STATE OF NEW YORK ________________________________________________________________________ 7946 2023-2024 Regular Sessions IN ASSEMBLY August 4, 2023 ___________ Introduced by M. of A. MILLER -- read once and referred to the Committee on Higher Education AN ACT to amend the education law, in relation to adopting the inter- state nurse licensure compact (Part A); and to amend the education law, in relation to adopting the advanced practice registered nurse compact (Part B) The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. This act enacts into law components of legislation relating 2 to enacting the interstate nurse licensure compact and the advanced 3 practice registered nurse compact. Each component is wholly contained 4 within a Part identified as Parts A through B. The effective date for 5 each particular provision contained within such Part is set forth in the 6 last section of such Part. Any provision in any section contained within 7 a Part, including the effective date of the Part, which makes reference 8 to a section "of this act", when used in connection with that particular 9 component, shall be deemed to mean and refer to the corresponding 10 section of the Part in which it is found. Section three of this act sets 11 forth the general effective date of this act. 12 PART A 13 Section 1. The education law is amended by adding a new section 6912 14 to read as follows: 15 § 6912. Interstate nurse licensure compact. The interstate nurse 16 licensure compact is hereby enacted into law and entered into with all 17 jurisdictions legally joining therein in the form substantially as 18 follows: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD11345-01-3A. 7946 2 1 INTERSTATE NURSE LICENSURE COMPACT 2 ARTICLE I. 3 Findings and declaration of purpose 4 a. The party states find that: 5 1. The health and safety of the public are affected by the degree of 6 compliance with and the effectiveness of enforcement activities related 7 to state nurse licensure laws; 8 2. Violations of nurse licensure and other laws regulating the prac- 9 tice of nursing may result in injury or harm to the public; 10 3. The expanded mobility of nurses and the use of advanced communi- 11 cation technologies as part of our nation's health care delivery system 12 require greater coordination and cooperation among states in the areas 13 of nurse licensure and regulation; 14 4. New practice modalities and technology make compliance with indi- 15 vidual state nurse licensure laws difficult and complex; 16 5. The current system of duplicative licensure for nurses practicing 17 in multiple states is cumbersome and redundant for both nurses and 18 states; and 19 6. Uniformity of nurse licensure requirements throughout the states 20 promotes public safety and public health benefits. 21 b. The general purposes of this compact are to: 22 1. Facilitate the states' responsibility to protect the public's 23 health and safety; 24 2. Ensure and encourage the cooperation of party states in the areas 25 of nurse licensure and regulation; 26 3. Facilitate the exchange of information between party states in the 27 areas of nurse regulation, investigation and adverse actions; 28 4. Promote compliance with the laws governing the practice of nursing 29 in each jurisdiction; 30 5. Invest all party states with the authority to hold a nurse account- 31 able for meeting all state practice laws in the state in which the 32 patient is located at the time care is rendered through the mutual 33 recognition of party state licenses; 34 6. Decrease redundancies in the consideration and issuance of nurse 35 licenses; and 36 7. Provide opportunities for interstate practice by nurses who meet 37 uniform licensure requirements. 38 ARTICLE II. 39 Definitions 40 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 isA. 7946 3 1 administered by a nonprofit organization composed of and controlled by 2 licensing boards. 3 d. "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. 12 e. "encumbrance" means a revocation or suspension of, or any limita- 13 tion on, the full and unrestricted practice of nursing imposed by a 14 licensing board. 15 f. "home state" means the party state which is the nurse's primary 16 state of residence. 17 g. "licensing board" means a party state's regulatory body responsible 18 for issuing nurse licenses. 19 h. "multistate license" means a license to practice as a registered or 20 a licensed practical/vocational nurse (lpn/vn) issued by a home state 21 licensing board that authorizes the licensed nurse to practice in all 22 party states under a multistate licensure privilege. 23 i. "multistate licensure privilege" means a legal authorization asso- 24 ciated with a multistate license permitting the practice of nursing as 25 either a registered nurse (rn) or lpn/vn in a remote state. 26 j. "nurse" means rn or lpn/vn, as those terms are defined by each 27 party state's practice laws. 28 k. "party state" means any state that has adopted this compact. 29 l. "remote state" means a party state, other than the home state. 30 m. "single-state license" means a nurse license issued by a party 31 state that authorizes practice only within the issuing state and does 32 not include a multistate licensure privilege to practice in any other 33 party state. 34 n. "state" means a state, territory or possession of the United States 35 and the District of Columbia. 36 o. "state practice laws" means a party state's laws, rules and regu- 37 lations that govern the practice of nursing, define the scope of nursing 38 practice, and create the methods and grounds for imposing discipline. 39 "state practice laws" do not include requirements necessary to obtain 40 and retain a license, except for qualifications or requirements of the 41 home state. 42 ARTICLE III. 43 General provisions and jurisdiction 44 a. A multistate license to practice registered or licensed 45 practical/vocational nursing issued by a home state to a resident in 46 that state will be recognized by each party state as authorizing a nurse 47 to practice as a registered nurse (rn) or as a licensed 48 practical/vocational nurse (lpn/vn), under a multistate licensure privi- 49 lege, in each party state. 50 b. A state must implement procedures for considering the criminal 51 history records of applicants for initial multistate license or licen- 52 sure by endorsement. Such procedures shall include the submission of 53 fingerprints or other biometric-based information by applicants for the 54 purpose of obtaining an applicant's criminal history record informationA. 7946 4 1 from the federal bureau of investigation and the agency responsible for 2 retaining that state's criminal records. 3 c. Each party state shall require the following for an applicant to 4 obtain or retain a multistate license in the home state: 5 1. Meets the home state's qualifications for licensure or renewal of 6 licensure, as well as, all other applicable state laws; 7 2. i. Has graduated or is eligible to graduate from a licensing board- 8 approved rn or lpn/vn prelicensure education program; or 9 ii. Has graduated from a foreign rn or lpn/vn prelicensure education 10 program that (a) has been approved by the authorized accrediting body in 11 the applicable country and (b) has been verified by an independent 12 credentials review agency to be comparable to a licensing board-approved 13 prelicensure education program; 14 3. Has, if a graduate of a foreign prelicensure education program not 15 taught in english or if english is not the individual's native language, 16 successfully passed an English proficiency examination that includes the 17 components of reading, speaking, writing and listening; 18 4. Has successfully passed an nclex-rn or nclex-pn examination or 19 recognized predecessor, as applicable; 20 5. Is eligible for or holds an active, unencumbered license; 21 6. Has submitted, in connection with an application for initial licen- 22 sure or licensure by endorsement, fingerprints or other biometric data 23 for the purpose of obtaining criminal history record information from 24 the federal bureau of investigation and the agency responsible for 25 retaining that state's criminal records; 26 7. Has not been convicted or found guilty, or has entered into an 27 agreed disposition, of a felony offense under applicable state or feder- 28 al criminal law; 29 8. Has not been convicted or found guilty, or has entered into an 30 agreed disposition, of a misdemeanor offense related to the practice of 31 nursing as determined on a case-by-case basis; 32 9. Is not currently enrolled in an alternative program; 33 10. Is subject to self-disclosure requirements regarding current 34 participation in an alternative program; and 35 11. Has a valid united states social security number. 36 d. All party states shall be authorized, in accordance with existing 37 state due process law, to take adverse action against a nurse's multi- 38 state licensure privilege such as revocation, suspension, probation or 39 any other action that affects a nurse's authorization to practice under 40 a multistate licensure privilege, including cease and desist actions. 41 If a party state takes such action, it shall promptly notify the admin- 42 istrator of the coordinated licensure information system. The adminis- 43 trator of the coordinated licensure information system shall promptly 44 notify the home state of any such actions by remote states. 45 e. A nurse practicing in a party state must comply with the state 46 practice laws of the state in which the client is located at the time 47 service is provided. The practice of nursing is not limited to patient 48 care, but shall include all nursing practice as defined by the state 49 practice laws of the party state in which the client is located. The 50 practice of nursing in a party state under a multistate licensure privi- 51 lege will subject a nurse to the jurisdiction of the licensing board, 52 the courts and the laws of the party state in which the client is 53 located at the time service is provided. 54 f. Individuals not residing in a party state shall continue to be able 55 to apply for a party state's single-state license as provided under the 56 laws of each party state. However, the single-state license granted toA. 7946 5 1 these individuals will not be recognized as granting the privilege to 2 practice nursing in any other party state. Nothing in this compact shall 3 affect the requirements established by a party state for the issuance of 4 a single-state license. 5 g. Any nurse holding a home state multistate license, on the effective 6 date of this compact, may retain and renew the multistate license issued 7 by the nurse's then-current home state, provided that: 8 1. A nurse, who changes primary state of residence after this 9 compact's effective date, must meet all applicable requirements of 10 subdivision c of this article to obtain a multistate license from a new 11 home state. 12 2. A nurse who fails to satisfy the multistate licensure requirements 13 in subdivision c of this article. Due to a disqualifying event occur- 14 ring after this compact's effective date shall be ineligible to retain 15 or renew a multistate license, and the nurse's multistate license shall 16 be revoked or deactivated in accordance with applicable rules adopted by 17 the interstate commission of nurse licensure compact administrators 18 ("commission"). 19 ARTICLE IV. 20 Applications for licensure in a party state 21 a. Upon application for a multistate license, the licensing board in 22 the issuing party state shall ascertain, through the coordinated licen- 23 sure information system, whether the applicant has ever held, or is the 24 holder of, a license issued by any other state, whether there are any 25 encumbrances on any license or multistate licensure privilege held by 26 the applicant, whether any adverse action has been taken against any 27 license or multistate licensure privilege held by the applicant and 28 whether the applicant is currently participating in an alternative 29 program. 30 b. A nurse may hold a multistate license, issued by the home state, in 31 only one party state at a time. 32 c. If a nurse changes primary state of residence by moving between two 33 party states, the nurse must apply for licensure in the new home state, 34 and the multistate license issued by the prior home state will be deac- 35 tivated in accordance with applicable rules adopted by the commission. 36 1. The nurse may apply for licensure in advance of a change in primary 37 state of residence. 38 2. A multistate license shall not be issued by the new home state 39 until the nurse provides satisfactory evidence of a change in primary 40 state of residence to the new home state and satisfies all applicable 41 requirements to obtain a multistate license from the new home state. 42 d. If a nurse changes primary state of residence by moving from a 43 party state to a non-party state, the multistate license issued by the 44 prior home state will convert to a single-state license, valid only in 45 the former home state. 46 ARTICLE V. 47 Additional authorities invested in party state licensing boards 48 a. In addition to the other powers conferred by state law, a licensing 49 board shall have the authority to: 50 1. Take adverse action against a nurse's multistate licensure privi- 51 lege to practice within that party state.A. 7946 6 1 i. Only the home state shall have the power to take adverse action 2 against a nurse's license issued by the home state. 3 ii. For purposes of taking adverse action, the home state licensing 4 board shall give the same priority and effect to reported conduct 5 received from a remote state as it would if such conduct had occurred 6 within the home state. In so doing, the home state shall apply its own 7 state laws to determine appropriate action. 8 2. Issue cease and desist orders or impose an encumbrance on a nurse's 9 authority to practice within that party state. 10 3. Complete any pending investigations of a nurse who changes primary 11 state of residence during the course of such investigations. The licens- 12 ing board shall also have the authority to take appropriate action(s) 13 and shall promptly report the conclusions of such investigations to the 14 administrator of the coordinated licensure information system. The 15 administrator of the coordinated licensure information system shall 16 promptly notify the new home state of any such actions. 17 4. Issue subpoenas for both hearings and investigations that require 18 the attendance and testimony of witnesses, as well as, the production of 19 evidence. Subpoenas issued by a licensing board in a party state for the 20 attendance and testimony of witnesses or the production of evidence from 21 another party state shall be enforced in the latter state by any court 22 of competent jurisdiction, according to the practice and procedure of 23 that court applicable to subpoenas issued in proceedings pending before 24 it. The issuing authority shall pay any witness fees, travel expenses, 25 mileage and other fees required by the service statutes of the state in 26 which the witnesses or evidence are located. 27 5. Obtain and submit, for each nurse licensure applicant, fingerprint 28 or other biometric-based information to the federal bureau of investi- 29 gation for criminal background checks, receive the results of the feder- 30 al bureau of investigation record search on criminal background checks 31 and use the results in making licensure decisions. 32 6. If otherwise permitted by state law, recover from the affected 33 nurse the costs of investigations and disposition of cases resulting 34 from any adverse action taken against that nurse. 35 7. Take adverse action based on the factual findings of the remote 36 state, provided that the licensing board follows its own procedures for 37 taking such adverse action. 38 b. If adverse action is taken by the home state against a nurse's 39 multistate license, the nurse's multistate licensure privilege to prac- 40 tice in all other party states shall be deactivated until all encum- 41 brances have been removed from the multistate license. All home state 42 disciplinary orders that impose adverse action against a nurse's multi- 43 state license shall include a statement that the nurse's multistate 44 licensure privilege is deactivated in all party states during the 45 pendency of the order. 46 c. Nothing in this compact shall override a party state's decision 47 that participation in an alternative program may be used in lieu of 48 adverse action. The home state licensing board shall deactivate the 49 multistate licensure privilege under the multistate license of any nurse 50 for the duration of the nurse's participation in an alternative program. 51 ARTICLE VI. 52 Coordinated licensure information system and exchange of information 53 a. All party states shall participate in a coordinated licensure 54 information system of all licensed registered nurses (rns) and licensedA. 7946 7 1 practical/vocational nurses (lpns/vns). This system will include infor- 2 mation on the licensure and disciplinary history of each nurse, as 3 submitted by party states, to assist in the coordination of nurse licen- 4 sure and enforcement efforts. 5 b. The commission, in consultation with the administrator of the coor- 6 dinated licensure information system, shall formulate necessary and 7 proper procedures for the identification, collection and exchange of 8 information under this compact. 9 c. All licensing boards shall promptly report to the coordinated 10 licensure information system any adverse action, any current significant 11 investigative information, denials of applications (with the reasons for 12 such denials) and nurse participation in alternative programs known to 13 the licensing board regardless of whether such participation is deemed 14 nonpublic or confidential under state law. 15 d. Current significant investigative information and participation in 16 nonpublic or confidential alternative programs shall be transmitted 17 through the coordinated licensure information system only to party state 18 licensing boards. 19 e. Notwithstanding any other provision of law, all party state licens- 20 ing boards contributing information to the coordinated licensure infor- 21 mation system may designate information that may not be shared with 22 non-party states or disclosed to other entities or individuals without 23 the express permission of the contributing state. 24 f. Any personally identifiable information obtained from the coordi- 25 nated licensure information system by a party state licensing board 26 shall not be shared with non-party states or disclosed to other entities 27 or individuals except to the extent permitted by the laws of the party 28 state contributing the information. 29 g. Any information contributed to the coordinated licensure informa- 30 tion system that is subsequently required to be expunged by the laws of 31 the party state contributing that information shall also be expunged 32 from the coordinated licensure information system. 33 h. The compact administrator of each party state shall furnish a 34 uniform data set to the compact administrator of each other party state, 35 which shall include, at a minimum: 36 1. Identifying information; 37 2. Licensure data; 38 3. Information related to alternative program participation; and 39 4. Other information that may facilitate the administration of this 40 compact, as determined by commission rules. 41 i. The compact administrator of a party state shall provide all inves- 42 tigative documents and information requested by another party state. 43 ARTICLE VII. 44 Establishment of the interstate commission of nurse licensure compact 45 administrators 46 a. The party states hereby create and establish a joint public entity 47 known as the interstate commission of nurse licensure compact adminis- 48 trators. 49 1. The commission is an instrumentality of the party states. 50 2. Venue is proper, and judicial proceedings by or against the commis- 51 sion shall be brought solely and exclusively, in a court of competent 52 jurisdiction where the principal office of the commission is located. 53 The commission may waive venue and jurisdictional defenses to the extentA. 7946 8 1 it adopts or consents to participate in alternative dispute resolution 2 proceedings. 3 3. Nothing in this compact shall be construed to be a waiver of sover- 4 eign immunity. 5 b. Membership, voting and meetings. 6 1. Each party state shall have and be limited to one administrator. 7 The head of the state licensing board or designee shall be the adminis- 8 trator of this compact for each party state. Any administrator may be 9 removed or suspended from office as provided by the law of the state 10 from which the administrator is appointed. Any vacancy occurring in the 11 commission shall be filled in accordance with the laws of the party 12 state in which the vacancy exists. 13 2. Each administrator shall be entitled to one (1) vote with regard to 14 the promulgation of rules and creation of bylaws and shall otherwise 15 have an opportunity to participate in the business and affairs of the 16 commission. An administrator shall vote in person or by such other means 17 as provided in the bylaws. The bylaws may provide for an administrator's 18 participation in meetings by telephone or other means of communication. 19 3. The commission shall meet at least once during each calendar year. 20 Additional meetings shall be held as set forth in the bylaws or rules of 21 the commission. 22 4. All meetings shall be open to the public, and public notice of 23 meetings shall be given in the same manner as required under the rule- 24 making provisions in article VIII of this compact. 25 5. The commission may convene in a closed, nonpublic meeting if the 26 commission must discuss: 27 i. Noncompliance of a party state with its obligations under this 28 compact; 29 ii. The employment, compensation, discipline or other personnel 30 matters, practices or procedures related to specific employees or other 31 matters related to the commission's internal personnel practices and 32 procedures; 33 iii. Current, threatened or reasonably anticipated litigation; 34 iv. Negotiation of contracts for the purchase or sale of goods, 35 services or real estate; 36 v. Accusing any person of a crime or formally censuring any person; 37 vi. Disclosure of trade secrets or commercial or financial information 38 that is privileged or confidential; 39 vii. Disclosure of information of a personal nature where disclosure 40 would constitute a clearly unwarranted invasion of personal privacy; 41 viii. Disclosure of investigatory records compiled for law enforcement 42 purposes; 43 ix. Disclosure of information related to any reports prepared by or on 44 behalf of the commission for the purpose of investigation of compliance 45 with this compact; or 46 x. Matters specifically exempted from disclosure by federal or state 47 statute. 48 6. If a meeting, or portion of a meeting, is closed pursuant to this 49 provision, the commission's legal counsel or designee shall certify that 50 the meeting may be closed and shall reference each relevant exempting 51 provision. The commission shall keep minutes that fully and clearly 52 describe all matters discussed in a meeting and shall provide a full and 53 accurate summary of actions taken, and the reasons therefor, including a 54 description of the views expressed. All documents considered in 55 connection with an action shall be identified in such minutes. All 56 minutes and documents of a closed meeting shall remain under seal,A. 7946 9 1 subject to release by a majority vote of the commission or order of a 2 court of competent jurisdiction. 3 c. The commission shall, by a majority vote of the administrators, 4 prescribe bylaws or rules to govern its conduct as may be necessary or 5 appropriate to carry out the purposes and exercise the powers of this 6 compact, including but not limited to: 7 1. Establishing the fiscal year of the commission; 8 2. Providing reasonable standards and procedures: 9 i. For the establishment and meetings of other committees; and 10 ii. Governing any general or specific delegation of any authority or 11 function of the commission; 12 3. Providing reasonable procedures for calling and conducting meetings 13 of the commission, ensuring reasonable advance notice of all meetings 14 and providing an opportunity for attendance of such meetings by inter- 15 ested parties, with enumerated exceptions designed to protect the 16 public's interest, the privacy of individuals, and proprietary informa- 17 tion, including trade secrets. The commission may meet in closed session 18 only after a majority of the administrators vote to close a meeting in 19 whole or in part. As soon as practicable, the commission must make 20 public a copy of the vote to close the meeting revealing the vote of 21 each administrator, with no proxy votes allowed; 22 4. Establishing the titles, duties and authority and reasonable proce- 23 dures for the election of the officers of the commission; 24 5. Providing reasonable standards and procedures for the establishment 25 of the personnel policies and programs of the commission. Notwithstand- 26 ing any civil service or other similar laws of any party state, the 27 bylaws shall exclusively govern the personnel policies and programs of 28 the commission; and 29 6. Providing a mechanism for winding up the operations of the commis- 30 sion and the equitable disposition of any surplus funds that may exist 31 after the termination of this compact after the payment or reserving of 32 all of its debts and obligations. 33 d. The commission shall publish its bylaws and rules, and any amend- 34 ments thereto, in a convenient form on the website of the commission. 35 e. The commission shall maintain its financial records in accordance 36 with the bylaws. 37 f. The commission shall meet and take such actions as are consistent 38 with the provisions of this compact and the bylaws. 39 g. The commission shall have the following powers: 40 1. To promulgate uniform rules to facilitate and coordinate implemen- 41 tation and administration of this compact. The rules shall have the 42 force and effect of law and shall be binding in all party states; 43 2. To bring and prosecute legal proceedings or actions in the name of 44 the commission, provided that the standing of any licensing board to sue 45 or be sued under applicable law shall not be affected; 46 3. To purchase and maintain insurance and bonds; 47 4. To borrow, accept or contract for services of personnel, including, 48 but not limited to, employees of a party state or nonprofit organiza- 49 tions; 50 5. To cooperate with other organizations that administer state 51 compacts related to the regulation of nursing, including but not limited 52 to sharing administrative or staff expenses, office space or other 53 resources; 54 6. To hire employees, elect or appoint officers, fix compensation, 55 define duties, grant such individuals appropriate authority to carry out 56 the purposes of this compact, and to establish the commission's person-A. 7946 10 1 nel policies and programs relating to conflicts of interest, qualifica- 2 tions of personnel and other related personnel matters; 3 7. To accept any and all appropriate donations, grants and gifts of 4 money, equipment, supplies, materials and services, and to receive, 5 utilize and dispose of the same; provided that at all times the commis- 6 sion shall avoid any appearance of impropriety or conflict of interest; 7 8. To lease, purchase, accept appropriate gifts or donations of, or 8 otherwise to own, hold, improve or use, any property, whether real, 9 personal or mixed; provided that at all times the commission shall avoid 10 any appearance of impropriety; 11 9. To sell, convey, mortgage, pledge, lease, exchange, abandon or 12 otherwise dispose of any property, whether real, personal or mixed; 13 10. To establish a budget and make expenditures; 14 11. To borrow money; 15 12. To appoint committees, including advisory committees comprised of 16 administrators, state nursing regulators, state legislators or their 17 representatives, and consumer representatives, and other such interested 18 persons; 19 13. To provide and receive information from, and to cooperate with, 20 law enforcement agencies; 21 14. To adopt and use an official seal; and 22 15. To perform such other functions as may be necessary or appropriate 23 to achieve the purposes of this compact consistent with the state regu- 24 lation of nurse licensure and practice. 25 h. Financing of the commission. 26 1. The commission shall pay, or provide for the payment of, the 27 reasonable expenses of its establishment, organization and ongoing 28 activities. 29 2. The commission may also levy on and collect an annual assessment 30 from each party state to cover the cost of its operations, activities 31 and staff in its annual budget as approved each year. The aggregate 32 annual assessment amount, if any, shall be allocated based upon a formu- 33 la to be determined by the commission, which shall promulgate a rule 34 that is binding upon all party states. 35 3. The commission shall not incur obligations of any kind prior to 36 securing the funds adequate to meet the same; nor shall the commission 37 pledge the credit of any of the party states, except by, and with the 38 authority of, such party state. 39 4. The commission shall keep accurate accounts of all receipts and 40 disbursements. The receipts and disbursements of the commission shall 41 be subject to the audit and accounting procedures established under its 42 bylaws. However, all receipts and disbursements of funds handled by the 43 commission shall be audited yearly by a certified or licensed public 44 accountant, and the report of the audit shall be included in and become 45 part of the annual report of the commission. 46 i. Qualified immunity, defense and indemnification. 47 1. The administrators, officers, executive director, employees and 48 representatives of the commission shall be immune from suit and liabil- 49 ity, either personally or in their official capacity, for any claim for 50 damage to or loss of property or personal injury or other civil liabil- 51 ity caused by or arising out of any actual or alleged act, error or 52 omission that occurred, or that the person against whom the claim is 53 made had a reasonable basis for believing occurred, within the scope of 54 commission employment, duties or responsibilities; provided that nothing 55 in this paragraph shall be construed to protect any such person fromA. 7946 11 1 suit or liability for any damage, loss, injury or liability caused by 2 the intentional, willful or wanton misconduct of that person. 3 2. The commission shall defend any administrator, officer, executive 4 director, employee or representative of the commission in any civil 5 action seeking to impose liability arising out of any actual or alleged 6 act, error or omission that occurred within the scope of commission 7 employment, duties or responsibilities, or that the person against whom 8 the claim is made had a reasonable basis for believing occurred within 9 the scope of commission employment, duties or responsibilities; provided 10 that nothing herein shall be construed to prohibit that person from 11 retaining his or her own counsel; and provided further that the actual 12 or alleged act, error or omission did not result from that person's 13 intentional, willful or wanton misconduct. 14 3. The commission shall indemnify and hold harmless any administrator, 15 officer, executive director, employee or representative of the commis- 16 sion for the amount of any settlement or judgment obtained against that 17 person arising out of any actual or alleged act, error or omission that 18 occurred within the scope of commission employment, duties or responsi- 19 bilities, or that such person had a reasonable basis for believing 20 occurred within the scope of commission employment, duties or responsi- 21 bilities, provided that the actual or alleged act, error or omission did 22 not result from the intentional, willful or wanton misconduct of that 23 person. 24 ARTICLE VIII. 25 Rulemaking 26 a. The commission shall exercise its rulemaking powers pursuant to the 27 criteria set forth in this article and the rules adopted thereunder. 28 Rules and amendments shall become binding as of the date specified in 29 each rule or amendment and shall have the same force and effect as 30 provisions of this compact. 31 b. Rules or amendments to the rules shall be adopted at a regular or 32 special meeting of the commission. 33 c. Prior to promulgation and adoption of a final rule or rules by the 34 commission, and at least sixty (60) days in advance of the meeting at 35 which the rule will be considered and voted upon, the commission shall 36 file a notice of proposed rulemaking: 37 1. On the website of the commission; and 38 2. On the website of each licensing board or the publication in which 39 each state would otherwise publish proposed rules. 40 d. The notice of proposed rulemaking shall include: 41 1. The proposed time, date and location of the meeting in which the 42 rule will be considered and voted upon; 43 2. The text of the proposed rule or amendment, and the reason for the 44 proposed rule; 45 3. A request for comments on the proposed rule from any interested 46 person; and 47 4. The manner in which interested persons may submit notice to the 48 commission of their intention to attend the public hearing and any writ- 49 ten comments. 50 e. Prior to adoption of a proposed rule, the commission shall allow 51 persons to submit written data, facts, opinions and arguments, which 52 shall be made available to the public. 53 f. The commission shall grant an opportunity for a public hearing 54 before it adopts a rule or amendment.A. 7946 12 1 g. The commission shall publish the place, time and date of the sched- 2 uled public hearing. 3 1. Hearings shall be conducted in a manner providing each person who 4 wishes to comment a fair and reasonable opportunity to comment orally or 5 in writing. All hearings will be recorded, and a copy will be made 6 available upon request. 7 2. Nothing in this section shall be construed as requiring a separate 8 hearing on each rule. Rules may be grouped for the convenience of the 9 commission at hearings required by this section. 10 h. If no one appears at the public hearing, the commission may proceed 11 with promulgation of the proposed rule. 12 i. Following the scheduled hearing date, or by the close of business 13 on the scheduled hearing date if the hearing was not held, the commis- 14 sion shall consider all written and oral comments received. 15 j. The commission shall, by majority vote of all administrators, take 16 final action on the proposed rule and shall determine the effective date 17 of the rule, if any, based on the rulemaking record and the full text of 18 the rule. 19 k. Upon determination that an emergency exists, the commission may 20 consider and adopt an emergency rule without prior notice, opportunity 21 for comment or hearing, provided that the usual rulemaking procedures 22 provided in this compact and in this section shall be retroactively 23 applied to the rule as soon as reasonably possible, in no event later 24 than ninety (90) days after the effective date of the rule. For the 25 purposes of this provision, an emergency rule is one that must be 26 adopted immediately in order to: 27 1. Meet an imminent threat to public health, safety or welfare; 28 2. Prevent a loss of commission or party state funds; or 29 3. Meet a deadline for the promulgation of an administrative rule that 30 is required by federal law or rule. 31 l. The commission may direct revisions to a previously adopted rule or 32 amendment for purposes of correcting typographical errors, errors in 33 format, errors in consistency or grammatical errors. Public notice of 34 any revisions shall be posted on the website of the commission. The 35 revision shall be subject to challenge by any person for a period of 36 thirty (30) days after posting. The revision may be challenged only on 37 grounds that the revision results in a material change to a rule. A 38 challenge shall be made in writing, and delivered to the commission, 39 prior to the end of the notice period. If no challenge is made, the 40 revision will take effect without further action. If the revision is 41 challenged, the revision may not take effect without the approval of the 42 commission. 43 ARTICLE IX. 44 Oversight, dispute resolution and enforcement 45 a. Oversight. 46 1. Each party state shall enforce this compact and take all actions 47 necessary and appropriate to effectuate this compact's purposes and 48 intent. 49 2. The commission shall be entitled to receive service of process in 50 any proceeding that may affect the powers, responsibilities or actions 51 of the commission, and shall have standing to intervene in such a 52 proceeding for all purposes. Failure to provide service of process in 53 such proceeding to the commission shall render a judgment or order void 54 as to the commission, this compact or promulgated rules.A. 7946 13 1 b. Default, technical assistance and termination. 2 1. If the commission determines that a party state has defaulted in 3 the performance of its obligations or responsibilities under this 4 compact or the promulgated rules, the commission shall: 5 i. Provide written notice to the defaulting state and other party 6 states of the nature of the default, the proposed means of curing the 7 default or any other action to be taken by the commission; and 8 ii. Provide remedial training and specific technical assistance 9 regarding the default. 10 2. If a state in default fails to cure the default, the defaulting 11 state's membership in this compact may be terminated upon an affirmative 12 vote of a majority of the administrators, and all rights, privileges and 13 benefits conferred by this compact may be terminated on the effective 14 date of termination. A cure of the default does not relieve the offend- 15 ing state of obligations or liabilities incurred during the period of 16 default. 17 3. Termination of membership in this compact shall be imposed only 18 after all other means of securing compliance have been exhausted. Notice 19 of intent to suspend or terminate shall be given by the commission to 20 the governor of the defaulting state and to the executive officer of the 21 defaulting state's licensing board and each of the party states. 22 4. A state whose membership in this compact has been terminated is 23 responsible for all assessments, obligations and liabilities incurred 24 through the effective date of termination, including obligations that 25 extend beyond the effective date of termination. 26 5. The commission shall not bear any costs related to a state that is 27 found to be in default or whose membership in this compact has been 28 terminated unless agreed upon in writing between the commission and the 29 defaulting state. 30 6. The defaulting state may appeal the action of the commission by 31 petitioning the u.s. district court for the district of columbia or the 32 federal district in which the commission has its principal offices. The 33 prevailing party shall be awarded all costs of such litigation, includ- 34 ing reasonable attorneys' fees. 35 c. Dispute resolution. 36 1. Upon request by a party state, the commission shall attempt to 37 resolve disputes related to the compact that arise among party states 38 and between party and non-party states. 39 2. The commission shall promulgate a rule providing for both mediation 40 and binding dispute resolution for disputes, as appropriate. 41 3. In the event the commission cannot resolve disputes among party 42 states arising under this compact: 43 i. The party states may submit the issues in dispute to an arbitration 44 panel, which will be comprised of individuals appointed by the compact 45 administrator in each of the affected party states and an individual 46 mutually agreed upon by the compact administrators of all the party 47 states involved in the dispute. 48 ii. The decision of a majority of the arbitrators shall be final and 49 binding. 50 d. Enforcement. 51 1. The commission, in the reasonable exercise of its discretion, shall 52 enforce the provisions and rules of this compact. 53 2. By majority vote, the commission may initiate legal action in the 54 u.s. district court for the district of columbia or the federal district 55 in which the commission has its principal offices against a party state 56 that is in default to enforce compliance with the provisions of thisA. 7946 14 1 compact and its promulgated rules and bylaws. The relief sought may 2 include both injunctive relief and damages. In the event judicial 3 enforcement is necessary, the prevailing party shall be awarded all 4 costs of such litigation, including reasonable attorneys' fees. 5 3. The remedies herein shall not be the exclusive remedies of the 6 commission. The commission may pursue any other remedies available under 7 federal or state law. 8 ARTICLE X. 9 Effective date, withdrawal and amendment 10 a. This compact shall become effective and binding on the earlier of 11 the date of legislative enactment of this compact into law by no less 12 than twenty-six (26) states or December 31, 2018. All party states to 13 this compact, that also were parties to the prior nurse licensure 14 compact, superseded by this compact, ("prior compact"), shall be deemed 15 to have withdrawn from said prior compact within six (6) months after 16 the effective date of this compact. 17 b. Each party state to this compact shall continue to recognize a 18 nurse's multistate licensure privilege to practice in that party state 19 issued under the prior compact until such party state has withdrawn from 20 the prior compact. 21 c. Any party state may withdraw from this compact by enacting a stat- 22 ute repealing the same. A party state's withdrawal shall not take effect 23 until six (6) months after enactment of the repealing statute. 24 d. A party state's withdrawal or termination shall not affect the 25 continuing requirement of the withdrawing or terminated state's licens- 26 ing board to report adverse actions and significant investigations 27 occurring prior to the effective date of such withdrawal or termination. 28 e. Nothing contained in this compact shall be construed to invalidate 29 or prevent any nurse licensure agreement or other cooperative arrange- 30 ment between a party state and a non-party state that is made in accord- 31 ance with the other provisions of this compact. 32 f. This compact may be amended by the party states. No amendment to 33 this compact shall become effective and binding upon the party states 34 unless and until it is enacted into the laws of all party states. 35 g. Representatives of non-party states to this compact shall be 36 invited to participate in the activities of the commission, on a nonvot- 37 ing basis, prior to the adoption of this compact by all states. 38 ARTICLE XI. 39 Construction and severability 40 This compact shall be liberally construed so as to effectuate the 41 purposes thereof. The provisions of this compact shall be severable, and 42 if any phrase, clause, sentence or provision of this compact is declared 43 to be contrary to the constitution of any party state or of the united 44 states, or if the applicability thereof to any government, agency, 45 person or circumstance is held invalid, the validity of the remainder of 46 this compact and the applicability thereof to any government, agency, 47 person or circumstance shall not be affected thereby. If this compact 48 shall be held to be contrary to the constitution of any party state, 49 this compact shall remain in full force and effect as to the remaining 50 party states and in full force and effect as to the party state affected 51 as to all severable matters.A. 7946 15 1 § 2. This act shall take effect on the ninetieth day after it shall 2 have become a law. Effective immediately, the addition, amendment 3 and/or repeal of any rule or regulation necessary for the implementation 4 of this act on its effective date are authorized to be made and 5 completed on or before such effective date. 6 PART B 7 Section 1. The education law is amended by adding a new section 6913 8 to read as follows: 9 § 6913. Advanced Practice Registered Nurse Compact. The advanced prac- 10 tice registered nurse compact is hereby enacted into law and entered 11 into with all jurisdictions legally joining therein in the form substan- 12 tially as follows: 13 ARTICLE I. 14 Findings and Declaration of Purpose 15 a. The party states find that: 16 1. The health and safety of the public are affected by the degree of 17 compliance with APRN licensure requirements and the effectiveness of 18 enforcement activities related to state APRN licensure laws; 19 2. Violations of APRN licensure and other laws regulating the practice 20 of nursing may result in injury or harm to the public; 21 3. The expanded mobility of APRNs and the use of advanced communi- 22 cation and intervention technologies as part of our nation's health care 23 delivery system require greater coordination and cooperation among 24 states in the areas of APRN licensure and regulation; 25 4. New practice modalities and technology make compliance with indi- 26 vidual state APRN licensure laws difficult and complex; 27 5. The current system of duplicative APRN licensure for APRNs practic- 28 ing in multiple states is cumbersome and redundant for healthcare deliv- 29 ery systems, payors, state licensing boards, regulators and APRNs; 30 6. Uniformity of APRN licensure requirements throughout the states 31 promotes public safety and public health benefits as well as providing a 32 mechanism to increase access to care. 33 b. The general purposes of this Compact are to: 34 1. Facilitate the states' responsibility to protect the public's 35 health and safety; 36 2. Ensure and encourage the cooperation of party states in the areas 37 of APRN licensure and regulation, including promotion of uniform licen- 38 sure requirements; 39 3. Facilitate the exchange of information between party states in the 40 areas of APRN regulation, investigation and adverse actions; 41 4. Promote compliance with the laws governing APRN practice in each 42 jurisdiction; 43 5. Invest all party states with the authority to hold an APRN account- 44 able for meeting all state practice laws in the state in which the 45 patient is located at the time care is rendered through the mutual 46 recognition of party state privileges to practice; 47 6. Decrease redundancies in the consideration and issuance of APRN 48 licenses; and 49 7. Provide opportunities for interstate practice by APRNs who meet 50 uniform licensure requirements.A. 7946 16 1 ARTICLE II. 2 Definitions 3 As used in this Compact: 4 a. "Advanced practice registered nurse" or "APRN" means a registered 5 nurse who has gained additional specialized knowledge, skills and expe- 6 rience through a program of study recognized or defined by the Inter- 7 state Commission of APRN Compact Administrators ("commission"), and who 8 is licensed to perform advanced nursing practice. An advanced practice 9 registered nurse is licensed in an APRN role that is congruent with an 10 APRN educational program, certification, and Commission rules. 11 b. "Adverse action" means any administrative, civil, equitable or 12 criminal action permitted by a state's laws which is imposed by a 13 licensing board or other authority against an APRN, including actions 14 against an individual's license or multistate licensure privilege such 15 as revocation, suspension, probation, monitoring of the licensee, limi- 16 tation on the licensee's practice, or any other encumbrance on licensure 17 affecting an APRN's authorization to practice, including the issuance of 18 a cease and desist action. 19 c. "Alternative program" means a non-disciplinary monitoring program 20 approved by a licensing board. 21 d. "APRN licensure" means the regulatory mechanism used by a party 22 state to grant legal authority to practice as an APRN. 23 e. "APRN uniform licensure requirements" means the minimum uniform 24 licensure, education and examination requirements set forth in subdivi- 25 sion b of article III of this compact. 26 f. "Coordinated licensure information system" means an integrated 27 process for collecting, storing and sharing information on APRN licen- 28 sure and enforcement activities related to APRN licensure laws that is 29 administered by a nonprofit organization composed of and controlled by 30 licensing boards. 31 g. "Current significant investigatory information" means: 32 1. Investigative information that a licensing board, after a prelimi- 33 nary inquiry that includes notification and an opportunity for the APRN 34 to respond, if required by state law, has reason to believe is not 35 groundless and, if proved true, would indicate more than a minor infrac- 36 tion; or 37 2. Investigative information that indicates that the APRN represents 38 an immediate threat to public health and safety regardless of whether 39 the APRN has been notified and had an opportunity to respond. 40 h. "Encumbrance" means a revocation or suspension of, or any limita- 41 tion on, the full and unrestricted practice of nursing imposed by a 42 licensing board in connection with a disciplinary proceeding. 43 i. "Home state" means the party state that is the APRN's primary state 44 of residence. 45 j. "Licensing board" means a party state's regulatory body responsible 46 for regulating the practice of advanced practice registered nursing. 47 k. "Multistate license" means an APRN license to practice as an APRN 48 issued by a home state licensing board that authorizes the APRN to prac- 49 tice as an APRN in all party states under a multistate licensure privi- 50 lege, in the same role and population focus as the APRN is licensed in 51 the home state. 52 l. "Multistate licensure privilege" means a legal authorization asso- 53 ciated with an APRN multistate license that permits an APRN to practice 54 as an APRN in a remote state, in the same role and population focus as 55 the APRN is licensed in the home state.A. 7946 17 1 m. "Non-controlled prescription drug" means a device or drug that is 2 not a controlled substance and is prohibited under state or federal law 3 from being dispensed without a prescription. The term includes a device 4 or drug that bears or is required to bear the legend "Caution: federal 5 law prohibits dispensing without prescription" or "prescription only" or 6 other legend that complies with federal law. 7 n. "Party state" means any state that has adopted this Compact. 8 o. "Population focus" means one of the six population foci of 9 family/individual across the lifespan, adult-gerontology, pediatrics, 10 neonatal, women's health/gender-related and psych/mental health. 11 p. "Prescriptive authority" means the legal authority to prescribe 12 medications and devices as defined by party state laws. 13 q. "Remote state" means a party state that is not the home state. 14 r. "Role" means one of the four recognized roles of certified regis- 15 tered nurse anesthetists (CRNA), certified nurse-midwives (CNM), clin- 16 ical nurse specialists (CNS) and certified nurse practitioners (CNP). 17 s. "Single-state license" means an APRN license issued by a party 18 state that authorizes practice only within the issuing state and does 19 not include a multistate licensure privilege to practice in any other 20 party state. 21 t. "State" means a state, territory or possession of the United States 22 and the District of Columbia. 23 u. "State practice laws" means a party state's laws, rules, and regu- 24 lations that govern APRN practice, define the scope of advanced nursing 25 practice and create the methods and grounds for imposing discipline 26 except that prescriptive authority shall be treated in accordance with 27 subdivisions f and g of Article III of this Compact. "State practice 28 laws" does not include: 29 1. A party state's laws, rules, and regulations requiring supervision 30 or collaboration with a healthcare professional, except for laws, rules, 31 and regulations regarding prescribing controlled substances; and 32 2. The requirements necessary to obtain and retain an APRN license, 33 except for qualifications or requirements of the home state. 34 ARTICLE III. 35 General Provisions and Jurisdiction 36 a. A state must implement procedures for considering the criminal 37 history records of applicants for initial APRN licensure or APRN licen- 38 sure by endorsement. Such procedures shall include the submission of 39 fingerprints or other biometric-based information by APRN applicants for 40 the purpose of obtaining an applicant's criminal history record informa- 41 tion from the Federal Bureau of Investigation and the agency responsible 42 for retaining that state's criminal records. 43 b. Each party state shall require an applicant to satisfy the follow- 44 ing APRN uniform licensure requirements to obtain or retain a multistate 45 license in the home state: 46 1. Meets the home state's qualifications for licensure or renewal of 47 licensure, as well as, all other applicable state laws; 48 2. i. Has completed an accredited graduate-level education program 49 that prepares the applicant for one of the four recognized roles and 50 population foci; or 51 ii. Has completed a foreign APRN education program for one of the four 52 recognized roles and population foci that (a) has been approved by the 53 authorized accrediting body in the applicable country and (b) has beenA. 7946 18 1 verified by an independent credentials review agency to be comparable to 2 a licensing board-approved APRN education program; 3 3. Has, if a graduate of a foreign APRN education program not taught 4 in English or if English is not the individual's native language, 5 successfully passed an English proficiency examination that includes the 6 components of reading, speaking, writing and listening; 7 4. Has successfully passed a national certification examination that 8 measures APRN, role and population-focused competencies and maintains 9 continued competence as evidenced by recertification in the role and 10 population focus through the national certification program; 11 5. Holds an active, unencumbered license as a registered nurse and an 12 active, unencumbered authorization to practice as an APRN; 13 6. Has successfully passed an NCLEX-RN examination or recognized pred- 14 ecessor, as applicable; 15 7. Has practiced for at least 2,080 hours as an APRN in a role and 16 population focus congruent with the applicant's education and training. 17 For purposes of this section, practice shall not include hours obtained 18 as part of enrollment in an APRN education program; 19 8. Has submitted, in connection with an application for initial licen- 20 sure or licensure by endorsement, fingerprints or other biometric data 21 for the purpose of obtaining criminal history record information from 22 the Federal Bureau of Investigation and the agency responsible for 23 retaining that state or, if applicable, foreign country's criminal 24 records; 25 9. Has not been convicted or found guilty, or has entered into an 26 agreed disposition, of a felony offense under applicable state, federal 27 or foreign criminal law; 28 10. Has not been convicted or found guilty, or has entered into an 29 agreed disposition, of a misdemeanor offense related to the practice of 30 nursing as determined by factors set forth in rules adopted by the 31 Commission; 32 11. Is not currently enrolled in an alternative program; 33 12. Is subject to self-disclosure requirements regarding current 34 participation in an alternative program; and 35 13. Has a valid United States Social Security number. 36 c. An APRN issued a multistate license shall be licensed in an 37 approved role and at least one approved population focus. 38 d. An APRN multistate license issued by a home state to a resident in 39 that state will be recognized by each party state as authorizing the 40 APRN to practice as an APRN in each party state, under a multistate 41 licensure privilege, in the same role and population focus as the APRN 42 is licensed in the home state. 43 e. Nothing in this Compact shall affect the requirements established 44 by a party state for the issuance of a single-state license, except that 45 an individual may apply for a single-state license, instead of a multi- 46 state license, even if otherwise qualified for the multistate license. 47 However, the failure of such an individual to affirmatively opt for a 48 single state license may result in the issuance of a multistate license. 49 f. Issuance of an APRN multistate license shall include prescriptive 50 authority for noncontrolled prescription drugs. 51 g. For each state in which an APRN seeks authority to prescribe 52 controlled substances, the APRN shall satisfy all requirements imposed 53 by such state in granting and/or renewing such authority. 54 h. An APRN issued a multistate license is authorized to assume respon- 55 sibility and accountability for patient care independent of any supervi- 56 sory or collaborative relationship. This authority may be exercised inA. 7946 19 1 the home state and in any remote state in which the APRN exercises a 2 multistate licensure privilege. 3 i. All party states shall be authorized, in accordance with state due 4 process laws, to take adverse action against an APRN's multistate licen- 5 sure privilege such as revocation, suspension, probation or any other 6 action that affects an APRN's authorization to practice under a multi- 7 state licensure privilege, including cease and desist actions. If a 8 party state takes such action, it shall promptly notify the administra- 9 tor of the coordinated licensure information system. The administrator 10 of the coordinated licensure information system shall promptly notify 11 the home state of any such actions by remote states. 12 j. Except as otherwise expressly provided in this Compact, an APRN 13 practicing in a party state must comply with the state practice laws of 14 the state in which the client is located at the time service is 15 provided. APRN practice is not limited to patient care, but shall 16 include all advanced nursing practice as defined by the state practice 17 laws of the party state in which the client is located. APRN practice in 18 a party state under a multistate licensure privilege will subject the 19 APRN to the jurisdiction of the licensing board, the courts, and the 20 laws of the party state in which the client is located at the time 21 service is provided. 22 k. Except as otherwise expressly provided in this Compact, this 23 Compact does not affect additional requirements imposed by states for 24 advanced practice registered nursing. However, a multistate licensure 25 privilege to practice registered nursing granted by a party state shall 26 be recognized by other party states as satisfying any state law require- 27 ment for registered nurse licensure as a precondition for authorization 28 to practice as an APRN in that state. 29 l. Individuals not residing in a party state shall continue to be able 30 to apply for a party state's single-state APRN license as provided under 31 the laws of each party state. However, the single-state license granted 32 to these individuals will not be recognized as granting the privilege to 33 practice as an APRN in any other party state. 34 ARTICLE IV. 35 Applications for APRN Licensure in a Party State 36 a. Upon application for an APRN multistate license, the licensing 37 board in the issuing party state shall ascertain, through the coordi- 38 nated licensure information system, whether the applicant has ever held 39 or is the holder of a licensed practical/vocational nursing license, a 40 registered nursing license or an advanced practice registered nurse 41 license issued by any other state, whether there are any encumbrances on 42 any license or multistate licensure privilege held by the applicant, 43 whether any adverse action has been taken against any license or multi- 44 state licensure privilege held by the applicant and whether the appli- 45 cant is currently participating in an alternative program. 46 b. An APRN may hold a multistate APRN license, issued by the home 47 state, in only one party state at a time. 48 c. If an APRN changes primary state of residence by moving between two 49 party states, the APRN must apply for APRN licensure in the new home 50 state, and the multistate license issued by the prior home state shall 51 be deactivated in accordance with applicable Commission rules. 52 1. The APRN may apply for licensure in advance of a change in primary 53 state of residence.A. 7946 20 1 2. A multistate APRN license shall not be issued by the new home state 2 until the APRN provides satisfactory evidence of a change in primary 3 state of residence to the new home state and satisfies all applicable 4 requirements to obtain a multistate APRN license from the new home 5 state. 6 d. If an APRN changes primary state of residence by moving from a 7 party state to a non-party state, the APRN multistate license issued by 8 the prior home state will convert to a single-state license, valid only 9 in the former home state. 10 ARTICLE V. 11 Additional Authorities Invested in Party State Licensing Boards 12 a. In addition to the other powers conferred by state law, a licensing 13 board shall have the authority to: 14 1. Take adverse action against an APRN's multistate licensure privi- 15 lege to practice within that party state. 16 i. Only the home state shall have power to take adverse action against 17 an APRN's license issued by the home state. 18 ii. For purposes of taking adverse action, the home state licensing 19 board shall give the same priority and effect to reported conduct that 20 occurred outside of the home state as it would if such conduct had 21 occurred within the home state. In so doing, the home state shall apply 22 its own state laws to determine appropriate action. 23 2. Issue cease and desist orders or impose an encumbrance on an APRN's 24 authority to practice within that party state. 25 3. Complete any pending investigations of an APRN who changes primary 26 state of residence during the course of such investigations. The licens- 27 ing board shall also have the authority to take appropriate action(s) 28 and shall promptly report the conclusions of such investigations to the 29 administrator of the coordinated licensure information system. The 30 administrator of the coordinated licensure information system shall 31 promptly notify the new home state of any such actions. 32 4. Issue subpoenas for both hearings and investigations that require 33 the attendance and testimony of witnesses, as well as, the production of 34 evidence. Subpoenas issued by a party state licensing board for the 35 attendance and testimony of witnesses and/or the production of evidence 36 from another party state shall be enforced in the latter state by any 37 court of competent jurisdiction, according to that court's practice and 38 procedure in considering subpoenas issued in its own proceedings. The 39 issuing licensing board shall pay any witness fees, travel expenses, 40 mileage and other fees required by the service statutes of the state in 41 which the witnesses and/or evidence are located. 42 5. Obtain and submit, for an APRN licensure applicant, fingerprints or 43 other biometric-based information to the Federal Bureau of Investigation 44 for criminal background checks, receive the results of the Federal 45 Bureau of Investigation record search on criminal background checks and 46 use the results in making licensure decisions. 47 6. If otherwise permitted by state law, recover from the affected APRN 48 the costs of investigations and disposition of cases resulting from any 49 adverse action taken against that APRN. 50 7. Take adverse action based on the factual findings of another party 51 state, provided that the licensing board follows its own procedures for 52 taking such adverse action. 53 b. If adverse action is taken by a home state against an APRN's multi- 54 state licensure, the privilege to practice in all other party statesA. 7946 21 1 under a multistate licensure privilege shall be deactivated until all 2 encumbrances have been removed from the APRN's multistate license. All 3 home state disciplinary orders that impose adverse action against an 4 APRN's multistate license shall include a statement that the APRN's 5 multistate licensure privilege is deactivated in all party states during 6 the pendency of the order. 7 c. Nothing in this Compact shall override a party state's decision 8 that participation in an alternative program may be used in lieu of 9 adverse action. The home state licensing board shall deactivate the 10 multistate licensure privilege under the multistate license of any APRN 11 for the duration of the APRN's participation in an alternative program. 12 ARTICLE VI. 13 Coordinated Licensure Information System and Exchange of Information 14 a. All party states shall participate in a coordinated licensure 15 information system of all APRNs, licensed registered nurses and licensed 16 practical/vocational nurses. This system will include information on the 17 licensure and disciplinary history of each APRN, as submitted by party 18 states, to assist in the coordinated administration of APRN licensure 19 and enforcement efforts. 20 b. The Commission, in consultation with the administrator of the coor- 21 dinated licensure information system, shall formulate necessary and 22 proper procedures for the identification, collection and exchange of 23 information under this Compact. 24 c. All licensing boards shall promptly report to the coordinated 25 licensure information system any adverse action, any current significant 26 investigative information, denials of applications (with the reasons for 27 such denials) and APRN participation in alternative programs known to 28 the licensing board regardless of whether such participation is deemed 29 nonpublic and/or confidential under state law. 30 d. Notwithstanding any other provision of law, all party state licens- 31 ing boards contributing information to the coordinated licensure infor- 32 mation system may designate information that may not be shared with 33 non-party states or disclosed to other entities or individuals without 34 the express permission of the contributing state. 35 e. Any personally identifiable information obtained from the coordi- 36 nated licensure information system by a party state licensing board 37 shall not be shared with non-party states or disclosed to other entities 38 or individuals except to the extent permitted by the laws of the party 39 state contributing the information. 40 f. Any information contributed to the coordinated licensure informa- 41 tion system that is subsequently required to be expunged by the laws of 42 the party state contributing the information shall be removed from the 43 coordinated licensure information system. 44 g. The Compact administrator of each party state shall furnish a 45 uniform data set to the Compact administrator of each other party state, 46 which shall include, at a minimum: 47 1. Identifying information; 48 2. Licensure data; 49 3. Information related to alternative program participation informa- 50 tion; and 51 4. Other information that may facilitate the administration of this 52 Compact, as determined by Commission rules. 53 h. The Compact administrator of a party state shall provide all inves- 54 tigative documents and information requested by another party state.A. 7946 22 1 ARTICLE VII. 2 Establishment of the Interstate Commission of APRN Compact 3 Administrators 4 a. The party states hereby create and establish a joint public agency 5 known as the Interstate Commission of APRN Compact Administrators. 6 1. The Commission is an instrumentality of the party states. 7 2. Venue is proper, and judicial proceedings by or against the Commis- 8 sion shall be brought solely and exclusively, in a court of competent 9 jurisdiction where the principal office of the Commission is located. 10 The Commission may waive venue and jurisdictional defenses to the extent 11 it adopts or consents to participate in alternative dispute resolution 12 proceedings. 13 3. Nothing in this Compact shall be construed to be a waiver of sover- 14 eign immunity. 15 b. Membership, Voting and Meetings. 16 1. Each party state shall have and be limited to one administrator. 17 The head of the state licensing board or designee shall be the adminis- 18 trator of this Compact for each party state. Any administrator may be 19 removed or suspended from office as provided by the law of the state 20 from which the administrator is appointed. Any vacancy occurring in the 21 Commission shall be filled in accordance with the laws of the party 22 state in which the vacancy exists. 23 2. Each administrator shall be entitled to one (1) vote with regard to 24 the promulgation of rules and creation of bylaws and shall otherwise 25 have an opportunity to participate in the business and affairs of the 26 Commission. An administrator shall vote in person or by such other means 27 as provided in the bylaws. The bylaws may provide for an administrator's 28 participation in meetings by telephone or other means of communication. 29 3. The Commission shall meet at least once during each calendar year. 30 Additional meetings shall be held as set forth in the bylaws or rules of 31 the commission. 32 4. All meetings shall be open to the public, and public notice of 33 meetings shall be given in the same manner as required under the rule- 34 making provisions in Article VIII. 35 5. The Commission may convene in a closed, nonpublic meeting if the 36 Commission must discuss: 37 i. Noncompliance of a party state with its obligations under this 38 Compact; 39 ii. The employment, compensation, discipline or other personnel 40 matters, practices or procedures related to specific employees or other 41 matters related to the Commission's internal personnel practices and 42 procedures; 43 iii. Current, threatened, or reasonably anticipated litigation; 44 iv. Negotiation of contracts for the purchase or sale of goods, 45 services or real estate; 46 v. Accusing any person of a crime or formally censuring any person; 47 vi. Disclosure of trade secrets or commercial or financial information 48 that is privileged or confidential; 49 vii. Disclosure of information of a personal nature where disclosure 50 would constitute a clearly unwarranted invasion of personal privacy; 51 viii. Disclosure of investigatory records compiled for law enforcement 52 purposes; 53 ix. Disclosure of information related to any reports prepared by or on 54 behalf of the Commission for the purpose of investigation of compliance 55 with this Compact; orA. 7946 23 1 x. Matters specifically exempted from disclosure by federal or state 2 statute. 3 6. If a meeting, or portion of a meeting, is closed pursuant to this 4 provision, the Commission's legal counsel or designee shall certify that 5 the meeting may be closed and shall reference each relevant exempting 6 provision. The Commission shall keep minutes that fully and clearly 7 describe all matters discussed in a meeting and shall provide a full and 8 accurate summary of actions taken, and the reasons therefor, including a 9 description of the views expressed. All documents considered in 10 connection with an action shall be identified in such minutes. All 11 minutes and documents of a closed meeting shall remain under seal, 12 subject to release by a majority vote of the Commission or order of a 13 court of competent jurisdiction. 14 c. The Commission shall, by a majority vote of the administrators, 15 prescribe bylaws or rules to govern its conduct as may be necessary or 16 appropriate to carry out the purposes and exercise the powers of this 17 Compact, including but not limited to: 18 1. Establishing the fiscal year of the Commission; 19 2. Providing reasonable standards and procedures: 20 i. For the establishment and meetings of other committees; and 21 ii. Governing any general or specific delegation of any authority or 22 function of the Commission; 23 3. Providing reasonable procedures for calling and conducting meetings 24 of the Commission, ensuring reasonable advance notice of all meetings 25 and providing an opportunity for attendance of such meetings by inter- 26 ested parties, with enumerated exceptions designed to protect the 27 public's interest, the privacy of individuals, and proprietary informa- 28 tion, including trade secrets. The Commission may meet in closed session 29 only after a majority of the administrators vote to close a meeting in 30 whole or in part. As soon as practicable, the Commission must make 31 public a copy of the vote to close the meeting revealing the vote of 32 each administrator, with no proxy votes allowed; 33 4. Establishing the titles, duties and authority and reasonable proce- 34 dures for the election of the officers of the Commission; 35 5. Providing reasonable standards and procedures for the establishment 36 of the personnel policies and programs of the Commission. Notwithstand- 37 ing any civil service or other similar laws of any party state, the 38 bylaws shall exclusively govern the personnel policies and programs of 39 the Commission; 40 6. Providing a mechanism for winding up the operations of the Commis- 41 sion and the equitable disposition of any surplus funds that may exist 42 after the termination of this Compact after the payment and/or reserving 43 of all of its debts and obligations; 44 d. The Commission shall publish its bylaws and rules, and any amend- 45 ments thereto, in a convenient form on the website of the Commission; 46 e. The Commission shall maintain its financial records in accordance 47 with the bylaws; and 48 f. The Commission shall meet and take such actions as are consistent 49 with the provisions of this Compact and the bylaws. 50 g. The Commission shall have the following powers: 51 1. To promulgate uniform rules to facilitate and coordinate implemen- 52 tation and administration of this Compact. The rules shall have the 53 force and effect of law and shall be binding in all party states; 54 2. To bring and prosecute legal proceedings or actions in the name of 55 the Commission, provided that the standing of any licensing board to sue 56 or be sued under applicable law shall not be affected;A. 7946 24 1 3. To purchase and maintain insurance and bonds; 2 4. To borrow, accept or contract for services of personnel, including 3 but not limited to employees of a party state or nonprofit organiza- 4 tions; 5 5. To cooperate with other organizations that administer state 6 compacts related to the regulation of nursing, including but not limited 7 to sharing administrative or staff expenses, office space or other 8 resources; 9 6. To hire employees, elect or appoint officers, fix compensation, 10 define duties, grant such individuals appropriate authority to carry out 11 the purposes of this Compact, and to establish the Commission's person- 12 nel policies and programs relating to conflicts of interest, qualifica- 13 tions of personnel and other related personnel matters; 14 7. To accept any and all appropriate donations, grants and gifts of 15 money, equipment, supplies, materials and services, and to receive, 16 utilize and dispose of the same; provided that at all times the Commis- 17 sion shall strive to avoid any appearance of impropriety and/or conflict 18 of interest; 19 8. To lease, purchase, accept appropriate gifts or donations of, or 20 otherwise to own, hold, improve or use, any property, whether real, 21 personal or mixed; provided that at all times the Commission shall 22 strive to avoid any appearance of impropriety; 23 9. To sell convey, mortgage, pledge, lease, exchange, abandon or 24 otherwise dispose of any property, whether real, personal or mixed; 25 10. To establish a budget and make expenditures; 26 11. To borrow money; 27 12. To appoint committees, including advisory committees comprised of 28 administrators, state nursing regulators, state legislators or their 29 representatives, and consumer representatives, and other such interested 30 persons; 31 13. To issue advisory opinions; 32 14. To provide and receive information from, and to cooperate with, 33 law enforcement agencies; 34 15. To adopt and use an official seal; and 35 16. To perform such other functions as may be necessary or appropriate 36 to achieve the purposes of this Compact consistent with the state regu- 37 lation of APRN licensure and practice. 38 h. Financing of the Commission. 39 1. The Commission shall pay, or provide for the payment of, the 40 reasonable expenses of its establishment, organization and ongoing 41 activities. 42 2. The Commission may also levy on and collect an annual assessment 43 from each party state to cover the cost of its operations, activities 44 and staff in its annual budget as approved each year. The aggregate 45 annual assessment amount, if any, shall be allocated based upon a formu- 46 la to be determined by the Commission, which shall promulgate a rule 47 that is binding upon all party states. 48 3. The Commission shall not incur obligations of any kind prior to 49 securing the funds adequate to meet the same; nor shall the Commission 50 pledge the credit of any of the party states, except by, and with the 51 authority of, such party state. 52 4. The Commission shall keep accurate accounts of all receipts and 53 disbursements. The receipts and disbursements of the Commission shall 54 be subject to the audit and accounting procedures established under its 55 bylaws. However, all receipts and disbursements of funds handled by the 56 Commission shall by audited yearly by a certified or licensed publicA. 7946 25 1 accountant, and the report of the audit shall be included in and become 2 part of the annual report of the Commission. 3 i. Qualified Immunity, Defense, and Indemnification. 4 1. The administrators, officers, executive director, employees and 5 representatives of the Commission shall be immune from suit and liabil- 6 ity, either personally or in their official capacity, for any claim for 7 damage to or loss of property or personal injury or other civil liabil- 8 ity caused by or arising out of any actual or alleged act, error or 9 omission that occurred, or that the person against whom the claim is 10 made had a reasonable basis for believing occurred, within the scope of 11 commission employment, duties or responsibilities; provided that nothing 12 in this paragraph shall be construed to protect any such person from 13 suit and/or liability for any damage, loss, injury or liability caused 14 by the intentional, willful or wanton misconduct of that person. 15 2. The Commission shall defend any administrator, officer, executive 16 director, employee or representative of the Commission in any civil 17 action seeking to impose liability arising out of any actual or alleged 18 act, error or omission that occurred within the scope of Commission 19 employment, duties or responsibilities, or that the person against whom 20 the claim is made had a reasonable basis for believing occurred within 21 the scope of Commission employment, duties or responsibilities; provided 22 that nothing herein shall be construed to prohibit that person from 23 retaining his or her own counsel; and provided further that the actual 24 or alleged act, error or omission did not result from that person's 25 intentional, willful or wanton misconduct. 26 3. The Commission shall indemnify and hold harmless any administrator, 27 officer, executive director, employee or representative of the Commis- 28 sion for the amount of any settlement or judgment obtained against that 29 person arising out of any actual or alleged act, error or omission that 30 occurred within the scope of Commission employment, duties or responsi- 31 bilities, or that such person had a reasonable basis for believing 32 occurred within the scope of Commission employment, duties or responsi- 33 bilities, provided that the actual or alleged act, error or omission did 34 not result from the intentional, willful or wanton misconduct of that 35 person. 36 ARTICLE VIII. 37 Rulemaking 38 a. The Commission shall exercise its rulemaking powers pursuant to the 39 criteria set forth in this Article and the rules adopted thereunder. 40 Rules and amendments shall become binding as of the date specified in 41 each rule or amendment and shall have the same force and effect as 42 provisions of this Compact. 43 b. Rules or amendments to the rules shall be adopted at a regular or 44 special meeting of the Commission. 45 c. Prior to promulgation and adoption of a final rule or rules by the 46 Commission, and at least sixty (60) days in advance of the meeting at 47 which the rule will be considered and voted upon, the Commission shall 48 file a notice of proposed rulemaking: 49 1. On the website of the Commission; and 50 2. On the website of each licensing board or the publication in which 51 each state would otherwise publish proposed rules. 52 d. The notice of proposed rulemaking shall include: 53 1. The proposed time, date and location of the meeting in which the 54 rule will be considered and voted upon;A. 7946 26 1 2. The text of the proposed rule or amendment, and the reason for the 2 proposed rule; 3 3. A request for comments on the proposed rule from any interested 4 person; and 5 4. The manner in which interested persons may submit notice to the 6 Commission of their intention to attend the public hearing and any writ- 7 ten comments. 8 e. Prior to adoption of a proposed rule, the Commission shall allow 9 persons to submit written data, facts, opinions and arguments, which 10 shall be made available to the public. 11 f. The Commission shall grant an opportunity for a public hearing 12 before it adopts a rule or amendment. 13 g. The Commission shall publish the place, time, and date of the sche- 14 duled public hearing. 15 1. Hearings shall be conducted in a manner providing each person who 16 wishes to comment a fair and reasonable opportunity to comment orally or 17 in writing. All hearings will be recorded, and a copy will be made 18 available upon request. 19 2. Nothing in this section shall be construed as requiring a separate 20 hearing on each rule. Rules may be grouped for the convenience of the 21 Commission at hearings required by this section. 22 h. If no one appears at the public hearing, the Commission may proceed 23 with promulgation of the proposed rule. 24 i. Following the scheduled hearing date, or by the close of business 25 on the scheduled hearing date if the hearing was not held, the Commis- 26 sion shall consider all written and oral comments received. 27 j. The Commission shall, by majority vote of all administrators, take 28 final action on the proposed rule and shall determine the effective date 29 of the rule, if any, based on the rulemaking record and the full text of 30 the rule. 31 k. Upon determination that an emergency exists, the Commission may 32 consider and adopt an emergency rule without prior notice, opportunity 33 for comment, or hearing, provided that the usual rulemaking procedures 34 provided in this Compact and in this section shall be retroactively 35 applied to the rule as soon as reasonably possible, in no event later 36 than ninety (90) days after the effective date of the rule. For the 37 purposes of this provision, an emergency rule is one that must be 38 adopted immediately in order to: 39 1. Meet an imminent threat to public health, safety or welfare; 40 2. Prevent a loss of Commission or party state funds; or 41 3. Meet a deadline for the promulgation of an administrative rule that 42 is established by federal law or rule. 43 l. The Commission may direct revisions to a previously adopted rule or 44 amendment for purposes of correcting typographical errors, errors in 45 format, errors in consistency or grammatical errors. Public notice of 46 any revisions shall be posted on the website of the Commission. The 47 revision shall be subject to challenge by any person for a period of 48 thirty (30) days after posting. The revision may be challenged only on 49 grounds that the revision results in a material change to a rule. A 50 challenge shall be made in writing, and delivered to the Commission, 51 prior to the end of the notice period. If no challenge is made, the 52 revision will take effect without further action. If the revision is 53 challenged, the revision may not take effect without the approval of the 54 Commission.A. 7946 27 1 ARTICLE IX. 2 Oversight, Dispute Resolution and Enforcement 3 a. Oversight. 4 1. Each party state shall enforce this Compact and take all actions 5 necessary and appropriate to effectuate this Compact's purposes and 6 intent. 7 2. The Commission shall be entitled to receive service of process in 8 any proceeding that may affect the powers, responsibilities or actions 9 of the Commission, and shall have standing to intervene in such a 10 proceeding for all purposes. Failure to provide service of process to 11 the Commission shall render a judgment or order void as to the Commis- 12 sion, this Compact or promulgated rules. 13 b. Default, Technical Assistance and Termination. 14 1. If the Commission determines that a party state has defaulted in 15 the performance of its obligations or responsibilities under this 16 Compact or the promulgated rules, the Commission shall: 17 i. Provide written notice to the defaulting state and other party 18 states of the nature of the default, the proposed means of curing the 19 default and/or any other action to be taken by the Commission; and 20 ii. Provide remedial training and specific technical assistance 21 regarding the default. 22 2. If a state in default fails to cure the default, the defaulting 23 state's membership in this Compact may be terminated upon an affirmative 24 vote of a majority of the administrators, and all rights, privileges and 25 benefits conferred by this Compact may be terminated on the effective 26 date of termination. A cure of the default does not relieve the offend- 27 ing state of obligations or liabilities incurred during the period of 28 default. 29 3. Termination of membership in this Compact shall be imposed only 30 after all other means of securing compliance have been exhausted. Notice 31 of intent to suspend or terminate shall be given by the Commission to 32 the governor of the defaulting state and to the executive officer of the 33 defaulting state's licensing board, the defaulting state's licensing 34 board, and each of the party states. 35 4. A state whose membership in this Compact has been terminated is 36 responsible for all assessments, obligations and liabilities incurred 37 through the effective date of termination, including obligations that 38 extend beyond the effective date of termination. 39 5. The Commission shall not bear any costs related to a state that is 40 found to be in default or whose membership in this Compact has been 41 terminated, unless agreed upon in writing between the Commission and the 42 defaulting state. 43 6. The defaulting state may appeal the action of the Commission by 44 petitioning the U.S. District Court for the District of Columbia or the 45 federal district in which the Commission has its principal offices. The 46 prevailing party shall be awarded all costs of such litigation, includ- 47 ing reasonable attorneys' fees. 48 c. Dispute Resolution. 49 1. Upon request by a party state, the Commission shall attempt to 50 resolve disputes related to the Compact that arise among party states 51 and between party and non-party states. 52 2. The Commission shall promulgate a rule providing for both mediation 53 and binding dispute resolution for disputes, as appropriate. 54 3. In the event the Commission cannot resolve disputes among party 55 states arising under this Compact:A. 7946 28 1 i. The party states may submit the issues in dispute to an arbitration 2 panel, which will be comprised of individuals appointed by the Compact 3 administrator in each of the affected party states and an individual 4 mutually agreed upon by the Compact administrators of all the party 5 states involved in the dispute. 6 ii. The decision of a majority of the arbitrators shall be final and 7 binding. 8 d. Enforcement. 9 1. The Commission, in the reasonable exercise of its discretion, shall 10 enforce the provisions and rules of this Compact. 11 2. By majority vote, the Commission may initiate legal action in the 12 United States District Court for the District of Columbia or the federal 13 district in which the Commission has its principal offices against a 14 party state that is in default to enforce compliance with the provisions 15 of this Compact and its promulgated rules and bylaws. The relief sought 16 may include both injunctive relief and damages. In the event judicial 17 enforcement is necessary, the prevailing party shall be awarded all 18 costs of such litigation, including reasonable attorneys' fees. 19 3. The remedies herein shall not be the exclusive remedies of the 20 Commission. The Commission may pursue any other remedies available under 21 federal or state law. 22 ARTICLE X. 23 Effective Date, Withdrawal and Amendment 24 a. This Compact shall come into limited effect at such time as this 25 Compact has been enacted into law in seven (7) party states for the sole 26 purpose of establishing and convening the Commission to adopt rules 27 relating to its operation. 28 b. Any state that joins this Compact subsequent to the Commission's 29 initial adoption of the APRN uniform licensure requirements shall be 30 subject to all rules that have been previously adopted by the Commis- 31 sion. 32 c. Any party state may withdraw from this Compact by enacting a stat- 33 ute repealing the same. A party state's withdrawal shall not take effect 34 until six (6) months after enactment of the repealing statute. 35 d. A party state's withdrawal or termination shall not affect the 36 continuing requirement of the withdrawing or terminated state's licens- 37 ing board to report adverse actions and significant investigations 38 occurring prior to the effective date of such withdrawal or termination. 39 e. Nothing contained in this Compact shall be construed to invalidate 40 or prevent any APRN licensure agreement or other cooperative arrangement 41 between a party state and a non-party state that does not conflict with 42 the provisions of this Compact. 43 f. This Compact may be amended by the party states. No amendment to 44 this Compact shall become effective and binding upon any party state 45 until it is enacted into the laws of all party states. 46 g. Representatives of non-party states to this Compact shall be 47 invited to participate in the activities of the Commission, on a nonvot- 48 ing basis, prior to the adoption of this Compact by all states. 49 ARTICLE XI. 50 Construction and Severability 51 This Compact shall be liberally construed so as to effectuate the 52 purposes thereof. The provisions of this Compact shall be severable, andA. 7946 29 1 if any phrase, clause, sentence or provision of this Compact is declared 2 to be contrary to the constitution of any party state or of the United 3 States, or if the applicability thereof to any government, agency, 4 person or circumstance is held invalid, the validity of the remainder of 5 this Compact and the applicability thereof to any government, agency, 6 person or circumstance shall not be affected thereby. If this Compact 7 shall be held to be contrary to the constitution of any party state, 8 this Compact shall remain in full force and effect as to the remaining 9 party states and in full force and effect as to the party state affected 10 as to all severable matters. 11 § 2. This act shall take effect on the ninetieth day after it shall 12 have become a law. Effective immediately, the addition, amendment 13 and/or repeal of any rule or regulation necessary for the implementation 14 of this act on its effective date are authorized to be made and 15 completed on or before such effective date. 16 § 2. Severability clause. If any clause, sentence, paragraph, subdivi- 17 sion, section or part of this act shall be adjudged by any court of 18 competent jurisdiction to be invalid, such judgment shall not affect, 19 impair, or invalidate the remainder thereof, but shall be confined in 20 its operation to the clause, sentence, paragraph, subdivision, section 21 or part thereof directly involved in the controversy in which such judg- 22 ment shall have been rendered. It is hereby declared to be the intent of 23 the legislature that this act would have been enacted even if such 24 invalid provisions had not been included herein. 25 § 3. This act shall take effect immediately; provided, however, that 26 the applicable effective date of Parts A through B of this act shall be 27 as specifically set forth in the last section of such Parts.