43-12.4-01. Nurse licensure compact

43-12.4-01. Nurse licensure compact

ARTICLE I - FINDINGS AND DECLARATION OF PURPOSE

1. The party states find that:

a. 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;

b. Violations of nurse licensure and other laws regulating the practice of nursing

may result in injury or harm to the public;

c. 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;

d. New practice modalities and technology make compliance with individual state

nurse licensure laws difficult and complex;

e. The current system of duplicative licensure for nurses practicing in multiple states

is cumbersome and redundant for both nurses and states; and

f. Uniformity of nurse licensure requirements throughout the states promotes public

safety and public health benefits.

2. The general purposes of this compact are to:

a. Facilitate the states' responsibility to protect the public's health and safety;

b. Ensure and encourage the cooperation of party states in the areas of nurse

licensure and regulation;

c. Facilitate the exchange of information between party states in the areas of nurse

regulation, investigation, and adverse actions;

d. Promote compliance with the laws governing the practice of nursing in each

jurisdiction;

e. 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;

f. Decrease redundancies in the consideration and issuance of nurse licenses; and

g. Provide opportunities for interstate practice by nurses who meet uniform licensure

requirements.

ARTICLE II - DEFINITIONS

As used in this compact:

1. "Adverse action" means any administrative, civil, equitable, or criminal action permitted

by a state's laws which is imposed by a licensing board or other authority against a

nurse, including actions against an individual's license or multistate licensure privilege

such as revocation, suspension, probation, monitoring of the licensee, limitation on the

licensee's practice, or any other encumbrance on licensure affecting a nurse's

authorization to practice, including issuance of a cease and desist action.

2. "Alternative program" means a nondisciplinary monitoring program approved by a

licensing board.

3. "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 licensing boards.

4. "Current significant investigative information" means:

a. 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

b. 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.

5. "Encumbrance" means a revocation or suspension of, or any limitation on, the full and

unrestricted practice of nursing imposed by a licensing board.

6. "Home state" means the party state that is the nurse's primary state of residence.

7. "Licensing board" means a party state's regulatory body responsible for issuing nurse

licenses.

8. "Multistate license" means a license to practice as a registered or a licensed

a revocation or suspension of, or any limitation on, the full and

unrestricted practice of nursing imposed by a licensing board.

6. "Home state" means the party state that is the nurse's primary state of residence.

7. "Licensing board" means a party state's regulatory body responsible for issuing nurse

licenses.

8. "Multistate license" means a license to practice as a registered or a licensed

practical/vocational nurse issued by a home state licensing board which authorizes the

licensed nurse to practice in all party states under a multistate licensure privilege.

9. "Multistate licensure privilege" means a legal authorization associated with a multistate

license permitting the practice of nursing as either a registered nurse or licensed

practical/vocational nurse in a remote state.

10. "Nurse" means registered nurse or licensed practical/vocational nurse, as those terms

are defined by each party state's practice laws.

11. "Party state" means any state that has adopted this compact.

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

13. "Single-state license" means a nurse license issued by a party state which authorizes

practice only within the issuing state and does not include a multistate licensure

privilege to practice in any other party state.

14. "State" means a state, territory, or possession of the United States and the District of

Columbia.

15. "State practice laws" means a party state's laws, rules, 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" do not include requirements

necessary to obtain and retain a license, except for qualifications or requirements of

the home state.

ARTICLE III - GENERAL PROVISIONS AND JURISDICTION

1. A multistate license to practice registered or 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 nurse to practice as a registered nurse or as a licensed

practical/vocational nurse, under a multistate licensure privilege, in each party state.

2. A state shall implement procedures for considering the criminal history records of

applicants for initial multistate license or licensure by endorsement. Such procedures

shall include the submission of fingerprints or other biometric-based information by

applicants for the purpose of obtaining an applicant's criminal history record

information from the federal bureau of investigation and the agency responsible for

retaining that state's criminal records.

3. Each party state shall require the following for an applicant to obtain or retain a

multistate license in the home state:

a. Meets the home state's qualifications for licensure or renewal of licensure, as well

as, all other applicable state laws;

b. (1) Has graduated or is eligible to graduate from a licensing board-approved

registered nurse or licensed practical/vocational nurse prelicensure

education program; or

(2) Has graduated from a foreign registered nurse or licensed

practical/vocational nurse prelicensure education program that:

(a) Has been approved by the authorized accrediting body in the

applicable country; and

te laws;

b. (1) Has graduated or is eligible to graduate from a licensing board-approved

registered nurse or licensed practical/vocational nurse prelicensure

education program; or

(2) Has graduated from a foreign registered nurse or licensed

practical/vocational nurse prelicensure education program that:

(a) Has been approved by the authorized accrediting body in the

applicable country; and

(b) Has been verified by an independent credentials review agency to be

comparable to a licensing board-approved prelicensure education

program;

c. Has, if a graduate of a foreign prelicensure education program not taught in

English or if English is not the individual's native language, successfully passed

an English proficiency examination that includes the components of reading,

speaking, writing, and listening;

d. Has successfully passed an NCLEX-RN® or NCLEX-PN® Examination or

recognized predecessor, as applicable;

e. Is eligible for or holds an active, unencumbered license;

f. Has submitted, in connection with an application for initial licensure or licensure

by endorsement, fingerprints or other biometric data for the purpose of obtaining

criminal history record information from the federal bureau of investigation and

the agency responsible for retaining that state's criminal records;

g. Has not been convicted or found guilty, or has entered an agreed disposition, of a

felony offense under applicable state or federal criminal law;

h. Has not been convicted or found guilty, or has entered an agreed disposition, of a

misdemeanor offense related to the practice of nursing as determined on a

case-by-case basis;

i. Is not currently enrolled in an alternative program;

j. Is subject to self-disclosure requirements regarding current participation in an

alternative program; and

k. Has a valid United States social security number.

4. All party states may, in accordance with existing state due process law, to take

adverse action against a nurse's multistate licensure privilege such as revocation,

suspension, probation, or any other action that affects a nurse's authorization to

practice under a multistate licensure privilege, including cease and desist actions. If a

party state takes such action, it promptly shall notify the administrator of the

coordinated licensure information system. The administrator of the coordinated

licensure information system promptly shall notify the home state of any such actions

by remote states.

5. A nurse practicing in a party state shall comply with the state practice laws of the state

in which the client is located at the time service is provided. The practice of nursing is

not limited to patient care, but includes all nursing practice as defined by the state

practice laws of the party state in which the client is located. The practice of nursing in

a party state under a multistate licensure privilege will subject a nurse to the

jurisdiction of the licensing board, the courts, and the laws of the party state in which

the client is located at the time service is provided.

6. Individuals not residing in a party state continue to be able to apply for a party state's

single-state license as provided under the laws of each party state. However, the

single-state license granted to these individuals will not be recognized as granting the

privilege to practice nursing in any other party state. This compact does not affect the

requirements established by a party state for the issuance of a single-state license.

7. Any nurse holding a home state multistate license, on the effective date of this

compact, may retain and renew the multistate license issued by the nurse's then-

current home state, provided that:

a. A nurse, who changes primary state of residence after this compact's effective

date, shall meet all applicable requirements of subsection 3 of article III to obtain

a multistate license from a new home state.

ding a home state multistate license, on the effective date of this

compact, may retain and renew the multistate license issued by the nurse's then-

current home state, provided that:

a. A nurse, who changes primary state of residence after this compact's effective

date, shall meet all applicable requirements of subsection 3 of article III to obtain

a multistate license from a new home state.

b. A nurse who fails to satisfy the multistate licensure requirements in subsection 3

of article III due to a disqualifying event occurring after this compact's effective

date is ineligible to retain or renew a multistate license, and the nurse's multistate

license must be revoked or deactivated in accordance with applicable rules

adopted by the Interstate Commission of Nurse Licensure Compact

Administrators ("commission").

ARTICLE IV - APPLICATIONS FOR LICENSURE IN A PARTY STATE

1. Upon application for a multistate license, the licensing board in the issuing 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 encumbrances on any license or multistate licensure privilege

held by the applicant, whether any adverse action has been taken against any license

or multistate licensure privilege held by the applicant, and whether the applicant is

currently participating in an alternative program.

2. A nurse may hold a multistate license, issued by the home state, in only one party

state at a time.

3. If a nurse changes primary state of residence by moving between two party states, the

nurse shall apply for licensure in the new home state, and the multistate license issued

by the prior home state will be deactivated in accordance with applicable rules adopted

by the commission.

a. The nurse may apply for licensure in advance of a change in primary state of

residence.

b. A multistate license may not be issued by the new home state until the nurse

provides satisfactory evidence of a change in primary state of residence to the

new home state and satisfies all applicable requirements to obtain a multistate

license from the new home state.

4. If a nurse changes primary state of residence by moving from a party state to a

nonparty state, the multistate license issued by the prior home state will convert to a

single-state license, valid only in the former home state.

ARTICLE V - ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING

BOARDS

1. In addition to the other powers conferred by state law, a licensing board may:

a. Take adverse action against a nurse's multistate licensure privilege to practice

within that party state.

(1) Only the home state has the power to take adverse action against a nurse's

license issued by the home state.

r home state.

ARTICLE V - ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING

BOARDS

1. In addition to the other powers conferred by state law, a licensing board may:

a. Take adverse action against a nurse's multistate licensure privilege to practice

within that party state.

(1) Only the home state has the power to take adverse action against a nurse's

license issued by the home state.

(2) For purposes of taking adverse action, the home state licensing board 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, the home state shall apply its own state laws to determine

appropriate action.

b. Issue cease and desist orders or impose an encumbrance on a nurse's authority

to practice within that party state.

c. Complete any pending investigations of a nurse who changes primary state of

residence during the course of such investigations. The licensing board also may

take any appropriate action and promptly shall report the conclusions of such

investigations to the administrator of the coordinated licensure information

system. The administrator of the coordinated licensure information system

promptly shall notify the new home state of any such actions.

d. Issue subpoenas for both hearings and investigations which require the

attendance and testimony of witnesses, as well as, the production of evidence.

Subpoenas issued by a licensing board in a party state for the attendance and

testimony of witnesses or the production of evidence from another party state

must 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 in which the witnesses or evidence are located.

e. Obtain and submit, for each nurse licensure applicant, fingerprint or other

biometric-based information to the federal bureau of investigation for criminal

background checks, receive the results of the federal bureau of investigation

record search on criminal background checks, and use the results in making

licensure decisions.

f. 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.

g. Take adverse action based on the factual findings of the remote state, if the

licensing board follows its own procedures for taking such adverse action.

2. If adverse action is taken by the home state against a nurse's multistate license, the

nurse's multistate licensure privilege to practice in all other party states must be

deactivated until all encumbrances have been removed from the multistate license. All

home state disciplinary orders that impose adverse action against a nurse's multistate

license shall include a statement that the nurse's multistate licensure privilege is

deactivated in all party states during the pendency of the order.

3. This compact does not override a party state's decision that participation in an

alternative program may be used in lieu of adverse action. The home state licensing

board shall deactivate the multistate licensure privilege under the multistate license of

any nurse for the duration of the nurse's participation in an alternative program.

ARTICLE VI - COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF

INFORMATION

1. All party states shall participate in a coordinated licensure information system of all

licensed registered nurses and licensed practical/vocational nurses. This system

includes information on the licensure and disciplinary history of each nurse, as

submitted by party states, to assist in the coordination of nurse licensure and

enforcement efforts.

ATION SYSTEM AND EXCHANGE OF

INFORMATION

1. All party states shall participate in a coordinated licensure information system of all

licensed registered nurses and licensed practical/vocational nurses. This system

includes information on the licensure and disciplinary history of each nurse, as

submitted by party states, to assist in the coordination of nurse licensure and

enforcement efforts.

2. The commission, 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.

3. All licensing boards promptly shall report to the coordinated licensure information

system any adverse action, any current significant investigative information, denials of

applications (with the reasons for such denials), and nurse participation in alternative

programs known to the licensing board regardless of whether such participation is

deemed nonpublic or confidential under state law.

4. Current significant investigative information and participation in nonpublic or

confidential alternative programs must be transmitted through the coordinated

licensure information system only to party state licensing boards.

5. Notwithstanding any other provision of law, all party state 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.

6. Any personally identifiable information obtained from the coordinated licensure

information system by a party state licensing board 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.

7. Any information contributed to the coordinated licensure information system which is

subsequently required to be expunged by the laws of the party state contributing that

information also must be expunged from the coordinated licensure information system.

8. The compact administrator of each party state shall furnish a uniform data set to the

compact administrator of each other party state, which must include, at a minimum:

a. Identifying information;

b. Licensure data;

c. Information related to alternative program participation; and

d. Other information that may facilitate the administration of this compact, as

determined by commission rules.

9. The compact administrator of a party state shall provide all investigative documents

and information requested by another party state.

ARTICLE VII - ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE

LICENSURE COMPACT ADMINISTRATORS

1. The party states hereby create and establish a joint public entity known as the

Interstate Commission of Nurse Licensure Compact Administrators.

a. The commission is an instrumentality of the party states.

b. Venue is proper, and judicial proceedings by or against the commission must be

brought solely and exclusively, in a court of competent jurisdiction where the

principal office of the commission is located. The commission may waive venue

and jurisdictional defenses to the extent it adopts or consents to participate in

alternative dispute resolution proceedings.

c. This compact may not be construed to be a waiver of sovereign immunity.

2. Membership, voting, and meetings.

a. Each party state must have and be limited to one administrator. The head of the

state licensing board or designee is the administrator of this compact for each

party state. Any administrator may be removed or suspended from office as

provided by the law of the state from which the administrator is appointed. Any

vacancy occurring in the commission must be filled in accordance with the laws of

the party state in which the vacancy exists.

one administrator. The head of the

state licensing board or designee is the administrator of this compact for each

party state. Any administrator may be removed or suspended from office as

provided by the law of the state from which the administrator is appointed. Any

vacancy occurring in the commission must be filled in accordance with the laws of

the party state in which the vacancy exists.

b. Each administrator is entitled to one vote with regard to the promulgation of rules

and creation of bylaws and otherwise has an opportunity to participate in the

business and affairs of the commission. An administrator shall vote in person or

by such other means as provided in the bylaws. The bylaws may provide for an

administrator's participation in meetings by telephone or other means of

communication.

c. The commission shall meet at least once during each calendar year. Additional

meetings must be held as set forth in the bylaws or rules of the commission.

d. All meetings are open to the public, and public notice of meetings must be given

in the same manner as required under the rulemaking provisions in Article VIII.

e. The commission may convene in a closed, nonpublic meeting if the commission

discusses:

(1) Noncompliance of a party state with its obligations under this compact;

(2) The employment, compensation, discipline, or other personnel matters,

practices, or procedures related to specific employees or other matters

related to the commission's internal personnel practices and procedures;

(3) Current, threatened, or reasonably anticipated litigation;

(4) Negotiation of contracts for the purchase or sale of goods, services, or real

estate;

(5) Accusing any person of a crime or formally censuring any person;

(6) Disclosure of trade secrets or commercial or financial information that is

privileged or confidential;

(7) Disclosure of information of a personal nature if disclosure would constitute

a clearly unwarranted invasion of personal privacy;

(8) Disclosure of investigatory records compiled for law enforcement purposes;

(9) Disclosure of information related to any reports prepared by or on behalf of

the Commission for the purpose of investigation of compliance with this

compact; or

(10) Matters specifically exempted from disclosure by federal or state statute.

f. If a meeting, or portion of a meeting, is closed pursuant to this provision, the

commission's legal counsel or designee shall certify that the meeting may be

closed and shall reference each relevant exempting provision. The commission

shall keep minutes that fully and clearly describe all matters discussed in a

meeting and shall provide a full and accurate summary of actions taken, and the

reasons for the actions taken, including a description of the views expressed. All

documents considered in connection with an action must be identified in such

minutes. All minutes and documents of a closed meeting must remain under seal,

subject to release by a majority vote of the commission or order of a court of

competent jurisdiction.

3. By a majority vote of the administrators, the commission shall prescribe bylaws or

rules to govern its conduct as may be necessary or appropriate to carry out the

purposes and exercise the powers of this compact, including:

a. Establishing the fiscal year of the commission;

b. Providing reasonable standards and procedures:

(1) For the establishment and meetings of other committees; and

n.

3. By a majority vote of the administrators, the commission shall prescribe bylaws or

rules to govern its conduct as may be necessary or appropriate to carry out the

purposes and exercise the powers of this compact, including:

a. Establishing the fiscal year of the commission;

b. Providing reasonable standards and procedures:

(1) For the establishment and meetings of other committees; and

(2) Governing any general or specific delegation of any authority or function of

the commission;

c. Providing reasonable procedures for calling and conducting meetings of the

commission, ensuring reasonable advance notice of all meetings and providing

an opportunity for attendance of such meetings by interested parties, with

enumerated exceptions designed to protect the public's interest, the privacy of

individuals, and proprietary information, including trade secrets. The commission

may meet in closed session only after a majority of the administrators vote to

close a meeting in whole or in part. As soon as practicable, the commission shall

make public a copy of the vote to close the meeting revealing the vote of each

administrator, with no proxy votes allowed;

d. Establishing the titles, duties, and authority and reasonable procedures for the

election of the officers of the commission;

e. Providing reasonable standards and procedures for the establishment of the

personnel policies and programs of the commission. Notwithstanding any civil

service or other similar laws of any party state, the bylaws exclusively must

govern the personnel policies and programs of the commission; and

f. Providing a mechanism for winding up the operations of the commission and the

equitable disposition of any surplus funds that may exist after the termination of

this compact after the payment or reserving of all of its debts and obligations;

4. The commission shall publish its bylaws and rules, and any amendments thereto, in a

convenient form on the website of the commission.

5. The commission shall maintain its financial records in accordance with the bylaws.

6. The commission shall meet and take such actions as are consistent with the

provisions of this compact and the bylaws.

7. The commission may:

a. Promulgate uniform rules to facilitate and coordinate implementation and

administration of this compact. The rules have the force and effect of law and are

binding in all party states;

b. Bring and prosecute legal proceedings or actions in the name of the commission,

provided that the standing of any licensing board to sue or be sued under

applicable law may not be affected;

c. Purchase and maintain insurance and bonds;

d. Borrow, accept, or contract for services of personnel, including, but not limited to,

employees of a party state or nonprofit organizations;

e. Cooperate with other organizations that administer state compacts related to the

regulation of nursing, including sharing administrative or staff expenses, office

space, or other resources;

f. Hire employees, elect or appoint officers, fix compensation, define duties, grant

such individuals appropriate authority to carry out the purposes of this compact,

and to establish the commission's personnel policies and programs relating to

conflicts of interest, qualifications of personnel, and other related personnel

matters;

g. Accept any and all appropriate donations, grants, and gifts of money, equipment,

supplies, materials, and services, and to receive, utilize, and dispose of the same

if at all times the commission avoids any appearance of impropriety or conflict of

interest;

h. Lease, purchase, accept appropriate gifts or donations of, or otherwise to own,

hold, improve or use, any property, whether real, personal, or mixed if at all times

the commission avoids any appearance of impropriety;

i. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose

of any property, whether real, personal, or mixed;

of impropriety or conflict of

interest;

h. Lease, purchase, accept appropriate gifts or donations of, or otherwise to own,

hold, improve or use, any property, whether real, personal, or mixed if at all times

the commission avoids any appearance of impropriety;

i. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose

of any property, whether real, personal, or mixed;

j. Establish a budget and make expenditures;

k. Borrow money;

l. Appoint committees, including advisory committees comprised of administrators,

state nursing regulators, state legislators or their representatives, consumer

representatives, and other such interested persons;

m. Provide and receive information from, and to cooperate with, law enforcement

agencies;

n. Adopt and use an official seal; and

o. Perform such other functions as may be necessary or appropriate to achieve the

purposes of this compact consistent with the state regulation of nurse licensure

and practice.

8. Financing of the commission.

a. The commission shall pay, or provide for the payment of, the reasonable

expenses of its establishment, organization, and ongoing activities.

b. The commission may also levy on and collect an annual assessment from each

party state to cover the cost of its operations, activities, and staff in its annual

budget as approved each year. The aggregate annual assessment amount, if

any, must be allocated based upon a formula to be determined by the

commission, which shall promulgate a rule that is binding upon all party states.

c. The commission may not incur obligations of any kind before securing the funds

adequate to meet the same, nor may the commission pledge the credit of any of

the party states, except by, and with the authority of, such party state.

d. The commission shall keep accurate accounts of all receipts and disbursements.

The receipts and disbursements of the commission are subject to the audit and

accounting procedures established under its bylaws. However, all receipts and

disbursements of funds handled by the commission must be audited yearly by a

certified or licensed public accountant, and the report of the audit must be

included in and become part of the annual report of the commission.

9. Qualified immunity, defense, and indemnification.

a. The administrators, officers, executive director, employees, and representatives

of the commission are immune from suit and liability, either personally or in their

official capacity, for any claim for damage to or loss of property or personal injury

or other civil liability caused by or arising out of any actual or alleged act, error, or

omission that occurred, or that the person against which the claim is made had a

reasonable basis for believing occurred, within the scope of commission

employment, duties or responsibilities. However, this subdivision may not be

construed to protect any such person from suit or liability for any damage, loss,

injury, or liability caused by the intentional, willful, or wanton misconduct of that

person.

b. The commission shall defend any administrator, officer, executive director,

employee, or representative of the commission in any civil action seeking to

impose liability arising out of any actual or alleged act, error, or omission that

occurred within the scope of commission employment, duties, or responsibilities,

or that the person against which the claim is made had a reasonable basis for

believing occurred within the scope of commission employment, duties, or

responsibilities. However, this subdivision may not be construed to prohibit that

person from retaining that person's own counsel and provided further that the

actual or alleged act, error, or omission did not result from that person's

intentional, willful, or wanton misconduct.

c. The commission shall indemnify and hold harmless any administrator, officer,

f commission employment, duties, or

responsibilities. However, this subdivision may not be construed to prohibit that

person from retaining that person's own counsel and provided further that the

actual or alleged act, error, or omission did not result from that person's

intentional, willful, or wanton misconduct.

c. The commission shall indemnify and hold harmless any administrator, officer,

executive director, employee, or representative of the commission for the amount

of any settlement or judgment obtained against that person arising out of any

actual or alleged act, error, or omission that occurred within the scope of

commission employment, duties, or responsibilities, or that such person had a

reasonable basis for believing occurred within the scope of commission

employment, duties, or responsibilities provided that the actual or alleged act,

error, or omission did not result from the intentional, willful, or wanton misconduct

of that person.

ARTICLE VIII - RULEMAKING

1. The commission shall exercise its rulemaking powers pursuant to the criteria set forth

in this article and the rules adopted under this article. Rules and amendments become

binding as of the date specified in each rule or amendment and have the same force

and effect as provisions of this compact.

2. Rules or amendments to the rules must be adopted at a regular or special meeting of

the commission.

3. Before the promulgation and adoption of a final rule or rules by the commission, and at

least sixty days in advance of the meeting at which the rule will be considered and

voted upon, the commission shall file a notice of proposed rulemaking:

a. On the website of the commission; and

b. On the website of each licensing board or the publication in which each state

would otherwise publish proposed rules.

4. The notice of proposed rulemaking must include:

a. The proposed time, date, and location of the meeting at which the rule will be

considered and voted upon;

b. The text of the proposed rule or amendment, and the reason for the proposed

rule;

c. A request for comments on the proposed rule from any interested person; and

d. The manner in which interested persons may submit notice to the commission of

their intention to attend the public hearing and any written comments.

5. Before adoption of a proposed rule, the commission shall allow persons to submit

written data, facts, opinions, and arguments, which must be made available to the

public.

6. The commission shall grant an opportunity for a public hearing before it adopts a rule

or amendment.

7. The commission shall publish the place, time, and date of the scheduled public

hearing.

a. Hearings must be conducted in a manner providing each person that wishes to

comment a fair and reasonable opportunity to comment orally or in writing. All

hearings will be recorded, and a copy must be made available upon request.

b. This section may not be construed as requiring a separate hearing on each rule.

Rules may be grouped for the convenience of the commission at hearings

required by this section.

8. If no one appears at the public hearing, the commission may proceed with

promulgation of the proposed rule.

9. Following the scheduled hearing date, or by the close of business on the scheduled

hearing date if the hearing was not held, the commission shall consider all written and

oral comments received.

10. By majority vote of all administrators, the commission shall take final action on the

proposed rule and shall determine the effective date of the rule, if any, based on the

rulemaking record and the full text of the rule.

11. Upon determination that an emergency exists, the commission may consider and

adopt an emergency rule without prior notice, opportunity for comment, or hearing.

However, the usual rulemaking procedures provided in this compact and in this section

must be retroactively applied to the rule as soon as reasonably possible, in no event

sed on the

rulemaking record and the full text of the rule.

11. Upon determination that an emergency exists, the commission may consider and

adopt an emergency rule without prior notice, opportunity for comment, or hearing.

However, the usual rulemaking procedures provided in this compact and in this section

must be retroactively applied to the rule as soon as reasonably possible, in no event

later than ninety days after the effective date of the rule. For the purposes of this

provision, an emergency rule is one that must be adopted immediately in order to:

a. Meet an imminent threat to public health, safety, or welfare;

b. Prevent a loss of commission or party state funds; or

c. Meet a deadline for the promulgation of an administrative rule that is required by

federal law or rule.

12. The commission may direct revisions to a previously adopted rule or amendment for

purposes of correcting typographical errors, errors in format, errors in consistency, or

grammatical errors. Public notice of any revisions must be posted on the website of

the commission. The revision is subject to challenge by any person for a period of

thirty days after posting. The revision may be challenged only on grounds that the

revision results in a material change to a rule. A challenge must be made in writing,

and delivered to the commission before the end of the notice period. If a challenge is

not made, the revision will take effect without further action. If the revision is

challenged, the revision may not take effect without the approval of the commission.

ARTICLE IX - OVERSIGHT, DISPUTE, RESOLUTION AND ENFORCEMENT

1. Oversight.

a. Each party state shall enforce this compact and take all actions necessary and

appropriate to effectuate this compact's purposes and intent.

b. The commission is entitled to receive service of process in any proceeding that

may affect the powers, responsibilities, or actions of the commission, and has

standing to intervene in such a proceeding for all purposes. Failure to provide

service of process in such proceeding to the commission renders a judgment or

order void as to the commission, this compact, or promulgated rules.

2. Default, technical assistance, and termination.

a. If the commission determines a party state has defaulted in the performance of its

obligations or responsibilities under this compact or the promulgated rules, the

commission shall:

(1) Provide written notice to the defaulting state and other party states of the

nature of the default, the proposed means of curing the default, or any other

action to be taken by the commission; and

(2) Provide remedial training and specific technical assistance regarding the

default.

b. If a state in default fails to cure the default, the defaulting state's membership in

this compact may be terminated upon an affirmative vote of a majority of the

administrators, and all rights, privileges, and benefits conferred by this compact

may be terminated on the effective date of termination. A cure of the default does

not relieve the offending state of obligations or liabilities incurred during the

period of default.

c. Termination of membership in this compact may be imposed only after all other

means of securing compliance have been exhausted. Notice of intent to suspend

or terminate must be given by the commission to the governor of the defaulting

state and to the executive officer of the defaulting state's licensing board and

each of the party states.

d. A state whose membership in this compact has been terminated is responsible

for all assessments, obligations, and liabilities incurred through the effective date

of termination, including obligations that extend beyond the effective date of

termination.

e. The commission may not bear any costs related to a state that is found to be in

default or whose membership in this compact has been terminated unless agreed

rship in this compact has been terminated is responsible

for all assessments, obligations, and liabilities incurred through the effective date

of termination, including obligations that extend beyond the effective date of

termination.

e. The commission may not bear any costs related to a state that is found to be in

default or whose membership in this compact has been terminated unless agreed

upon in writing between the commission and the defaulting state.

f. The defaulting state may appeal the action of the commission by petitioning the

United States district court for the District of Columbia or the federal district in

which the commission has its principal offices. The prevailing party must be

awarded all costs of such litigation, including reasonable attorney's fees.

3. Dispute resolution.

a. Upon request by a party state, the commission shall attempt to resolve disputes

related to the compact which arise among party states and between party and

nonparty states.

b. The commission shall promulgate a rule providing for both mediation and binding

dispute resolution for disputes, as appropriate.

c. If the commission cannot resolve disputes among party states arising under this

compact:

(1) The party states may submit the issues in dispute to an arbitration panel,

which will be comprised of individuals appointed by the compact

administrator in each of the affected party states 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 is final and binding.

4. Enforcement.

a. The commission, in the reasonable exercise of its discretion, shall enforce the

provisions and rules of this compact.

b. By majority vote, the commission may initiate legal action in the United States

district court for the District of Columbia or the federal district in which the

commission has its principal offices against a party state that is in default to

enforce compliance with the provisions of this compact and its promulgated rules

and bylaws. The relief sought may include both injunctive relief and damages. If

judicial enforcement is necessary, the prevailing party must be awarded all costs

of such litigation, including reasonable attorney's fees.

c. The remedies herein are not the exclusive remedies of the commission. The

commission may pursue any other remedies available under federal or state law.

ARTICLE X - EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT

1. This compact becomes effective and binding on the earlier of the date of legislative

enactment of this compact into law by no less than twenty-six states or December 31,

2018. All party states to this compact, that also were parties to the prior nurse

licensure compact, superseded by this compact, ("prior compact"), are deemed to

have withdrawn from said prior compact within six months after the effective date of

this compact.

2. Each party state to this compact shall continue to recognize a nurse's multistate

licensure privilege to practice in that party state issued under the prior compact until

such party state has withdrawn from the prior compact.

3. Any party state may withdraw from this compact by enacting a statute repealing the

same. A party state's withdrawal does not take effect until six months after enactment

of the repealing statute.

4. A party state's withdrawal or termination does not affect the continuing requirement of

the withdrawing or terminated state's licensing board to report adverse actions and

significant investigations occurring prior to the effective date of such withdrawal or

termination.

5. This compact may 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.

6. This compact may be amended by the party states. An amendment to this compact

ons occurring prior to the effective date of such withdrawal or

termination.

5. This compact may 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.

6. This compact may be amended by the party states. An amendment to this compact

does not become effective and binding upon the party states unless and until it is

enacted into the laws of all party states.

7. Representatives of nonparty states to this compact must be invited to participate in the

activities of the commission, on a nonvoting basis, prior to the adoption of this compact

by all states.

ARTICLE XI - CONSTRUCTION AND SEVERABILITY

This compact must be liberally construed so as to effectuate the purposes thereof. The

provisions of this compact are 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 if 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 may not be affected thereby. If this compact is

held to be contrary to the constitution of any party state, this compact remains 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.

The term "head of the state licensing board" as used to define the compact administrator in

subdivision a of subsection 2 of article VII means the executive director of the state board of

nursing.