursing in another jurisdiction or under federal law;
277	277	(9) intemperate use of alcohol or drugs that the board
278	278	determines endangers or could endanger a patient;
279	279	(10) unprofessional [or dishonorable] conduct in the
280	280	practice of nursing that[, in the board's opinion,] is likely to
281	281	deceive, defraud, or injure a patient or the public;
282	282	(11) adjudication of mental incompetency;
283	283	(12) lack of fitness to practice because of a mental or
284	284	physical health condition that could result in injury to a patient
285	285	or the public; or
286	286	(13) failure to care adequately for a patient or to
287	287	conform to the minimum standards of acceptable nursing practice in
288	288	a manner that, in the board's opinion, exposes a patient or other
289	289	person unnecessarily to risk of harm.
290	290	(e) The board shall adopt rules to ensure that license
291	291	denials and disciplinary action under Subsection (b)(10) are based
292	292	on the application of objective criteria that are clearly and
293	293	rationally connected to the applicant's or license holder's conduct
294	294	and that any negative outcome resulting from that conduct is
295	295	determined to affect the person's ability to effectively practice
296	296	nursing.
297	297	SECTION 9. Subchapter L, Chapter 301, Occupations Code, is
298	298	amended by adding Section 301.5525 to read as follows:
299	299	Sec. 301.5525. MONITORING HARMFUL PRESCRIBING PATTERNS OR
300	300	PRACTICES. (a) The board shall periodically check the prescribing
301	301	information submitted to the Texas State Board of Pharmacy as
302	302	authorized by Section 481.076(a)(1), Health and Safety Code, to
303	303	determine whether an advanced practice registered nurse licensed
304	304	under this chapter is engaging in potentially harmful prescribing
305	305	patterns or practices.
306	306	(b) The board, in coordination with the Texas State Board of
307	307	Pharmacy, shall determine the conduct that constitutes a
308	308	potentially harmful prescribing pattern or practice for purposes of
309	309	Subsection (a). In determining the conduct that constitutes a
310	310	potentially harmful prescribing pattern or practice, the board at a
311	311	minimum shall consider:
312	312	(1) the number of times an advanced practice
313	313	registered nurse prescribes a drug listed in Section 301.355(b);
314	314	and
315	315	(2) for prescriptions described by Subdivision (1),
316	316	patterns of prescribing combinations of those drugs and other
317	317	dangerous combinations of drugs identified by the board.
318	318	(c) If the board suspects that an advanced practice
319	319	registered nurse licensed under this chapter may be engaging in
320	320	potentially harmful prescribing patterns or practices, the board
321	321	may notify the advanced practice registered nurse of the
322	322	potentially harmful prescribing pattern or practice.
323	323	(d) The board may initiate a complaint against an advanced
324	324	practice registered nurse based on information obtained under this
325	325	section.
326	326	SECTION 10. Chapter 304, Occupations Code, is amended by
327	327	adding Section 304.0015 to read as follows:
328	328	Sec. 304.0015. NURSE LICENSURE COMPACT. The Nurse
329	329	Licensure Compact is enacted and entered into with all other
330	330	jurisdictions that legally join in the compact, which reads as
331	331	follows:
332	332	NURSE LICENSURE COMPACT
333	333	ARTICLE I. FINDINGS AND DECLARATION OF PURPOSE
334	334	(a) The party states find that:
335	335	(1) the health and safety of the public are affected by
336	336	the degree of compliance with and the effectiveness of enforcement
337	337	activities related to state nurse licensure laws;
338	338	(2) violations of nurse licensure and other laws
339	339	regulating the practice of nursing may result in injury or harm to
340	340	the public;
341	341	(3) the expanded mobility of nurses and the use of
342	342	advanced communication technologies as part of our nation's health
343	343	care delivery system require greater coordination and cooperation
344	344	among states in the areas of nurse licensure and regulation;
345	345	(4) new practice modalities and technology make
346	346	compliance with individual state nurse licensure laws difficult and
347	347	complex;
348	348	(5) the current system of duplicative licensure for
349	349	nurses practicing in multiple states is cumbersome and redundant
350	350	for both nurses and states; and
351	351	(6) uniformity of nurse licensure requirements
352	352	throughout the states promotes public safety and public health
353	353	benefits.
354	354	(b) The general purposes of this compact are to:
355	355	(1) facilitate the states' responsibility to protect
356	356	the public's health and safety;
357	357	(2) ensure and encourage the cooperation of party
358	358	states in the areas of nurse licensure and regulation;
359	359	(3) facilitate the exchange of information between
360	360	party states in the areas of nurse regulation, investigation, and
361	361	adverse actions;
362	362	(4) promote compliance with the laws governing the
363	363	practice of nursing in each jurisdiction;
364	364	(5) invest all party states with the authority to hold
365	365	a nurse accountable for meeting all state practice laws in the state
366	366	in which the patient is located at the time care is rendered through
367	367	the mutual recognition of party state licenses;
368	368	(6) decrease redundancies in the consideration and
369	369	issuance of nurse licenses; and
370	370	(7) provide opportunities for interstate practice by
371	371	nurses who meet uniform licensure requirements.
372	372	ARTICLE II. DEFINITIONS
373	373	As used in this compact:
374	374	(a) "Adverse action" means any administrative, civil,
375	375	equitable, or criminal action permitted by a state's laws that is
376	376	imposed by a licensing board or other authority against a nurse,
377	377	including actions against an individual's license or multistate
378	378	licensure privilege such as revocation, suspension, probation,
379	379	monitoring of the licensee, limitation on the licensee's practice,
380	380	or any other encumbrance on licensure affecting a nurse's
381	381	authorization to practice, including issuance of a cease and desist
382	382	action.
383	383	(b) "Alternative program" means a nondisciplinary
384	384	monitoring program approved by a licensing board.
385	385	(c) "Coordinated licensure information system" means an
386	386	integrated process for collecting, storing, and sharing
387	387	information on nurse licensure and enforcement activities related
388	388	to nurse licensure laws that is administered by a nonprofit
389	389	organization composed of and controlled by licensing boards.
390	390	(d) "Current significant investigative information" means:
391	391	(1) investigative information that a licensing board,
392	392	after a preliminary inquiry that includes notification and an
393	393	opportunity for the nurse to respond, if required by state law, has
394	394	reason to believe is not groundless and, if proven true, would
395	395	indicate more than a minor infraction; or
396	396	(2) investigative information that indicates that the
397	397	nurse represents an immediate threat to public health and safety
398	398	regardless of whether the nurse has been notified and had an
399	399	opportunity to respond.
400	400	(e) "Encumbrance" means a revocation or suspension of, or
401	401	any limitation on, the full and unrestricted practice of nursing
402	402	imposed by a licensing board.
403	403	(f) "Home state" means the party state which is the nurse's
404	404	primary state of residence.
405	405	(g) "Licensing board" means a party state's regulatory body
406	406	responsible for issuing nurse licenses.
407	407	(h) "Multistate license" means a license to practice as a
408	408	registered or a licensed practical/vocational nurse (LPN/VN)
409	409	issued by a home state licensing board that authorizes the licensed
410	410	nurse to practice in all party states under a multistate licensure
411	411	privilege.
412	412	(i) "Multistate licensure privilege" means a legal
413	413	authorization associated with a multistate license permitting the
414	414	practice of nursing as either a registered nurse (RN) or LPN/VN in a
415	415	remote state.
416	416	(j) "Nurse" means RN or LPN/VN, as those terms are defined
417	417	by each party state's practice laws.
418	418	(k) "Party state" means any state that has adopted this
419	419	compact.
420	420	(l) "Remote state" means a party state, other than the home
421	421	state.
422	422	(m) "Single-state license" means a nurse license issued by a
423	423	party state that authorizes practice only within the issuing state
424	424	and does not include a multistate licensure privilege to practice
425	425	in any other party state.
426	426	(n) "State" means a state, territory, or possession of the
427	427	United States and the District of Columbia.
428	428	(o) "State practice laws" means a party state's laws, rules,
429	429	and regulations that govern the practice of nursing, define the
430	430	scope of nursing practice, and create the methods and grounds for
431	431	imposing discipline. "State practice laws" do not include
432	432	requirements necessary to obtain and retain a license, except for
433	433	qualifications or requirements of the home state.
434	434	ARTICLE III. GENERAL PROVISIONS AND JURISDICTION
435	435	(a) A multistate license to practice registered or licensed
436	436	practical/vocational nursing issued by a home state to a resident
437	437	in that state will be recognized by each party state as authorizing
438	438	a nurse to practice as a registered nurse (RN) or as a licensed
439	439	practical/vocational nurse (LPN/VN), under a multistate licensure
440	440	privilege, in each party state.
441	441	(b) A state must implement procedures for considering the
442	442	criminal history records of applicants for initial multistate
443	443	license or licensure by endorsement. Such procedures shall include
444	444	the submission of fingerprints or other biometric-based
445	445	information by applicants for the purpose of obtaining an
446	446	applicant's criminal history record information from the Federal
447	447	Bureau of Investigation and the agency responsible for retaining
448	448	that state's criminal records.
449	449	(c) Each party state shall require the following for an
450	450	applicant to obtain or retain a multistate license in the home
451	451	state:
452	452	(1) meets the home state's qualifications for
453	453	licensure or renewal of licensure, as well as all other applicable
454	454	state laws;
455	455	(2)(i) has graduated or is eligible to graduate from a
456	456	licensing board-approved RN or LPN/VN prelicensure education
457	457	program; or
458	458	(ii) has graduated from a foreign RN or LPN/VN
459	459	prelicensure education program that (a) has been approved by the
460	460	authorized accrediting body in the applicable country and (b) has
461	461	been verified by an independent credentials review agency to be
462	462	comparable to a licensing board-approved prelicensure education
463	463	program;
464	464	(3) has, if a graduate of a foreign prelicensure
465	465	education program not taught in English or if English is not the
466	466	individual's native language, successfully passed an English
467	467	proficiency examination that includes the components of reading,
468	468	speaking, writing, and listening;
469	469	(4) has successfully passed an NCLEX-RN or NCLEX-PN
470	470	Examination or a recognized predecessor, as applicable;
471	471	(5) is eligible for or holds an active, unencumbered
472	472	license;
473	473	(6) has submitted, in connection with an application
474	474	for initial licensure or licensure by endorsement, fingerprints or
475	475	other biometric data for the purpose of obtaining criminal history
476	476	record information from the Federal Bureau of Investigation and the
477	477	agency responsible for retaining that state's criminal records;
478	478	(7) has not been convicted or found guilty, or has
479	479	entered into an agreed disposition, of a felony offense under
480	480	applicable state or federal criminal law;
481	481	(8) has not been convicted or found guilty, or has
482	482	entered into an agreed disposition, of a misdemeanor offense
483	483	related to the practice of nursing as determined on a case-by-case
484	484	basis;
485	485	(9) is not currently enrolled in an alternative
486	486	program;
487	487	(10) is subject to self-disclosure requirements
488	488	regarding current participation in an alternative program; and
489	489	(11) has a valid United States social security number.
490	490	(d) All party states shall be authorized, in accordance with
491	491	existing state due process law, to take adverse action against a
492	492	nurse's multistate licensure privilege such as revocation,
493	493	suspension, probation, or any other action that affects a nurse's
494	494	authorization to practice under a multistate licensure privilege,
495	495	including cease and desist actions. If a party state takes such
496	496	action, it shall promptly notify the administrator of the
497	497	coordinated licensure information system. The administrator of the
498	498	coordinated licensure information system shall promptly notify the
499	499	home state of any such actions by remote states.
500	500	(e) A nurse practicing in a party state must comply with the
501	501	state practice laws of the state in which the client is located at
502	502	the time service is provided. The practice of nursing is not
503	503	limited to patient care, but shall include all nursing practice as
504	504	defined by the state practice laws of the party state in which the
505	505	client is located. The practice of nursing in a party state under a
506	506	multistate licensure privilege will subject a nurse to the
507	507	jurisdiction of the licensing board, the courts, and the laws of the
508	508	party state in which the client is located at the time service is
509	509	provided.
510	510	(f) Individuals not residing in a party state shall continue
511	511	to be able to apply for a party state's single-state license as
512	512	provided under the laws of each party state. However, the
513	513	single-state license granted to these individuals will not be
514	514	recognized as granting the privilege to practice nursing in any
515	515	other party state. Nothing in this compact shall affect the
516	516	requirements established by a party state for the issuance of a
517	517	single-state license.
518	518	(g) Any nurse holding a home state multistate license, on
519	519	the effective date of this compact, may retain and renew the
520	520	multistate license issued by the nurse's then-current home state,
521	521	provided that:
522	522	(1) a nurse, who changes primary state of residence
523	523	after this compact's effective date, must meet all applicable
524	524	Article III(c) requirements to obtain a multistate license from the
525	525	new home state; or
526	526	(2) a nurse who fails to satisfy the multistate
527	527	licensure requirements in Article III(c) due to a disqualifying
528	528	event occurring after this compact's effective date shall be
529	529	ineligible to retain or renew a multistate license, and the nurse's
530	530	multistate license shall be revoked or deactivated in accordance
531	531	with applicable rules adopted by the Interstate Commission of Nurse
532	532	Licensure Compact Administrators ("commission").
533	533	ARTICLE IV. APPLICATIONS FOR LICENSURE IN A PARTY STATE
534	534	(a) Upon application for a multistate license, the
535	535	licensing board in the issuing party state shall ascertain, through
536	536	the coordinated licensure information system, whether the
537	537	applicant has ever held, or is the holder of, a license issued by
538	538	any other state, whether there are any encumbrances on any license
539	539	or multistate licensure privilege held by the applicant, whether
540	540	any adverse action has been taken against any license or multistate
541	541	licensure privilege held by the applicant, and whether the
542	542	applicant is currently participating in an alternative program.
543	543	(b) A nurse may hold a multistate license, issued by the
544	544	home state, in only one party state at a time.
545	545	(c) If a nurse changes primary state of residence by moving
546	546	between two party states, the nurse must apply for licensure in the
547	547	new home state, and the multistate license issued by the prior home
548	548	state will be deactivated in accordance with applicable rules
549	549	adopted by the commission.
550	550	(1) The nurse may apply for licensure in advance of a
551	551	change in primary state of residence.
552	552	(2) A multistate license shall not be issued by the new
553	553	home state until the nurse provides satisfactory evidence of a
554	554	change in primary state of residence to the new home state and
555	555	satisfies all applicable requirements to obtain a multistate
556	556	license from the new home state.
557	557	(d) If a nurse changes primary state of residence by moving
558	558	from a party state to a nonparty state, the multistate license
559	559	issued by the prior home state will convert to a single-state
560	560	license, valid only in the former home state.
561	561	ARTICLE V. ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE
562	562	LICENSING BOARDS
563	563	(a) In addition to the other powers conferred by state law,
564	564	a licensing board shall have the authority to:
565	565	(1) take adverse action against a nurse's multistate
566	566	licensure privilege to practice within that party state.
567	567	(i) Only the home state shall have the power to
568	568	take adverse action against a nurse's license issued by the home
569	569	state.
570	570	(ii) For purposes of taking adverse action, the
571	571	home state licensing board shall give the same priority and effect
572	572	to reported conduct received from a remote state as it would if such
573	573	conduct had occurred within the home state. In so doing, the home
574	574	state shall apply its own state laws to determine appropriate
575	575	action.
576	576	(2) issue cease and desist orders or impose an
577	577	encumbrance on a nurse's authority to practice within that party
578	578	state.
579	579	(3) complete any pending investigation of a nurse who
580	580	changes primary state of residence during the course of such
581	581	investigation. The licensing board shall also have the authority
582	582	to take appropriate action(s) and shall promptly report the
583	583	conclusions of such investigations to the administrator of the
584	584	coordinated licensure information system. The administrator of the
585	585	coordinated licensure information system shall promptly notify the
586	586	new home state of any such actions.
587	587	(4) issue subpoenas for both hearings and
588	588	investigations that require the attendance and testimony of a
589	589	witness, as well as the production of evidence. Subpoenas issued by
590	590	a licensing board in a party state for the attendance and testimony
591	591	of witnesses or the production of evidence from another party state
592	592	shall be enforced in the latter state by any court of competent
593	593	jurisdiction, according to the practice and procedures of that
594	594	court applicable to subpoenas issued in proceedings pending before
595	595	it. The issuing authority shall pay any witness fees, travel
596	596	expenses, mileage, and other fees required by the service statutes
597	597	of the state in which the witnesses or evidence are located.
598	598	(5) obtain and submit, for each nurse licensure
599	599	applicant, fingerprint or other biometric-based information to the
600	600	Federal Bureau of Investigation for criminal background checks,
601	601	receive the results of the Federal Bureau of Investigation record
602	602	search on criminal background checks, and use the results in making
603	603	licensure decisions.
604	604	(6) if otherwise permitted by state law, recover from
605	605	the affected nurse the costs of investigations and disposition of
606	606	cases resulting from any adverse action taken against that nurse.
607	607	(7) take adverse action based on the factual findings
608	608	of the remote state, provided that the licensing board follows its
609	609	own procedures for taking such adverse action.
610	610	(b) If adverse action is taken by the home state against a
611	611	nurse's multistate license, the nurse's multistate licensure
612	612	privilege to practice in all other party states shall be
613	613	deactivated until all encumbrances have been removed from the
614	614	multistate license. All home state disciplinary orders that impose
615	615	adverse action against a nurse's multistate license shall include a
616	616	statement that the nurse's multistate licensure privilege is
617	617	deactivated in all party states during the pendency of the order.
618	618	(c) Nothing in this compact shall override a party state's
619	619	decision that participation in an alternative program may be used
620	620	in lieu of adverse action. The home state licensing board shall
621	621	deactivate the multistate licensure privilege under the multistate
622	622	license of any nurse for the duration of the nurse's participation
623	623	in an alternative program.
624	624	ARTICLE VI. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE
625	625	OF INFORMATION
626	626	(a) All party states shall participate in a coordinated
627	627	licensure information system of all licensed registered nurses
628	628	(RNs) and licensed practical/vocational nurses (LPNs/VNs). This
629	629	system will include information on the licensure and disciplinary
630	630	history of each nurse, as submitted by party states, to assist in
631	631	the coordination of nurse licensure and enforcement efforts.
632	632	(b) The commission, in consultation with the administrator
633	633	of the coordinated licensure information system, shall formulate
634	634	necessary and proper procedures for the identification,
635	635	collection, and exchange of information under this compact.
636	636	(c) All licensing boards shall promptly report to the
637	637	coordinated licensure information system any adverse action, any
638	638	current significant investigative information, denials of
639	639	applications (with the reasons for such denials), and nurse
640	640	participation in alternative programs known to the licensing board
641	641	regardless of whether such participation is deemed nonpublic or
642	642	confidential under state law.
643	643	(d) Current significant investigative information and
644	644	participation in nonpublic or confidential alternative programs
645	645	shall be transmitted through the coordinated licensure information
646	646	system only to party state licensing boards.
647	647	(e) Notwithstanding any other provision of law, all party
648	648	state licensing boards contributing information to the coordinated
649	649	licensure information system may designate information that may not
650	650	be shared with nonparty states or disclosed to other entities or
651	651	individuals without the express permission of the contributing
652	652	state.
653	653	(f) Any personally identifiable information obtained from
654	654	the coordinated licensure information system by a party state
655	655	licensing board shall not be shared with nonparty states or
656	656	disclosed to other entities or individuals except to the extent
657	657	permitted by the laws of the party state contributing the
658	658	information.
659	659	(g) Any information contributed to the coordinated
660	660	licensure information system that is subsequently required to be
661	661	expunged by the laws of the party state contributing that
662	662	information shall also be expunged from the coordinated licensure
663	663	information system.
664	664	(h) The compact administrator of each party state shall
665	665	furnish a uniform data set to the compact administrator of each
666	666	other party state, which shall include, at a minimum:
667	667	(1) identifying information;
668	668	(2) licensure data;
669	669	(3) information related to alternative program
670	670	participation; and
671	671	(4) other information that may facilitate the
672	672	administration of this compact, as determined by commission rules.
673	673	(i) The compact administrator of a party state shall provide
674	674	all investigative documents and information requested by another
675	675	party state.
676	676	ARTICLE VII. ESTABLISHMENT OF INTERSTATE COMMISSION OF NURSE
677	677	LICENSURE COMPACT ADMINISTRATORS
678	678	(a) The party states hereby create and establish a joint
679	679	public entity known as the Interstate Commission of Nurse Licensure
680	680	Compact Administrators.
681	681	(1) The commission is an instrumentality of the party
682	682	states.
683	683	(2) Venue is proper and judicial proceedings by or
684	684	against the commission shall be brought solely and exclusively in a
685	685	court of competent jurisdiction where the principal office of the
686	686	commission is located. The commission may waive venue and
687	687	jurisdictional defenses to the extent it adopts or consents to
688	688	participate in alternative dispute resolution proceedings.
689	689	(3) Nothing in this compact shall be construed to be a
690	690	waiver of sovereign immunity.
691	691	(b) Membership, Voting, and Meetings
692	692	(1) Each party state shall have and be limited to one
693	693	administrator. The head of the state licensing board or a designee
694	694	shall be the administrator of this compact for each party state.
695	695	Any administrator may be removed or suspended from office as
696	696	provided by the law of the state from which the administrator is
697	697	appointed. Any vacancy occurring in the commission shall be filled
698	698	in accordance with the laws of the party state in which the vacancy
699	699	exists.
700	700	(2) Each administrator shall be entitled to one (1)
701	701	vote with regard to the promulgation of rules and the creation of
702	702	bylaws and shall otherwise have an opportunity to participate in
703	703	the business and affairs of the commission. An administrator shall
704	704	vote in person or by such other means as provided in the bylaws. The
705	705	bylaws may provide for an administrator's participation in meetings
706	706	by telephone or other means of communication.
707	707	(3) The commission shall meet at least once during
708	708	each calendar year. Additional meetings shall be held as set forth
709	709	in the bylaws or rules of the commission.
710	710	(4) All meetings shall be open to the public, and
711	711	public notice of meetings shall be given in the same manner as
712	712	required under the rulemaking provisions in Article VIII.
713	713	(5) The commission may convene in a closed, nonpublic
714	714	meeting if the commission must discuss:
715	715	(i) noncompliance of a party state with its
716	716	obligations under this compact;
717	717	(ii) the employment, compensation, discipline,
718	718	or other personnel matters, practices, or procedures related to
719	719	specific employees or other matters related to the commission's
720	720	internal personnel practices and procedures;
721	721	(iii) current, threatened, or reasonably
722	722	anticipated litigation;
723	723	(iv) negotiation of contracts for the purchase or
724	724	sale of goods, services, or real estate;
725	725	(v) accusing any person of a crime or formally
726	726	censuring any person;
727	727	(vi) disclosure of trade secrets or commercial or
728	728	financial information that is privileged or confidential;
729	729	(vii) disclosure of information of a personal
730	730	nature where disclosure would constitute a clearly unwarranted
731	731	invasion of personal privacy;
732	732	(viii) disclosure of investigatory records
733	733	compiled for law enforcement purposes;
734	734	(ix) disclosure of information related to any
735	735	reports prepared by or on behalf of the commission for the purpose
736	736	of investigation of compliance with this compact; or
737	737	(x) matters specifically exempted from
738	738	disclosure by federal or state statute.
739	739	(6) If a meeting or portion of a meeting is closed
740	740	pursuant to this provision, the commission's legal counsel or
741	741	designee shall certify that the meeting may be closed and shall
742	742	reference each relevant exempting provision. The commission shall
743	743	keep minutes that fully and clearly describe all matters discussed
744	744	in a meeting and shall provide a full and accurate summary of
745	745	actions taken, and the reasons therefor, including a description of
746	746	the views expressed. All documents considered in connection with
747	747	an action shall be identified in such minutes. All minutes and
748	748	documents of a closed meeting shall remain under seal, subject to
749	749	release by a majority vote of the commission or order of a court of
750	750	competent jurisdiction.
751	751	(c) The commission shall, by a majority vote of the
752	752	administrators, prescribe bylaws or rules to govern its conduct as
753	753	may be necessary or appropriate to carry out the purposes and
754	754	exercise the powers of this compact, including but not limited to:
755	755	(1) establishing the fiscal year of the commission;
756	756	(2) providing reasonable standards and procedures:
757	757	(i) for the establishment and meeting of other
758	758	committees; and
759	759	(ii) governing any general or specific
760	760	delegation of any authority or function of the commission;
761	761	(3) providing reasonable procedures for calling and
762	762	conducting meetings of the commission, ensuring reasonable advance
763	763	notice of all meetings, and providing an opportunity for attendance
764	764	of such meetings by interested parties, with enumerated exceptions
765	765	designed to protect the public's interest, the privacy of
766	766	individuals, and proprietary information, including trade secrets.
767	767	The commission may meet in closed session only after a majority of
768	768	the administrators vote to close a meeting in whole or in part. As
769	769	soon as practicable, the commission must make public a copy of the
770	770	vote to close the meeting revealing the vote of each administrator,
771	771	with no proxy votes allowed;
772	772	(4) establishing the titles, duties and authority, and
773	773	reasonable procedures for the election of the officers of the
774	774	commission;
775	775	(5) providing reasonable standards and procedures for
776	776	the establishment of the personnel policies and programs of the
777	777	commission. Notwithstanding any civil service or other similar
778	778	laws of any party state, the bylaws shall exclusively govern the
779	779	personnel policies and programs of the commission; and
780	780	(6) providing a mechanism for winding up the
781	781	operations of the commission and the equitable disposition of any
782	782	surplus funds that may exist after the termination of this compact
783	783	after the payment or reserving of all of its debts and obligations.
784	784	(d) The commission shall publish its bylaws and rules, and
785	785	any amendments thereto, in a convenient form on the website of the
786	786	commission.
787	787	(e) The commission shall maintain its financial records in
788	788	accordance with the bylaws.
789	789	(f) The commission shall meet and take such actions as are
790	790	consistent with the provisions of this compact and the bylaws.
791	791	(g) The commission shall have the following powers:
792	792	(1) to promulgate uniform rules to facilitate and
793	793	coordinate implementation and administration of this compact. The
794	794	rules shall have the force and effect of law and shall be binding in
795	795	all party states;
796	796	(2) to bring and prosecute legal proceedings or
797	797	actions in the name of the commission, provided that the standing of
798	798	any licensing board to sue or be sued under applicable law shall not
799	799	be affected;
800	800	(3) to purchase and maintain insurance and bonds;
801	801	(4) to borrow, accept, or contract for services of
802	802	personnel, including, but not limited to, employees of a party
803	803	state or nonprofit organizations;
804	804	(5) to cooperate with other organizations that
805	805	administer state compacts related to the regulation of nursing,
806	806	including, but not limited to, sharing administrative or staff
807	807	expenses, office space, or other resources;
808	808	(6) to hire employees, elect or appoint officers, fix
809	809	compensation, define duties, grant such individuals appropriate
810	810	authority to carry out the purposes of this compact, and to
811	811	establish the commission's personnel policies and programs
812	812	relating to conflicts of interest, qualifications of personnel, and
813	813	other related personnel matters;
814	814	(7) to accept any and all appropriate donations,
815	815	grants, and gifts of money, equipment, supplies, materials, and
816	816	services, and to receive, utilize, and dispose of the same;
817	817	provided that at all times the commission shall avoid any
818	818	appearance of impropriety or conflict of interest;
819	819	(8) to lease, purchase, accept appropriate gifts or
820	820	donations of, or otherwise to own, hold, improve, or use, any
821	821	property, whether real, personal, or mixed; provided that at all
822	822	times the commission shall avoid any appearance of impropriety;
823	823	(9) to sell, convey, mortgage, pledge, lease,
824	824	exchange, abandon, or otherwise dispose of any property, whether
825	825	real, personal, or mixed;
826	826	(10) to establish a budget and make expenditures;
827	827	(11) to borrow money;
828	828	(12) to appoint committees, including advisory
829	829	committees comprised of administrators, state nursing regulators,
830	830	state legislators or their representatives, consumer
831	831	representatives, and other such interested persons;
832	832	(13) to provide and receive information from, and to
833	833	cooperate with, law enforcement agencies;
834	834	(14) to adopt and use an official seal; and
835	835	(15) to perform such other functions as may be
836	836	necessary or appropriate to achieve the purposes of this compact
837	837	consistent with the state regulation of nurse licensure and
838	838	practice.
839	839	(h) Financing of the Commission
840	840	(1) The commission shall pay, or provide for the
841	841	payment of, the reasonable expenses of its establishment,
842	842	organization, and ongoing activities.
843	843	(2) The commission may also levy on and collect an
844	844	annual assessment from each party state to cover the cost of its
845	845	operations, activities, and staff in its annual budget as approved
846	846	each year. The aggregate annual assessment amount, if any, shall be
847	847	allocated based upon a formula to be determined by the commission,
848	848	which shall promulgate a rule that is binding upon all party states.
849	849	(3) The commission shall not incur an obligation of
850	850	any kind prior to securing the funds adequate to meet the same; nor
851	851	shall the commission pledge the credit of any of the party states,
852	852	except by and with the authority of such party state.
853	853	(4) The commission shall keep accurate accounts of all
854	854	receipts and disbursements. The receipts and disbursements of the
855	855	commission shall be subject to the audit and accounting procedures
856	856	established under its bylaws. However, all receipts and
857	857	disbursements of funds handled by the commission shall be audited
858	858	yearly by a certified or licensed public accountant, and the report
859	859	of the audit shall be included in and become part of the annual
860	860	report of the commission.
861	861	(i) Qualified Immunity, Defense, and Indemnification
862	862	(1) The compact administrators, officers, executive
863	863	directors, employees, and representatives of the commission shall
864	864	be immune from suit and liability, either personally or in their
865	865	official capacity, for any claim for damage to or loss of property,
866	866	or personal injury or other civil liability caused by or arising out
867	867	of any actual or alleged act, error, or omission that occurred, or
868	868	that the person against whom the claim is made had a reasonable
869	869	basis for believing occurred, within the scope of commission
870	870	employment, duties, or responsibilities; provided that nothing in
871	871	this subdivision shall be construed to protect any such person from
872	872	suit or liability for any damages, loss, injury, or liability
873	873	caused by the intentional, wilful, or wanton misconduct of that
874	874	person.
875	875	(2) The commission shall defend any administrator,
876	876	officer, executive director, employee, or representative of the
877	877	commission in any civil action seeking to impose liability arising
878	878	out of any actual or alleged act, error, or omission that occurred
879	879	within the scope of commission employment, duties, or
880	880	responsibilities, or that the person against whom the claim is made
881	881	had a reasonable basis for believing occurred within the scope of
882	882	commission employment, duties, or responsibilities; provided that
883	883	nothing herein shall be construed to prohibit that person from
884	884	retaining his or her own counsel; and provided further that the
885	885	actual or alleged act, error, or omission did not result from that
886	886	person's intentional, wilful, or wanton misconduct.
887	887	(3) The commission shall indemnify and hold harmless
888	888	any administrator, officer, executive director, employee, or
889	889	representative of the commission for the amount of any settlement
890	890	or judgment obtained against that person arising out of any actual
891	891	or alleged act, error, or omission that occurred within the scope of
892	892	commission employment, duties, or responsibilities, or that such
893	893	person had a reasonable basis for believing occurred within the
894	894	scope of commission employment, duties, or responsibilities;
895	895	provided that the actual or alleged act, error, or omission did not
896	896	result from the intentional, wilful, or wanton misconduct of that
897	897	person.
898	898	ARTICLE VIII. RULEMAKING
899	899	(a) The commission shall exercise its rulemaking powers
900	900	pursuant to the criteria set forth in this article and the rules
901	901	adopted thereunder. Rules and amendments shall become binding as
902	902	of the date specified in each rule or amendment and shall have the
903	903	same force and effect as provisions of this compact.
904	904	(b) Rules or amendments to the rules shall be adopted at a
905	905	regular or special meeting of the commission.
906	906	(c) Prior to promulgation and adoption of a final rule or
907	907	rules by the commission, and at least sixty (60) days in advance of
908	908	the meeting at which the rule will be considered and voted upon, the
909	909	commission shall file a notice of proposed rulemaking:
910	910	(1) on the website of the commission; and
911	911	(2) on the website of each licensing board or the
912	912	publication in which each state would otherwise publish proposed
913	913	rules.
914	914	(d) The notice of proposed rulemaking shall include:
915	915	(1) the proposed time, date, and location of the
916	916	meeting in which the rule will be considered and voted upon;
917	917	(2) the text of the proposed rule or amendment, and the
918	918	reason for the proposed rule;
919	919	(3) a request for comments on the proposed rule from
920	920	any interested person; and
921	921	(4) the manner in which interested persons may submit
922	922	notice to the commission of their intention to attend the public
923	923	hearing and any written comments.
924	924	(e) Prior to adoption of a proposed rule, the commission
925	925	shall allow persons to submit written data, facts, opinions, and
926	926	arguments, which shall be made available to the public.
927	927	(f) The commission shall grant an opportunity for a public
928	928	hearing before it adopts a rule or amendment.
929	929	(g) The commission shall publish the place, time, and date
930	930	of the scheduled public hearing.
931	931	(1) Hearings shall be conducted in a manner providing
932	932	each person who wishes to comment a fair and reasonable opportunity
933	933	to comment orally or in writing. All hearings will be recorded, and
934	934	a copy will be made available upon request.
935	935	(2) Nothing in this section shall be construed as
936	936	requiring a separate hearing on each rule. Rules may be grouped for
937	937	the convenience of the commission at hearings required by this
938	938	section.
939	939	(h) If no one appears at the public hearing, the commission
940	940	may proceed with promulgation of the proposed rule.
941	941	(i) Following the scheduled hearing date, or by the close of
942	942	business on the scheduled hearing date if the hearing was not held,
943	943	the commission shall consider all written and oral comments
944	944	received.
945	945	(j) The commission shall, by majority vote of all
946	946	administrators, take final action on the proposed rule and shall
947	947	determine the effective date of the rule, if any, based on the
948	948	rulemaking record and the full text of the rule.
949	949	(k) Upon determination that an emergency exists, the
950	950	commission may consider and adopt an emergency rule without prior
951	951	notice, opportunity for comment, or hearing; provided that the
952	952	usual rulemaking procedures provided in this compact and in this
953	953	section shall be retroactively applied to the rule as soon as
954	954	reasonably possible, and in no event later than ninety (90) days
955	955	after the effective date of the rule. For the purposes of this
956	956	provision, an emergency rule is one that must be adopted
957	957	immediately in order to:
958	958	(1) meet an imminent threat to public health, safety,
959	959	or welfare;
960	960	(2) prevent a loss of commission or party state funds;
961	961	or
962	962	(3) meet a deadline for the promulgation of an
963	963	administrative rule that is required by federal law or rule.
964	964	(l) The commission may direct revisions to a previously
965	965	adopted rule or amendment for purposes of correcting typographical
966	966	errors, errors in format, errors in consistency, or grammatical
967	967	errors. Public notice of any revisions shall be posted on the
968	968	website of the commission. The revision shall be subject to
969	969	challenge by any person for a period of thirty (30) days after
970	970	posting. The revision may be challenged only on grounds that the
971	971	revision results in a material change to a rule. A challenge shall
972	972	be made in writing, and delivered to the commission, prior to the
973	973	end of the notice period. If no challenge is made, the revision
974	974	will take effect without further action. If the revision is
975	975	challenged, the revision may not take effect without the approval
976	976	of the commission.
977	977	ARTICLE IX. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
978	978	(a) Oversight
979	979	(1) Each party state shall enforce this compact and
980	980	take all actions necessary and appropriate to effectuate this
981	981	compact's purposes and intent.
982	982	(2) The commission shall be entitled to receive
983	983	service of process in any proceeding that may affect the powers,
984	984	responsibilities, or actions of the commission, and shall have
985	985	standing to intervene in such a proceeding for all purposes.
986	986	Failure to provide service of process in such proceeding to the
987	987	commission shall render a judgment or order void as to the
988	988	commission, this compact, or promulgated rules.
989	989	(b) Default, Technical Assistance, and Termination
990	990	(1) If the commission determines that a party state
991	991	has defaulted in the performance of its obligations or
992	992	responsibilities under this compact or the promulgated rules, the
993	993	commission shall:
994	994	(i) provide written notice to the defaulting
995	995	state and other party states of the nature of the default, the
996	996	proposed means of curing the default, or any other action to be
997	997	taken by the commission; and
998	998	(ii) provide remedial training and specific
999	999	technical assistance regarding the default.
1000	1000	(2) If a state in default fails to cure the default,
1001	1001	the defaulting state's membership in this compact may be terminated
1002	1002	upon an affirmative vote of a majority of the administrators, and
1003	1003	all rights, privileges, and benefits conferred by this compact may
1004	1004	be terminated on the effective date of termination. A cure of the
1005	1005	default does not relieve the offending state of obligations or
1006	1006	liabilities incurred during the period of default.
1007	1007	(3) Termination of membership in this compact shall be
1008	1008	imposed only after all other means of securing compliance have been
1009	1009	exhausted. Notice of intent to suspend or terminate shall be given
1010	1010	by the commission to the governor of the defaulting state and to the
1011	1011	executive officer of the defaulting state's licensing board and
1012	1012	each of the party states.
1013	1013	(4) A state whose membership in this compact has been
1014	1014	terminated is responsible for all assessments, obligations, and
1015	1015	liabilities incurred through the effective date of the termination,
1016	1016	including obligations that extend beyond the effective date of
1017	1017	termination.
1018	1018	(5) The commission shall not bear any costs related to
1019	1019	a state that is found to be in default or whose membership in this
1020	1020	compact has been terminated unless agreed upon in writing between
1021	1021	the commission and the defaulting state.
1022	1022	(6) The defaulting state may appeal the action of the
1023	1023	commission by petitioning the U.S. District Court for the District
1024	1024	of Columbia or the federal district in which the commission has its
1025	1025	principal offices. The prevailing party shall be awarded all costs
1026	1026	of such litigation, including reasonable attorneys' fees.
1027	1027	(c) Dispute Resolution
1028	1028	(1) Upon request by a party state, the commission
1029	1029	shall attempt to resolve disputes related to the compact that arise
1030	1030	among party states and between party and nonparty states.
1031	1031	(2) The commission shall promulgate a rule providing
1032	1032	for both mediation and binding dispute resolution for disputes, as
1033	1033	appropriate.
1034	1034	(3) In the event the commission cannot resolve
1035	1035	disputes among party states arising under this compact:
1036	1036	(i) the party states may submit the issues in
1037	1037	dispute to an arbitration panel, which will be comprised of
1038	1038	individuals appointed by the compact administrator in each of the
1039	1039	affected party states and an individual mutually agreed upon by the
1040	1040	compact administrators of all the party states involved in the
1041	1041	dispute; and
1042	1042	(ii) the decision of a majority of the
1043	1043	arbitrators shall be final and binding.
1044	1044	(d) Enforcement
1045	1045	(1) The commission, in the reasonable exercise of its
1046	1046	discretion, shall enforce the provisions and rules of this compact.
1047	1047	(2) By majority vote, the commission may initiate
1048	1048	legal action in the U.S. District Court for the District of Columbia
1049	1049	or in the federal district in which the commission has its principal
1050	1050	offices against a party state that is in default to enforce
1051	1051	compliance with the provisions of this compact and its promulgated
1052	1052	rules and bylaws. The relief sought may include both injunctive
1053	1053	relief and damages. In the event judicial enforcement is
1054	1054	necessary, the prevailing party shall be awarded all costs of such
1055	1055	litigation, including reasonable attorneys' fees.
1056	1056	(3) The remedies herein shall not be the exclusive
1057	1057	remedies of the commission. The commission may pursue any other
1058	1058	remedies available under federal or state law.
1059	1059	ARTICLE X. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENTS
1060	1060	(a) This compact shall become effective and binding on the
1061	1061	earlier of the date of legislative enactment of this compact into
1062	1062	law by no less than twenty-six (26) states or December 31, 2018. All
1063	1063	party states to this compact that also were parties to the prior
1064	1064	Nurse Licensure Compact, superseded by this compact ("prior
1065	1065	compact"), shall be deemed to have withdrawn from said prior
1066	1066	compact within six (6) months after the effective date of this
1067	1067	compact.
1068	1068	(b) Each party state to this compact shall continue to
1069	1069	recognize a nurse's multistate licensure privilege to practice in
1070	1070	that party state issued under the prior compact until the party
1071	1071	state has withdrawn from the prior compact.
1072	1072	(c) Any party state may withdraw from this compact by
1073	1073	enacting a statute repealing the same. A party state's withdrawal
1074	1074	shall not take effect until six (6) months after enactment of the
1075	1075	repealing statute.
1076	1076	(d) A party state's withdrawal or termination shall not
1077	1077	affect the continuing requirement of the withdrawing or terminated
1078	1078	state's licensing board to report adverse actions and significant
1079	1079	investigations occurring prior to the effective date of such
1080	1080	withdrawal or termination.
1081	1081	(e) Nothing contained in this compact shall be construed to
1082	1082	invalidate or prevent any nurse licensure agreement or other
1083	1083	cooperative arrangement between a party state and a nonparty state
1084	1084	that is made in accordance with the other provisions of this
1085	1085	compact.
1086	1086	(f) This compact may be amended by the party states. No
1087	1087	amendment to this compact shall become effective and binding upon
1088	1088	the party states unless and until it is enacted into the laws of all
1089	1089	party states.
1090	1090	(g) Representatives of nonparty states to this compact
1091	1091	shall be invited to participate in the activities of the
1092	1092	commission, on a nonvoting basis, prior to the adoption of this
1093	1093	compact by all states.
1094	1094	ARTICLE XI. CONSTRUCTION AND SEVERABILITY
1095	1095	This compact shall be liberally construed so as to effectuate
1096	1096	the purposes thereof. The provisions of this compact shall be
1097	1097	severable, and if any phrase, clause, sentence, or provision of
1098	1098	this compact is declared to be contrary to the constitution of any
1099	1099	party state or the United States, or if the applicability thereof to
1100	1100	any government, agency, person, or circumstance is held invalid,
1101	1101	the validity of the remainder of this compact and the applicability
1102	1102	thereof to any government, agency, person, or circumstance shall
1103	1103	not be affected thereby. If this compact shall be held to be
1104	1104	contrary to the constitution of any party state, this compact shall
1105	1105	remain in full force and effect as to the remaining party states and
1106	1106	in full force and effect as to the party state affected as to all
1107	1107	severable matters.
1108	1108	SECTION 11. Chapter 304, Occupations Code, is amended by
1109	1109	adding Section 304.0025 to read as follows:
1110	1110	Sec. 304.0025. RULES ADOPTED UNDER COMPACT. The Interstate
1111	1111	Commission of Nurse Licensure Compact Administrators established
1112	1112	under the Nurse Licensure Compact under Section 304.0015 may not
1113	1113	adopt rules that alter the requirements or scope of practice of a
1114	1114	license issued under Chapter 301. Any rule adopted by the
1115	1115	Interstate Commission of Nurse Licensure Compact Administrators
1116	1116	that purports to alter the requirements or scope of practice of a
1117	1117	license issued under Chapter 301 is not enforceable.
1118	1118	SECTION 12. Section 304.006(a), Occupations Code, is
1119	1119	amended to read as follows:
1120	1120	(a) On request and payment of a reasonable fee, the Texas
1121	1121	Board of Nursing shall provide a registered or vocational nurse
1122	1122	licensed by this state with a copy of information regarding the
1123	1123	nurse maintained by the coordinated licensure information system
1124	1124	under Article VI [7] of the Nurse Licensure Compact.
1125	1125	SECTION 13. Section 304.008(a), Occupations Code, is
1126	1126	amended to read as follows:
1127	1127	(a) In reporting information to the coordinated licensure
1128	1128	information system under Article VI [7] of the Nurse Licensure
1129	1129	Compact, the Texas Board of Nursing may disclose personally
1130	1130	identifiable information about the nurse, including the nurse's
1131	1131	social security number.
1132	1132	SECTION 14. (a) Sections 301.160 and 301.163, Occupations
1133	1133	Code, are repealed.
1134	1134	(b) Effective December 31, 2018, Sections 304.001 and
1135	1135	304.009, Occupations Code, are repealed.
1136	1136	SECTION 15. (a) Except as provided by Subsection (b) of
1137	1137	this section, Section 301.059, Occupations Code, as amended by this
1138	1138	Act, applies to a member of the Texas Board of Nursing appointed
1139	1139	before, on, or after the effective date of this Act.
1140	1140	(b) A member of the Texas Board of Nursing who, before the
1141	1141	effective date of this Act, completed the training program required
1142	1142	by Section 301.059, Occupations Code, as that law existed before
1143	1143	the effective date of this Act, is required to complete additional
1144	1144	training only on subjects added to the training program required by
1145	1145	Section 301.059, Occupations Code, as amended by this Act. A board
1146	1146	member described by this subsection may not vote, deliberate, or be
1147	1147	counted as a member in attendance at a meeting of the board held on
1148	1148	or after December 1, 2017, until the member completes the
1149	1149	additional training.
1150	1150	SECTION 16. (a) Not later than May 31, 2018, the Texas
1151	1151	Board of Nursing shall adopt the rules necessary to implement the
1152	1152	changes in law made by this Act to Section 301.157, Occupations
1153	1153	Code. In adopting rules under this subsection, the board shall
1154	1154	provide an opportunity for public comment and, through the board's
1155	1155	Advisory Committee on Education, seek comment from interested
1156	1156	parties. The rules must:
1157	1157	(1) clearly define substantially equivalent education
1158	1158	standards for purposes of recognizing a school of nursing or
1159	1159	educational program operated in another state; and
1160	1160	(2) establish a process for enabling students enrolled
1161	1161	in an out-of-state school of nursing or educational program that
1162	1162	does not meet standards substantially equivalent to the board's
1163	1163	standards to apply for initial licensure under Chapter 301,
1164	1164	Occupations Code.
1165	1165	(b) Not later than March 1, 2018, the Texas Board of Nursing
1166	1166	shall adopt the rules necessary to implement the changes in law made
1167	1167	by this Act to Sections 301.252 and 301.452, Occupations Code. In
1168	1168	adopting rules under this subsection, the board shall seek comments
1169	1169	from relevant interested parties.
1170	1170	(c) Section 301.157(d-11), Occupations Code, as amended by
1171	1171	this Act, applies beginning with the passage rates available in
1172	1172	January 2018, reflecting the passage rates for the preceding year.
1173	1173	If the passage rate for a clinical competency assessment program
1174	1174	available in January 2018 does not meet the Texas Board of Nursing's
1175	1175	required passage rate for students of approved in-state programs,
1176	1176	the clinical competency assessment program shall complete the
1177	1177	self-study required under Section 301.157(d-11)(1), Occupations
1178	1178	Code, as amended by this Act, not later than May 31, 2018.
1179	1179	SECTION 17. Section 301.355, Occupations Code, as added by
1180	1180	this Act, applies only to a prescription issued on or after
1181	1181	September 1, 2018. A prescription issued before September 1, 2018,
1182	1182	is governed by the law in effect on the date the prescription was
1183	1183	issued, and the former law is continued in effect for that purpose.
1184	1184	SECTION 18. Except as otherwise provided by this Act, this
1185	1185	Act takes effect September 1, 2017.