PRINTER'S NO. 619
No. 549 Session of 2007
INTRODUCED BY HERSHEY, BAKER, BARRAR, BASTIAN, BELFANTI, BENNINGHOFF, BEYER, BOYD, CAPPELLI, CARROLL, CUTLER, DALLY, DENLINGER, FABRIZIO, FAIRCHILD, FRANKEL, FREEMAN, GEORGE, GERGELY, GILLESPIE, GINGRICH, GOODMAN, GRELL, GRUCELA, HENNESSEY, HESS, HORNAMAN, HUTCHINSON, JAMES, M. KELLER, MACKERETH, MANN, MARSICO, McILHATTAN, MOUL, MOYER, MUSTIO, NICKOL, PAYNE, PAYTON, PETRARCA, PETRONE, PHILLIPS, PICKETT, RAPP, REICHLEY, ROAE, RUBLEY, SABATINA, SCAVELLO, SIPTROTH, SOLOBAY, SONNEY, STABACK, STERN, R. STEVENSON, SURRA, SWANGER, TRUE, WALKO, WATSON, WOJNAROSKI AND YOUNGBLOOD, MARCH 6, 2007
REFERRED TO COMMITTEE ON INTERGOVERNMENTAL AFFAIRS, MARCH 6, 2007
AN ACT 1 Authorizing the Commonwealth of Pennsylvania to join the Nurse 2 Licensure Compact; and providing for the form of the compact. 3 The General Assembly of the Commonwealth of Pennsylvania 4 hereby enacts as follows: 5 Section 1. Short title. 6 This act shall be known and may be cited as the Nurse 7 Licensure Compact Act. 8 Section 2. Nurse Licensure Compact. 9 The Nurse Licensure Compact is enacted into law and entered 10 into with all jurisdictions legally joining in the compact in 11 the form substantially as set forth as follows: 12 NURSE LICENSURE COMPACT 13 ARTICLE I
1 Findings and Declaration of Purpose 2 a. The party states find that: 3 1. the health and safety of the public are affected by 4 the degree of compliance with and the effectiveness of 5 enforcement activities related to state nurse licensure laws; 6 2. violations of nurse licensure and other laws 7 regulating the practice of nursing may result in injury or 8 harm to the public; 9 3. the expanded mobility of nurses and the use of 10 advanced communication technologies as part of our nation's 11 healthcare delivery system require greater coordination and 12 cooperation among states in the areas of nurse licensure and 13 regulation; 14 4. new practice modalities and technology make 15 compliance with individual state nurse licensure laws 16 difficult and complex; 17 5. the current system of duplicative licensure for 18 nurses practicing in multiple states is cumbersome and 19 redundant to both nurses and states; 20 b. The general purposes of this Compact are to: 21 1. facilitate the states' responsibility to protect the 22 public's health and safety; 23 2. ensure and encourage the cooperation of party states 24 in the areas of nurse licensure and regulation; 25 3. facilitate the exchange of information between party 26 states in the areas of nurse regulation, investigation and 27 adverse actions; 28 4. promote compliance with the laws governing the 29 practice of nursing in each jurisdiction; and 30 5. invest all party states with the authority to hold a 20070H0549B0619 - 2 -
1 nurse accountable for meeting all state practice laws in the 2 state in which the patient is located at the time care is 3 rendered through the mutual recognition of party state 4 licenses. 5 ARTICLE II 6 Definitions 7 As used in this Compact: 8 "Adverse Action" means a home or remote state action. 9 "Alternative program" means a voluntary, nondisciplinary 10 monitoring program approved by a nurse licensing board. 11 "Coordinated licensure information system" means an integrated 12 process for collecting, storing, and sharing information on 13 nurse licensure and enforcement activities related to nurse 14 licensure laws, which is administered by a nonprofit 15 organization composed of and controlled by state nurse licensing 16 boards. 17 "Current significant investigative information" means: 18 investigative information that a licensing board, after a 19 preliminary inquiry that includes notification and an 20 opportunity for the nurse to respond if required by state law, 21 has reason to believe is not groundless and, if proved true, 22 would indicate more than a minor infraction; or investigative 23 information that indicates that the nurse represents an 24 immediate threat to public health and safety regardless of 25 whether the nurse has been notified and had an opportunity to 26 respond. 27 "Home state" means the party state which is the nurse's primary 28 state of residence. 29 "Home state action" means any administrative, civil, equitable 30 or criminal action permitted by the home state's laws which are 20070H0549B0619 - 3 -
1 imposed on a nurse by the home state's licensing board or other 2 authority including actions against an individual's license such 3 as: revocation, suspension, probation or any other action which 4 affects a nurse's authorization to practice. 5 "Licensing board" means a party state's regulatory body 6 responsible for issuing nurse licenses. 7 "Multistate licensure privilege" means current, official 8 authority from a remote state permitting the practice of nursing 9 as either a registered nurse or a licensed practical/vocational 10 nurse in such party state. All party states have the authority, 11 in accordance with existing state due process law, to take 12 actions against the nurse's privilege such as: revocation, 13 suspension, probation or any other action which affects a 14 nurse's authorization to practice. 15 "Nurse" means a registered nurse or licensed 16 practical/vocational nurse, as those terms are defined by each 17 party's state practice laws. 18 "Party state" means any state that has adopted this Compact. 19 "Remote state" means a party state, other than the home state, 20 where the patient is located at the time nursing care is 21 provided, or, in the case of the practice of nursing not 22 involving a patient, in such party state where the recipient of 23 nursing practice is located. 24 "Remote state action" means any administrative, civil, equitable 25 or criminal action permitted by a remote state's laws which are 26 imposed on a nurse by the remote state's licensing board or 27 other authority including actions against an individual's 28 multistate licensure privilege to practice in the remote state, 29 and cease and desist and other injunctive or equitable orders 30 issued by remote states or the licensing boards thereof. 20070H0549B0619 - 4 -
1 "State" means a state, territory, or possession of the United 2 States, the District of Columbia or the Commonwealth of Puerto 3 Rico. 4 "State practice laws" means those individual party's state laws 5 and regulations that govern the practice of nursing, define the 6 scope of nursing practice, and create the methods and grounds 7 for imposing discipline. 8 "State practice laws" does not include the initial 9 qualifications for licensure or requirements necessary to obtain 10 and retain a license, except for qualifications or requirements 11 of the home state. 12 ARTICLE III 13 General Provisions and Jurisdiction 14 a. A license to practice registered nursing issued by a home 15 state to a resident in that state will be recognized by each 16 party state as authorizing a multistate licensure privilege to 17 practice as a registered nurse in such party state. A license to 18 practice licensed practical/vocational nursing issued by a home 19 state to a resident in that state will be recognized by each 20 party state as authorizing a multistate licensure privilege to 21 practice as a licensed practical/vocational nurse in such party 22 state. In order to obtain or retain a license, an applicant must 23 meet the home state's qualifications for licensure and license 24 renewal as well as all other applicable state laws. 25 b. Party states may, in accordance with state due process 26 laws, limit or revoke the multistate licensure privilege of any 27 nurse to practice in their state and may take any other actions 28 under their applicable state laws necessary to protect the 29 health and safety of their citizens. If a party state takes such 30 action, it shall promptly notify the administrator of the 20070H0549B0619 - 5 -
1 coordinated licensure information system. The administrator of 2 the coordinated licensure information system shall promptly 3 notify the home state of any such actions by remote states. 4 c. Every nurse practicing in a party state must comply with 5 the state practice laws of the state in which the patient is 6 located at the time care is rendered. In addition, the practice 7 of nursing is not limited to patient care, but shall include all 8 nursing practice as defined by the state practice laws of a 9 party state. The practice of nursing will subject a nurse to the 10 jurisdiction of the nurse licensing board and the courts, as 11 well as the laws, in that party state. 12 d. This Compact does not affect additional requirements 13 imposed by states for advanced practice registered nursing. 14 However, a multistate licensure privilege to practice registered 15 nursing granted by a party state shall be recognized by other 16 party states as a license to practice registered nursing if one 17 is required by state law as a precondition for qualifying for 18 advanced practice registered nurse authorization. 19 e. Individuals not residing in a party state shall continue 20 to be able to apply for nurse licensure as provided for under 21 the laws of each party state. However, the license granted to 22 these individuals will not be recognized as granting the 23 privilege to practice nursing in any other party state unless 24 explicitly agreed to by that party state. 25 ARTICLE IV 26 Applications for Licensure in a Party State 27 a. Upon application for a license, the licensing board in a 28 party state shall ascertain, through the coordinated licensure 29 information system, whether the applicant has ever held, or is 30 the holder of, a license issued by any other state, whether 20070H0549B0619 - 6 -
1 there are any restrictions on the multistate licensure 2 privilege, and whether any other adverse action by any state has 3 been taken against the license. 4 b. A nurse in a party state shall hold licensure in only one 5 party state at a time, issued by the home state. 6 c. A nurse who intends to change primary state of residence 7 may apply for licensure in the new home state in advance of such 8 change. However, new licenses will not be issued by a party 9 state until after a nurse provides evidence of change in primary 10 state of residence satisfactory to the new home state's 11 licensing board. 12 d. When a nurse changes primary state of residence by: 13 1. moving between two party states, and obtains a 14 license from the new home state, the license from the former 15 home state is no longer valid; 16 2. moving from a nonparty state to a party state, and 17 obtains a license from the new home state, the individual 18 state license issued by the nonparty state is not affected 19 and will remain in full force if so provided by the laws of 20 the nonparty state; 21 3. moving from a party state to a nonparty state, the 22 license issued by the prior home state converts to an 23 individual state license, valid only in the former home 24 state, without the multistate licensure privilege to practice 25 in other party states. 26 ARTICLE V 27 Adverse Actions 28 In addition to the General Provisions described in Article 29 III, the following provisions apply: 30 a. The licensing board of a remote state shall promptly 20070H0549B0619 - 7 -
1 report to the administrator of the coordinated licensure 2 information system any remote state actions including the 3 factual and legal basis for such action, if known. The licensing 4 board of a remote state shall also promptly report any 5 significant current investigative information yet to result in a 6 remote state action. The administrator of the coordinated 7 licensure information system shall promptly notify the home 8 state of any such reports. 9 b. The licensing board of a party state shall have the 10 authority to complete any pending investigations for a nurse who 11 changes primary state of residence during the course of such 12 investigations. It shall also have the authority to take 13 appropriate action(s), and shall promptly report the conclusions 14 of such investigations to the administrator of the coordinated 15 licensure information system. The administrator of the 16 coordinated licensure information system shall promptly notify 17 the new home state of any such actions. 18 c. A remote state may take adverse action affecting the 19 multistate licensure privilege to practice within that party 20 state. However, only the home state shall have the power to 21 impose adverse action against the license issued by the home 22 state. 23 d. For purposes of imposing adverse action, the licensing 24 board of the home state shall give the same priority and effect 25 to reported conduct received from a remote state as it would if 26 such conduct had occurred within the home state. In so doing, it 27 shall apply its own state laws to determine appropriate action. 28 e. The home state may take adverse action based on the 29 factual findings of the remote state, so long as each state 30 follows its own procedures for imposing such adverse action. 20070H0549B0619 - 8 -
1 f. Nothing in this Compact shall override a party state's 2 decision that participation in an alternative program may be 3 used in lieu of licensure action and that such participation 4 shall remain nonpublic if required by the party state's laws. 5 Party states must require nurses who enter any alternative 6 programs to agree not to practice in any other party state 7 during the term of the alternative program without prior 8 authorization from such other party state. 9 ARTICLE VI 10 Additional Authorities Invested in 11 Party State Nurse Licensing Boards 12 Notwithstanding any other powers, party state nurse licensing 13 boards shall have the authority to: 14 a. if otherwise permitted by state law, recover from the 15 affected nurse the costs of investigations and disposition of 16 cases resulting from any adverse action taken against that 17 nurse; 18 b. issue subpoenas for both hearings and investigations 19 which require the attendance and testimony of witnesses, and the 20 production of evidence. Subpoenas issued by a nurse licensing 21 board in a party state for the attendance and testimony of 22 witnesses, and/or the production of evidence from another party 23 state, shall be enforced in the latter state by any court of 24 competent jurisdiction, according to the practice and procedure 25 of that court applicable to subpoenas issued in proceedings 26 pending before it. The issuing authority shall pay any witness 27 fees, travel expenses, mileage and other fees required by the 28 service statutes of the state where the witnesses and/or 29 evidence are located; 30 c. issue cease and desist orders to limit or revoke a 20070H0549B0619 - 9 -
1 nurse's authority to practice in their respective states; 2 d. promulgate uniform rules and regulations as provided for 3 in Article VIII(c). 4 ARTICLE VII 5 Coordinated Licensure Information System 6 a. All party states shall participate in a cooperative 7 effort to create a coordinated data base of all licensed 8 registered nurses and licensed practical/vocational nurses. This 9 system will include information on the licensure and 10 disciplinary history of each nurse, as contributed by party 11 states, to assist in the coordination of nurse licensure and 12 enforcement efforts. 13 b. Notwithstanding any other provision of law, all party 14 states' licensing boards shall promptly report adverse actions, 15 actions against multistate licensure privileges, any current 16 significant investigative information yet to result in adverse 17 action, denials of applications, and the reasons for such 18 denials, to the coordinated licensure information system. 19 c. Current significant investigative information shall be 20 transmitted through the coordinated licensure information system 21 only to party state licensing boards. 22 d. Notwithstanding any other provision of law, all party 23 states' licensing boards contributing information to the 24 coordinated licensure information system may designate 25 information that may not be shared with nonparty states or 26 disclosed to other entities or individuals without the express 27 permission of the contributing state. 28 e. Any personally identifiable information obtained by a 29 party state's licensing board from the coordinated licensure 30 information system may not be shared with nonparty states or 20070H0549B0619 - 10 -
1 disclosed to other entities or individuals except to the extent 2 permitted by the laws of the party state contributing the 3 information. 4 f. Any information contributed to the coordinated licensure 5 information system that is subsequently required to be expunged 6 by the laws of the party state contributing that information, 7 shall also be expunged from the coordinated licensure 8 information system. 9 g. The Compact administrators, acting jointly with each 10 other and in consultation with the administrator of the 11 coordinated licensure information system, shall formulate 12 necessary and proper procedures for the identification, 13 collection and exchange of information under this Compact. 14 ARTICLE VIII 15 Compact Administration and Interchange of Information 16 a. The head of the nurse licensing board, or his/her 17 designee, of each party state shall be the administrator of this 18 Compact for his/her state. 19 b. The Compact administrator of each party state shall 20 furnish to the Compact administrator of each other party state 21 any information and documents including, but not limited to, a 22 uniform data set of investigations, identifying information, 23 licensure data, and disclosable alternative program 24 participation information to facilitate the administration of 25 this Compact. 26 c. Compact administrators shall have the authority to 27 develop uniform rules to facilitate and coordinate 28 implementation of this Compact. These uniform rules shall be 29 adopted by party states, under the authority invested under 30 Article VI (d). 20070H0549B0619 - 11 -
1 ARTICLE IX 2 Immunity 3 No party state or the officers or employees or agents of a 4 party state's nurse licensing board who acts in accordance with 5 the provisions of this Compact shall be liable on account of any 6 act or omission in good faith while engaged in the performance 7 of their duties under this Compact. Good faith in this article 8 shall not include willful misconduct, gross negligence, or 9 recklessness. 10 ARTICLE X 11 Entry into Force, Withdrawal and Amendment 12 a. This Compact shall enter into force and become effective 13 as to any state when it has been enacted into the laws of that 14 state. Any party state may withdraw from this Compact by 15 enacting a statute repealing the same, but no such withdrawal 16 shall take effect until six months after the withdrawing state 17 has given notice of the withdrawal to the executive heads of all 18 other party states. 19 b. No withdrawal shall affect the validity or applicability 20 by the licensing boards of states remaining party to Compact of 21 any report of adverse action occurring prior to the withdrawal. 22 c. Nothing contained in this Compact shall be construed to 23 invalidate or prevent any nurse licensure agreement or other 24 cooperative arrangement between a party state and a nonparty 25 state that is made in accordance with the other provisions of 26 this Compact. 27 d. This Compact may be amended by the party states. No 28 amendment to this Compact shall become effective and binding 29 upon the party states unless and until it is enacted into the 30 laws of all party states. 20070H0549B0619 - 12 -
1 ARTICLE XI 2 Construction and Severability 3 a. This Compact shall be liberally construed so as to 4 effectuate the purposes thereof. The provisions of this Compact 5 shall be severable and if any phrase, clause, sentence or 6 provision of this Compact is declared to be contrary to the 7 constitution of any party state or of the United States or the 8 applicability thereof to any government, agency, person or 9 circumstance is held invalid, the validity of the remainder of 10 this Compact and the applicability thereof to any government, 11 agency, person or circumstance shall not be affected thereby. If 12 this Compact shall be held contrary to the constitution of any 13 state party thereto, the Compact shall remain in full force and 14 effect as to the remaining party states and in full force and 15 effect as to the party state affected as to all severable 16 matters. 17 b. In the event party states find a need for settling 18 disputes arising under this Compact: 19 1. The party states may submit the issues in dispute to 20 an arbitration panel which will be comprised of an individual 21 appointed by the Compact administrator in the home state; an 22 individual appointed by the Compact administrator in the 23 remote state(s) involved; and an individual mutually agreed 24 upon by the Compact administrators of all the party states 25 involved in the dispute. 26 2. The decision of a majority of the arbitrators shall 27 be final and binding. 28 Section 10. Effective date. 29 This act shall take effect immediately. L11L71BIL/20070H0549B0619 - 13 -