Bill Text: IA SF430 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to the advanced practice registered nurse compact, including assessments against party states, and including effective date provisions. (Formerly SSB 1075.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2017-03-31 - Referred to Human Resources. S.J. 837. [SF430 Detail]
Download: Iowa-2017-SF430-Introduced.html
Senate File 430 - Introduced SENATE FILE BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO SSB 1075) A BILL FOR 1 An Act relating to the advanced practice registered nurse 2 compact, including assessments against party states, and 3 including effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 1110SV (1) 87 tr/nh PAG LIN 1 1 Section 1. Section 152E.3, Code 2017, is amended by striking 1 2 the section and inserting in lieu thereof the following: 1 3 152E.3 Form of advanced practice registered nurse compact. 1 4 1. Article I == Findings and declaration of purpose. 1 5 a. The party states find all of the following: 1 6 (1) The health and safety of the public are affected by the 1 7 degree of compliance with advanced practice registered nurse 1 8 licensure requirements and the effectiveness of enforcement 1 9 activities related to state advanced practice registered nurse 1 10 licensure laws. 1 11 (2) Violations of advanced practice registered nurse 1 12 licensure and other laws regulating the practice of nursing may 1 13 result in injury or harm to the public. 1 14 (3) The expanded mobility of advanced practice registered 1 15 nurses and the use of advanced communication technologies 1 16 as part of our nation's health care delivery system require 1 17 greater coordination and cooperation among states in the areas 1 18 of advanced practice registered nurse licensure and regulation. 1 19 (4) New practice modalities and technology make compliance 1 20 with individual state advanced practice registered nurse 1 21 licensure laws difficult and complex. 1 22 (5) The current system of duplicative advanced practice 1 23 registered nurse licensure for advanced practice registered 1 24 nurses practicing in multiple states is cumbersome and 1 25 redundant for both advanced practice registered nurses and 1 26 states. 1 27 (6) Uniformity of advanced practice registered nurse 1 28 licensure requirements throughout the states promotes public 1 29 safety and public health benefits. 1 30 b. The general purposes of this compact are to: 1 31 (1) Facilitate the states' responsibility to protect the 1 32 public's health and safety. 1 33 (2) Ensure and encourage the cooperation of party states 1 34 in the areas of advanced practice registered nurse licensure 1 35 and regulation, including promotion of uniform licensure 2 1 requirements. 2 2 (3) Facilitate the exchange of information between party 2 3 states in the areas of advanced practice registered nurse 2 4 regulation, investigation, and adverse actions. 2 5 (4) Promote compliance with the laws governing advanced 2 6 practice registered nurse practice in each jurisdiction. 2 7 (5) Invest all party states with the authority to hold an 2 8 advanced practice registered nurse accountable for meeting 2 9 all state practice laws in the state in which the patient 2 10 is located at the time care is rendered through the mutual 2 11 recognition of party state licenses. 2 12 (6) Decrease redundancies in the consideration and issuance 2 13 of advanced practice registered nurse licenses. 2 14 (7) Provide opportunities for interstate practice by 2 15 advanced practice registered nurses who meet uniform licensure 2 16 requirements. 2 17 2. Article II == Definitions. As used in this compact: 2 18 a. "Advanced practice registered nurse" means a registered 2 19 nurse who has gained additional specialized knowledge, skills 2 20 and experience through a program of study recognized or defined 2 21 by the interstate commission of advanced practice registered 2 22 nurse compact administrators ("commission"), and who is 2 23 licensed to perform advanced nursing practice. An advanced 2 24 practice registered nurse is licensed in an advanced practice 2 25 registered nurse role that is congruent with an advanced 2 26 practice registered nurse educational program, certification, 2 27 and commission rules. 2 28 b. "Advanced practice registered nurse licensure" means 2 29 the regulatory mechanism used by a party state to grant legal 2 30 authority to practice as an advanced practice registered nurse. 2 31 c. "Advanced practice registered nurse uniform licensure 2 32 requirements" means minimum uniform licensure, education, and 2 33 examination requirements as adopted by the commission. 2 34 d. "Adverse action" means any administrative, civil, 2 35 equitable, or criminal action permitted by a state's laws which 3 1 is imposed by a licensing board or other authority against an 3 2 advanced practice registered nurse, including actions against 3 3 an individual's license or multistate licensure privilege 3 4 such as revocation, suspension, probation, monitoring of 3 5 the licensee, limitation on the licensee's practice, or any 3 6 other encumbrance on licensure affecting an advanced practice 3 7 registered nurse's authorization to practice, including the 3 8 issuance of a cease and desist action. 3 9 e. "Alternative program" means a nondisciplinary monitoring 3 10 program approved by a licensing board. 3 11 f. "Coordinated licensure information system" means an 3 12 integrated process for collecting, storing, and sharing 3 13 information on advanced practice registered nurse licensure and 3 14 enforcement activities related to advanced practice registered 3 15 nurse licensure laws that is administered by a nonprofit 3 16 organization composed of and controlled by licensing boards. 3 17 g. "Current significant investigatory information" means 3 18 either of the following: 3 19 (1) Investigative information that a licensing board, 3 20 after a preliminary inquiry that includes notification and 3 21 an opportunity for the advanced practice registered nurse to 3 22 respond, if required by state law, has reason to believe is 3 23 not groundless and, if proved true, would indicate more than a 3 24 minor infraction. 3 25 (2) Investigative information that indicates that the 3 26 advanced practice registered nurse represents an immediate 3 27 threat to public health and safety regardless of whether the 3 28 advanced practice registered nurse has been notified and had an 3 29 opportunity to respond. 3 30 h. "Encumbrance" means a revocation or suspension of, or any 3 31 limitation on, the full and unrestricted practice of nursing 3 32 imposed by a licensing board. 3 33 i. "Home state" means the party state that is the advanced 3 34 practice registered nurse's primary state of residence. 3 35 j. "Licensing board" means a party state's regulatory body 4 1 responsible for regulating the practice of advanced practice 4 2 registered nursing. 4 3 k. "Multistate license" means an advanced practice 4 4 registered nurse license to practice as an advanced practice 4 5 registered nurse issued by a home state licensing board that 4 6 authorizes the advanced practice registered nurse to practice 4 7 as an advanced practice registered nurse in all party states 4 8 under a multistate licensure privilege, in the same role and 4 9 population focus as the advanced practice registered nurse is 4 10 licensed in the home state. 4 11 l. "Multistate licensure privilege" means a legal 4 12 authorization associated with an advanced practice registered 4 13 nurse multistate license that permits an advanced practice 4 14 registered nurse to practice as an advanced practice registered 4 15 nurse in a remote state, in the same role and population focus 4 16 as the advanced practice registered nurse is licensed in the 4 17 home state. 4 18 m. "Noncontrolled prescription drug" means a device or 4 19 drug that is not a controlled substance and is prohibited 4 20 under state or federal law from being dispensed without a 4 21 prescription. The term includes a device or drug that bears or 4 22 is required to bear the legend "Caution: federal law prohibits 4 23 dispensing without prescription" or "prescription only" or 4 24 other legend that complies with federal law. 4 25 n. "Party state" means any state that has adopted this 4 26 compact. 4 27 o. "Population focus" means a specific patient population 4 28 that is congruent with the advanced practice registered nurse 4 29 educational program, certification, and commission rules. 4 30 p. "Prescriptive authority" means the legal authority to 4 31 prescribe medications and devices as defined by party state 4 32 laws. 4 33 q. "Remote state" means a party state that is not the home 4 34 state. 4 35 r. "Single=state license" means an advanced practice 5 1 registered nurse license issued by a party state that 5 2 authorizes practice only within the issuing state and does not 5 3 include a multistate licensure privilege to practice in any 5 4 other party state. 5 5 s. "State" means a state, territory, or possession of the 5 6 United States and the District of Columbia. 5 7 t. "State practice laws" means a party state's laws, rules, 5 8 and regulations that govern advanced practice registered nurse 5 9 practice, define the scope of advanced nursing practice, 5 10 including prescriptive authority, and create the methods and 5 11 grounds for imposing discipline. State practice laws do 5 12 not include the requirements necessary to obtain and retain 5 13 an advanced practice registered nurse license, except for 5 14 qualifications or requirements of the home state. 5 15 3. Article III == General provisions and jurisdiction. 5 16 a. A state must implement procedures for considering the 5 17 criminal history records of applicants for initial advanced 5 18 practice registered nurse licensure or advanced practice 5 19 registered nurse licensure by endorsement. Such procedures 5 20 shall include the submission of fingerprints or other 5 21 biometric=based information by advanced practice registered 5 22 nurse applicants for the purpose of obtaining an applicant's 5 23 criminal history record information from the federal bureau of 5 24 investigation and the agency responsible for retaining that 5 25 state's criminal records. 5 26 b. By rule, the commission shall adopt the advanced practice 5 27 registered nurse uniform licensure requirements. The uniform 5 28 licensure requirements shall provide the minimum requirements 5 29 for advanced practice registered nurse multistate licensure 5 30 in party states, provided that the commission may adopt 5 31 rules whereby an advanced practice registered nurse, with an 5 32 unencumbered license on the effective date of this compact, may 5 33 obtain, by endorsement or otherwise, and retain a multistate 5 34 license in a party state. 5 35 c. In order to obtain or retain a multistate license, an 6 1 advanced practice registered nurse must meet, in addition 6 2 to the uniform licensure requirements, the home state's 6 3 qualifications for licensure or renewal of licensure, as well 6 4 as all other applicable home state laws. 6 5 d. By rule, the commission shall identify the approved 6 6 advanced practice registered nurse roles and population foci 6 7 for licensure as an advanced practice registered nurse. An 6 8 advanced practice registered nurse issued a multistate license 6 9 shall be licensed in an approved advanced practice registered 6 10 nurse role and at least one approved population focus. 6 11 e. An advanced practice registered nurse multistate license 6 12 issued by a home state to a resident in that state will be 6 13 recognized by each party state as authorizing the advanced 6 14 practice registered nurse to practice as an advanced practice 6 15 registered nurse in each party state, under a multistate 6 16 licensure privilege, in the same role and population focus 6 17 as the advanced practice registered nurse is licensed in the 6 18 home state. If an applicant does not qualify for a multistate 6 19 license, a single=state license may be issued by a home state. 6 20 f. Issuance of an advanced practice registered nurse 6 21 multistate license shall include prescriptive authority for 6 22 noncontrolled prescription drugs, unless the advanced practice 6 23 registered nurse was licensed by the home state prior to the 6 24 home state's adoption of this compact and has not previously 6 25 held prescriptive authority. 6 26 (1) An advanced practice registered nurse granted 6 27 prescriptive authority for noncontrolled prescription drugs 6 28 in the home state may exercise prescriptive authority for 6 29 noncontrolled prescription drugs in any remote state while 6 30 exercising a multistate licensure privilege under an advanced 6 31 practice registered nurse multistate license; the advanced 6 32 practice registered nurse shall not be required to meet any 6 33 additional eligibility requirements imposed by the remote 6 34 state in exercising prescriptive authority for noncontrolled 6 35 prescription drugs. 7 1 (2) Prescriptive authority in the home state for an advanced 7 2 practice registered nurse who was not granted prescriptive 7 3 authority at the time of initial licensure by the home state, 7 4 prior to the adoption of this compact, shall be determined 7 5 under home state law. 7 6 (3) Prescriptive authority eligibility for an advanced 7 7 practice registered nurse holding a single=state license shall 7 8 be determined under the law of the licensing state. 7 9 g. For each state in which an advanced practice registered 7 10 nurse seeks authority to prescribe controlled substances, 7 11 the advanced practice registered nurse shall satisfy all 7 12 requirements imposed by such state in granting or renewing such 7 13 authority. 7 14 h. An advanced practice registered nurse issued a 7 15 multistate license is authorized to assume responsibility and 7 16 accountability for patient care independent of a supervisory or 7 17 collaborative relationship with a physician. This authority 7 18 may be exercised in the home state and in any remote state 7 19 in which the advanced practice registered nurse exercises a 7 20 multistate licensure privilege. For an advanced practice 7 21 registered nurse issued a single=state license in a party 7 22 state, the requirement for a supervisory or collaborative 7 23 relationship with a physician shall be determined under 7 24 applicable party state law. 7 25 i. All party states shall be authorized, in accordance 7 26 with state due process laws, to take adverse action against 7 27 an advanced practice registered nurse's multistate licensure 7 28 privilege such as revocation, suspension, probation, or any 7 29 other action that affects an advanced practice registered 7 30 nurse's authorization to practice under a multistate licensure 7 31 privilege, including cease and desist actions. If a party 7 32 state takes such action, it shall promptly notify the 7 33 administrator of the coordinated licensure information system. 7 34 The administrator of the coordinated licensure information 7 35 system shall promptly notify the home state of any such actions 8 1 by remote states. 8 2 j. An advanced practice registered nurse practicing in a 8 3 party state must comply with the state practice laws of the 8 4 state in which the client is located at the time service is 8 5 provided. Advanced practice registered nurse practice is 8 6 not limited to patient care, but shall include all advanced 8 7 nursing practice as defined by the state practice laws of the 8 8 party state in which the client is located. Advanced practice 8 9 registered nurse practice in a party state under a multistate 8 10 licensure privilege will subject the advanced practice 8 11 registered nurse to the jurisdiction of the licensing board, 8 12 the courts, and the laws of the party state in which the client 8 13 is located at the time service is provided. 8 14 k. This compact does not affect additional requirements 8 15 imposed by states for advanced practice registered nursing. 8 16 However, a multistate licensure privilege to practice 8 17 registered nursing granted by a party state shall be recognized 8 18 by other party states as satisfying any state law requirement 8 19 for registered nurse licensure as a precondition for 8 20 authorization to practice as an advanced practice registered 8 21 nurse in that state. 8 22 l. Individuals not residing in a party state shall continue 8 23 to be able to apply for a party state's single=state advanced 8 24 practice registered nurse license as provided under the laws of 8 25 each party state. However, the single=state license granted 8 26 to these individuals will not be recognized as granting the 8 27 privilege to practice as an advanced practice registered nurse 8 28 in any other party state. 8 29 4. Article IV == Applications for advanced practice 8 30 registered nurse licensure in a party state. 8 31 a. Upon application for an advanced practice registered 8 32 nurse multistate license, the licensing board in the issuing 8 33 party state shall ascertain, through the coordinated licensure 8 34 information system, whether the applicant has ever held or 8 35 is the holder of a licensed practical or vocational nursing 9 1 license, a registered nursing license, or an advanced practice 9 2 registered nurse license issued by any other state, whether 9 3 there are any encumbrances on any license or multistate 9 4 licensure privilege held by the applicant, whether any adverse 9 5 action has been taken against any license or multistate 9 6 licensure privilege held by the applicant, and whether the 9 7 applicant is currently participating in an alternative program. 9 8 b. An advanced practice registered nurse may hold a 9 9 multistate advanced practice registered nurse license, issued 9 10 by the home state, in only one party state at a time. 9 11 c. If an advanced practice registered nurse changes primary 9 12 state of residence by moving between two party states, the 9 13 advanced practice registered nurse must apply for advanced 9 14 practice registered nurse licensure in the new home state, and 9 15 the multistate license issued by the prior home state shall be 9 16 deactivated in accordance with applicable commission rules. 9 17 (1) The advanced practice registered nurse may apply for 9 18 licensure in advance of a change in primary state of residence. 9 19 (2) A multistate advanced practice registered nurse license 9 20 shall not be issued by the new home state until the advanced 9 21 practice registered nurse provides satisfactory evidence of a 9 22 change in primary state of residence to the new home state and 9 23 satisfies all applicable requirements to obtain a multistate 9 24 advanced practice registered nurse license from the new home 9 25 state. 9 26 d. If an advanced practice registered nurse changes primary 9 27 state of residence by moving from a party state to a nonparty 9 28 state, the advanced practice registered nurse multistate 9 29 license issued by the prior home state will convert to a 9 30 single=state license, valid only in the former home state. 9 31 5. Article V == Additional authorities invested in party 9 32 state licensing boards. 9 33 a. In addition to the other powers conferred by state law, 9 34 a licensing board shall have the authority to do all of the 9 35 following: 10 1 (1) Take adverse action against an advanced practice 10 2 registered nurse's multistate licensure privilege to practice 10 3 within that party state. 10 4 (a) Only the home state shall have power to take adverse 10 5 action against an advanced practice registered nurse's license 10 6 issued by the home state. 10 7 (b) For purposes of taking adverse action, the home state 10 8 licensing board shall give the same priority and effect to 10 9 reported conduct that occurred outside of the home state as 10 10 it would if such conduct had occurred within the home state. 10 11 In so doing, the home state shall apply its own state laws to 10 12 determine appropriate action. 10 13 (2) Issue cease and desist orders or impose an encumbrance 10 14 on an advanced practice registered nurse's authority to 10 15 practice within that party state. 10 16 (3) Complete any pending investigations of an advanced 10 17 practice registered nurse who changes primary state of 10 18 residence during the course of such investigations. The 10 19 licensing board shall also have the authority to take 10 20 appropriate action and shall promptly report the conclusions 10 21 of such investigations to the administrator of the coordinated 10 22 licensure information system. The administrator of the 10 23 coordinated licensure information system shall promptly notify 10 24 the new home state of any such actions. 10 25 (4) Issue subpoenas for both hearings and investigations 10 26 that require the attendance and testimony of witnesses, as 10 27 well as the production of evidence. Subpoenas issued by a 10 28 party state licensing board for the attendance and testimony 10 29 of witnesses or the production of evidence from another party 10 30 state shall be enforced in the latter state by any court of 10 31 competent jurisdiction, according to that court's practice 10 32 and procedure in considering subpoenas issued in its own 10 33 proceedings. The issuing licensing board shall pay any witness 10 34 fees, travel expenses, mileage, and other fees required by 10 35 the service statutes of the state in which the witnesses or 11 1 evidence are located. 11 2 (5) Obtain and submit, for an advanced practice 11 3 registered nurse licensure applicant, fingerprints or 11 4 other biometric=based information to the federal bureau of 11 5 investigation for criminal background checks, receive the 11 6 results of the federal bureau of investigation record search 11 7 on criminal background checks, and use the results in making 11 8 licensure decisions. 11 9 (6) If otherwise permitted by state law, recover from 11 10 the affected advanced practice registered nurse the costs of 11 11 investigations and disposition of cases resulting from any 11 12 adverse action taken against that advanced practice registered 11 13 nurse. 11 14 (7) Take adverse action based on the factual findings of 11 15 another party state, provided that the licensing board follows 11 16 its own procedures for taking such adverse action. 11 17 b. If adverse action is taken by a home state against an 11 18 advanced practice registered nurse's multistate licensure, 11 19 the privilege to practice in all other party states under a 11 20 multistate licensure privilege shall be deactivated until all 11 21 encumbrances have been removed from the advanced practice 11 22 registered nurse's multistate license. All home state 11 23 disciplinary orders that impose adverse action against an 11 24 advanced practice registered nurse's multistate license shall 11 25 include a statement that the advanced practice registered 11 26 nurse's multistate licensure privilege is deactivated in all 11 27 party states during the pendency of the order. 11 28 c. Nothing in this compact shall override a party state's 11 29 decision that participation in an alternative program may be 11 30 used in lieu of adverse action. The home state licensing board 11 31 shall deactivate the multistate licensure privilege under the 11 32 multistate license of any advanced practice registered nurse 11 33 for the duration of the advanced practice registered nurse's 11 34 participation in an alternative program. 11 35 6. Article VI == Coordinated licensure information system and 12 1 exchange of information. 12 2 a. All party states shall participate in a coordinated 12 3 licensure information system of all advanced practice 12 4 registered nurses, licensed registered nurses, and licensed 12 5 practical or vocational nurses. This system will include 12 6 information on the licensure and disciplinary history of each 12 7 advanced practice registered nurse, as submitted by party 12 8 states, to assist in the coordinated administration of advanced 12 9 practice registered nurse licensure and enforcement efforts. 12 10 b. The commission, in consultation with the administrator of 12 11 the coordinated licensure information system, shall formulate 12 12 necessary and proper procedures for the identification, 12 13 collection and exchange of information under this compact. 12 14 c. All licensing boards shall promptly report to the 12 15 coordinated licensure information system any adverse action, 12 16 any current significant investigative information, denials of 12 17 applications, with the reasons for such denials, and advanced 12 18 practice registered nurse participation in alternative programs 12 19 known to the licensing board regardless of whether such 12 20 participation is deemed nonpublic or confidential under state 12 21 law. 12 22 d. Current significant investigative information and 12 23 participation in nonpublic or confidential alternative 12 24 programs shall be transmitted through the coordinated licensure 12 25 information system only to party state licensing boards. 12 26 e. Notwithstanding any other provision of law, all 12 27 party state licensing boards contributing information to 12 28 the coordinated licensure information system may designate 12 29 information that may not be shared with nonparty states or 12 30 disclosed to other entities or individuals without the express 12 31 permission of the contributing state. 12 32 f. Any personally identifiable information obtained from 12 33 the coordinated licensure information system by a party state 12 34 licensing board shall not be shared with nonparty states or 12 35 disclosed to other entities or individuals except to the extent 13 1 permitted by the laws of the party state contributing the 13 2 information. 13 3 g. Any information contributed to the coordinated licensure 13 4 information system that is subsequently required to be expunged 13 5 by the laws of the party state contributing the information 13 6 shall be removed from the coordinated licensure information 13 7 system. 13 8 h. The compact administrator of each party state shall 13 9 furnish a uniform data set to the compact administrator of each 13 10 other party state, which shall include but not be limited to 13 11 the following: 13 12 (1) Identifying information. 13 13 (2) Licensure data. 13 14 (3) Information related to alternative program 13 15 participation information. 13 16 (4) Other information that may facilitate the 13 17 administration of this compact, as determined by commission 13 18 rules. 13 19 i. The compact administrator of a party state shall provide 13 20 all investigative documents and information requested by 13 21 another party state. 13 22 7. Article VII == Establishment of the interstate commission 13 23 of advanced practice registered nurse compact administrators. 13 24 a. The party states hereby create and establish a joint 13 25 public agency known as the interstate commission of advanced 13 26 practice registered nurse compact administrators. 13 27 (1) The commission is an instrumentality of the party 13 28 states. 13 29 (2) Venue is proper, and judicial proceedings by or against 13 30 the commission shall be brought solely and exclusively, in a 13 31 court of competent jurisdiction where the principal office of 13 32 the commission is located. The commission may waive venue and 13 33 jurisdictional defenses to the extent it adopts or consents to 13 34 participate in alternative dispute resolution proceedings. 13 35 (3) Nothing in this compact shall be construed to be a 14 1 waiver of sovereign immunity. 14 2 b. Membership, voting, and meetings. 14 3 (1) Each party state shall have and be limited to one 14 4 administrator. The head of the state licensing board or 14 5 designee shall be the administrator of this compact for each 14 6 party state. Any administrator may be removed or suspended 14 7 from office as provided by the law of the state from which 14 8 the administrator is appointed. Any vacancy occurring in the 14 9 commission shall be filled in accordance with the laws of the 14 10 party state in which the vacancy exists. 14 11 (2) Each administrator shall be entitled to one vote with 14 12 regard to the promulgation of rules and creation of bylaws 14 13 and shall otherwise have an opportunity to participate in the 14 14 business and affairs of the commission. An administrator 14 15 shall vote in person or by such other means as provided in 14 16 the bylaws. The bylaws may provide for an administrator's 14 17 participation in meetings by telephone or other means of 14 18 communication. 14 19 (3) The commission shall meet at least once during each 14 20 calendar year. Additional meetings shall be held as set forth 14 21 in the bylaws or rules of the commission. 14 22 (4) All meetings shall be open to the public, and public 14 23 notice of meetings shall be given in the same manner as 14 24 required under the rulemaking provisions in article VIII. 14 25 (5) The commission may convene in a closed, nonpublic 14 26 meeting if the commission must discuss any of the following: 14 27 (a) Noncompliance of a party state with its obligations 14 28 under this compact. 14 29 (b) The employment, compensation, discipline or, other 14 30 personnel matters, practices, or procedures related to specific 14 31 employees or other matters related to the commission's internal 14 32 personnel practices and procedures. 14 33 (c) Current, threatened, or reasonably anticipated 14 34 litigation. 14 35 (d) Negotiation of contracts for the purchase or sale of 15 1 goods, services, or real estate. 15 2 (e) Accusing any person of a crime or formally censuring any 15 3 person. 15 4 (f) Disclosure of trade secrets or commercial or financial 15 5 information that is privileged or confidential. 15 6 (g) Disclosure of information of a personal nature where 15 7 disclosure would constitute a clearly unwarranted invasion of 15 8 personal privacy. 15 9 (h) Disclosure of investigatory records compiled for law 15 10 enforcement purposes. 15 11 (i) Disclosure of information related to any reports 15 12 prepared by or on behalf of the commission for the purpose of 15 13 investigation of compliance with this compact. 15 14 (j) Matters specifically exempted from disclosure by 15 15 federal or state statute. 15 16 (6) If a meeting, or portion of a meeting, is closed 15 17 pursuant to this provision, the commission's legal counsel or 15 18 designee shall certify that the meeting may be closed and shall 15 19 reference each relevant exempting provision. The commission 15 20 shall keep minutes that fully and clearly describe all matters 15 21 discussed in a meeting and shall provide a full and accurate 15 22 summary of actions taken, and the reasons therefor, including a 15 23 description of the views expressed. All documents considered 15 24 in connection with an action shall be identified in such 15 25 minutes. All minutes and documents of a closed meeting shall 15 26 remain under seal, subject to release by a majority vote of the 15 27 commission or order of a court of competent jurisdiction. 15 28 c. The commission shall, by a majority vote of the 15 29 administrators, prescribe bylaws or rules to govern its conduct 15 30 as may be necessary or appropriate to carry out the purposes 15 31 and exercise the powers of this compact, including but not 15 32 limited to all of the following: 15 33 (1) Establishing the fiscal year of the commission. 15 34 (2) Providing reasonable standards and procedures for both 15 35 of the following: 16 1 (a) The establishment and meetings of other committees. 16 2 (b) Governing any general or specific delegation of any 16 3 authority or function of the commission. 16 4 (3) Providing reasonable procedures for calling and 16 5 conducting meetings of the commission, ensuring reasonable 16 6 advance notice of all meetings, and providing an opportunity 16 7 for attendance of such meetings by interested parties, 16 8 with enumerated exceptions designed to protect the public's 16 9 interest, the privacy of individuals, and proprietary 16 10 information, including trade secrets. The commission may meet 16 11 in closed session only after a majority of the administrators 16 12 vote to close a meeting in whole or in part. As soon as 16 13 practicable, the commission must make public a copy of the vote 16 14 to close the meeting revealing the vote of each administrator, 16 15 with no proxy votes allowed. 16 16 (4) Establishing the titles, duties, and authority and 16 17 reasonable procedures for the election of the officers of the 16 18 commission. 16 19 (5) Providing reasonable standards and procedures for the 16 20 establishment of the personnel policies and programs of the 16 21 commission. Notwithstanding any civil service or other similar 16 22 laws of any party state, the bylaws shall exclusively govern 16 23 the personnel policies and programs of the commission. 16 24 (6) Providing a mechanism for winding up the operations 16 25 of the commission and the equitable disposition of any 16 26 surplus funds that may exist after the termination of this 16 27 compact after the payment or reserving of all of its debts and 16 28 obligations. 16 29 d. The commission shall publish its bylaws and rules, and 16 30 any amendments thereto, in a convenient form on the internet 16 31 site of the commission. 16 32 e. The commission shall maintain its financial records in 16 33 accordance with the bylaws. 16 34 f. The commission shall meet and take such actions as are 16 35 consistent with the provisions of this compact and the bylaws. 17 1 g. The commission shall have the following powers: 17 2 (1) To promulgate uniform rules to facilitate and 17 3 coordinate implementation and administration of this compact. 17 4 The rules shall have the force and effect of law and shall be 17 5 binding in all party states. 17 6 (2) To bring and prosecute legal proceedings or actions in 17 7 the name of the commission, provided that the standing of any 17 8 licensing board to sue or be sued under applicable law shall 17 9 not be affected. 17 10 (3) To purchase and maintain insurance and bonds. 17 11 (4) To borrow, accept, or contract for services of 17 12 personnel, including but not limited to employees of a party 17 13 state or nonprofit organizations. 17 14 (5) To cooperate with other organizations that administer 17 15 state compacts related to the regulation of nursing, including 17 16 but not limited to sharing administrative or staff expenses, 17 17 office space, or other resources. 17 18 (6) To hire employees, elect or appoint officers, fix 17 19 compensation, define duties, grant such individuals appropriate 17 20 authority to carry out the purposes of this compact, and to 17 21 establish the commission's personnel policies and programs 17 22 relating to conflicts of interest, qualifications of personnel, 17 23 and other related personnel matters. 17 24 (7) To accept any and all appropriate donations, grants, and 17 25 gifts of money, equipment, supplies, materials, and services, 17 26 and to receive, utilize, and dispose of the same; provided 17 27 that at all times the commission shall strive to avoid any 17 28 appearance of impropriety or conflict of interest. 17 29 (8) To lease, purchase, accept appropriate gifts or 17 30 donations of, or otherwise to own, hold, improve, or use, any 17 31 property, whether real, personal, or mixed; provided that at 17 32 all times the commission shall strive to avoid any appearance 17 33 of impropriety. 17 34 (9) To sell, convey, mortgage, pledge, lease, exchange, 17 35 abandon, or otherwise dispose of any property, whether real, 18 1 personal, or mixed. 18 2 (10) To establish a budget and make expenditures. 18 3 (11) To borrow money. 18 4 (12) To appoint committees, including advisory committees 18 5 comprised of administrators, state nursing regulators, 18 6 state legislators or their representatives, and consumer 18 7 representatives, and other such interested persons. 18 8 (13) To provide and receive information from, and to 18 9 cooperate with, law enforcement agencies. 18 10 (14) To adopt and use an official seal. 18 11 (15) To perform such other functions as may be necessary or 18 12 appropriate to achieve the purposes of this compact consistent 18 13 with the state regulation of advanced practice registered nurse 18 14 licensure and practice. 18 15 h. Financing of the commission. 18 16 (1) The commission shall pay, or provide for the payment of, 18 17 the reasonable expenses of its establishment, organization, and 18 18 ongoing activities. 18 19 (2) The commission may levy on and collect an annual 18 20 assessment from each party state to cover the cost of the 18 21 operations and activities of the interstate commission and its 18 22 staff which must be in a total amount sufficient to cover its 18 23 annual budget as approved each year. The aggregate annual 18 24 assessment amount shall be allocated based upon a formula to 18 25 be determined by the commission, which shall promulgate a rule 18 26 that is binding upon all party states. 18 27 (3) The commission shall not incur obligations of any kind 18 28 prior to securing the funds adequate to meet the same; nor 18 29 shall the commission pledge the credit of any of the party 18 30 states, except by, and with the authority of, such party state. 18 31 (4) The commission shall keep accurate accounts of all 18 32 receipts and disbursements. The receipts and disbursements of 18 33 the commission shall be subject to the audit and accounting 18 34 procedures established under its bylaws. However, all receipts 18 35 and disbursements of funds handled by the commission shall be 19 1 audited yearly by a certified or licensed public accountant, 19 2 and the report of the audit shall be included in and become 19 3 part of the annual report of the commission. 19 4 i. Qualified immunity, defense, and indemnification. 19 5 (1) The administrators, officers, executive director, 19 6 employees, and representatives of the commission shall be 19 7 immune from suit and liability, either personally or in their 19 8 official capacity, for any claim for damage to or loss of 19 9 property or personal injury or other civil liability caused by 19 10 or arising out of any actual or alleged act, error, or omission 19 11 that occurred, or that the person against whom the claim is 19 12 made had a reasonable basis for believing occurred, within the 19 13 scope of commission employment, duties, or responsibilities; 19 14 provided that nothing in this paragraph "i" shall be construed 19 15 to protect any such person from suit or liability for any 19 16 damage, loss, injury, or liability caused by the intentional, 19 17 willful, or wanton misconduct of that person. 19 18 (2) The commission shall defend any administrator, 19 19 officer, executive director, employee, or representative of 19 20 the commission in any civil action seeking to impose liability 19 21 arising out of any actual or alleged act, error, or omission 19 22 that occurred within the scope of commission employment, 19 23 duties, or responsibilities, or that the person against 19 24 whom the claim is made had a reasonable basis for believing 19 25 occurred within the scope of commission employment, duties, 19 26 or responsibilities; provided that nothing herein shall be 19 27 construed to prohibit that person from retaining the person's 19 28 own counsel; and provided further that the actual or alleged 19 29 act, error, or omission did not result from that person's 19 30 intentional, willful, or wanton misconduct. 19 31 (3) The commission shall indemnify and hold harmless 19 32 any administrator, officer, executive director, employee, 19 33 or representative of the commission for the amount of any 19 34 settlement or judgment obtained against that person arising 19 35 out of any actual or alleged act, error, or omission that 20 1 occurred within the scope of commission employment, duties, 20 2 or responsibilities, or that such person had a reasonable 20 3 basis for believing occurred within the scope of commission 20 4 employment, duties, or responsibilities, provided that the 20 5 actual or alleged act, error, or omission did not result from 20 6 the intentional, willful, or wanton misconduct of that person. 20 7 8. Article VIII == Rulemaking. 20 8 a. The commission shall exercise its rulemaking powers 20 9 pursuant to the criteria set forth in this article and the 20 10 rules adopted thereunder. Rules and amendments shall become 20 11 binding as of the date specified in each rule or amendment and 20 12 shall have the same force and effect as provisions of this 20 13 compact. 20 14 b. Rules or amendments to the rules shall be adopted at a 20 15 regular or special meeting of the commission. 20 16 c. Prior to promulgation and adoption of a final rule or 20 17 rules by the commission, and at least sixty days in advance 20 18 of the meeting at which the rule will be considered and voted 20 19 upon, the commission shall file a notice of proposed rulemaking 20 20 on the internet site of the commission and on the internet site 20 21 of each licensing board or the publication in which each state 20 22 would otherwise publish proposed rules. 20 23 d. The notice of proposed rulemaking shall include all of 20 24 the following: 20 25 (1) The proposed time, date, and location of the meeting in 20 26 which the rule will be considered and voted upon. 20 27 (2) The text of the proposed rule or amendment, and the 20 28 reason for the proposed rule. 20 29 (3) A request for comments on the proposed rule from any 20 30 interested person. 20 31 (4) The manner in which interested persons may submit notice 20 32 to the commission of their intention to attend the public 20 33 hearing and any written comments. 20 34 e. Prior to adoption of a proposed rule, the commission 20 35 shall allow persons to submit written data, facts, opinions, 21 1 and arguments, which shall be made available to the public. 21 2 f. The commission shall grant an opportunity for a public 21 3 hearing before it adopts a rule or amendment. 21 4 g. The commission shall publish the place, time, and date of 21 5 the scheduled public hearing. 21 6 (1) Hearings shall be conducted in a manner providing each 21 7 person who wishes to comment a fair and reasonable opportunity 21 8 to comment orally or in writing. All hearings will be 21 9 recorded, and a copy will be made available upon request. 21 10 (2) Nothing in this article shall be construed as requiring 21 11 a separate hearing on each rule. Rules may be grouped for the 21 12 convenience of the commission at hearings required by this 21 13 article. 21 14 h. If no one appears at the public hearing, the commission 21 15 may proceed with promulgation of the proposed rule. 21 16 i. Following the scheduled hearing date, or by the close 21 17 of business on the scheduled hearing date if the hearing was 21 18 not held, the commission shall consider all written and oral 21 19 comments received. 21 20 j. The commission shall, by majority vote of all 21 21 administrators, take final action on the proposed rule and 21 22 shall determine the effective date of the rule, if any, based 21 23 on the rulemaking record and the full text of the rule. 21 24 k. Upon determination that an emergency exists, the 21 25 commission may consider and adopt an emergency rule without 21 26 prior notice, opportunity for comment, or hearing, provided 21 27 that the usual rulemaking procedures provided in this compact 21 28 and in this article shall be retroactively applied to the rule 21 29 as soon as reasonably possible, in no event later than ninety 21 30 days after the effective date of the rule. For the purposes of 21 31 this provision, an emergency rule is one that must be adopted 21 32 immediately in order to do any of the following: 21 33 (1) Meet an imminent threat to public health, safety, or 21 34 welfare. 21 35 (2) Prevent a loss of commission or party state funds. 22 1 (3) Meet a deadline for the promulgation of an 22 2 administrative rule that is established by federal law or rule. 22 3 l. The commission may direct revisions to a previously 22 4 adopted rule or amendment for purposes of correcting 22 5 typographical errors, errors in format, errors in consistency, 22 6 or grammatical errors. Public notice of any revisions shall be 22 7 posted on the internet site of the commission. The revision 22 8 shall be subject to challenge by any person for a period of 22 9 thirty days after posting. The revision may be challenged only 22 10 on grounds that the revision results in a material change to 22 11 a rule. A challenge shall be made in writing, and delivered 22 12 to the commission, prior to the end of the notice period. If 22 13 no challenge is made, the revision will take effect without 22 14 further action. If the revision is challenged, the revision 22 15 may not take effect without the approval of the commission. 22 16 9. Article IX == Oversight, dispute resolution, and 22 17 enforcement. 22 18 a. Oversight. 22 19 (1) Each party state shall enforce this compact and take all 22 20 actions necessary and appropriate to effectuate this compact's 22 21 purposes and intent. 22 22 (2) The commission shall be entitled to receive service 22 23 of process in any proceeding that may affect the powers, 22 24 responsibilities, or actions of the commission, and shall have 22 25 standing to intervene in such a proceeding for all purposes. 22 26 Failure to provide service of process to the commission shall 22 27 render a judgment or order void as to the commission, this 22 28 compact, or promulgated rules. 22 29 b. Default, technical assistance, and termination. 22 30 (1) If the commission determines that a party state 22 31 has defaulted in the performance of its obligations or 22 32 responsibilities under this compact or the promulgated rules, 22 33 the commission shall do both of the following: 22 34 (a) Provide written notice to the defaulting state and other 22 35 party states of the nature of the default, the proposed means 23 1 of curing the default, or any other action to be taken by the 23 2 commission. 23 3 (b) Provide remedial training and specific technical 23 4 assistance regarding the default. 23 5 (2) If a state in default fails to cure the default, the 23 6 defaulting state's membership in this compact may be terminated 23 7 upon an affirmative vote of a majority of the administrators, 23 8 and all rights, privileges, and benefits conferred by this 23 9 compact may be terminated on the effective date of termination. 23 10 A cure of the default does not relieve the offending state 23 11 of obligations or liabilities incurred during the period of 23 12 default. 23 13 (3) Termination of membership in this compact shall be 23 14 imposed only after all other means of securing compliance have 23 15 been exhausted. Notice of intent to suspend or terminate shall 23 16 be given by the commission to the governor of the defaulting 23 17 state and to the executive officer of the defaulting state's 23 18 licensing board, the defaulting state's licensing board, and 23 19 each of the party states. 23 20 (4) A state whose membership in this compact has been 23 21 terminated is responsible for all assessments, obligations, and 23 22 liabilities incurred through the effective date of termination, 23 23 including obligations that extend beyond the effective date of 23 24 termination. 23 25 (5) The commission shall not bear any costs related to a 23 26 state that is found to be in default or whose membership in 23 27 this compact has been terminated, unless agreed upon in writing 23 28 between the commission and the defaulting state. 23 29 (6) The defaulting state may appeal the action of the 23 30 commission by petitioning the United States district court 23 31 for the District of Columbia or the federal district in which 23 32 the commission has its principal offices. The prevailing 23 33 party shall be awarded all costs of such litigation, including 23 34 reasonable attorneys' fees. 23 35 c. Dispute resolution. 24 1 (1) Upon request by a party state, the commission shall 24 2 attempt to resolve disputes related to the compact that arise 24 3 among party states and between party and nonparty states. 24 4 (2) The commission shall promulgate a rule providing for 24 5 both mediation and binding dispute resolution for disputes, as 24 6 appropriate. 24 7 (3) In the event the commission cannot resolve disputes 24 8 among party states arising under this compact: 24 9 (a) The party states may submit the issues in dispute to 24 10 an arbitration panel, which will be comprised of individuals 24 11 appointed by the compact administrator in each of the affected 24 12 party states and an individual mutually agreed upon by the 24 13 compact administrators of all the party states involved in the 24 14 dispute. 24 15 (b) The decision of a majority of the arbitrators shall be 24 16 final and binding. 24 17 d. Enforcement. 24 18 (1) The commission, in the reasonable exercise of its 24 19 discretion, shall enforce the provisions and rules of this 24 20 compact. 24 21 (2) By majority vote, the commission may initiate legal 24 22 action in the United States district court for the District of 24 23 Columbia or the federal district in which the commission has 24 24 its principal offices against a party state that is in default 24 25 to enforce compliance with the provisions of this compact 24 26 and its promulgated rules and bylaws. The relief sought may 24 27 include both injunctive relief and damages. In the event 24 28 judicial enforcement is necessary, the prevailing party shall 24 29 be awarded all costs of such litigation, including reasonable 24 30 attorneys' fees. 24 31 (3) The remedies herein shall not be the exclusive remedies 24 32 of the commission. The commission may pursue any other 24 33 remedies available under federal or state law. 24 34 10. Article X == Effective date, withdrawal, and amendment. 24 35 a. This compact shall come into limited effect at such 25 1 time as this compact has been enacted into law in ten party 25 2 states for the sole purpose of establishing and convening 25 3 the commission to adopt rules relating to its operation and 25 4 the advanced practice registered nurse uniform licensure 25 5 requirements. 25 6 b. On the date of the commission's adoption of the advanced 25 7 practice registered nurse uniform licensure requirements, all 25 8 remaining provisions of this compact, and rules adopted by the 25 9 commission, shall come into full force and effect in all party 25 10 states. 25 11 c. Any state that joins this compact subsequent to the 25 12 commission's initial adoption of the advanced practice 25 13 registered nurse uniform licensure requirements shall be 25 14 subject to all rules that have been previously adopted by the 25 15 commission. 25 16 d. Any party state may withdraw from this compact by 25 17 enacting a statute repealing the same. A party state's 25 18 withdrawal shall not take effect until six months after 25 19 enactment of the repealing statute. 25 20 e. A party state's withdrawal or termination shall not 25 21 affect the continuing requirement of the withdrawing or 25 22 terminated state's licensing board to report adverse actions 25 23 and significant investigations occurring prior to the effective 25 24 date of such withdrawal or termination. 25 25 f. Nothing contained in this compact shall be construed to 25 26 invalidate or prevent any advanced practice registered nurse 25 27 licensure agreement or other cooperative arrangement between a 25 28 party state and a nonparty state that does not conflict with 25 29 the provisions of this compact. 25 30 g. This compact may be amended by the party states. No 25 31 amendment to this compact shall become effective and binding 25 32 upon any party state until it is enacted into the laws of all 25 33 party states. 25 34 h. Representatives of nonparty states to this compact shall 25 35 be invited to participate in the activities of the commission, 26 1 on a nonvoting basis, prior to the adoption of this compact by 26 2 all states. 26 3 11. Article XI == Construction and severability. This 26 4 compact shall be liberally construed so as to effectuate the 26 5 purposes thereof. The provisions of this compact shall be 26 6 severable, and if any phrase, clause, sentence, or provision 26 7 of this compact is declared to be contrary to the constitution 26 8 of any party state or of the United States, or if the 26 9 applicability thereof to any government, agency, person, or 26 10 circumstance is held invalid, the validity of the remainder of 26 11 this compact and the applicability thereof to any government, 26 12 agency, person, or circumstance shall not be affected 26 13 thereby. If this compact shall be held to be contrary to the 26 14 constitution of any party state, this compact shall remain in 26 15 full force and effect as to the remaining party states and in 26 16 full force and effect as to the party state affected as to all 26 17 severable matters. 26 18 Sec. 2. Section 152E.2, Code 2017, is amended to read as 26 19 follows: 26 20 152E.2 Compact administrator. 26 21 The executive director of the board of nursing, as provided 26 22 for in section 152.2, shall serve as the compact administrator 26 23 identified in article VIII, paragraph "a", of the nurse 26 24 licensure compact contained in section 152E.1 and as the 26 25 compact administrator identified in articleVIIIVII, paragraph 26 26"a""b", of the advanced practice registered nurse compact 26 27 contained in section 152E.3. 26 28 Sec. 3. EFFECTIVE DATE. This Act takes effect upon the 26 29 adoption of the advanced practice registered nurse compact 26 30 contained in this Act by no less than ten states. The 26 31 executive director of the board of nursing shall notify the 26 32 Code editor upon adoption of the compact by the requisite 26 33 number of states. 26 34 EXPLANATION 26 35 The inclusion of this explanation does not constitute agreement with 27 1 the explanation's substance by the members of the general assembly. 27 2 This bill adopts a revised version of the advanced practice 27 3 registered nurse compact in Code chapter 152E. The new 27 4 compact creates an interstate commission of advanced practice 27 5 registered nurse compact administrators that will have the 27 6 power to adopt rules binding on its members, or "party states", 27 7 bring legal action in its own name, purchase insurance and 27 8 bonds, hire and compensate employees, and rent or purchase 27 9 property. 27 10 The commission may also levy on and collect an annual 27 11 assessment from this state and all other party states to cover 27 12 the cost of its operations, activities, and staff in its annual 27 13 budget as approved each year. The aggregate annual assessment 27 14 amount, if any, shall be allocated based upon a formula to be 27 15 determined by the commission, which shall adopt a rule that is 27 16 binding upon all party states. 27 17 In this state, the compact administrator shall be the 27 18 executive director of the board of nursing. 27 19 The bill becomes effective upon the adoption of the compact 27 20 by no less than 10 states. LSB 1110SV (1) 87 tr/nh
