THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY HORNAMAN, ADOLPH, BAKER, BELFANTI, BEYER, BRENNAN, CARROLL, CAUSER, CUTLER, DONATUCCI, FABRIZIO, FAIRCHILD, FLECK, FREEMAN, GEORGE, GIBBONS, GROVE, HALUSKA, HARHAI, HENNESSEY, HESS, HOUGHTON, JOSEPHS, W. KELLER, KORTZ, KOTIK, KULA, MAHONEY, McILVAINE SMITH, MELIO, MILLARD, MUNDY, PETRARCA, PHILLIPS, READSHAW, REICHLEY, SANTONI, SIPTROTH, SOLOBAY, SONNEY, STERN, SWANGER, VULAKOVICH, YOUNGBLOOD AND YUDICHAK, JUNE 5, 2009

REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, JUNE 5, 2009  

AN ACT

Authorizing the Commonwealth of Pennsylvania to join the Nurse

Licensure Compact; and providing for the form of the compact.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Nurse

Licensure Compact Act.

Section 2.  Nurse Licensure Compact.

The Nurse Licensure Compact is enacted into law and entered

into with all jurisdictions legally joining in the compact in

the form substantially as set forth as follows:

NURSE LICENSURE COMPACT

ARTICLE I

Findings and Declaration of Purpose

a.  The party states find that:

1.  the health and safety of the public are affected by

the degree of compliance with and the effectiveness of

enforcement activities related to state nurse licensure laws;

2.  violations of nurse licensure and other laws

regulating the practice of nursing may result in injury or

harm to the public;

3.  the expanded mobility of nurses and the use of

advanced communication technologies as part of our nation's

healthcare delivery system require greater coordination and

cooperation among states in the areas of nurse licensure and

regulation;

4.  new practice modalities and technology make

compliance with individual state nurse licensure laws

difficult and complex;

5.  the current system of duplicative licensure for

nurses practicing in multiple states is cumbersome and

redundant to both nurses and states;

b.  The general purposes of this Compact are to:

1.  facilitate the states' responsibility to protect the

public's health and safety;

2.  ensure and encourage the cooperation of party states

in the areas of nurse licensure and regulation;

3.  facilitate the exchange of information between party

states in the areas of nurse regulation, investigation and

adverse actions;

4.  promote compliance with the laws governing the

practice of nursing in each jurisdiction; and

5.  invest all party states with the authority to hold a

nurse accountable for meeting all state practice laws in the

state in which the patient is located at the time care is

rendered through the mutual recognition of party state

licenses.

ARTICLE II

Definitions

As used in this Compact:

"Adverse Action" means a home or remote state action.

"Alternative program" means a voluntary, nondisciplinary

monitoring program approved by a nurse licensing board.

"Coordinated licensure information system" means an

integrated process for collecting, storing, and sharing

information on nurse licensure and enforcement activities

related to nurse licensure laws, which is administered by a

nonprofit organization composed of and controlled by state nurse

licensing boards.

"Current significant investigative information" means:

investigative information that a licensing board, after a

preliminary inquiry that includes notification and an

opportunity for the nurse to respond if required by state law,

has reason to believe is not groundless and, if proved true,

would indicate more than a minor infraction; or investigative

information that indicates that the nurse represents an

immediate threat to public health and safety regardless of

whether the nurse has been notified and had an opportunity to

respond.

"Home state" means the party state which is the nurse's

primary state of residence.

"Home state action" means any administrative, civil,

equitable or criminal action permitted by the home state's laws

which are imposed on a nurse by the home state's licensing board

or other authority including actions against an individual's

license such as: revocation, suspension, probation or any other

action which affects a nurse's authorization to practice.

"Licensing board" means a party state's regulatory body

responsible for issuing nurse licenses.

"Multistate licensure privilege" means current, official

authority from a remote state permitting the practice of nursing

as either a registered nurse or a licensed practical/vocational

nurse in such party state. All party states have the authority,

in accordance with existing state due process law, to take

actions against the nurse's privilege such as: revocation,

suspension, probation or any other action which affects a

nurse's authorization to practice.

"Nurse" means a registered nurse or licensed

practical/vocational nurse, as those terms are defined by each

party's state practice laws.

"Party state" means any state that has adopted this Compact.

"Remote state" means a party state, other than the home

state, where the patient is located at the time nursing care is

provided, or, in the case of the practice of nursing not

involving a patient, in such party state where the recipient of

nursing practice is located.

"Remote state action" means any administrative, civil,

equitable or criminal action permitted by a remote state's laws

which are imposed on a nurse by the remote state's licensing

board or other authority including actions against an

individual's multistate licensure privilege to practice in the

remote state, and cease and desist and other injunctive or

equitable orders issued by remote states or the licensing boards

thereof.

"State" means a state, territory, or possession of the United

States, the District of Columbia or the Commonwealth of Puerto

Rico.

"State practice laws" means those individual party's state

laws and regulations that govern the practice of nursing, define

the scope of nursing practice, and create the methods and

grounds for imposing discipline.

"State practice laws" does not include the initial

qualifications for licensure or requirements necessary to obtain

and retain a license, except for qualifications or requirements

of the home state.

ARTICLE III

General Provisions and Jurisdiction

a.  A license to practice registered nursing issued by a home

state to a resident in that state will be recognized by each

party state as authorizing a multistate licensure privilege to

practice as a registered nurse in such party state. A license to

practice licensed practical/vocational nursing issued by a home

state to a resident in that state will be recognized by each

party state as authorizing a multistate licensure privilege to

practice as a licensed practical/vocational nurse in such party

state. In order to obtain or retain a license, an applicant must

meet the home state's qualifications for licensure and license

renewal as well as all other applicable state laws.

b.  Party states may, in accordance with state due process

laws, limit or revoke the multistate licensure privilege of any

nurse to practice in their state and may take any other actions

under their applicable state laws necessary to protect the

health and safety of their citizens. If a party state takes such

action, it shall promptly notify the administrator of the

coordinated licensure information system. The administrator of

the coordinated licensure information system shall promptly

notify the home state of any such actions by remote states.

c.  Every nurse practicing in a party state must comply with

the state practice laws of the state in which the patient is

located at the time care is rendered. In addition, the practice

of nursing is not limited to patient care, but shall include all

nursing practice as defined by the state practice laws of a

party state. The practice of nursing will subject a nurse to the

jurisdiction of the nurse licensing board and the courts, as

well as the laws, in that party state.

d.  This Compact does not affect additional requirements

imposed by states for advanced practice registered nursing.

However, a multistate licensure privilege to practice registered

nursing granted by a party state shall be recognized by other

party states as a license to practice registered nursing if one

is required by state law as a precondition for qualifying for

advanced practice registered nurse authorization.

e.  Individuals not residing in a party state shall continue

to be able to apply for nurse licensure as provided for under

the laws of each party state. However, the license granted to

these individuals will not be recognized as granting the

privilege to practice nursing in any other party state unless

explicitly agreed to by that party state.

ARTICLE IV

Applications for Licensure in a Party State

a.  Upon application for a license, the licensing board in a

party state shall ascertain, through the coordinated licensure

information system, whether the applicant has ever held, or is

the holder of, a license issued by any other state, whether

there are any restrictions on the multistate licensure

privilege, and whether any other adverse action by any state has

been taken against the license.

b.  A nurse in a party state shall hold licensure in only one

party state at a time, issued by the home state.

c.  A nurse who intends to change primary state of residence

may apply for licensure in the new home state in advance of such

change. However, new licenses will not be issued by a party

state until after a nurse provides evidence of change in primary

state of residence satisfactory to the new home state's

licensing board.

d.  When a nurse changes primary state of residence by:

1.  moving between two party states, and obtains a

license from the new home state, the license from the former

home state is no longer valid;

2.  moving from a nonparty state to a party state, and

obtains a license from the new home state, the individual

state license issued by the nonparty state is not affected

and will remain in full force if so provided by the laws of

the nonparty state;

3.  moving from a party state to a nonparty state, the

license issued by the prior home state converts to an

individual state license, valid only in the former home

state, without the multistate licensure privilege to practice

in other party states.

ARTICLE V

Adverse Actions

In addition to the General Provisions described in Article

III, the following provisions apply:

a.  The licensing board of a remote state shall promptly

report to the administrator of the coordinated licensure

information system any remote state actions including the

factual and legal basis for such action, if known. The licensing

board of a remote state shall also promptly report any

significant current investigative information yet to result in a

remote state action. The administrator of the coordinated

licensure information system shall promptly notify the home

state of any such reports.

b.  The licensing board of a party state shall have the

authority to complete any pending investigations for a nurse who

changes primary state of residence during the course of such

investigations. It shall also have the authority to take

appropriate action(s), and shall promptly report the conclusions

of such investigations to the administrator of the coordinated

licensure information system. The administrator of the

coordinated licensure information system shall promptly notify

the new home state of any such actions.

c.  A remote state may take adverse action affecting the

multistate licensure privilege to practice within that party

state. However, only the home state shall have the power to

impose adverse action against the license issued by the home

state.

d.  For purposes of imposing adverse action, the licensing

board of the home state shall give the same priority and effect

to reported conduct received from a remote state as it would if

such conduct had occurred within the home state. In so doing, it

shall apply its own state laws to determine appropriate action.

e.  The home state may take adverse action based on the

factual findings of the remote state, so long as each state

follows its own procedures for imposing such adverse action.

f.  Nothing in this Compact shall override a party state's

decision that participation in an alternative program may be

used in lieu of licensure action and that such participation

shall remain nonpublic if required by the party state's laws.

Party states must require nurses who enter any alternative

programs to agree not to practice in any other party state

during the term of the alternative program without prior

authorization from such other party state.

ARTICLE VI

Additional Authorities Invested in

Party State Nurse Licensing Boards

Notwithstanding any other powers, party state nurse licensing

boards shall have the authority to:

a.  if otherwise permitted by state law, recover from the

affected nurse the costs of investigations and disposition of

cases resulting from any adverse action taken against that

nurse;

b.  issue subpoenas for both hearings and investigations

which require the attendance and testimony of witnesses, and the

production of evidence. Subpoenas issued by a nurse licensing

board in a party state for the attendance and testimony of

witnesses, and/or the production of evidence from another party

state, shall be enforced in the latter state by any court of

competent jurisdiction, according to the practice and procedure

of that court applicable to subpoenas issued in proceedings

pending before it. The issuing authority shall pay any witness

fees, travel expenses, mileage and other fees required by the

service statutes of the state where the witnesses and/or

evidence are located;

c.  issue cease and desist orders to limit or revoke a

nurse's authority to practice in their respective states;

d.  promulgate uniform rules and regulations as provided for

in Article VIII(c).

ARTICLE VII

Coordinated Licensure Information System

a.  All party states shall participate in a cooperative

effort to create a coordinated data base of all licensed

registered nurses and licensed practical/vocational nurses. This

system will include information on the licensure and

disciplinary history of each nurse, as contributed by party

states, to assist in the coordination of nurse licensure and

enforcement efforts.

b.  Notwithstanding any other provision of law, all party

states' licensing boards shall promptly report adverse actions,

actions against multistate licensure privileges, any current

significant investigative information yet to result in adverse

action, denials of applications, and the reasons for such

denials, to the coordinated licensure information system.

c.  Current significant investigative information shall be

transmitted through the coordinated licensure information system

only to party state licensing boards.

d.  Notwithstanding any other provision of law, all party

states' licensing boards contributing information to the

coordinated licensure information system may designate

information that may not be shared with nonparty states or

disclosed to other entities or individuals without the express

permission of the contributing state.

e.  Any personally identifiable information obtained by a

party state's licensing board from the coordinated licensure

information system may not be shared with nonparty states or

disclosed to other entities or individuals except to the extent

permitted by the laws of the party state contributing the

information.

f.  Any information contributed to the coordinated licensure

information system that is subsequently required to be expunged

by the laws of the party state contributing that information,

shall also be expunged from the coordinated licensure

information system.

g.  The Compact administrators, acting jointly with each

other and in consultation with the administrator of the

coordinated licensure information system, shall formulate

necessary and proper procedures for the identification,

collection and exchange of information under this Compact.

ARTICLE VIII

Compact Administration and Interchange of Information

a.  The head of the nurse licensing board, or his/her

designee, of each party state shall be the administrator of this

Compact for his/her state.

b.  The Compact administrator of each party state shall

furnish to the Compact administrator of each other party state

any information and documents including, but not limited to, a

uniform data set of investigations, identifying information,

licensure data, and disclosable alternative program

participation information to facilitate the administration of

this Compact.

c.  Compact administrators shall have the authority to

develop uniform rules to facilitate and coordinate

implementation of this Compact. These uniform rules shall be

adopted by party states, under the authority invested under

Article VI (d).

ARTICLE IX

Immunity

No party state or the officers or employees or agents of a

party state's nurse licensing board who acts in accordance with

the provisions of this Compact shall be liable on account of any

act or omission in good faith while engaged in the performance

of their duties under this Compact. Good faith in this article

shall not include willful misconduct, gross negligence, or

recklessness.

ARTICLE X

Entry into Force, Withdrawal and Amendment

a.  This Compact shall enter into force and become effective

as to any state when it has been enacted into the laws of that

state. Any party state may withdraw from this Compact by

enacting a statute repealing the same, but no such withdrawal

shall take effect until six months after the withdrawing state

has given notice of the withdrawal to the executive heads of all

other party states.

b.  No withdrawal shall affect the validity or applicability

by the licensing boards of states remaining party to Compact of

any report of adverse action occurring prior to the withdrawal.

c.  Nothing contained in this Compact shall be construed to

invalidate or prevent any nurse licensure agreement or other

cooperative arrangement between a party state and a nonparty

state that is made in accordance with the other provisions of

this Compact.

d.  This Compact may be amended by the party states. No

amendment to this Compact shall become effective and binding

upon the party states unless and until it is enacted into the

laws of all party states.

ARTICLE XI

Construction and Severability

a.  This Compact shall be liberally construed so as to

effectuate the purposes thereof. The provisions of this Compact

shall be severable and if any phrase, clause, sentence or

provision of this Compact is declared to be contrary to the

constitution of any party state or of the United States or the

applicability thereof to any government, agency, person or

circumstance is held invalid, the validity of the remainder of

this Compact and the applicability thereof to any government,

agency, person or circumstance shall not be affected thereby. If

this Compact shall be held contrary to the constitution of any

state party thereto, the Compact shall remain in full force and

effect as to the remaining party states and in full force and

effect as to the party state affected as to all severable

matters.

b.  In the event party states find a need for settling

disputes arising under this Compact:

1.  The party states may submit the issues in dispute to

an arbitration panel which will be comprised of an individual

appointed by the Compact administrator in the home state; an

individual appointed by the Compact administrator in the

remote state(s) involved; and an individual mutually agreed

upon by the Compact administrators of all the party states

involved in the dispute.

2.  The decision of a majority of the arbitrators shall

be final and binding.

Section 10.  Effective date.

This act shall take effect immediately.