STATE OF NEW YORK
        ________________________________________________________________________

                                          3391

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                    February 2, 2023
                                       ___________

        Introduced  by  M.  of  A.  O'DONNELL  --  read once and referred to the
          Committee on Higher Education

        AN ACT to amend the education law, in relation to  enacting  the  inter-
          state medical licensure compact and the nurse licensure compact

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The education law is amended by adding a new article 169 to
     2  read as follows:
     3                                 ARTICLE 169
     4                    INTERSTATE MEDICAL LICENSURE COMPACT
     5  Section 8860. Short title.
     6          8861. Purpose.
     7          8862. Definitions.
     8          8863. Eligibility.
     9          8864. Designation of state of principal license.
    10          8865. Application and issuance of expedited licensure.
    11          8866. Fees for expedited licensure.
    12          8867. Renewal and continued participation.
    13          8868. Coordinated information system.
    14          8869. Joint investigations.
    15          8870. Disciplinary actions.
    16          8871. Interstate medical licensure compact commission.
    17          8872. Powers and duties of the interstate commission.
    18          8873. Finance powers.
    19          8874. Organization and operation of the interstate commission.
    20          8875. Rulemaking functions of the interstate commission.
    21          8876. Oversight of interstate compact.
    22          8877. Enforcement of interstate compact.
    23          8878. Default procedures.
    24          8879. Dispute resolution.
    25          8880. Member states, effective date and amendment.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07951-01-3

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     1          8881. Withdrawal.
     2          8882. Dissolution.
     3          8883. Severability and construction.
     4          8884. Binding effect of compact and other laws.
     5    § 8860. Short  title.  This article shall be known and may be cited as
     6  the "interstate medical licensure compact".
     7    § 8861. Purpose. In order to strengthen access to health care, and  in
     8  recognition  of  the advances in the delivery of health care, the member
     9  states of the interstate medical licensure compact have allied in common
    10  purpose to develop a comprehensive process that complements the existing
    11  licensing and regulatory authority of state medical boards,  provides  a
    12  streamlined  process that allows physicians to become licensed in multi-
    13  ple states, thereby enhancing the portability of a medical  license  and
    14  ensuring  the  safety of patients.   The compact creates another pathway
    15  for licensure and does not otherwise change a state's  existing  medical
    16  practice act. The compact also adopts the prevailing standard for licen-
    17  sure  and affirms that the practice of medicine occurs where the patient
    18  is located at the time of the physician-patient  encounter,  and  there-
    19  fore,  requires  the physician to be under the jurisdiction of the state
    20  medical board where the patient is located. State  medical  boards  that
    21  participate  in the compact retain the jurisdiction to impose an adverse
    22  action against a license to practice medicine in that state issued to  a
    23  physician through the procedures in the compact.
    24    § 8862. Definitions. In this compact:
    25    1.  "Bylaws"  means those bylaws established by the interstate commis-
    26  sion pursuant to section eighty-eight hundred seventy-one of this  arti-
    27  cle for its governance, or for directing and controlling its actions and
    28  conduct.
    29    2.  "Commissioner"  means  the voting representative appointed by each
    30  member board pursuant to section  eighty-eight  hundred  seventy-one  of
    31  this article.
    32    3. "Conviction" means a finding by a court that an individual is guil-
    33  ty  of  a  criminal  offense through adjudication, or entry of a plea of
    34  guilt or no contest to the charge by the offender. Evidence of an  entry
    35  of  a  conviction of a criminal offense by the court shall be considered
    36  final for purposes of disciplinary action by a member board.
    37    4. "Expedited license" means a full and unrestricted  medical  license
    38  granted  by  a member state to an eligible physician through the process
    39  set forth in the compact.
    40    5. "Interstate commission" means  the  interstate  commission  created
    41  pursuant to section eighty-eight hundred seventy-one of this article.
    42    6.  "License" means authorization by a state for a physician to engage
    43  in the practice of medicine, which would be unlawful without the author-
    44  ization.
    45    7. "Medical practice act" means laws  and  regulations  governing  the
    46  practice of allopathic and osteopathic medicine within a member state.
    47    8.  "Member board" means a state agency in a member state that acts in
    48  the sovereign interests of the state by protecting  the  public  through
    49  licensure,  regulation,  and  education of physicians as directed by the
    50  state government.
    51    9. "Member state" means a state that has enacted the compact.
    52    10. "Practice of medicine" means the clinical  prevention,  diagnosis,
    53  or  treatment  of human disease, injury, or condition requiring a physi-
    54  cian to obtain and maintain a license in  compliance  with  the  medical
    55  practice act of a member state.
    56    11. "Physician" means any person who:

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     1    (a)  Is  a  graduate  of  a  medical  school accredited by the Liaison
     2  Committee on Medical Education, the Commission  on  Osteopathic  College
     3  Accreditation,  or  a medical school listed in the International Medical
     4  Education Directory or its equivalent;
     5    (b) Passed each component of the United States Medical Licensing Exam-
     6  ination (USMLE) or the Comprehensive Osteopathic Medical Licensing Exam-
     7  ination  (COMLEX-USA)  within  three attempts, or any of its predecessor
     8  examinations accepted by a state medical board as an equivalent examina-
     9  tion for licensure purposes;
    10    (c) Successfully completed graduate medical education approved by  the
    11  Accreditation  Council  for  Graduate  Medical Education or the American
    12  Osteopathic Association;
    13    (d)  Holds  specialty  certification  or  a  time-unlimited  specialty
    14  certificate  recognized  by the American Board of Medical Specialties or
    15  the American Osteopathic Association's Bureau  of  Osteopathic  Special-
    16  ists;
    17    (e)  Possesses  a full and unrestricted license to engage in the prac-
    18  tice of medicine issued by a member board;
    19    (f) Has never been convicted, received adjudication, deferred  adjudi-
    20  cation,  community  supervision, or deferred disposition for any offense
    21  by a court of appropriate jurisdiction;
    22    (g) Has never held a license  authorizing  the  practice  of  medicine
    23  subjected  to discipline by a licensing agency in any state, federal, or
    24  foreign jurisdiction, excluding any action  related  to  non-payment  of
    25  fees related to a license;
    26    (h)  Has  never had a controlled substance license or permit suspended
    27  or revoked by a state or the United  States  drug  enforcement  adminis-
    28  tration; and
    29    (i)  Is  not  under  active investigation by a licensing agency or law
    30  enforcement authority in any state, federal, or foreign jurisdiction.
    31    12. "Offense" means a felony, gross misdemeanor,  or  crime  of  moral
    32  turpitude.
    33    13.  "Rule"  means  a  written  statement by the interstate commission
    34  promulgated pursuant to section eighty-eight hundred seventy-two of this
    35  article that is of general  applicability,  implements,  interprets,  or
    36  prescribes  a  policy or provision of the compact, or an organizational,
    37  procedural, or practice requirement of the  interstate  commission,  and
    38  has  the  force  and  effect  of  statutory  law  in a member state, and
    39  includes the amendment, repeal, or suspension of an existing rule.
    40    14. "State" means any state, commonwealth, district, or  territory  of
    41  the United States.
    42    15.  "State  of principal license" means a member state where a physi-
    43  cian holds a license to practice medicine and which has been  designated
    44  as  such by the physician for purposes of registration and participation
    45  in the compact.
    46    § 8863. Eligibility. 1. A physician must meet the eligibility require-
    47  ments as defined in subdivision eleven of section  eighty-eight  hundred
    48  sixty-two  of  this  article  to  receive an expedited license under the
    49  terms and provisions of the compact.
    50    2. A physician who does not meet the requirements of subdivision elev-
    51  en of section eighty-eight hundred sixty-two of this article may  obtain
    52  a  license  to  practice  medicine  in  a member state if the individual
    53  complies with all laws and requirements, other than the compact,  relat-
    54  ing to the issuance of a license to practice medicine in that state.
    55    § 8864. Designation  of  state  of  principal  license. 1. A physician
    56  shall designate a member state as the state  of  principal  license  for

        A. 3391                             4

     1  purposes  of registration for expedited licensure through the compact if
     2  the physician possesses a full  and  unrestricted  license  to  practice
     3  medicine in that state, and the state is:
     4    (a) the state of primary residence for the physician, or
     5    (b)  the  state  where at least twenty-five percent of the practice of
     6  medicine occurs, or
     7    (c) the location of the physician's employer, or
     8    (d) if no state qualifies under paragraph (a), (b),  or  (c)  of  this
     9  subdivision,  the  state designated as state of residence for purpose of
    10  federal income tax.
    11    2. A physician may redesignate a member state as  state  of  principal
    12  license  at  any  time,  as  long as the state meets the requirements of
    13  subdivision one of this section.
    14    3. The interstate commission is authorized to develop rules to facili-
    15  tate redesignation of another member state as  the  state  of  principal
    16  license.
    17    § 8865. Application  and  issuance of expedited licensure. 1. A physi-
    18  cian seeking licensure through the compact shall file an application for
    19  an expedited license with the member board of the state selected by  the
    20  physician as the state of principal license.
    21    2. Upon receipt of an application for an expedited license, the member
    22  board  within the state selected as the state of principal license shall
    23  evaluate whether the physician is eligible for expedited  licensure  and
    24  issue  a  letter  of qualification, verifying or denying the physician's
    25  eligibility, to the interstate commission.
    26    (a) Static  qualifications,  which  include  verification  of  medical
    27  education, graduate medical education, results of any medical or licens-
    28  ing  examination,  and  other qualifications as determined by the inter-
    29  state commission through rule, shall not be subject to additional prima-
    30  ry source verification where already  primary  source  verified  by  the
    31  state of principal license.
    32    (b) The member board within the state selected as the state of princi-
    33  pal  license  shall,  in  the course of verifying eligibility, perform a
    34  criminal background check of an applicant,  including  the  use  of  the
    35  results of fingerprint or other biometric data checks compliant with the
    36  requirements  of the Federal Bureau of Investigation, with the exception
    37  of federal employees who have suitability  determination  in  accordance
    38  with U.S. C.F.R. § 731.202.
    39    (c)  Appeal  on  the determination of eligibility shall be made to the
    40  member state where the application was filed and shall be subject to the
    41  law of that state.
    42    3. Upon verification under subdivision two of this section, physicians
    43  eligible for an expedited license shall complete the registration  proc-
    44  ess  established  by the interstate commission to receive a license in a
    45  member state selected pursuant  to  subdivision  one  of  this  section,
    46  including the payment of any applicable fees.
    47    4.  After  receiving verification of eligibility under subdivision two
    48  of this section and any fees under subdivision three of this section,  a
    49  member  board  shall  issue  an expedited license to the physician. This
    50  license shall authorize the physician to practice medicine in the  issu-
    51  ing  state  consistent  with the medical practice act and all applicable
    52  laws and regulations of the issuing member board and member state.
    53    5. An expedited license shall be valid for a  period  consistent  with
    54  the  licensure  period  in  the  member  state and in the same manner as
    55  required for other physicians holding a full  and  unrestricted  license
    56  within the member state.

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     1    6.  An  expedited  license obtained though the compact shall be termi-
     2  nated if a physician fails to maintain a license in the state of princi-
     3  pal licensure for a non-disciplinary reason, without redesignation of  a
     4  new state of principal licensure.
     5    7.  The interstate commission is authorized to develop rules regarding
     6  the application process, including payment of any applicable  fees,  and
     7  the issuance of an expedited license.
     8    § 8866. Fees  for  expedited  licensure.  1. A member state issuing an
     9  expedited license authorizing the practice of medicine in that state may
    10  impose a fee for a license issued or renewed through the compact.
    11    2. The interstate commission is authorized to develop rules  regarding
    12  fees for expedited licenses.
    13    § 8867. Renewal and continued participation. 1. A physician seeking to
    14  renew  an  expedited  license granted in a member state shall complete a
    15  renewal process with the interstate commission if the physician:
    16    (a) Maintains a full and unrestricted license in a state of  principal
    17  license;
    18    (b)  Has  not  been convicted, received adjudication, deferred adjudi-
    19  cation, community supervision, or deferred disposition for  any  offense
    20  by a court of appropriate jurisdiction;
    21    (c) Has not had a license authorizing the practice of medicine subject
    22  to  discipline  by  a licensing agency in any state, federal, or foreign
    23  jurisdiction, excluding  any  action  related  to  non-payment  of  fees
    24  related to a license; and
    25    (d)  Has not had a controlled substance license or permit suspended or
    26  revoked by a state or the United States drug enforcement administration.
    27    2. Physicians shall comply with all continuing  professional  develop-
    28  ment  or  continuing  medical  education  requirements  for renewal of a
    29  license issued by a member state.
    30    3. The interstate commission shall collect any  renewal  fees  charged
    31  for  the  renewal of a license and distribute the fees to the applicable
    32  member board.
    33    4. Upon receipt of any renewal fees collected in subdivision three  of
    34  this section, a member board shall renew the physician's license.
    35    5. Physician information collected by the interstate commission during
    36  the renewal process will be distributed to all member boards.
    37    6. The interstate commission is authorized to develop rules to address
    38  renewal of licenses obtained through the compact.
    39    § 8868. Coordinated  information  system. 1. The interstate commission
    40  shall establish a database of  all  physicians  licensed,  or  who  have
    41  applied  for licensure, under section eighty-eight hundred sixty-five of
    42  this article.
    43    2. Notwithstanding any other provision of  law,  member  boards  shall
    44  report  to  the  interstate  commission  any public action or complaints
    45  against a licensed physician who has applied or  received  an  expedited
    46  license through the compact.
    47    3.  Member  boards shall report disciplinary or investigatory informa-
    48  tion determined as necessary  and  proper  by  rule  of  the  interstate
    49  commission.
    50    4. Member boards may report any non-public complaint, disciplinary, or
    51  investigatory  information  not  required  by  subdivision three of this
    52  section to the interstate commission.
    53    5. Member boards shall share  complaint  or  disciplinary  information
    54  about a physician upon request of another member board.

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     1    6.  All  information provided to the interstate commission or distrib-
     2  uted by member boards shall be confidential, filed under seal, and  used
     3  only for investigatory or disciplinary matters.
     4    7.  The  interstate  commission  is  authorized  to  develop rules for
     5  mandated or discretionary sharing of information by member boards.
     6    § 8869. Joint investigations. 1. Licensure and disciplinary records of
     7  physicians are deemed investigative.
     8    2. In addition to the authority granted  to  a  member  board  by  its
     9  respective  medical practice act or other applicable state law, a member
    10  board may participate with other member boards in  joint  investigations
    11  of physicians licensed by the member boards.
    12    3.  A  subpoena issued by a member state shall be enforceable in other
    13  member states.
    14    4. Member boards may share any investigative, litigation,  or  compli-
    15  ance  materials  in furtherance of any joint or individual investigation
    16  initiated under the compact.
    17    5. Any member state may investigate actual or  alleged  violations  of
    18  the  statutes  authorizing  the practice of medicine in any other member
    19  state in which a physician holds a license to practice medicine.
    20    § 8870. Disciplinary actions. 1. Any disciplinary action taken by  any
    21  member  board  against a physician licensed through the compact shall be
    22  deemed unprofessional conduct which may  be  subject  to  discipline  by
    23  other  member  boards, in addition to any violation of the medical prac-
    24  tice act or regulations in that state.
    25    2. If a license granted to a physician by  the  member  board  in  the
    26  state  of  principal  license is revoked, surrendered or relinquished in
    27  lieu of discipline, or suspended, then all licenses issued to the physi-
    28  cian by member boards shall automatically  be  placed,  without  further
    29  action  necessary by any member board, on the same status. If the member
    30  board in the state of  principal  license  subsequently  reinstates  the
    31  physician's  license,  a  license  issued  to the physician by any other
    32  member board shall remain encumbered until that respective member  board
    33  takes  action  to  reinstate the license in a manner consistent with the
    34  medical practice act of that state.
    35    3. If disciplinary action is taken against a  physician  by  a  member
    36  board  not in the state of principal license, any other member board may
    37  deem the action conclusive as to matter of law and fact decided, and:
    38    (a) impose the same or lesser sanction or sanctions against the physi-
    39  cian so long as such sanctions are consistent with the medical  practice
    40  act of that state; or
    41    (b)  pursue  separate  disciplinary action against the physician under
    42  its respective medical practice act, regardless of the action  taken  in
    43  other member states.
    44    4.  If  a license granted to a physician by a member board is revoked,
    45  surrendered, or relinquished in lieu of discipline, or  suspended,  then
    46  any  license  or  licenses  issued  to the physician by any other member
    47  board or boards shall be suspended, automatically and immediately  with-
    48  out  further  action  necessary by the other member board or boards, for
    49  ninety days upon entry of the order by the disciplining board, to permit
    50  the member board or boards to investigate the basis for the action under
    51  the medical practice act of that state. A member board may terminate the
    52  automatic suspension of the license it issued prior to the completion of
    53  the ninety day suspension period in a manner consistent with the medical
    54  practice act of that state.

        A. 3391                             7

     1    § 8871. Interstate medical licensure compact commission. 1. The member
     2  states hereby create the "interstate medical licensure  compact  commis-
     3  sion".
     4    2.  The  purpose of the interstate commission is the administration of
     5  the interstate medical licensure compact, which is a discretionary state
     6  function.
     7    3. The interstate commission shall be a body corporate and joint agen-
     8  cy of the member states and shall have all the responsibilities, powers,
     9  and duties set forth in the compact, and such additional powers  as  may
    10  be conferred upon it by a subsequent concurrent action of the respective
    11  legislatures  of  the  member states in accordance with the terms of the
    12  compact.
    13    4. The interstate commission shall consist  of  two  voting  represen-
    14  tatives appointed by each member state who shall serve as commissioners.
    15  In  states  where allopathic and osteopathic physicians are regulated by
    16  separate member boards, or if the licensing and  disciplinary  authority
    17  is  split  between  multiple  member  boards  within a member state, the
    18  member state shall appoint one representative from each member board.  A
    19  commissioner shall be a or an:
    20    (a) Allopathic or osteopathic physician appointed to a member board;
    21    (b) Executive director, executive secretary, or similar executive of a
    22  member board; or
    23    (c) Member of the public appointed to a member board.
    24    5.  The  interstate  commission shall meet at least once each calendar
    25  year. A portion of this meeting shall be a business meeting  to  address
    26  such  matters  as may properly come before the commission, including the
    27  election of officers. The chairperson may call additional  meetings  and
    28  shall  call  for  a meeting upon the request of a majority of the member
    29  states.
    30    6. The bylaws may provide for meetings of the interstate commission to
    31  be conducted by telecommunication or electronic communication.
    32    7. Each commissioner participating at  a  meeting  of  the  interstate
    33  commission  is  entitled  to one vote. A majority of commissioners shall
    34  constitute a quorum for the transaction of  business,  unless  a  larger
    35  quorum is required by the bylaws of the interstate commission. A commis-
    36  sioner shall not delegate a vote to another commissioner. In the absence
    37  of  its commissioner, a member state may delegate voting authority for a
    38  specified meeting to another person from that state who shall  meet  the
    39  requirements of subdivision four of this section.
    40    8.  The interstate commission shall provide public notice of all meet-
    41  ings and all meetings shall  be  open  to  the  public.  The  interstate
    42  commission  may  close a meeting, in full or in portion, where it deter-
    43  mines by a two-thirds vote of the commissioners  present  that  an  open
    44  meeting would be likely to:
    45    (a)  Relate  solely to the internal personnel practices and procedures
    46  of the interstate commission;
    47    (b) Discuss matters specifically exempted from disclosure  by  federal
    48  statute;
    49    (c)  Discuss  trade secrets, commercial, or financial information that
    50  is privileged or confidential;
    51    (d) Involve accusing a person of a  crime,  or  formally  censuring  a
    52  person;
    53    (e)  Discuss  information  of a personal nature where disclosure would
    54  constitute a clearly unwarranted invasion of personal privacy;
    55    (f)  Discuss  investigative  records  compiled  for  law   enforcement
    56  purposes; or

        A. 3391                             8

     1    (g)  Specifically  relate  to  the  participation in a civil action or
     2  other legal proceeding.
     3    9.  The  interstate  commission  shall  keep minutes which shall fully
     4  describe all matters discussed in a meeting and shall provide a full and
     5  accurate summary of actions taken, including record  of  any  roll  call
     6  votes.
     7    10.  The interstate commission shall make its information and official
     8  records, to the extent not otherwise designated in the compact or by its
     9  rules, available to the public for inspection.
    10    11. The interstate commission shall establish an executive  committee,
    11  which  shall  include officers, members, and others as determined by the
    12  bylaws. The executive committee shall have the power to act on behalf of
    13  the interstate commission, with  the  exception  of  rulemaking,  during
    14  periods when the interstate commission is not in session. When acting on
    15  behalf of the interstate commission, the executive committee shall over-
    16  see  the administration of the compact including enforcement and compli-
    17  ance with the provisions of the compact, its bylaws and rules, and other
    18  such duties as necessary.
    19    12. The interstate  commission  may  establish  other  committees  for
    20  governance and administration of the compact.
    21    § 8872. Powers and duties of the interstate commission. The interstate
    22  commission shall have the duty and power to:
    23    1. Oversee and maintain the administration of the compact;
    24    2.  Promulgate  rules  which shall be binding to the extent and in the
    25  manner provided for in the compact;
    26    3. Issue, upon the request of a member state or member board, advisory
    27  opinions concerning the meaning or interpretation of  the  compact,  its
    28  bylaws, rules, and actions;
    29    4.  Enforce  compliance with compact provisions, the rules promulgated
    30  by the interstate commission, and the bylaws, using  all  necessary  and
    31  proper means, including but not limited to the use of judicial process;
    32    5.  Establish and appoint committees including, but not limited to, an
    33  executive committee as required by section eighty-eight  hundred  seven-
    34  ty-one  of  this article, which shall have the power to act on behalf of
    35  the interstate commission in carrying out its powers and duties;
    36    6. Pay, or provide for the payment of  the  expenses  related  to  the
    37  establishment,  organization,  and  ongoing activities of the interstate
    38  commission;
    39    7. Establish and maintain one or more offices;
    40    8. Borrow, accept, hire, or contract for services of personnel;
    41    9. Purchase and maintain insurance and bonds;
    42    10. Employ an executive director who shall have such powers to employ,
    43  select or appoint employees, agents, or consultants,  and  to  determine
    44  their qualifications, define their duties, and fix their compensation;
    45    11. Establish personnel policies and programs relating to conflicts of
    46  interest, rates of compensation, and qualifications of personnel;
    47    12. Accept donations and grants of money, equipment, supplies, materi-
    48  als and services, and to receive, utilize, and dispose of it in a manner
    49  consistent  with  the  conflict  of interest policies established by the
    50  interstate commission;
    51    13. Lease, purchase, accept contributions or donations of,  or  other-
    52  wise  to  own,  hold,  improve, or use, any property, real, personal, or
    53  mixed;
    54    14. Sell, convey,  mortgage,  pledge,  lease,  exchange,  abandon,  or
    55  otherwise dispose of any property, real, personal, or mixed;
    56    15. Establish a budget and make expenditures;

        A. 3391                             9

     1    16.  Adopt a seal and bylaws governing the management and operation of
     2  the interstate commission;
     3    17.  Report  annually  to the legislatures and governors of the member
     4  states concerning the activities of the interstate commission during the
     5  preceding year.  Such reports shall also include  reports  of  financial
     6  audits  and any recommendations that may have been adopted by the inter-
     7  state commission;
     8    18. Coordinate education, training, and public awareness regarding the
     9  compact, its implementation, and its operation;
    10    19. Maintain records in accordance with the bylaws;
    11    20. Seek and obtain trademarks, copyrights, and patents; and
    12    21. Perform such functions as  may  be  necessary  or  appropriate  to
    13  achieve the purposes of the compact.
    14    § 8873. Finance  powers.  1. The interstate commission may levy on and
    15  collect an annual assessment from each member state to cover the cost of
    16  the operations and activities  of  the  interstate  commission  and  its
    17  staff. The total assessment must be sufficient to cover the annual budg-
    18  et  approved each year for which revenue is not provided by other sourc-
    19  es. The aggregate annual assessment amount shall  be  allocated  upon  a
    20  formula  to  be  determined  by  the  interstate commission, which shall
    21  promulgate a rule binding upon all member states.
    22    2. The interstate commission shall not incur obligations of  any  kind
    23  prior to securing the funds adequate to meet the same.
    24    3. The interstate commission shall not pledge the credit of any of the
    25  member states, except by, and with the authority of, the member state.
    26    4.  The  interstate  commission shall be subject to a yearly financial
    27  audit conducted by a certified or licensed  public  accountant  and  the
    28  report of the audit shall be included in the annual report of the inter-
    29  state commission.
    30    § 8874. Organization  and  operation  of the interstate commission. 1.
    31  The interstate commission shall, by a majority of commissioners  present
    32  and  voting,  adopt  bylaws to govern its conduct as may be necessary or
    33  appropriate to carry out the  purposes  of  the  compact  within  twelve
    34  months of the first interstate commission meeting.
    35    2.  The  interstate  commission  shall  elect or appoint annually from
    36  among its commissioners a chairperson, a vice-chairperson, and a  treas-
    37  urer, each of whom shall have such authority and duties as may be speci-
    38  fied  in the bylaws. The chairperson, or in the chairperson's absence or
    39  disability, the vice-chairperson, shall preside at all meetings  of  the
    40  interstate commission.
    41    3. Officers selected pursuant to subdivision two of this section shall
    42  serve without remuneration from the interstate commission.
    43    4.  The  officers  and employees of the interstate commission shall be
    44  immune from suit and liability, either personally or in  their  official
    45  capacity,  for  a  claim  for  damage to or loss of property or personal
    46  injury or other civil liability caused or arising out  of,  or  relating
    47  to,  an actual or alleged act, error, or omission that occurred, or that
    48  such person had a reasonable basis for believing  occurred,  within  the
    49  scope  of interstate commission employment, duties, or responsibilities;
    50  provided that such person shall not be protected from suit or  liability
    51  for  damage,  loss,  injury,  or  liability caused by the intentional or
    52  willful and wanton misconduct of such person.
    53    (a) The liability of the  executive  director  and  employees  of  the
    54  interstate  commission  or representatives of the interstate commission,
    55  acting within the scope of such person's employment or duties for  acts,
    56  errors,  or  omissions  occurring  within  such  person's state, may not

        A. 3391                            10

     1  exceed the limits of liability set forth under the constitution and laws
     2  of that state for state officials, employees, and agents. The interstate
     3  commission is considered to be an instrumentality of the states for  the
     4  purposes  of  any  such  action.    Nothing  in  this paragraph shall be
     5  construed to protect such person from  suit  or  liability  for  damage,
     6  loss,  injury,  or  liability  caused  by the intentional or willful and
     7  wanton misconduct of such person.
     8    (b) The interstate commission shall defend the executive director, its
     9  employees, and subject to the approval of the attorney general or  other
    10  appropriate  legal  counsel of the member state represented by an inter-
    11  state commission representative, shall defend such interstate commission
    12  representative in any civil action seeking to impose  liability  arising
    13  out  of an actual or alleged act, error or omission that occurred within
    14  the scope of interstate commission employment,  duties  or  responsibil-
    15  ities,  or  that  the  defendant  had  a  reasonable basis for believing
    16  occurred within the scope of interstate commission  employment,  duties,
    17  or  responsibilities, provided that the actual or alleged act, error, or
    18  omission did not result from intentional or willful and  wanton  miscon-
    19  duct on the part of such person.
    20    (c)  To the extent not covered by the state involved, member state, or
    21  the interstate commission,  the  representatives  or  employees  of  the
    22  interstate  commission shall be held harmless in the amount of a settle-
    23  ment or judgment, including attorney's fees and costs, obtained  against
    24  such persons arising out of an actual or alleged act, error, or omission
    25  that  occurred  within  the  scope  of interstate commission employment,
    26  duties, or responsibilities, or that such persons had a reasonable basis
    27  for believing occurred within the scope of interstate commission employ-
    28  ment, duties, or responsibilities, provided that the actual  or  alleged
    29  act,  error,  or omission did not result from intentional or willful and
    30  wanton misconduct on the part of such persons.
    31    § 8875. Rulemaking functions of the interstate  commission.  1.    The
    32  interstate  commission  shall  promulgate  reasonable  rules in order to
    33  effectively  and  efficiently  achieve  the  purposes  of  the  compact.
    34  Notwithstanding  the  foregoing,  in the event the interstate commission
    35  exercises its rulemaking authority in a manner that is beyond the  scope
    36  of  the  purposes  of the compact, or the powers granted hereunder, then
    37  such an action by the interstate commission shall be invalid and have no
    38  force or effect.
    39    2. Rules deemed appropriate  for  the  operations  of  the  interstate
    40  commission  shall be made pursuant to a rulemaking process that substan-
    41  tially conforms to the federal Model State Administrative Procedure  Act
    42  of 2010, and subsequent amendments thereto.
    43    3.  Not later than thirty days after a rule is promulgated, any person
    44  may file a petition for judicial review of the rule in the United States
    45  District Court for the District of  Columbia  or  the  federal  district
    46  where the interstate commission has its principal offices, provided that
    47  the  filing  of  such a petition shall not stay or otherwise prevent the
    48  rule from becoming effective unless the court finds that the  petitioner
    49  has  a substantial likelihood of success. The court shall give deference
    50  to the actions of the interstate commission consistent  with  applicable
    51  law  and shall not find the rule to be unlawful if the rule represents a
    52  reasonable exercise of the authority granted to the  interstate  commis-
    53  sion.
    54    § 8876. Oversight  of  interstate  compact. 1. The executive, legisla-
    55  tive, and judicial branches of state government  in  each  member  state
    56  shall  enforce  the  compact  and  shall  take all actions necessary and

        A. 3391                            11

     1  appropriate  to  effectuate  the  compact's  purposes  and  intent.  The
     2  provisions of the compact and the rules promulgated hereunder shall have
     3  standing as statutory law but shall not override existing state authori-
     4  ty to regulate the practice of medicine.
     5    2.  All courts shall take judicial notice of the compact and the rules
     6  in any judicial or administrative proceeding in a member state  pertain-
     7  ing  to  the  subject matter of the compact which may affect the powers,
     8  responsibilities or actions of the interstate commission.
     9    3. The interstate commission shall be entitled to receive all  service
    10  of  process in any such proceeding, and shall have standing to intervene
    11  in the proceeding for all purposes. Failure to provide service of  proc-
    12  ess  to  the interstate commission shall render a judgment or order void
    13  as to the interstate commission, the compact, or promulgated rules.
    14    § 8877. Enforcement of interstate compact. 1. The  interstate  commis-
    15  sion,  in  the  reasonable exercise of its discretion, shall enforce the
    16  provisions and rules of the compact.
    17    2. The interstate commission may, by majority vote of the  commission-
    18  ers,  initiate  legal action in the United States District Court for the
    19  District of Columbia, or, at the discretion of  the  interstate  commis-
    20  sion,  in  the  federal district where the interstate commission has its
    21  principal offices, to enforce compliance  with  the  provisions  of  the
    22  compact, and its promulgated rules and bylaws, against a member state in
    23  default.  The  relief  sought  may  include  both  injunctive relief and
    24  damages. In the event judicial enforcement is necessary, the  prevailing
    25  party shall be awarded all costs of such litigation including reasonable
    26  attorney's fees.
    27    3.  The  remedies  herein  shall  not be the exclusive remedies of the
    28  interstate commission.  The interstate commission may  avail  itself  of
    29  any  other  remedies  available  under  state law or the regulation of a
    30  profession.
    31    § 8878. Default procedures. 1. The grounds for  default  include,  but
    32  are  not  limited  to,  failure  of a member state to perform such obli-
    33  gations or responsibilities imposed upon it by the compact, or the rules
    34  and bylaws of the interstate commission promulgated under the compact.
    35    2. If the interstate commission determines that  a  member  state  has
    36  defaulted  in  the  performance  of  its obligations or responsibilities
    37  under the compact, or the bylaws or promulgated  rules,  the  interstate
    38  commission shall:
    39    (a)  Provide  written  notice to the defaulting state and other member
    40  states, of the nature of the default, the means of curing  the  default,
    41  and  any  action  taken  by  the interstate commission.   The interstate
    42  commission shall specify the conditions by which  the  defaulting  state
    43  must cure its default; and
    44    (b)  Provide  remedial  training  and  specific  technical  assistance
    45  regarding the default.
    46    3. If the defaulting state fails to cure the default,  the  defaulting
    47  state shall be terminated from the compact upon an affirmative vote of a
    48  majority  of  the commissioners and all rights, privileges, and benefits
    49  conferred by the compact shall terminate on the effective date of termi-
    50  nation. A cure of the default does not relieve the  offending  state  of
    51  obligations or liabilities incurred during the period of the default.
    52    4.  Termination  of  membership  in  the compact shall be imposed only
    53  after all other means of securing compliance have been exhausted. Notice
    54  of intent to terminate shall be given by the  interstate  commission  to
    55  the  governor,  the  majority  and  minority  leaders  of the defaulting
    56  state's legislature, and each of the member states.

        A. 3391                            12

     1    5. The interstate commission shall establish rules and  procedures  to
     2  address  licenses  and  physicians  that  are materially impacted by the
     3  termination of a member state, or the withdrawal of a member state.
     4    6.  The  member state which has been terminated is responsible for all
     5  dues, obligations, and liabilities incurred through the  effective  date
     6  of  termination  including obligations, the performance of which extends
     7  beyond the effective date of termination.
     8    7. The interstate commission shall not bear any costs relating to  any
     9  state  that has been found to be in default or which has been terminated
    10  from the compact, unless  otherwise  mutually  agreed  upon  in  writing
    11  between the interstate commission and the defaulting state.
    12    8.  The  defaulting  state  may  appeal  the  action of the interstate
    13  commission by petitioning the  United  States  District  Court  for  the
    14  District  of  Columbia  or  the  federal  district  where the interstate
    15  commission has its principal offices.  The  prevailing  party  shall  be
    16  awarded  all  costs  of  such litigation including reasonable attorney's
    17  fees.
    18    § 8879. Dispute  resolution.  1.  The  interstate   commission   shall
    19  attempt,  upon  the request of a member state, to resolve disputes which
    20  are subject to the compact and which may arise among  member  states  or
    21  member boards.
    22    2. The interstate commission shall promulgate rules providing for both
    23  mediation and binding dispute resolution as appropriate.
    24    § 8880. Member  states,  effective date and amendment. 1. Any state is
    25  eligible to become a member state of the compact.
    26    2. The compact shall become effective  and  binding  upon  legislative
    27  enactment  of  the compact into law by no less than seven states. There-
    28  after, it shall become effective and binding on a state  upon  enactment
    29  of the compact into law by that state.
    30    3.  The  governors  of non-member states, or their designees, shall be
    31  invited to participate in the activities of the interstate commission on
    32  a non-voting basis prior to adoption of the compact by all states.
    33    4. The interstate commission may propose amendments to the compact for
    34  enactment by the member states. No amendment shall become effective  and
    35  binding  upon the interstate commission and the member states unless and
    36  until it is enacted into law by unanimous consent of the member states.
    37    § 8881. Withdrawal. 1. Once effective, the compact shall  continue  in
    38  force and remain binding upon each and every member state; provided that
    39  a  member  state may withdraw from the compact by specifically repealing
    40  the statute which enacted the compact into law.
    41    2. Withdrawal from the compact shall be by the enactment of a  statute
    42  repealing  the  same, but shall not take effect until one year after the
    43  effective date of such statute and until written  notice  of  the  with-
    44  drawal  has  been given by the withdrawing state to the governor of each
    45  other member state.
    46    3. The withdrawing state shall immediately notify the  chairperson  of
    47  the  interstate  commission  in  writing upon the introduction of legis-
    48  lation repealing the compact in the withdrawing state.
    49    4. The interstate commission shall notify the other member  states  of
    50  the  withdrawing  state's  intent  to  withdraw within sixty days of its
    51  receipt of notice provided under subdivision three of this section.
    52    5. The withdrawing state is responsible for all dues, obligations  and
    53  liabilities incurred through the effective date of withdrawal, including
    54  obligations,  the  performance of which extend beyond the effective date
    55  of withdrawal.

        A. 3391                            13

     1    6. Reinstatement following withdrawal of a member  state  shall  occur
     2  upon  the  withdrawing  state  reenacting the compact or upon such later
     3  date as determined by the interstate commission.
     4    7. The interstate commission is authorized to develop rules to address
     5  the  impact  of  the withdrawal of a member state on licenses granted in
     6  other member states to physicians who designated the withdrawing  member
     7  state as the state of principal license.
     8    § 8882. Dissolution.  1. The compact shall dissolve effective upon the
     9  date of the withdrawal or default of the member state which reduces  the
    10  membership in the compact to one member state.
    11    2.  Upon  the dissolution of the compact, the compact becomes null and
    12  void and shall be of no further force or effect, and  the  business  and
    13  affairs  of  the  interstate  commission  shall be concluded and surplus
    14  funds shall be distributed in accordance with the bylaws.
    15    § 8883. Severability  and  construction.  1.  The  provisions  of  the
    16  compact  shall  be  severable,  and  if any phrase, clause, sentence, or
    17  provision is deemed  unenforceable,  the  remaining  provisions  of  the
    18  compact shall be enforceable.
    19    2.  The  provisions  of  the  compact  shall be liberally construed to
    20  effectuate its purposes.
    21    3. Nothing in the compact shall be construed to prohibit the  applica-
    22  bility of other interstate compacts to which the states are members.
    23    § 8884. Binding effect of compact and other laws. 1. Nothing contained
    24  in  this  article  shall  prevent  the enforcement of any other law of a
    25  member state that is not inconsistent with the compact.
    26    2. All laws in a member state in conflict with the compact are  super-
    27  seded to the extent of the conflict.
    28    3.  All  lawful  actions  of  the interstate commission, including all
    29  rules and bylaws promulgated by the commission,  are  binding  upon  the
    30  member states.
    31    4.  All  agreements  between  the interstate commission and the member
    32  states are binding in accordance with their terms.
    33    5. In the event any provision of the  compact  exceeds  the  constitu-
    34  tional  limits  imposed  on  the  legislature  of any member state, such
    35  provision shall be ineffective to the extent of the  conflict  with  the
    36  constitutional provision in question in that member state.
    37    § 2. Article 170 of the education law, as renumbered by chapter 905 of
    38  the  laws  of  1990,  is renumbered article 171 and a new article 170 is
    39  added to title 8 of the education law to read as follows:
    40                                 ARTICLE 170
    41                           NURSE LICENSURE COMPACT
    42  Section 8900. Nurse licensure compact.
    43          8901. Findings and declaration of purpose.
    44          8902. Definitions.
    45          8903. General provisions and jurisdiction.
    46          8904. Applications for licensure in a party state.
    47          8905. Additional authorities invested in party  state  licensing
    48                  boards.
    49          8906. Coordinated  licensure  information system and exchange of
    50                  information.
    51          8907. Establishment of the interstate commission of nurse licen-
    52                  sure compact administrators.
    53          8908. Rulemaking.
    54          8909. Oversight, dispute resolution and enforcement.
    55          8910. Effective date, withdrawal and amendment.
    56          8911. Construction and severability.

        A. 3391                            14

     1    § 8900. Nurse licensure compact. The  nurse  license  compact  as  set
     2  forth  in  the article is hereby adopted and entered into with all party
     3  states joining therein.
     4    § 8901. Findings  and  declaration of purpose  1. Findings.  The party
     5  states find that:
     6    a. The health and safety of the public are affected by the  degree  of
     7  compliance  with and the effectiveness of enforcement activities related
     8  to state nurse licensure laws;
     9    b. Violations of nurse licensure and other laws regulating  the  prac-
    10  tice of nursing may result in injury or harm to the public;
    11    c.  The  expanded  mobility of nurses and the use of advanced communi-
    12  cation technologies as part of our nation's health care delivery  system
    13  require  greater  coordination and cooperation among states in the areas
    14  of nurse licensure and regulation;
    15    d. New practice modalities and technology make compliance  with  indi-
    16  vidual state nurse licensure laws difficult and complex;
    17    e.  The  current system of duplicative licensure for nurses practicing
    18  in multiple states is cumbersome  and  redundant  for  both  nurses  and
    19  states; and
    20    f.  Uniformity  of  nurse licensure requirements throughout the states
    21  promotes public safety and public health benefits.
    22    2. Declaration of purpose. The general purposes of  this  compact  are
    23  to:
    24    a.  Facilitate  the  states'  responsibility  to  protect the public's
    25  health and safety;
    26    b. Ensure and encourage the cooperation of party states in  the  areas
    27  of nurse licensure and regulation;
    28    c.  Facilitate the exchange of information between party states in the
    29  areas of nurse regulation, investigation and adverse actions;
    30    d. Promote compliance with the laws governing the practice of  nursing
    31  in each jurisdiction;
    32    e. Invest all party states with the authority to hold a nurse account-
    33  able  for  meeting  all  state  practice  laws in the state in which the
    34  patient is located at the time  care  is  rendered  through  the  mutual
    35  recognition of party state licenses;
    36    f.  Decrease  redundancies  in the consideration and issuance of nurse
    37  licenses; and
    38    g. Provide opportunities for interstate practice by  nurses  who  meet
    39  uniform licensure requirements.
    40    § 8902. Definitions. 1. Definitions. As used in this compact:
    41    a.  "Adverse  action"  means  any  administrative, civil, equitable or
    42  criminal action permitted by a  state's  laws  which  is  imposed  by  a
    43  licensing  board  or  other authority against a nurse, including actions
    44  against an individual's license or multistate licensure  privilege  such
    45  as  revocation, suspension, probation, monitoring of the licensee, limi-
    46  tation on the licensee's practice, or any other encumbrance on licensure
    47  affecting a nurse's authorization to practice, including issuance  of  a
    48  cease and desist action.
    49    b.  "Alternative  program" means a non-disciplinary monitoring program
    50  approved by a licensing board.
    51    c. "Coordinated licensure  information  system"  means  an  integrated
    52  process  for collecting, storing and sharing information on nurse licen-
    53  sure and enforcement activities related to nurse licensure laws that  is
    54  administered  by  a nonprofit organization composed of and controlled by
    55  licensing boards.

        A. 3391                            15

     1    d. "Commission" means the interstate  commission  of  nurse  licensure
     2  compact administrators.
     3    e. "Current significant investigative information" means:
     4    1.  Investigative information that a licensing board, after a prelimi-
     5  nary inquiry that includes notification and an opportunity for the nurse
     6  to respond, if required by state law,  has  reason  to  believe  is  not
     7  groundless and, if proved true, would indicate more than a minor infrac-
     8  tion; or
     9    2.  Investigative information that indicates that the nurse represents
    10  an immediate threat to public health and safety  regardless  of  whether
    11  the nurse has been notified and had an opportunity to respond; or
    12    3. Any information concerning a nurse reported to a licensing board by
    13  a  health  care  entity,  health care professional, or any other person,
    14  which indicates that the nurse demonstrated an impairment, gross  incom-
    15  petence, or unprofessional conduct that would present an imminent danger
    16  to a patient or the public health, safety, or welfare.
    17    f.  "Encumbrance"  means a revocation or suspension of, or any limita-
    18  tion on, the full and unrestricted practice  of  nursing  imposed  by  a
    19  licensing board.
    20    g.  "Home  state"  means  the party state which is the nurse's primary
    21  state of residence.
    22    h. "Licensing board" means a party state's regulatory body responsible
    23  for issuing nurse licenses.
    24    i. "Multistate license" means a license to practice  as  a  registered
    25  nurse  (RN)  or as a licensed practical/vocational nurse (LPN/VN), which
    26  is issued by a home state licensing  board,  and  which  authorizes  the
    27  licensed nurse to practice in all party states under a multistate licen-
    28  sure privilege.
    29    j.  "Multistate licensure privilege" means a legal authorization asso-
    30  ciated with a multistate license permitting the practice of  nursing  as
    31  either a RN or a LPN/VN in a remote state.
    32    k.  "Nurse"  means  RN  or  LPN/VN, as those terms are defined by each
    33  party state's practice laws.
    34    l. "Party state" means any state that has adopted this compact.
    35    m. "Remote state" means a party state, other than the home state.
    36    n. "Single-state license" means a nurse  license  issued  by  a  party
    37  state  that  authorizes  practice only within the issuing state and does
    38  not include a multistate licensure privilege to practice  in  any  other
    39  party state.
    40    o. "State" means a state, territory or possession of the United States
    41  and the District of Columbia.
    42    p.  "State  practice laws" means a party state's laws, rules and regu-
    43  lations that govern the practice of nursing, define the scope of nursing
    44  practice, and create the methods and grounds  for  imposing  discipline.
    45  "State practice laws" shall not include requirements necessary to obtain
    46  and  retain  a license, except for qualifications or requirements of the
    47  home state.
    48    § 8903. General provisions and jurisdiction. 1. General provisions and
    49  jurisdiction. a. A multistate license to practice registered or licensed
    50  practical/vocational nursing issued by a home state  to  a  resident  in
    51  that state will be recognized by each party state as authorizing a nurse
    52  to   practice   as   a   registered   nurse   (RN)   or  as  a  licensed
    53  practical/vocational nurse (LPN/VN), under a multistate licensure privi-
    54  lege, in each party state.
    55    b. A state shall implement procedures  for  considering  the  criminal
    56  history  records  of  applicants  for  an  initial multistate license or

        A. 3391                            16

     1  licensure by endorsement. Such procedures shall include  the  submission
     2  of  fingerprints  or other biometric-based information by applicants for
     3  the purpose of obtaining an applicant's criminal history record informa-
     4  tion from the federal bureau of investigation and the agency responsible
     5  for retaining that state's criminal records.
     6    c.  Each party state shall require its licensing board to authorize an
     7  applicant to obtain or retain a multistate license  in  the  home  state
     8  only if the applicant:
     9    i.  Meets  the home state's qualifications for licensure or renewal of
    10  licensure, and complies with all other applicable state laws;
    11    ii. (1) Has graduated or is eligible  to  graduate  from  a  licensing
    12  board-approved RN or LPN/VN prelicensure education program; or
    13    (2)  Has  graduated from a foreign RN or LPN/VN prelicensure education
    14  program that has been: (A) approved by the authorized  accrediting  body
    15  in  the  applicable  country, and (B) verified by an independent creden-
    16  tials review agency to be comparable to a licensing board-approved prel-
    17  icensure education program;
    18    iii. Has, if a graduate of a foreign  prelicensure  education  program
    19  not  taught  in  English  or  if  English is not the individual's native
    20  language, successfully passed an English  proficiency  examination  that
    21  includes the components of reading, speaking, writing and listening;
    22    iv.  Has  successfully  passed  an NCLEX-RN or NCLEX-PN examination or
    23  recognized predecessor, as applicable;
    24    v. Is eligible for or holds an active, unencumbered license;
    25    vi. Has submitted, in  connection  with  an  application  for  initial
    26  licensure  or  licensure by endorsement, fingerprints or other biometric
    27  data for the purpose of obtaining criminal  history  record  information
    28  from  the federal bureau of investigation and the agency responsible for
    29  retaining that state's criminal records;
    30    vii. Has not been convicted or found guilty, or has  entered  into  an
    31  agreed disposition, of a felony offense under applicable state or feder-
    32  al criminal law;
    33    viii.  Has  not been convicted or found guilty, or has entered into an
    34  agreed disposition, of a misdemeanor offense related to the practice  of
    35  nursing as determined on a case-by-case basis;
    36    ix. Is not currently enrolled in an alternative program;
    37    x.  Is  subject  to  self-disclosure  requirements  regarding  current
    38  participation in an alternative program; and
    39    xi. Has a valid United States social security number.
    40    d. All party states shall be authorized, in accordance  with  existing
    41  state  due  process law, to take adverse action against a nurse's multi-
    42  state licensure privilege such as revocation, suspension,  probation  or
    43  any  other action that affects a nurse's authorization to practice under
    44  a multistate licensure privilege, including cease and desist actions. If
    45  a party state takes such action, it shall promptly notify  the  adminis-
    46  trator  of the coordinated licensure information system. The administra-
    47  tor of the coordinated licensure information system shall promptly noti-
    48  fy the home state of any such actions by remote states.
    49    e. A nurse practicing in a party state shall  comply  with  the  state
    50  practice  laws  of  the state in which the client is located at the time
    51  service is provided. The practice of nursing is not limited  to  patient
    52  care  but  shall  include  all  nursing practice as defined by the state
    53  practice laws of the party state in which the  client  is  located.  The
    54  practice of nursing in a party state under a multistate licensure privi-
    55  lege  will  subject  a nurse to the jurisdiction of the licensing board,

        A. 3391                            17

     1  the courts and the laws of the  party  state  in  which  the  client  is
     2  located at the time service is provided.
     3    f. Individuals not residing in a party state shall continue to be able
     4  to  apply for a party state's single-state license as provided under the
     5  laws of each party state. However, the single-state license  granted  to
     6  these  individuals  will  not be recognized as granting the privilege to
     7  practice nursing in any other party state. Nothing in this compact shall
     8  affect the requirements established by a party state for the issuance of
     9  a single-state license.
    10    g. Any nurse holding a home state multistate license, on the effective
    11  date of this compact, may retain and renew the multistate license issued
    12  by the nurse's then-current home state, provided that:
    13    i. A  nurse,  who  changes  primary  state  of  residence  after  this
    14  compact's  effective  date,  shall  meet all applicable requirements set
    15  forth in this article to obtain a multistate license  from  a  new  home
    16  state.
    17    ii. A nurse who fails to satisfy the multistate licensure requirements
    18  set  forth  in this article due to a disqualifying event occurring after
    19  this compact's effective date shall be ineligible to retain or  renew  a
    20  multistate  license, and the nurse's multistate license shall be revoked
    21  or deactivated in  accordance  with  applicable  rules  adopted  by  the
    22  commission.
    23    § 8904. Applications  for  licensure in a party state. 1. Applications
    24  for licensure in a party state. a. Upon  application  for  a  multistate
    25  license, the licensing board in the issuing party state shall ascertain,
    26  through the coordinated licensure information system, whether the appli-
    27  cant  has  ever held, or is the holder of, a license issued by any other
    28  state, whether there are any encumbrances on any license  or  multistate
    29  licensure  privilege  held  by the applicant, whether any adverse action
    30  has been taken against any license  or  multistate  licensure  privilege
    31  held by the applicant and whether the applicant is currently participat-
    32  ing in an alternative program.
    33    b. A nurse may hold a multistate license, issued by the home state, in
    34  only one party state at a time.
    35    c. If a nurse changes primary state of residence by moving between two
    36  party  states, the nurse must apply for licensure in the new home state,
    37  and the multistate license issued by the prior home state will be  deac-
    38  tivated in accordance with applicable rules adopted by the commission.
    39    i. The nurse may apply for licensure in advance of a change in primary
    40  state of residence.
    41    ii.  A  multistate  license  shall not be issued by the new home state
    42  until the nurse provides satisfactory evidence of a  change  in  primary
    43  state  of  residence  to the new home state and satisfies all applicable
    44  requirements to obtain a multistate license from the new home state.
    45    d. If a nurse changes primary state of  residence  by  moving  from  a
    46  party  state  to a non-party state, the multistate license issued by the
    47  prior home state will convert to a single-state license, valid  only  in
    48  the former home state.
    49    § 8905. Additional  authorities  invested  in  party  state  licensing
    50  boards. 1. Licensing board authority. In addition to  the  other  powers
    51  conferred by state law, a licensing board shall have the authority to:
    52    a.  Take  adverse action against a nurse's multistate licensure privi-
    53  lege to practice within that party state.
    54    i. Only the home state shall have the power  to  take  adverse  action
    55  against a nurse's license issued by the home state.

        A. 3391                            18

     1    ii.  For  purposes  of taking adverse action, the home state licensing
     2  board shall give the  same  priority  and  effect  to  reported  conduct
     3  received  from  a  remote state as it would if such conduct had occurred
     4  within the home state. In so doing, the home state shall apply  its  own
     5  state laws to determine appropriate action.
     6    b. Issue cease and desist orders or impose an encumbrance on a nurse's
     7  authority to practice within that party state.
     8    c.  Complete any pending investigations of a nurse who changes primary
     9  state of residence during the course of such investigations. The licens-
    10  ing board shall also have the authority to take  appropriate  action  or
    11  actions and shall promptly report the conclusions of such investigations
    12  to  the  administrator  of the coordinated licensure information system.
    13  The administrator of the coordinated licensure information system  shall
    14  promptly notify the new home state of any such actions.
    15    d.  Issue  subpoenas for both hearings and investigations that require
    16  the attendance and testimony of witnesses, as well as the production  of
    17  evidence. Subpoenas issued by a licensing board in a party state for the
    18  attendance and testimony of witnesses or the production of evidence from
    19  another  party  state shall be enforced in the latter state by any court
    20  of competent jurisdiction, according to the practice  and  procedure  of
    21  that  court applicable to subpoenas issued in proceedings pending before
    22  it.  The issuing authority shall pay any witness fees, travel  expenses,
    23  mileage  and other fees required by the service statutes of the state in
    24  which the witnesses or evidence are located.
    25    e. Obtain and submit, for each nurse licensure applicant,  fingerprint
    26  or  other  biometric-based information to the federal bureau of investi-
    27  gation for criminal background checks, receive the results of the feder-
    28  al bureau of investigation record search on criminal  background  checks
    29  and use the results in making licensure decisions.
    30    f.  If  otherwise  permitted  by  state law, recover from the affected
    31  nurse the costs of investigations and  disposition  of  cases  resulting
    32  from any adverse action taken against that nurse.
    33    g.  Take  adverse  action  based on the factual findings of the remote
    34  state, provided that the licensing board follows its own procedures  for
    35  taking such adverse action.
    36    2.  Adverse  actions.  a. If adverse action is taken by the home state
    37  against a nurse's multistate license, the nurse's  multistate  licensure
    38  privilege  to  practice  in  all other party states shall be deactivated
    39  until all encumbrances have been removed from  the  multistate  license.
    40  All  home state disciplinary orders that impose adverse action against a
    41  nurse's multistate license shall include a statement  that  the  nurse's
    42  multistate licensure privilege is deactivated in all party states during
    43  the pendency of the order.
    44    b.  Nothing  in  this  compact shall override a party state's decision
    45  that participation in an alternative program may  be  used  in  lieu  of
    46  adverse  action.  The  home  state  licensing board shall deactivate the
    47  multistate licensure privilege under the multistate license of any nurse
    48  for the duration of the nurse's participation in an alternative program.
    49    § 8906. Coordinated  licensure  information  system  and  exchange  of
    50  information.  1.   Coordinated licensure information system and exchange
    51  of information. a. All party states shall participate in  a  coordinated
    52  licensure information system of all licensed registered nurses (RNs) and
    53  licensed   practical/vocational  nurses  (LPNs/VNs).  This  system  will
    54  include information on the licensure and disciplinary  history  of  each
    55  nurse,  as  submitted  by party states, to assist in the coordination of
    56  nurse licensure and enforcement efforts.

        A. 3391                            19

     1    b. The commission, in consultation with the administrator of the coor-
     2  dinated licensure information  system,  shall  formulate  necessary  and
     3  proper  procedures  for  the  identification, collection and exchange of
     4  information under this compact.
     5    c.  All  licensing  boards  shall  promptly  report to the coordinated
     6  licensure information system any adverse action, any current significant
     7  investigative information, denials of applications with the reasons  for
     8  such  denials  and  nurse participation in alternative programs known to
     9  the licensing board regardless of whether such participation  is  deemed
    10  nonpublic or confidential under state law.
    11    d.  Current significant investigative information and participation in
    12  nonpublic or confidential  alternative  programs  shall  be  transmitted
    13  through the coordinated licensure information system only to party state
    14  licensing boards.
    15    e. Notwithstanding any other provision of law, all party state licens-
    16  ing  boards contributing information to the coordinated licensure infor-
    17  mation system may designate information that  may  not  be  shared  with
    18  non-party  states  or disclosed to other entities or individuals without
    19  the express permission of the contributing state.
    20    f. Any personally identifiable information obtained from  the  coordi-
    21  nated  licensure  information  system  by  a party state licensing board
    22  shall not be shared with non-party states or disclosed to other entities
    23  or individuals except to the extent permitted by the laws of  the  party
    24  state contributing the information.
    25    g.  Any  information contributed to the coordinated licensure informa-
    26  tion system that is subsequently required to be expunged by the laws  of
    27  the  party  state  contributing  that information shall also be expunged
    28  from the coordinated licensure information system.
    29    h. The compact administrator of  each  party  state  shall  furnish  a
    30  uniform data set to the compact administrator of each other party state,
    31  which shall include, at a minimum:
    32    i. Identifying information;
    33    ii. Licensure data;
    34    iii. Information related to alternative program participation; and
    35    iv.  Other  information that may facilitate the administration of this
    36  compact, as determined by commission rules.
    37    i. The compact administrator of a party state shall provide all inves-
    38  tigative documents and information requested by another party state.
    39    § 8907. Establishment of the interstate commission of nurse  licensure
    40  compact administrators.  1. Commission of nurse licensure compact admin-
    41  istrators.  The  party states hereby create and establish a joint public
    42  entity known as the interstate commission  of  nurse  licensure  compact
    43  administrators.  The  commission  is  an  instrumentality  of  the party
    44  states.
    45    2. Venue. Venue is proper, and judicial proceedings by or against  the
    46  commission shall be brought solely and exclusively, in a court of compe-
    47  tent  jurisdiction  where  the  principal  office  of  the commission is
    48  located. The commission may waive venue and jurisdictional  defenses  to
    49  the  extent  it adopts or consents to participate in alternative dispute
    50  resolution proceedings.
    51    3. Sovereign immunity. Nothing in this compact shall be  construed  to
    52  be a waiver of sovereign immunity.
    53    4. Membership, voting and meetings. a. Each party state shall have and
    54  be  limited  to one administrator. The head of the state licensing board
    55  or designee shall be the administrator of this compact  for  each  party
    56  state.    Any  administrator  may be removed or suspended from office as

        A. 3391                            20

     1  provided by the law  of  the  state  from  which  the  administrator  is
     2  appointed.  Any  vacancy  occurring in the commission shall be filled in
     3  accordance with the laws of the party state in which the vacancy exists.
     4    b. Each administrator shall be entitled to one vote with regard to the
     5  promulgation of rules and creation of bylaws and shall otherwise have an
     6  opportunity  to  participate  in the business and affairs of the commis-
     7  sion.  An administrator shall vote in person or by such other  means  as
     8  provided  in  the  bylaws. The bylaws may provide for an administrator's
     9  participation in meetings by telephone or other means of communication.
    10    c. The commission shall meet at least once during each calendar  year.
    11  Additional meetings shall be held as set forth in the bylaws or rules of
    12  the commission.
    13    d.  All  meetings  shall  be  open to the public, and public notice of
    14  meetings shall be given in the same manner as required under  the  rule-
    15  making provisions in section eighty-nine hundred three of this article.
    16    5. Closed meetings. a. The commission may convene in a closed, nonpub-
    17  lic meeting if the commission shall discuss:
    18    i.  Noncompliance  of  a  party  state with its obligations under this
    19  compact;
    20    ii.  The  employment,  compensation,  discipline  or  other  personnel
    21  matters,  practices or procedures related to specific employees or other
    22  matters related to the commission's  internal  personnel  practices  and
    23  procedures;
    24    iii. Current, threatened or reasonably anticipated litigation;
    25    iv.  Negotiation  of  contracts  for  the  purchase  or sale of goods,
    26  services or real estate;
    27    v. Accusing any person of a crime or formally censuring any person;
    28    vi. Disclosure of trade secrets or commercial or financial information
    29  that is privileged or confidential;
    30    vii. Disclosure of information of a personal nature  where  disclosure
    31  would constitute a clearly unwarranted invasion of personal privacy;
    32    viii. Disclosure of investigatory records compiled for law enforcement
    33  purposes;
    34    ix. Disclosure of information related to any reports prepared by or on
    35  behalf  of the commission for the purpose of investigation of compliance
    36  with this compact; or
    37    x. Matters specifically exempted from disclosure by federal  or  state
    38  statute.
    39    b.  If  a meeting, or portion of a meeting, is closed pursuant to this
    40  paragraph the commission's legal counsel or designee shall certify  that
    41  the  meeting  may  be closed and shall reference each relevant exempting
    42  provision. The commission shall keep  minutes  that  fully  and  clearly
    43  describe all matters discussed in a meeting and shall provide a full and
    44  accurate summary of actions taken, and the reasons therefor, including a
    45  description   of  the  views  expressed.  All  documents  considered  in
    46  connection with an action shall  be  identified  in  such  minutes.  All
    47  minutes  and  documents  of  a  closed  meeting shall remain under seal,
    48  subject to release by a majority vote of the commission or  order  of  a
    49  court of competent jurisdiction.
    50    c.  The  commission  shall,  by a majority vote of the administrators,
    51  prescribe bylaws or rules to govern its conduct as may be  necessary  or
    52  appropriate  to  carry  out the purposes and exercise the powers of this
    53  compact, including but not limited to:
    54    i. Establishing the fiscal year of the commission;
    55    ii. Providing reasonable standards and procedures:
    56    (1) For the establishment and meetings of other committees; and

        A. 3391                            21

     1    (2) Governing any general or specific delegation of any  authority  or
     2  function of the commission;
     3    iii.  Providing reasonable procedures for calling and conducting meet-
     4  ings of the commission, ensuring reasonable advance notice of all  meet-
     5  ings  and  providing  an  opportunity for attendance of such meetings by
     6  interested parties, with enumerated exceptions designed to  protect  the
     7  public's  interest, the privacy of individuals, and proprietary informa-
     8  tion, including trade secrets. The commission may meet in closed session
     9  only after a majority of the administrators vote to close a  meeting  in
    10  whole  or  in  part.  As  soon  as practicable, the commission must make
    11  public a copy of the vote to close the meeting  revealing  the  vote  of
    12  each administrator, with no proxy votes allowed;
    13    iv.  Establishing  the  titles,  duties  and  authority and reasonable
    14  procedures for the election of the officers of the commission;
    15    v. Providing reasonable standards and procedures for the establishment
    16  of the personnel policies and programs of the commission.  Notwithstand-
    17  ing  any  civil  service  or  other similar laws of any party state, the
    18  bylaws shall exclusively govern the personnel policies and  programs  of
    19  the commission; and
    20    vi. Providing a mechanism for winding up the operations of the commis-
    21  sion  and  the equitable disposition of any surplus funds that may exist
    22  after the termination of this compact after the payment or reserving  of
    23  all of its debts and obligations.
    24    6.  General provisions. a. The commission shall publish its bylaws and
    25  rules, and any amendments thereto, in a convenient form on  the  website
    26  of the commission.
    27    b.  The  commission shall maintain its financial records in accordance
    28  with the bylaws.
    29    c. The commission shall meet and take such actions as  are  consistent
    30  with the provisions of this compact and the bylaws.
    31     7.  Powers of the commission. The commission shall have the following
    32  powers:
    33    a. To promulgate uniform rules to facilitate and coordinate  implemen-
    34  tation  and  administration  of  this  compact. The rules shall have the
    35  force and effect of law and shall be binding in all party states;
    36    b. To bring and prosecute legal proceedings or actions in the name  of
    37  the commission, provided that the standing of any licensing board to sue
    38  or be sued under applicable law shall not be affected;
    39    c. To purchase and maintain insurance and bonds;
    40    d. To borrow, accept or contract for services of personnel, including,
    41  but  not  limited  to, employees of a party state or nonprofit organiza-
    42  tions;
    43    e.  To  cooperate  with  other  organizations  that  administer  state
    44  compacts related to the regulation of nursing, including but not limited
    45  to  sharing  administrative  or  staff  expenses,  office space or other
    46  resources;
    47    f. To hire employees, elect or  appoint  officers,  fix  compensation,
    48  define duties, grant such individuals appropriate authority to carry out
    49  the  purposes of this compact, and to establish the commission's person-
    50  nel policies and programs relating to conflicts of interest,  qualifica-
    51  tions of personnel and other related personnel matters;
    52    g.  To  accept  any and all appropriate donations, grants and gifts of
    53  money, equipment, supplies, materials  and  services,  and  to  receive,
    54  utilize  and dispose of the same; provided that at all times the commis-
    55  sion shall avoid any appearance of impropriety or conflict of interest;

        A. 3391                            22

     1    h. To lease, purchase, accept appropriate gifts or  donations  of,  or
     2  otherwise  to  own,  hold,  improve  or use, any property, whether real,
     3  personal or mixed; provided that at all times the commission shall avoid
     4  any appearance of impropriety;
     5    i.  To  sell,  convey,  mortgage,  pledge, lease, exchange, abandon or
     6  otherwise dispose of any property, whether real, personal or mixed;
     7    j. To establish a budget and make expenditures;
     8    k. To borrow money;
     9    l. To appoint committees, including advisory committees  comprised  of
    10  administrators,  state  nursing  regulators,  state legislators or their
    11  representatives, and consumer representatives, and other such interested
    12  persons;
    13    m. To provide and receive information from, and to cooperate with, law
    14  enforcement agencies;
    15    n. To adopt and use an official seal; and
    16    o. To perform such other functions as may be necessary or  appropriate
    17  to  achieve the purposes of this compact consistent with the state regu-
    18  lation of nurse licensure and practice.
    19    8. Financing of the  commission.  a.  The  commission  shall  pay,  or
    20  provide  for  the  payment of, the reasonable expenses of its establish-
    21  ment, organization and ongoing activities.
    22    b. The commission may also levy on and collect  an  annual  assessment
    23  from  each  party  state to cover the cost of its operations, activities
    24  and staff in its annual budget as  approved  each  year.  The  aggregate
    25  annual assessment amount, if any, shall be allocated based upon a formu-
    26  la  to  be  determined  by the commission, which shall promulgate a rule
    27  that is binding upon all party states.
    28    c. The commission shall not incur obligations of  any  kind  prior  to
    29  securing  the  funds adequate to meet the same; nor shall the commission
    30  pledge the credit of any of the party states, except by,  and  with  the
    31  authority of, such party state.
    32    d.  The  commission  shall  keep accurate accounts of all receipts and
    33  disbursements. The receipts and disbursements of the commission shall be
    34  subject to the audit and accounting  procedures  established  under  its
    35  bylaws.  However, all receipts and disbursements of funds handled by the
    36  commission shall be audited yearly by a  certified  or  licensed  public
    37  accountant,  and the report of the audit shall be included in and become
    38  part of the annual report of the commission.
    39    9. Qualified immunity, defense and indemnification. a. The administra-
    40  tors, officers, executive director, employees and representatives of the
    41  commission shall be immune from suit and liability, either personally or
    42  in their official capacity, for any claim for damage to or loss of prop-
    43  erty or personal injury or other civil liability caused  by  or  arising
    44  out  of  any  actual or alleged act, error or omission that occurred, or
    45  that the person against whom the claim is made had  a  reasonable  basis
    46  for believing occurred, within the scope of the commission's employment,
    47  duties  or  responsibilities;  provided  that  nothing in this paragraph
    48  shall be construed to protect any such person from suit or liability for
    49  any damage, loss, injury or liability caused by the intentional, willful
    50  or wanton misconduct of that person.
    51    b. The commission shall defend any administrator,  officer,  executive
    52  director,  employee  or  representative  of  the commission in any civil
    53  action seeking to impose liability arising out of any actual or  alleged
    54  act,  error  or  omission  that occurred within the scope of the commis-
    55  sion's employment,  duties  or  responsibilities,  or  that  the  person
    56  against  whom  the  claim  is  made had a reasonable basis for believing

        A. 3391                            23

     1  occurred within the scope of  the  commission's  employment,  duties  or
     2  responsibilities;  provided  that  nothing  herein shall be construed to
     3  prohibit that person from retaining his or her own counsel; and provided
     4  further that the actual or alleged act, error or omission did not result
     5  from that person's intentional, willful or wanton misconduct.
     6    c. The commission shall indemnify and hold harmless any administrator,
     7  officer,  executive  director, employee or representative of the commis-
     8  sion for the amount of any settlement or judgment obtained against  that
     9  person  arising out of any actual or alleged act, error or omission that
    10  occurred within the scope of  the  commission's  employment,  duties  or
    11  responsibilities, or that such person had a reasonable basis for believ-
    12  ing  occurred within the scope of the commission's employment, duties or
    13  responsibilities, provided that the actual  or  alleged  act,  error  or
    14  omission  did not result from the intentional, willful or wanton miscon-
    15  duct of that person.
    16    § 8908. Rulemaking. 1. Rulemaking. a. The  commission  shall  exercise
    17  its rulemaking powers pursuant to the criteria set forth in this article
    18  and  the  rules  adopted  thereunder.  Rules and amendments shall become
    19  binding as of the date specified in each rule  or  amendment  and  shall
    20  have the same force and effect as provisions of this compact.
    21    b.  Rules  or amendments to the rules shall be adopted at a regular or
    22  special meeting of the commission.
    23    2. Notice. a. Prior to promulgation and adoption of a  final  rule  or
    24  rules by the commission, and at least sixty days in advance of the meet-
    25  ing  at which the rule will be considered and voted upon, the commission
    26  shall file a notice of proposed rulemaking:
    27    i. On the website of the commission; and
    28    ii. On the website of each licensing board or the publication in which
    29  each state would otherwise publish proposed rules.
    30    b. The notice of proposed rulemaking shall include:
    31    i. The proposed time, date and location of the meeting  in  which  the
    32  rule will be considered and voted upon;
    33    ii. The text of the proposed rule or amendment, and the reason for the
    34  proposed rule;
    35    iii.  A  request for comments on the proposed rule from any interested
    36  person; and
    37    iv. The manner in which interested persons may submit  notice  to  the
    38  commission of their intention to attend the public hearing and any writ-
    39  ten comments.
    40    c.  Prior  to  adoption of a proposed rule, the commission shall allow
    41  persons to submit written data, facts,  opinions  and  arguments,  which
    42  shall be made available to the public.
    43    3. Public hearings on rules. a. The commission shall grant an opportu-
    44  nity for a public hearing before it adopts a rule or amendment.
    45    b. The commission shall publish the place, time and date of the sched-
    46  uled public hearing.
    47    i.  Hearings  shall be conducted in a manner providing each person who
    48  wishes to comment a fair and reasonable opportunity to comment orally or
    49  in writing. All hearings will be recorded,  and  a  copy  will  be  made
    50  available upon request.
    51    ii. Nothing in this section shall be construed as requiring a separate
    52  hearing  on  each  rule. Rules may be grouped for the convenience of the
    53  commission at hearings required by this section.
    54    c. If no one appears at the public hearing, the commission may proceed
    55  with promulgation of the proposed rule.

        A. 3391                            24

     1    d. Following the scheduled hearing date, or by the close  of  business
     2  on  the  scheduled hearing date if the hearing was not held, the commis-
     3  sion shall consider all written and oral comments received.
     4    4.  Voting  on  rules.  The  commission shall, by majority vote of all
     5  administrators, take final action on the proposed rule and shall  deter-
     6  mine  the  effective  date  of the rule, if any, based on the rulemaking
     7  record and the full text of the rule.
     8    5. Emergency rules. Upon determination that an emergency  exists,  the
     9  commission  may  consider  and  adopt  an  emergency  rule without prior
    10  notice, opportunity for comment or  hearing,  provided  that  the  usual
    11  rulemaking procedures provided in this compact and in this section shall
    12  be  retroactively applied to the rule as soon as reasonably possible, in
    13  no event later than ninety days after the effective date  of  the  rule.
    14  For  the  purposes of this provision, an emergency rule is one that must
    15  be adopted immediately in order to:
    16    a. Meet an imminent threat to public health, safety or welfare;
    17    b. Prevent a loss of the commission or party state funds; or
    18    c. Meet a deadline for the promulgation of an administrative rule that
    19  is required by federal law or rule.
    20    6. Revisions. The commission may  direct  revisions  to  a  previously
    21  adopted  rule  or  amendment  for  purposes  of correcting typographical
    22  errors, errors in format, errors in consistency or  grammatical  errors.
    23  Public  notice  of  any  revisions shall be posted on the website of the
    24  commission. The revision shall be subject to challenge by any person for
    25  a period of thirty days after posting. The revision  may  be  challenged
    26  only  on  grounds  that  the  revision results in a material change to a
    27  rule.   A challenge shall be made  in  writing,  and  delivered  to  the
    28  commission,  prior  to  the end of the notice period. If no challenge is
    29  made, the revision will take  effect  without  further  action.  If  the
    30  revision  is  challenged,  the  revision may not take effect without the
    31  approval of the commission.
    32    § 8909. Oversight, dispute resolution and enforcement.  1.  Oversight.
    33  a.  Each  party  state  shall  enforce this compact and take all actions
    34  necessary and appropriate to  effectuate  this  compact's  purposes  and
    35  intent.
    36    b.  The  commission shall be entitled to receive service of process in
    37  any proceeding that may affect the powers, responsibilities  or  actions
    38  of  the  commission,  and  shall  have  standing  to intervene in such a
    39  proceeding for all purposes. Failure to provide service  of  process  in
    40  such  proceeding to the commission shall render a judgment or order void
    41  as to the commission, this compact or promulgated rules.
    42    2. Default, technical assistance and termination. a. If the commission
    43  determines that a party state has defaulted in the  performance  of  its
    44  obligations  or  responsibilities  under this compact or the promulgated
    45  rules, the commission shall:
    46    i. Provide written notice to the  defaulting  state  and  other  party
    47  states  of  the  nature of the default, the proposed means of curing the
    48  default or any other action to be taken by the commission; and
    49    ii.  Provide  remedial  training  and  specific  technical  assistance
    50  regarding the default.
    51    b.  If  a  state  in default fails to cure the default, the defaulting
    52  state's membership in this compact may be terminated upon an affirmative
    53  vote of a majority of the administrators, and all rights, privileges and
    54  benefits conferred by this compact may be terminated  on  the  effective
    55  date  of termination. A cure of the default does not relieve the offend-

        A. 3391                            25

     1  ing state of obligations or liabilities incurred during  the  period  of
     2  default.
     3    c.  Termination  of  membership  in this compact shall be imposed only
     4  after all other means of securing compliance have been exhausted. Notice
     5  of intent to suspend or terminate shall be given by  the  commission  to
     6  the governor of the defaulting state and to the executive officer of the
     7  defaulting state's licensing board and each of the party states.
     8    d.  A  state  whose  membership in this compact has been terminated is
     9  responsible for all assessments, obligations  and  liabilities  incurred
    10  through  the  effective  date of termination, including obligations that
    11  extend beyond the effective date of termination.
    12    e. The commission shall not bear any costs related to a state that  is
    13  found  to  be  in  default  or whose membership in this compact has been
    14  terminated unless agreed upon in writing between the commission and  the
    15  defaulting state.
    16    f.  The  defaulting  state  may appeal the action of the commission by
    17  petitioning the U.S. District Court for the District of Columbia or  the
    18  federal  district in which the commission has its principal offices. The
    19  prevailing party shall be awarded all costs of such litigation,  includ-
    20  ing reasonable attorneys' fees.
    21    3.  Dispute  resolution. a. Upon request by a party state, the commis-
    22  sion shall attempt to resolve disputes related to the compact that arise
    23  among party states and between party and non-party states.
    24    b. The commission shall promulgate a rule providing for both mediation
    25  and binding dispute resolution for disputes, as appropriate.
    26    c. In the event the commission cannot  resolve  disputes  among  party
    27  states arising under this compact:
    28    i. The party states may submit the issues in dispute to an arbitration
    29  panel,  which  will be comprised of individuals appointed by the compact
    30  administrator in each of the affected party states,  and  an  individual
    31  mutually  agreed  upon  by  the  compact administrators of all the party
    32  states involved in the dispute.
    33    ii. The decision of a majority of the arbitrators shall be  final  and
    34  binding.
    35    4.  Enforcement.  a. The commission, in the reasonable exercise of its
    36  discretion, shall enforce the provisions and rules of this compact.
    37    b. By majority vote, the commission may initiate legal action  in  the
    38  U.S.    District  Court  for  the  District  of  Columbia or the federal
    39  district in which the commission has its  principal  offices  against  a
    40  party state that is in default to enforce compliance with the provisions
    41  of  this compact and its promulgated rules and bylaws. The relief sought
    42  may include both injunctive relief and damages. In  the  event  judicial
    43  enforcement  is  necessary,  the  prevailing  party shall be awarded all
    44  costs of such litigation, including reasonable attorneys' fees.
    45    c. The remedies herein shall not be  the  exclusive  remedies  of  the
    46  commission. The commission may pursue any other remedies available under
    47  federal or state law.
    48    § 8910. Effective  date,  withdrawal and amendment. 1. Effective date.
    49  a.  This compact shall become effective and binding on  the  earlier  of
    50  the  date  of  legislative enactment of this compact into law by no less
    51  than twenty-six states or the effective date of the chapter of the  laws
    52  that  enacted this compact.  Thereafter, the compact shall become effec-
    53  tive and binding as to any other compacting state upon enactment of  the
    54  compact  into  law by that state. All party states to this compact, that
    55  also were parties to the prior nurse licensure  compact,  superseded  by
    56  this  compact,  (herein referred to as "prior compact"), shall be deemed

        A. 3391                            26

     1  to have withdrawn from said prior compact within six  months  after  the
     2  effective date of this compact.
     3    b.  Each  party  state  to  this compact shall continue to recognize a
     4  nurse's multistate licensure privilege to practice in that  party  state
     5  issued under the prior compact until such party state has withdrawn from
     6  the prior compact.
     7    2.  Withdrawal.  a.  Any party state may withdraw from this compact by
     8  enacting a statute repealing the same. A party state's withdrawal  shall
     9  not  take effect until six months after enactment of the repealing stat-
    10  ute.
    11    b. A party state's withdrawal or  termination  shall  not  affect  the
    12  continuing  requirement of the withdrawing or terminated state's licens-
    13  ing board to  report  adverse  actions  and  significant  investigations
    14  occurring prior to the effective date of such withdrawal or termination.
    15    c.  Nothing contained in this compact shall be construed to invalidate
    16  or prevent any nurse licensure agreement or other  cooperative  arrange-
    17  ment between a party state and a non-party state that is made in accord-
    18  ance with the other provisions of this compact.
    19    3.  Amendment.  a. This compact may be amended by the party states. No
    20  amendment to this compact shall become effective and  binding  upon  the
    21  party  states  unless and until it is enacted into the laws of all party
    22  states.
    23    b. Representatives of  non-party  states  to  this  compact  shall  be
    24  invited to participate in the activities of the commission, on a nonvot-
    25  ing basis, prior to the adoption of this compact by all states.
    26    § 8911. Construction and severability.  1. Construction and severabil-
    27  ity.  This  compact shall be liberally construed so as to effectuate the
    28  purposes thereof. The provisions of this compact shall be severable, and
    29  if any phrase, clause, sentence or provision of this compact is declared
    30  to be contrary to the constitution of any party state or of  the  United
    31  States,  or  if  the  applicability  thereof  to any government, agency,
    32  person or circumstance is held  to  be  invalid,  the  validity  of  the
    33  remainder  of  this compact and the applicability thereof to any govern-
    34  ment, agency, person or circumstance shall not be affected  thereby.  If
    35  this  compact  shall  be  held to be contrary to the constitution of any
    36  party state, this compact shall remain in full force and  effect  as  to
    37  the  remaining party states and in full force and effect as to the party
    38  state affected as to all severable matters.
    39    § 3. This act shall take effect  immediately.  Effective  immediately,
    40  the  addition,  amendment and/or repeal of any rule or regulation neces-
    41  sary for the implementation of  this  act  on  its  effective  date  are
    42  authorized to be made and completed on or before such effective date.