152E.1 - FORM OF COMPACT.
152E.1 FORM OF COMPACT.
The nurse licensure compact is entered into and enacted into law
with all jurisdictions legally joining therein, in the form
substantially as follows:
1. Article I -- Findings and purpose.
a. The party states find all of the following:
(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 health care
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.
(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.
2. Article II -- Definitions. As used in this compact:
a. "Adverse action" means a home or remote state action.
b. "Alternative program" means a voluntary, nondisciplinary
monitoring program approved by a nurse licensing board.
c. "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.
d. "Current significant investigative information" means
either of the following:
(1) 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.
(2) 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.
e. "Home state" means the party state which is the nurse's
primary state of residence.
f. "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.
g. "Licensing board" means a party state's regulatory body
responsible for issuing nurse licenses.
h. "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 or 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.
i. "Nurse" means a registered nurse or licensed practical or
vocational nurse, as those terms are defined by each party state's
practice laws.
j. "Party state" means any state that has adopted this
compact.
k. "Remote state" means a party state, other than the home
state, where either of the following applies:
(1) Where the patient is located at the time nursing care is
provided.
(2) In the case of the practice of nursing not involving a
patient, in such party state where the recipient of nursing care is
located.
l. "Remote state action" means either of the following:
(1) Any administrative, civil, equitable, or criminal action
permitted by a remote state's laws which is 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.
(2) Cease and desist and other injunctive or equitable orders
issued by remote states or the licensing boards of remote states.
m. "State" means a state, territory, or possession of the
United States, the District of Columbia, or the Commonwealth of
Puerto Rico.
n. "State practice laws" means those individual party 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.
3. Article III -- General provisions and jurisdiction.
a. A license to practice registered nursing issued by a home
state to a resident in that state shall 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 or vocational nursing issued by a home state to a
resident in that state shall be recognized by each party state as
authorizing a multistate licensure privilege to practice as a
licensed practical or 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 subjects 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 shall not be recognized as granting the privilege to
practice nursing in any other party state unless explicitly agreed to
by that party state.
4. 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 the nurse's primary state of
residence may apply for licensure in the new home state in advance of
such change. However, new licenses shall not be issued by a party
state until after a nurse provides evidence of change in the nurse's
primary state of residence satisfactory to the new home state's
licensing board.
d. (1) If a nurse changes the nurse's primary state of
residence by 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) If a nurse changes the nurse's primary state of residence by
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 shall remain in full force if so
provided by the laws of the nonparty state.
(3) If a nurse changes the nurse's primary state of residence by
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.
5. 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 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.
6. 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 do all of
the following:
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 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 or evidence
is located.
c. Issue cease and desist orders to limit or revoke a nurse's
authority to practice in the state.
d. Promulgate uniform rules and regulations as provided for
in article VIII, paragraph "c".
7. Article VII -- Coordinated licensure information system.
a. All party states shall participate in a cooperative effort
to create a coordinated database of all licensed registered nurses
and licensed practical or vocational nurses. This system shall
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 shall 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 shall 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.
8. Article VIII -- Compact administration and interchange of
information.
a. The head of the nurse licensing board, or the head's
designee, of each party state shall be the administrator of this
compact for the head's 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, paragraph "d".
9. Article IX -- Immunity. A party state or the officers or
employees or agents of a party state's nurse licensing board who act
in accordance with the provisions of this compact shall not 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.
10. 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 such withdrawal shall not 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. Withdrawal shall not affect the validity or applicability
by the licensing boards of states remaining party to the compact of
any report of adverse action occurring prior to the withdrawal.
c. This compact shall not 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. An
amendment to this compact shall not become effective and binding upon
the party states unless and until it is enacted into the laws of all
party states.
11. 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 party state, 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. (1) In the event party states find a need for settling
disputes arising under this compact, the party states may submit the
issues in dispute to an arbitration panel which shall 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 or states 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 History: Recent Form
2000 Acts, ch 1008, §8; 2000 Acts, ch 1232, §51--55; 2008 Acts, ch
1032, §201
Referred to in § 147.2, 147.5, 147.7, 152.6, 152.7, 152.8, 152.10,
152E.2, 272C.6