Bill Text: TX HB2950 | 2017-2018 | 85th Legislature | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the continuation and functions of the Texas Board of Nursing and to the regulation of the practice of nursing.
Spectrum: Bipartisan Bill
Status: (Passed) 2017-06-09 - See remarks for effective date [HB2950 Detail]
Download: Texas-2017-HB2950-Engrossed.html
Bill Title: Relating to the continuation and functions of the Texas Board of Nursing and to the regulation of the practice of nursing.
Spectrum: Bipartisan Bill
Status: (Passed) 2017-06-09 - See remarks for effective date [HB2950 Detail]
Download: Texas-2017-HB2950-Engrossed.html
By: Burkett, Thompson of Harris, Flynn, | H.B. No. 2950 | |
Raymond |
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relating to the continuation and functions of the Texas Board of | ||
Nursing and to the regulation of the practice of nursing. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 301.003, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 301.003. APPLICATION OF SUNSET ACT. The Texas Board of | ||
Nursing is subject to Chapter 325, Government Code (Texas Sunset | ||
Act). Unless continued in existence as provided by that chapter, | ||
the board is abolished September 1, 2029 [ |
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SECTION 2. Subchapter A, Chapter 301, Occupations Code, is | ||
amended by adding Section 301.006 to read as follows: | ||
Sec. 301.006. CLAIM OR DEFENSE FOR PROHIBITED RULE OR | ||
POLICY. (a) A person may assert as an affirmative defense in an | ||
administrative hearing or as a claim or defense in a judicial | ||
proceeding under Chapter 37, Civil Practice and Remedies Code, that | ||
a board rule, regulation, or policy, or a penalty imposed by the | ||
board: | ||
(1) limits the ability of an applicant for a license | ||
under this chapter to be licensed based on a sincerely held | ||
religious belief of the applicant; or | ||
(2) burdens a license holder's: | ||
(A) free exercise of religion, regardless of | ||
whether the burden is the result of a rule generally applicable to | ||
all license holders; | ||
(B) freedom of speech regarding a sincerely held | ||
religious belief; or | ||
(C) membership in any religious organization. | ||
(b) Subsection (a) does not apply if the board demonstrates | ||
that the limitation or burden with respect to the applicant or | ||
license holder: | ||
(1) is in furtherance of a compelling governmental | ||
interest; and | ||
(2) is the least restrictive means of furthering that | ||
interest. | ||
(c) A person may bring an action for injunctive relief | ||
against a violation of this section. | ||
SECTION 3. Section 301.059, Occupations Code, is amended by | ||
amending Subsection (b) and adding Subsection (d) to read as | ||
follows: | ||
(b) The training program must provide the person with | ||
information regarding: | ||
(1) the law governing [ |
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(2) the programs, functions, rules, and budget of the | ||
board; | ||
(3) the scope of and limitations on the board's | ||
rulemaking authority; | ||
(4) [ |
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of the board; | ||
(5) [ |
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(A) laws relating to open meetings, public | ||
information, administrative procedure, and disclosing conflicts of | ||
interest; and | ||
(B) other laws applicable to members of the board | ||
in performing their duties; and | ||
(6) [ |
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the board or the Texas Ethics Commission. | ||
(d) The executive director of the board shall create a | ||
training manual that includes the information required by | ||
Subsection (b). The executive director shall distribute a copy of | ||
the training manual annually to each board member. On receipt of | ||
the training manual, each board member shall sign and submit to the | ||
executive director a statement acknowledging receipt of the | ||
training manual. | ||
SECTION 4. Section 301.157, Occupations Code, is amended by | ||
amending Subsections (d-4), (d-8), (d-9), and (d-11) and adding | ||
Subsection (d-12) to read as follows: | ||
(d-4) The board may recognize and accept as approved under | ||
this section a school of nursing or educational program operated in | ||
another state and approved by a state board of nursing or other | ||
regulatory body of that state. The board shall adopt rules [ |
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substantially equivalent to the board's standards. The board by | ||
rule shall develop a process for students enrolled in a school of | ||
nursing or educational program operated in another state that does | ||
not meet standards substantially equivalent to the board's | ||
standards to apply for an initial license under this chapter. | ||
(d-8) For purposes of Subsection (d-4), a nursing program | ||
is considered to meet standards substantially equivalent to the | ||
board's standards if the program: | ||
(1) is part of an institution of higher education | ||
located outside this state that is approved by the appropriate | ||
regulatory authorities of that state; | ||
(2) holds regional accreditation by an accrediting | ||
body recognized by the United States secretary of education and the | ||
Council for Higher Education Accreditation; | ||
(3) holds specialty accreditation by an accrediting | ||
body recognized by the United States secretary of education and the | ||
Council for Higher Education Accreditation[ |
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(4) requires program applicants to be a licensed | ||
practical or vocational nurse, a military service corpsman, or a | ||
paramedic, or to hold a college degree in a clinically oriented | ||
health care field with demonstrated experience providing direct | ||
patient care; and | ||
(5) graduates students who: | ||
(A) achieve faculty-determined program outcomes, | ||
including passing criterion-referenced examinations of nursing | ||
knowledge essential to beginning a registered nursing practice and | ||
transitioning to the role of registered nurse; | ||
(B) pass a criterion-referenced summative | ||
performance examination developed by faculty subject matter | ||
experts that measures clinical competencies essential to beginning | ||
a registered nursing practice and that meets nationally recognized | ||
standards for educational testing, including the educational | ||
testing standards of the American Educational Research | ||
Association, the American Psychological Association, and the | ||
National Council on Measurement in Education; and | ||
(C) pass the National Council Licensure | ||
Examination for Registered Nurses at a rate equivalent to the | ||
board's required passage rate for students of approved in-state | ||
programs. | ||
(d-9) A graduate of a clinical competency assessment | ||
program operated in another state and approved by a state board of | ||
nursing or other regulatory body of another state is eligible to | ||
apply for an initial license under this chapter if: | ||
(1) [ |
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changes in the length or content of its clinical competency | ||
assessment without the board's approval; and | ||
(2) [ |
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the state board of nursing or other regulatory body in the other | ||
state[ |
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(d-11) If a clinical competency assessment program operated | ||
in another state graduates students who pass the National Council | ||
Licensure Examination for Registered Nurses at a rate lower than | ||
the board's required passage rate for graduating students of | ||
approved in-state programs, not later than May 31 of the next school | ||
year the program shall: | ||
(1) for the first year the student passage rate is | ||
lower than the board's required passage rate for students of | ||
approved in-state programs, complete and submit to the board for | ||
review and comment a self-study of the program in accordance with | ||
the board's guidelines; | ||
(2) for the second consecutive year the student | ||
passage rate is lower than the board's required passage rate for | ||
students of approved in-state programs, allow the board to conduct | ||
a desk review to evaluate the program using the criteria typically | ||
used in an on-site visit and make recommendations to improve the | ||
program; and | ||
(3) for the third consecutive year the student passage | ||
rate is lower than the board's required passage rate for students of | ||
approved in-state programs, provide notice on the program's | ||
Internet website that prospective students of the program may need | ||
to complete additional requirements to apply for an initial license | ||
in this state because the program has failed to meet the board's | ||
standards related to the required passage rate on the National | ||
Council Licensure Examination for Registered Nurses [ |
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(d-12) A clinical competency assessment program operated in | ||
another state is not considered to meet standards substantially | ||
equivalent to the board's standards if the program fails to meet the | ||
applicable requirements under Subsection (d-11) or if the program's | ||
graduating student passage rate on the National Council Licensure | ||
Examination for Registered Nurses is lower than the board's | ||
required passage rate for graduating students of approved in-state | ||
programs for four consecutive years. A student enrolled in a | ||
program described by this subsection before December 31 of the | ||
fourth consecutive year is eligible to apply for an initial license | ||
under this chapter. The program shall notify a student who enrolls | ||
in the program after December 31 of the fourth consecutive year that | ||
the student is required to complete additional requirements | ||
established by the board under Subsection (d-4) to apply for an | ||
initial license under this chapter. | ||
SECTION 5. Subchapter D, Chapter 301, Occupations Code, is | ||
amended by adding Section 301.1583 to read as follows: | ||
Sec. 301.1583. DISCIPLINARY RECORD. (a) The board shall | ||
remove a disciplinary action from a nurse's record on the board's | ||
Internet website if: | ||
(1) the nurse applies to the board for removal; | ||
(2) the disciplinary action is the only disciplinary | ||
action taken against the nurse; | ||
(3) the disciplinary action was an administrative, | ||
clerical, or other minor violation not causing harm to a patient; | ||
(4) the disciplinary action did not result in the | ||
suspension or revocation of, or the probation of the suspension or | ||
revocation of, the nurse's license; | ||
(5) the disciplinary action does not provide any | ||
indication that continued practice by the nurse may risk harm to a | ||
patient; and | ||
(6) the disciplinary action occurred at least five | ||
years before the date the nurse applied for removal. | ||
(b) Information contained in the coordinated licensure | ||
information system, as defined in Section 304.0015 in Article II of | ||
the Nurse Licensure Compact, that is removed from the board's | ||
Internet website under this section may not be provided to a state | ||
that is not a party to the compact under that section or to any other | ||
person. | ||
SECTION 6. Section 301.252, Occupations Code, is amended by | ||
amending Subsection (a) and adding Subsection (a-2) to read as | ||
follows: | ||
(a) Each applicant for a registered nurse license or a | ||
vocational nurse license must submit to the board a sworn | ||
application that demonstrates the applicant's qualifications under | ||
this chapter, accompanied by evidence that the applicant: | ||
(1) has good professional character related to the | ||
practice of nursing; | ||
(2) has successfully completed a program of | ||
professional or vocational nursing education approved under | ||
Section 301.157(d); and | ||
(3) has passed the jurisprudence examination approved | ||
by the board as provided by Subsection (a-1). | ||
(a-2) An applicant who provides satisfactory evidence that | ||
the applicant has not committed a violation of this chapter or a | ||
rule adopted under this chapter is considered to have good | ||
professional character related to the practice of nursing. A | ||
determination by the board that an applicant does not have good | ||
professional character related to the practice of nursing must be | ||
based on a showing by the board of a clear and rational connection | ||
between a violation of this chapter or a rule adopted under this | ||
chapter and the applicant's ability to effectively practice | ||
nursing. | ||
SECTION 7. Section 301.257, Occupations Code, is amended by | ||
adding Subsections (l) and (m) to read as follows: | ||
(l) The board may require in a declaratory order under this | ||
section that a person begin participation in a peer assistance | ||
program at the time of receipt of an initial license under this | ||
chapter. The board shall notify the person that, on issuance of the | ||
person's initial license, the person may request reevaluation of | ||
the person's required participation in the peer assistance program. | ||
(m) The board by rule shall develop a process to determine | ||
whether a person should continue to be required to participate in a | ||
peer assistance program. In making the determination, the board | ||
shall: | ||
(1) review the person's criminal history record | ||
information and, if applicable, determine whether participation in | ||
the program is warranted based on the time that has elapsed since | ||
the conviction or end of community supervision; | ||
(2) reevaluate or require a contractor administering a | ||
peer assistance program to reevaluate the treatment plan or the | ||
time the person is required to participate in the peer assistance | ||
program based on the person's individualized needs; and | ||
(3) authorize, as appropriate, a waiver of peer | ||
assistance program completion if the board is satisfied the person | ||
has achieved a satisfactory period of treatment or documented | ||
sobriety, as defined by board rules, and continued participation is | ||
not necessary. | ||
SECTION 8. Section 301.301(b), Occupations Code, is amended | ||
to read as follows: | ||
(b) A person may renew an unexpired license issued under | ||
this chapter on payment to the board of the required renewal fee | ||
before the expiration date of the license[ |
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other renewal requirements adopted by the board. A person whose | ||
license has expired may not engage in activities that require a | ||
license until the license has been renewed. | ||
SECTION 9. Subchapter H, Chapter 301, Occupations Code, is | ||
amended by adding Section 301.355 to read as follows: | ||
Sec. 301.355. DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a) | ||
An advanced practice registered nurse authorized to prescribe or | ||
order a drug or device may not prescribe a drug listed in Subsection | ||
(b) to a patient unless the advanced practice registered nurse has | ||
reviewed the patient's prescription history by accessing the | ||
prescription information submitted to the Texas State Board of | ||
Pharmacy as authorized by Section 481.076(a)(5), Health and Safety | ||
Code. | ||
(b) Subsection (a) applies only to the prescribing of: | ||
(1) opioids; | ||
(2) benzodiazepines; | ||
(3) barbiturates; or | ||
(4) carisoprodol. | ||
(c) Failure by an advanced practice registered nurse to | ||
comply with the requirements of this section is grounds for | ||
disciplinary action under Section 301.452. | ||
SECTION 10. Section 301.4106, Occupations Code, is amended | ||
to read as follows: | ||
Sec. 301.4106. PEER ASSISTANCE PROGRAMS. The board by rule | ||
shall develop guidelines to: | ||
(1) outline the roles and responsibilities of the | ||
board and a peer assistance program established or approved by the | ||
board under Chapter 467, Health and Safety Code; | ||
(2) outline the process for a peer assistance program | ||
to refer to the board complaints alleging a violation of the | ||
practice of nursing; | ||
(3) establish requirements for successfully | ||
completing a peer assistance program and for notification of the | ||
board of the successful completion by a nurse the board has ordered | ||
to attend or referred to the program; [ |
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(4) establish a clear procedure based on meaningful | ||
performance goals for evaluating the success of a peer assistance | ||
program established or approved by the board under Chapter 467, | ||
Health and Safety Code; | ||
(5) establish individualized requirements for | ||
participants in a peer assistance program, including the duration | ||
of participation in a peer assistance program for substance use, | ||
based on the individual's diagnosis and needs; and | ||
(6) ensure that participation requirements and | ||
treatment plans for peer assistance program participants who are | ||
referred to peer assistance for similar reasons are administered | ||
consistently. | ||
SECTION 11. Section 301.452, Occupations Code, is amended | ||
by amending Subsection (b) and adding Subsection (e) to read as | ||
follows: | ||
(b) A person is subject to denial of a license or to | ||
disciplinary action under this subchapter for: | ||
(1) a violation of this chapter, a rule or regulation | ||
not inconsistent with this chapter, or an order issued under this | ||
chapter; | ||
(2) fraud or deceit in procuring or attempting to | ||
procure a license to practice professional nursing or vocational | ||
nursing; | ||
(3) a conviction for, or placement on deferred | ||
adjudication community supervision or deferred disposition for, a | ||
felony or for a misdemeanor involving moral turpitude; | ||
(4) conduct that results in the revocation of | ||
probation imposed because of conviction for a felony or for a | ||
misdemeanor involving moral turpitude; | ||
(5) use of a nursing license, diploma, or permit, or | ||
the transcript of such a document, that has been fraudulently | ||
purchased, issued, counterfeited, or materially altered; | ||
(6) impersonating or acting as a proxy for another | ||
person in the licensing examination required under Section 301.253 | ||
or 301.255; | ||
(7) directly or indirectly aiding or abetting an | ||
unlicensed person in connection with the unauthorized practice of | ||
nursing; | ||
(8) revocation, suspension, or denial of, or any other | ||
action relating to, the person's license or privilege to practice | ||
nursing in another jurisdiction or under federal law; | ||
(9) intemperate use of alcohol or drugs that the board | ||
determines endangers or could endanger a patient; | ||
(10) unprofessional [ |
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practice of nursing that[ |
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deceive, defraud, or injure a patient or the public; | ||
(11) adjudication of mental incompetency; | ||
(12) lack of fitness to practice because of a mental or | ||
physical health condition that could result in injury to a patient | ||
or the public; or | ||
(13) failure to care adequately for a patient or to | ||
conform to the minimum standards of acceptable nursing practice in | ||
a manner that, in the board's opinion, exposes a patient or other | ||
person unnecessarily to risk of harm. | ||
(e) The board shall adopt rules to ensure that license | ||
denials and disciplinary action under Subsection (b)(10) are based | ||
on the application of objective criteria that are clearly and | ||
rationally connected to the applicant's or license holder's conduct | ||
and that any negative outcome resulting from that conduct is | ||
determined to affect the person's ability to effectively practice | ||
nursing. | ||
SECTION 12. Section 301.459, Occupations Code, is amended | ||
by amending Subsection (a) and adding Subsection (a-1) to read as | ||
follows: | ||
(a) The board by rule shall adopt procedures under Chapter | ||
2001, Government Code, governing formal disposition of a contested | ||
case. An administrative law judge employed by the [ |
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Office of Administrative Hearings shall conduct a formal hearing. | ||
After receiving the administrative law judge's findings of fact and | ||
conclusions of law for a contested case, the board shall dispose of | ||
the case by issuing a final order based on the administrative law | ||
judge's findings of fact and conclusions of law. | ||
(a-1) Notwithstanding Section 2001.058(e), Government | ||
Code, the board in a contested case may not change a finding of fact | ||
or conclusion of law or vacate or modify an order of the | ||
administrative law judge. The board may obtain judicial review of | ||
any finding of fact or conclusion of law issued by the | ||
administrative law judge as provided by Section 2001.058(f)(5), | ||
Government Code. For each case, the administrative law judge may | ||
make a recommendation regarding an appropriate action or sanction. | ||
The board has the sole authority and discretion to determine the | ||
appropriate action or sanction. | ||
SECTION 13. Subchapter L, Chapter 301, Occupations Code, is | ||
amended by adding Section 301.5525 to read as follows: | ||
Sec. 301.5525. MONITORING HARMFUL PRESCRIBING PATTERNS OR | ||
PRACTICES. (a) The board shall periodically check the prescribing | ||
information submitted to the Texas State Board of Pharmacy as | ||
authorized by Section 481.076(a)(1), Health and Safety Code, to | ||
determine whether an advanced practice registered nurse licensed | ||
under this chapter is engaging in potentially harmful prescribing | ||
patterns or practices. | ||
(b) The board, in coordination with the Texas State Board of | ||
Pharmacy, shall determine the conduct that constitutes a | ||
potentially harmful prescribing pattern or practice for purposes of | ||
Subsection (a). In determining the conduct that constitutes a | ||
potentially harmful prescribing pattern or practice, the board at a | ||
minimum shall consider: | ||
(1) the number of times an advanced practice | ||
registered nurse prescribes a drug listed in Section 301.355(b); | ||
and | ||
(2) for prescriptions described by Subdivision (1), | ||
patterns of prescribing combinations of those drugs and other | ||
dangerous combinations of drugs identified by the board. | ||
(c) If the board suspects that an advanced practice | ||
registered nurse licensed under this chapter may be engaging in | ||
potentially harmful prescribing patterns or practices, the board | ||
may notify the advanced practice registered nurse of the | ||
potentially harmful prescribing pattern or practice. | ||
(d) The board may initiate a complaint against an advanced | ||
practice registered nurse based on information obtained under this | ||
section. | ||
SECTION 14. Section 301.461, Occupations Code, is amended | ||
to read as follows: | ||
Sec. 301.461. ASSESSMENT OF COSTS PROHIBITED. The board | ||
may not assess a person who is found to have violated this chapter | ||
the administrative costs of conducting a hearing to determine the | ||
violation. | ||
SECTION 15. Section 301.466, Occupations Code, is amended | ||
by adding Subsection (e) to read as follows: | ||
(e) Information regarding a complaint, investigation, or | ||
disciplinary action contained in the coordinated licensure | ||
information system, as defined in Section 304.0015 in Article II of | ||
the Nurse Licensure Compact, may not be provided to a state that is | ||
not a party to the compact under that section or to any other | ||
person. | ||
SECTION 16. Chapter 304, Occupations Code, is amended by | ||
adding Section 304.0015 to read as follows: | ||
Sec. 304.0015. NURSE LICENSURE COMPACT. The Nurse | ||
Licensure Compact is enacted and entered into with all other | ||
jurisdictions that legally join in the compact, which reads as | ||
follows: | ||
NURSE LICENSURE COMPACT | ||
ARTICLE I. FINDINGS AND DECLARATION OF PURPOSE | ||
(a) The party states find that: | ||
(1) the health and safety of the public are affected by | ||
the degree of compliance with and the effectiveness of enforcement | ||
activities related to state nurse licensure laws; | ||
(2) violations of nurse licensure and other laws | ||
regulating the practice of nursing may result in injury or harm to | ||
the public; | ||
(3) the expanded mobility of nurses and the use of | ||
advanced communication technologies as part of our nation's health | ||
care delivery system require greater coordination and cooperation | ||
among states in the areas of nurse licensure and regulation; | ||
(4) new practice modalities and technology make | ||
compliance with individual state nurse licensure laws difficult and | ||
complex; | ||
(5) the current system of duplicative licensure for | ||
nurses practicing in multiple states is cumbersome and redundant | ||
for both nurses and states; and | ||
(6) uniformity of nurse licensure requirements | ||
throughout the states promotes public safety and public health | ||
benefits. | ||
(b) The general purposes of this compact are to: | ||
(1) facilitate the states' responsibility to protect | ||
the public's health and safety; | ||
(2) ensure and encourage the cooperation of party | ||
states in the areas of nurse licensure and regulation; | ||
(3) facilitate the exchange of information between | ||
party states in the areas of nurse regulation, investigation, and | ||
adverse actions; | ||
(4) promote compliance with the laws governing the | ||
practice of nursing in each jurisdiction; | ||
(5) invest all party states with the authority to hold | ||
a nurse accountable for meeting all state practice laws in the state | ||
in which the patient is located at the time care is rendered through | ||
the mutual recognition of party state licenses; | ||
(6) decrease redundancies in the consideration and | ||
issuance of nurse licenses; and | ||
(7) provide opportunities for interstate practice by | ||
nurses who meet uniform licensure requirements. | ||
ARTICLE II. DEFINITIONS | ||
As used in this compact: | ||
(a) "Adverse action" means any administrative, civil, | ||
equitable, or criminal action permitted by a state's laws that is | ||
imposed by a licensing board or other authority against a nurse, | ||
including actions against an individual's license or multistate | ||
licensure privilege such as revocation, suspension, probation, | ||
monitoring of the licensee, limitation on the licensee's practice, | ||
or any other encumbrance on licensure affecting a nurse's | ||
authorization to practice, including issuance of a cease and desist | ||
action. | ||
(b) "Alternative program" means a nondisciplinary | ||
monitoring program approved by a licensing board. | ||
(c) "Coordinated licensure information system" means an | ||
integrated process for collecting, storing, and sharing | ||
information on nurse licensure and enforcement activities related | ||
to nurse licensure laws that is administered by a nonprofit | ||
organization composed of and controlled by licensing boards. | ||
(d) "Current significant investigative information" means: | ||
(1) investigative information that a licensing board, | ||
after a preliminary inquiry that includes notification and an | ||
opportunity for the nurse to respond, if required by state law, has | ||
reason to believe is not groundless and, if proven true, would | ||
indicate more than a minor infraction; or | ||
(2) investigative information that indicates that the | ||
nurse represents an immediate threat to public health and safety | ||
regardless of whether the nurse has been notified and had an | ||
opportunity to respond. | ||
(e) "Encumbrance" means a revocation or suspension of, or | ||
any limitation on, the full and unrestricted practice of nursing | ||
imposed by a licensing board. | ||
(f) "Home state" means the party state which is the nurse's | ||
primary state of residence. | ||
(g) "Licensing board" means a party state's regulatory body | ||
responsible for issuing nurse licenses. | ||
(h) "Multistate license" means a license to practice as a | ||
registered or a licensed practical/vocational nurse (LPN/VN) | ||
issued by a home state licensing board that authorizes the licensed | ||
nurse to practice in all party states under a multistate licensure | ||
privilege. | ||
(i) "Multistate licensure privilege" means a legal | ||
authorization associated with a multistate license permitting the | ||
practice of nursing as either a registered nurse (RN) or LPN/VN in a | ||
remote state. | ||
(j) "Nurse" means RN or LPN/VN, as those terms are defined | ||
by each party state's practice laws. | ||
(k) "Party state" means any state that has adopted this | ||
compact. | ||
(l) "Remote state" means a party state, other than the home | ||
state. | ||
(m) "Single-state license" means a nurse license issued by a | ||
party state that authorizes practice only within the issuing state | ||
and does not include a multistate licensure privilege to practice | ||
in any other party state. | ||
(n) "State" means a state, territory, or possession of the | ||
United States and the District of Columbia. | ||
(o) "State practice laws" means a party state's laws, rules, | ||
and regulations that govern the practice of nursing, define the | ||
scope of nursing practice, and create the methods and grounds for | ||
imposing discipline. "State practice laws" do not include | ||
requirements necessary to obtain and retain a license, except for | ||
qualifications or requirements of the home state. | ||
ARTICLE III. GENERAL PROVISIONS AND JURISDICTION | ||
(a) A multistate license to practice registered or licensed | ||
practical/vocational nursing issued by a home state to a resident | ||
in that state will be recognized by each party state as authorizing | ||
a nurse to practice as a registered nurse (RN) or as a licensed | ||
practical/vocational nurse (LPN/VN), under a multistate licensure | ||
privilege, in each party state. | ||
(b) A state must implement procedures for considering the | ||
criminal history records of applicants for initial multistate | ||
license or licensure by endorsement. Such procedures shall include | ||
the submission of fingerprints or other biometric-based | ||
information by applicants for the purpose of obtaining an | ||
applicant's criminal history record information from the Federal | ||
Bureau of Investigation and the agency responsible for retaining | ||
that state's criminal records. | ||
(c) Each party state shall require the following for an | ||
applicant to obtain or retain a multistate license in the home | ||
state: | ||
(1) meets the home state's qualifications for | ||
licensure or renewal of licensure, as well as all other applicable | ||
state laws; | ||
(2)(i) has graduated or is eligible to graduate from a | ||
licensing board-approved RN or LPN/VN prelicensure education | ||
program; or | ||
(ii) has graduated from a foreign RN or LPN/VN | ||
prelicensure education program that (a) has been approved by the | ||
authorized accrediting body in the applicable country and (b) has | ||
been verified by an independent credentials review agency to be | ||
comparable to a licensing board-approved prelicensure education | ||
program; | ||
(3) has, if a graduate of a foreign prelicensure | ||
education program not taught in English or if English is not the | ||
individual's native language, successfully passed an English | ||
proficiency examination that includes the components of reading, | ||
speaking, writing, and listening; | ||
(4) has successfully passed an NCLEX-RN or NCLEX-PN | ||
Examination or a recognized predecessor, as applicable; | ||
(5) is eligible for or holds an active, unencumbered | ||
license; | ||
(6) has submitted, in connection with an application | ||
for initial licensure or licensure by endorsement, fingerprints or | ||
other biometric data for the purpose of obtaining criminal history | ||
record information from the Federal Bureau of Investigation and the | ||
agency responsible for retaining that state's criminal records; | ||
(7) has not been convicted or found guilty, or has | ||
entered into an agreed disposition, of a felony offense under | ||
applicable state or federal criminal law; | ||
(8) has not been convicted or found guilty, or has | ||
entered into an agreed disposition, of a misdemeanor offense | ||
related to the practice of nursing as determined on a case-by-case | ||
basis; | ||
(9) is not currently enrolled in an alternative | ||
program; | ||
(10) is subject to self-disclosure requirements | ||
regarding current participation in an alternative program; and | ||
(11) has a valid United States social security number. | ||
(d) All party states shall be authorized, in accordance with | ||
existing state due process law, to take adverse action against a | ||
nurse's multistate licensure privilege such as revocation, | ||
suspension, probation, or any other action that affects a nurse's | ||
authorization to practice under a multistate licensure privilege, | ||
including cease and desist actions. If a party state takes such | ||
action, it shall promptly notify the administrator of the | ||
coordinated licensure information system. The administrator of the | ||
coordinated licensure information system shall promptly notify the | ||
home state of any such actions by remote states. | ||
(e) A nurse practicing in a party state must comply with the | ||
state practice laws of the state in which the client is located at | ||
the time service is provided. The practice of nursing is not | ||
limited to patient care, but shall include all nursing practice as | ||
defined by the state practice laws of the party state in which the | ||
client is located. The practice of nursing in a party state under a | ||
multistate licensure privilege will subject a nurse to the | ||
jurisdiction of the licensing board, the courts, and the laws of the | ||
party state in which the client is located at the time service is | ||
provided. | ||
(f) Individuals not residing in a party state shall continue | ||
to be able to apply for a party state's single-state license as | ||
provided under the laws of each party state. However, the | ||
single-state license granted to these individuals will not be | ||
recognized as granting the privilege to practice nursing in any | ||
other party state. Nothing in this compact shall affect the | ||
requirements established by a party state for the issuance of a | ||
single-state license. | ||
(g) Any nurse holding a home state multistate license, on | ||
the effective date of this compact, may retain and renew the | ||
multistate license issued by the nurse's then-current home state, | ||
provided that: | ||
(1) a nurse, who changes primary state of residence | ||
after this compact's effective date, must meet all applicable | ||
Article III(c) requirements to obtain a multistate license from the | ||
new home state; or | ||
(2) a nurse who fails to satisfy the multistate | ||
licensure requirements in Article III(c) due to a disqualifying | ||
event occurring after this compact's effective date shall be | ||
ineligible to retain or renew a multistate license, and the nurse's | ||
multistate license shall be revoked or deactivated in accordance | ||
with applicable rules adopted by the Interstate Commission of Nurse | ||
Licensure Compact Administrators ("commission"). | ||
ARTICLE IV. APPLICATIONS FOR LICENSURE IN A PARTY STATE | ||
(a) Upon application for a multistate license, the | ||
licensing board in the issuing party state shall ascertain, through | ||
the coordinated licensure information system, whether the | ||
applicant has ever held, or is the holder of, a license issued by | ||
any other state, whether there are any encumbrances on any license | ||
or multistate licensure privilege held by the applicant, whether | ||
any adverse action has been taken against any license or multistate | ||
licensure privilege held by the applicant, and whether the | ||
applicant is currently participating in an alternative program. | ||
(b) A nurse may hold a multistate license, issued by the | ||
home state, in only one party state at a time. | ||
(c) If a nurse changes primary state of residence by moving | ||
between two party states, the nurse must apply for licensure in the | ||
new home state, and the multistate license issued by the prior home | ||
state will be deactivated in accordance with applicable rules | ||
adopted by the commission. | ||
(1) The nurse may apply for licensure in advance of a | ||
change in primary state of residence. | ||
(2) A multistate license shall not be issued by the new | ||
home state until the nurse provides satisfactory evidence of a | ||
change in primary state of residence to the new home state and | ||
satisfies all applicable requirements to obtain a multistate | ||
license from the new home state. | ||
(d) If a nurse changes primary state of residence by moving | ||
from a party state to a nonparty state, the multistate license | ||
issued by the prior home state will convert to a single-state | ||
license, valid only in the former home state. | ||
ARTICLE V. ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE | ||
LICENSING BOARDS | ||
(a) In addition to the other powers conferred by state law, | ||
a licensing board shall have the authority to: | ||
(1) take adverse action against a nurse's multistate | ||
licensure privilege to practice within that party state. | ||
(i) Only the home state shall have the power to | ||
take adverse action against a nurse's license issued by the home | ||
state. | ||
(ii) For purposes of taking adverse action, the | ||
home state licensing board shall give the same priority and effect | ||
to reported conduct received from a remote state as it would if such | ||
conduct had occurred within the home state. In so doing, the home | ||
state shall apply its own state laws to determine appropriate | ||
action. | ||
(2) issue cease and desist orders or impose an | ||
encumbrance on a nurse's authority to practice within that party | ||
state. | ||
(3) complete any pending investigation of a nurse who | ||
changes primary state of residence during the course of such | ||
investigation. The licensing board shall also have the authority | ||
to take appropriate action(s) and shall promptly report the | ||
conclusions of such investigations to the administrator of the | ||
coordinated licensure information system. The administrator of the | ||
coordinated licensure information system shall promptly notify the | ||
new home state of any such actions. | ||
(4) issue subpoenas for both hearings and | ||
investigations that require the attendance and testimony of a | ||
witness, as well as the production of evidence. Subpoenas issued by | ||
a licensing board in a party state for the attendance and testimony | ||
of witnesses or the production of evidence from another party state | ||
shall be enforced in the latter state by any court of competent | ||
jurisdiction, according to the practice and procedures of that | ||
court applicable to subpoenas issued in proceedings pending before | ||
it. The issuing authority shall pay any witness fees, travel | ||
expenses, mileage, and other fees required by the service statutes | ||
of the state in which the witnesses or evidence are located. | ||
(5) obtain and submit, for each nurse licensure | ||
applicant, fingerprint or other biometric-based information to the | ||
Federal Bureau of Investigation for criminal background checks, | ||
receive the results of the Federal Bureau of Investigation record | ||
search on criminal background checks, and use the results in making | ||
licensure decisions. | ||
(6) if otherwise permitted by state law, recover from | ||
the affected nurse the costs of investigations and disposition of | ||
cases resulting from any adverse action taken against that nurse. | ||
(7) take adverse action based on the factual findings | ||
of the remote state, provided that the licensing board follows its | ||
own procedures for taking such adverse action. | ||
(b) If adverse action is taken by the home state against a | ||
nurse's multistate license, the nurse's multistate licensure | ||
privilege to practice in all other party states shall be | ||
deactivated until all encumbrances have been removed from the | ||
multistate license. All home state disciplinary orders that impose | ||
adverse action against a nurse's multistate license shall include a | ||
statement that the nurse's multistate licensure privilege is | ||
deactivated in all party states during the pendency of the order. | ||
(c) Nothing in this compact shall override a party state's | ||
decision that participation in an alternative program may be used | ||
in lieu of adverse action. The home state licensing board shall | ||
deactivate the multistate licensure privilege under the multistate | ||
license of any nurse for the duration of the nurse's participation | ||
in an alternative program. | ||
ARTICLE VI. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE | ||
OF INFORMATION | ||
(a) All party states shall participate in a coordinated | ||
licensure information system of all licensed registered nurses | ||
(RNs) and licensed practical/vocational nurses (LPNs/VNs). This | ||
system will include information on the licensure and disciplinary | ||
history of each nurse, as submitted by party states, to assist in | ||
the coordination of nurse licensure and enforcement efforts. | ||
(b) The commission, in consultation with the administrator | ||
of the coordinated licensure information system, shall formulate | ||
necessary and proper procedures for the identification, | ||
collection, and exchange of information under this compact. | ||
(c) All licensing boards shall promptly report to the | ||
coordinated licensure information system any adverse action, any | ||
current significant investigative information, denials of | ||
applications (with the reasons for such denials), and nurse | ||
participation in alternative programs known to the licensing board | ||
regardless of whether such participation is deemed nonpublic or | ||
confidential under state law. | ||
(d) Current significant investigative information and | ||
participation in nonpublic or confidential alternative programs | ||
shall be transmitted through the coordinated licensure information | ||
system only to party state licensing boards. | ||
(e) Notwithstanding any other provision of law, all party | ||
state licensing boards contributing information to the coordinated | ||
licensure information system may designate information that may not | ||
be shared with nonparty states or disclosed to other entities or | ||
individuals without the express permission of the contributing | ||
state. | ||
(f) Any personally identifiable information obtained from | ||
the coordinated licensure information system by a party state | ||
licensing board shall not be shared with nonparty states or | ||
disclosed to other entities or individuals except to the extent | ||
permitted by the laws of the party state contributing the | ||
information. | ||
(g) Any information contributed to the coordinated | ||
licensure information system that is subsequently required to be | ||
expunged by the laws of the party state contributing that | ||
information shall also be expunged from the coordinated licensure | ||
information system. | ||
(h) The compact administrator of each party state shall | ||
furnish a uniform data set to the compact administrator of each | ||
other party state, which shall include, at a minimum: | ||
(1) identifying information; | ||
(2) licensure data; | ||
(3) information related to alternative program | ||
participation; and | ||
(4) other information that may facilitate the | ||
administration of this compact, as determined by commission rules. | ||
(i) The compact administrator of a party state shall provide | ||
all investigative documents and information requested by another | ||
party state. | ||
ARTICLE VII. ESTABLISHMENT OF INTERSTATE COMMISSION OF NURSE | ||
LICENSURE COMPACT ADMINISTRATORS | ||
(a) The party states hereby create and establish a joint | ||
public entity known as the Interstate Commission of Nurse Licensure | ||
Compact Administrators. | ||
(1) The commission is an instrumentality of the party | ||
states. | ||
(2) Venue is proper and judicial proceedings by or | ||
against the commission shall be brought solely and exclusively in a | ||
court of competent jurisdiction where the principal office of the | ||
commission is located. The commission may waive venue and | ||
jurisdictional defenses to the extent it adopts or consents to | ||
participate in alternative dispute resolution proceedings. | ||
(3) Nothing in this compact shall be construed to be a | ||
waiver of sovereign immunity. | ||
(b) Membership, Voting, and Meetings | ||
(1) Each party state shall have and be limited to one | ||
administrator. The head of the state licensing board or a designee | ||
shall be the administrator of this compact for each party state. | ||
Any administrator may be removed or suspended from office as | ||
provided by the law of the state from which the administrator is | ||
appointed. Any vacancy occurring in the commission shall be filled | ||
in accordance with the laws of the party state in which the vacancy | ||
exists. | ||
(2) Each administrator shall be entitled to one (1) | ||
vote with regard to the promulgation of rules and the creation of | ||
bylaws and shall otherwise have an opportunity to participate in | ||
the business and affairs of the commission. An administrator shall | ||
vote in person or by such other means as provided in the bylaws. The | ||
bylaws may provide for an administrator's participation in meetings | ||
by telephone or other means of communication. | ||
(3) The commission shall meet at least once during | ||
each calendar year. Additional meetings shall be held as set forth | ||
in the bylaws or rules of the commission. | ||
(4) All meetings shall be open to the public, and | ||
public notice of meetings shall be given in the same manner as | ||
required under the rulemaking provisions in Article VIII. | ||
(5) The commission may convene in a closed, nonpublic | ||
meeting if the commission must discuss: | ||
(i) noncompliance of a party state with its | ||
obligations under this compact; | ||
(ii) the employment, compensation, discipline, | ||
or other personnel matters, practices, or procedures related to | ||
specific employees or other matters related to the commission's | ||
internal personnel practices and procedures; | ||
(iii) current, threatened, or reasonably | ||
anticipated litigation; | ||
(iv) negotiation of contracts for the purchase or | ||
sale of goods, services, or real estate; | ||
(v) accusing any person of a crime or formally | ||
censuring any person; | ||
(vi) disclosure of trade secrets or commercial or | ||
financial information that is privileged or confidential; | ||
(vii) disclosure of information of a personal | ||
nature where disclosure would constitute a clearly unwarranted | ||
invasion of personal privacy; | ||
(viii) disclosure of investigatory records | ||
compiled for law enforcement purposes; | ||
(ix) disclosure of information related to any | ||
reports prepared by or on behalf of the commission for the purpose | ||
of investigation of compliance with this compact; or | ||
(x) matters specifically exempted from | ||
disclosure by federal or state statute. | ||
(6) If a meeting or portion of a meeting is closed | ||
pursuant to this provision, the commission's legal counsel or | ||
designee shall certify that the meeting may be closed and shall | ||
reference each relevant exempting provision. The commission shall | ||
keep minutes that fully and clearly describe all matters discussed | ||
in a meeting and shall provide a full and accurate summary of | ||
actions taken, and the reasons therefor, including a description of | ||
the views expressed. All documents considered in connection with | ||
an action shall be identified in such minutes. All minutes and | ||
documents of a closed meeting shall remain under seal, subject to | ||
release by a majority vote of the commission or order of a court of | ||
competent jurisdiction. | ||
(c) The commission shall, by a majority vote of the | ||
administrators, prescribe bylaws or rules to govern its conduct as | ||
may be necessary or appropriate to carry out the purposes and | ||
exercise the powers of this compact, including but not limited to: | ||
(1) establishing the fiscal year of the commission; | ||
(2) providing reasonable standards and procedures: | ||
(i) for the establishment and meeting of other | ||
committees; and | ||
(ii) governing any general or specific | ||
delegation of any authority or function of the commission; | ||
(3) providing reasonable procedures for calling and | ||
conducting meetings of the commission, ensuring reasonable advance | ||
notice of all meetings, and providing an opportunity for attendance | ||
of such meetings by interested parties, with enumerated exceptions | ||
designed to protect the public's interest, the privacy of | ||
individuals, and proprietary information, including trade secrets. | ||
The commission may meet in closed session only after a majority of | ||
the administrators vote to close a meeting in whole or in part. As | ||
soon as practicable, the commission must make public a copy of the | ||
vote to close the meeting revealing the vote of each administrator, | ||
with no proxy votes allowed; | ||
(4) establishing the titles, duties and authority, and | ||
reasonable procedures for the election of the officers of the | ||
commission; | ||
(5) providing reasonable standards and procedures for | ||
the establishment of the personnel policies and programs of the | ||
commission. Notwithstanding any civil service or other similar | ||
laws of any party state, the bylaws shall exclusively govern the | ||
personnel policies and programs of the commission; and | ||
(6) providing a mechanism for winding up the | ||
operations of the commission and the equitable disposition of any | ||
surplus funds that may exist after the termination of this compact | ||
after the payment or reserving of all of its debts and obligations. | ||
(d) The commission shall publish its bylaws and rules, and | ||
any amendments thereto, in a convenient form on the website of the | ||
commission. | ||
(e) The commission shall maintain its financial records in | ||
accordance with the bylaws. | ||
(f) The commission shall meet and take such actions as are | ||
consistent with the provisions of this compact and the bylaws. | ||
(g) The commission shall have the following powers: | ||
(1) to promulgate uniform rules to facilitate and | ||
coordinate implementation and administration of this compact. The | ||
rules shall have the force and effect of law and shall be binding in | ||
all party states; | ||
(2) to bring and prosecute legal proceedings or | ||
actions in the name of the commission, provided that the standing of | ||
any licensing board to sue or be sued under applicable law shall not | ||
be affected; | ||
(3) to purchase and maintain insurance and bonds; | ||
(4) to borrow, accept, or contract for services of | ||
personnel, including, but not limited to, employees of a party | ||
state or nonprofit organizations; | ||
(5) to cooperate with other organizations that | ||
administer state compacts related to the regulation of nursing, | ||
including, but not limited to, sharing administrative or staff | ||
expenses, office space, or other resources; | ||
(6) to hire employees, elect or appoint officers, fix | ||
compensation, define duties, grant such individuals appropriate | ||
authority to carry out the purposes of this compact, and to | ||
establish the commission's personnel policies and programs | ||
relating to conflicts of interest, qualifications of personnel, and | ||
other related personnel matters; | ||
(7) to accept any and all appropriate donations, | ||
grants, and gifts of money, equipment, supplies, materials, and | ||
services, and to receive, utilize, and dispose of the same; | ||
provided that at all times the commission shall avoid any | ||
appearance of impropriety or conflict of interest; | ||
(8) to lease, purchase, accept appropriate gifts or | ||
donations of, or otherwise to own, hold, improve, or use, any | ||
property, whether real, personal, or mixed; provided that at all | ||
times the commission shall avoid any appearance of impropriety; | ||
(9) to sell, convey, mortgage, pledge, lease, | ||
exchange, abandon, or otherwise dispose of any property, whether | ||
real, personal, or mixed; | ||
(10) to establish a budget and make expenditures; | ||
(11) to borrow money; | ||
(12) to appoint committees, including advisory | ||
committees comprised of administrators, state nursing regulators, | ||
state legislators or their representatives, consumer | ||
representatives, and other such interested persons; | ||
(13) to provide and receive information from, and to | ||
cooperate with, law enforcement agencies; | ||
(14) to adopt and use an official seal; and | ||
(15) to perform such other functions as may be | ||
necessary or appropriate to achieve the purposes of this compact | ||
consistent with the state regulation of nurse licensure and | ||
practice. | ||
(h) Financing of the Commission | ||
(1) The commission shall pay, or provide for the | ||
payment of, the reasonable expenses of its establishment, | ||
organization, and ongoing activities. | ||
(2) The commission may also levy on and collect an | ||
annual assessment from each party state to cover the cost of its | ||
operations, activities, and staff in its annual budget as approved | ||
each year. The aggregate annual assessment amount, if any, shall be | ||
allocated based upon a formula to be determined by the commission, | ||
which shall promulgate a rule that is binding upon all party states. | ||
(3) The commission shall not incur an obligation of | ||
any kind prior to securing the funds adequate to meet the same; nor | ||
shall the commission pledge the credit of any of the party states, | ||
except by and with the authority of such party state. | ||
(4) The commission shall keep accurate accounts of all | ||
receipts and disbursements. The receipts and disbursements of the | ||
commission shall be subject to the audit and accounting procedures | ||
established under its bylaws. However, all receipts and | ||
disbursements of funds handled by the commission shall be audited | ||
yearly by a certified or licensed public accountant, and the report | ||
of the audit shall be included in and become part of the annual | ||
report of the commission. | ||
(i) Qualified Immunity, Defense, and Indemnification | ||
(1) The compact administrators, officers, executive | ||
directors, employees, and representatives of the commission shall | ||
be immune from suit and liability, either personally or in their | ||
official capacity, for any claim for damage to or loss of property, | ||
or personal injury or other civil liability caused by or arising out | ||
of any actual or alleged act, error, or omission that occurred, or | ||
that the person against whom the claim is made had a reasonable | ||
basis for believing occurred, within the scope of commission | ||
employment, duties, or responsibilities; provided that nothing in | ||
this subdivision shall be construed to protect any such person from | ||
suit or liability for any damages, loss, injury, or liability | ||
caused by the intentional, wilful, or wanton misconduct of that | ||
person. | ||
(2) The commission shall defend any administrator, | ||
officer, executive director, employee, or representative of the | ||
commission in any civil action seeking to impose liability arising | ||
out of any actual or alleged act, error, or omission that occurred | ||
within the scope of commission employment, duties, or | ||
responsibilities, or that the person against whom the claim is made | ||
had a reasonable basis for believing occurred within the scope of | ||
commission employment, duties, or responsibilities; provided that | ||
nothing herein shall be construed to prohibit that person from | ||
retaining his or her own counsel; and provided further that the | ||
actual or alleged act, error, or omission did not result from that | ||
person's intentional, wilful, or wanton misconduct. | ||
(3) The commission shall indemnify and hold harmless | ||
any administrator, officer, executive director, employee, or | ||
representative of the commission for the amount of any settlement | ||
or judgment obtained against that person arising out of any actual | ||
or alleged act, error, or omission that occurred within the scope of | ||
commission employment, duties, or responsibilities, or that such | ||
person had a reasonable basis for believing occurred within the | ||
scope of commission employment, duties, or responsibilities; | ||
provided that the actual or alleged act, error, or omission did not | ||
result from the intentional, wilful, or wanton misconduct of that | ||
person. | ||
ARTICLE VIII. RULEMAKING | ||
(a) The commission shall exercise its rulemaking powers | ||
pursuant to the criteria set forth in this article and the rules | ||
adopted thereunder. Rules and amendments shall become binding as | ||
of the date specified in each rule or amendment and shall have the | ||
same force and effect as provisions of this compact. | ||
(b) Rules or amendments to the rules shall be adopted at a | ||
regular or special meeting of the commission. | ||
(c) Prior to promulgation and adoption of a final rule or | ||
rules by the commission, and at least sixty (60) days in advance of | ||
the meeting at which the rule will be considered and voted upon, the | ||
commission shall file a notice of proposed rulemaking: | ||
(1) on the website of the commission; and | ||
(2) on the website of each licensing board or the | ||
publication in which each state would otherwise publish proposed | ||
rules. | ||
(d) The notice of proposed rulemaking shall include: | ||
(1) the proposed time, date, and location of the | ||
meeting in which the rule will be considered and voted upon; | ||
(2) the text of the proposed rule or amendment, and the | ||
reason for the proposed rule; | ||
(3) a request for comments on the proposed rule from | ||
any interested person; and | ||
(4) the manner in which interested persons may submit | ||
notice to the commission of their intention to attend the public | ||
hearing and any written comments. | ||
(e) Prior to adoption of a proposed rule, the commission | ||
shall allow persons to submit written data, facts, opinions, and | ||
arguments, which shall be made available to the public. | ||
(f) The commission shall grant an opportunity for a public | ||
hearing before it adopts a rule or amendment. | ||
(g) The commission shall publish the place, time, and date | ||
of the scheduled public hearing. | ||
(1) Hearings shall be conducted in a manner providing | ||
each person who wishes to comment a fair and reasonable opportunity | ||
to comment orally or in writing. All hearings will be recorded, and | ||
a copy will be made available upon request. | ||
(2) Nothing in this section shall be construed as | ||
requiring a separate hearing on each rule. Rules may be grouped for | ||
the convenience of the commission at hearings required by this | ||
section. | ||
(h) If no one appears at the public hearing, the commission | ||
may proceed with promulgation of the proposed rule. | ||
(i) Following the scheduled hearing date, or by the close of | ||
business on the scheduled hearing date if the hearing was not held, | ||
the commission shall consider all written and oral comments | ||
received. | ||
(j) The commission shall, by majority vote of all | ||
administrators, take final action on the proposed rule and shall | ||
determine the effective date of the rule, if any, based on the | ||
rulemaking record and the full text of the rule. | ||
(k) Upon determination that an emergency exists, the | ||
commission may consider and adopt an emergency rule without prior | ||
notice, opportunity for comment, or hearing; provided that the | ||
usual rulemaking procedures provided in this compact and in this | ||
section shall be retroactively applied to the rule as soon as | ||
reasonably possible, and in no event later than ninety (90) days | ||
after the effective date of the rule. For the purposes of this | ||
provision, an emergency rule is one that must be adopted | ||
immediately in order to: | ||
(1) meet an imminent threat to public health, safety, | ||
or welfare; | ||
(2) prevent a loss of commission or party state funds; | ||
or | ||
(3) meet a deadline for the promulgation of an | ||
administrative rule that is required by federal law or rule. | ||
(l) The commission may direct revisions to a previously | ||
adopted rule or amendment for purposes of correcting typographical | ||
errors, errors in format, errors in consistency, or grammatical | ||
errors. Public notice of any revisions shall be posted on the | ||
website of the commission. The revision shall be subject to | ||
challenge by any person for a period of thirty (30) days after | ||
posting. The revision may be challenged only on grounds that the | ||
revision results in a material change to a rule. A challenge shall | ||
be made in writing, and delivered to the commission, prior to the | ||
end of the notice period. If no challenge is made, the revision | ||
will take effect without further action. If the revision is | ||
challenged, the revision may not take effect without the approval | ||
of the commission. | ||
ARTICLE IX. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT | ||
(a) Oversight | ||
(1) Each party state shall enforce this compact and | ||
take all actions necessary and appropriate to effectuate this | ||
compact's purposes and intent. | ||
(2) The commission shall be entitled to receive | ||
service of process in any proceeding that may affect the powers, | ||
responsibilities, or actions of the commission, and shall have | ||
standing to intervene in such a proceeding for all purposes. | ||
Failure to provide service of process in such proceeding to the | ||
commission shall render a judgment or order void as to the | ||
commission, this compact, or promulgated rules. | ||
(b) Default, Technical Assistance, and Termination | ||
(1) If the commission determines that a party state | ||
has defaulted in the performance of its obligations or | ||
responsibilities under this compact or the promulgated rules, the | ||
commission shall: | ||
(i) provide written notice to the defaulting | ||
state and other party states of the nature of the default, the | ||
proposed means of curing the default, or any other action to be | ||
taken by the commission; and | ||
(ii) provide remedial training and specific | ||
technical assistance regarding the default. | ||
(2) If a state in default fails to cure the default, | ||
the defaulting state's membership in this compact may be terminated | ||
upon an affirmative vote of a majority of the administrators, and | ||
all rights, privileges, and benefits conferred by this compact may | ||
be terminated on the effective date of termination. A cure of the | ||
default does not relieve the offending state of obligations or | ||
liabilities incurred during the period of default. | ||
(3) Termination of membership in this compact shall be | ||
imposed only after all other means of securing compliance have been | ||
exhausted. Notice of intent to suspend or terminate shall be given | ||
by the commission to the governor of the defaulting state and to the | ||
executive officer of the defaulting state's licensing board and | ||
each of the party states. | ||
(4) A state whose membership in this compact has been | ||
terminated is responsible for all assessments, obligations, and | ||
liabilities incurred through the effective date of the termination, | ||
including obligations that extend beyond the effective date of | ||
termination. | ||
(5) The commission shall not bear any costs related to | ||
a state that is found to be in default or whose membership in this | ||
compact has been terminated unless agreed upon in writing between | ||
the commission and the defaulting state. | ||
(6) The defaulting state may appeal the action of the | ||
commission by petitioning the U.S. District Court for the District | ||
of Columbia or the federal district in which the commission has its | ||
principal offices. The prevailing party shall be awarded all costs | ||
of such litigation, including reasonable attorneys' fees. | ||
(c) Dispute Resolution | ||
(1) Upon request by a party state, the commission | ||
shall attempt to resolve disputes related to the compact that arise | ||
among party states and between party and nonparty states. | ||
(2) The commission shall promulgate a rule providing | ||
for both mediation and binding dispute resolution for disputes, as | ||
appropriate. | ||
(3) In the event the commission cannot resolve | ||
disputes among party states arising under this compact: | ||
(i) the party states may submit the issues in | ||
dispute to an arbitration panel, which will be comprised of | ||
individuals appointed by the compact administrator in each of the | ||
affected party states and an individual mutually agreed upon by the | ||
compact administrators of all the party states involved in the | ||
dispute; and | ||
(ii) the decision of a majority of the | ||
arbitrators shall be final and binding. | ||
(d) Enforcement | ||
(1) The commission, in the reasonable exercise of its | ||
discretion, shall enforce the provisions and rules of this compact. | ||
(2) By majority vote, the commission may initiate | ||
legal action in the U.S. District Court for the District of Columbia | ||
or in the federal district in which the commission has its principal | ||
offices against a party state that is in default to enforce | ||
compliance with the provisions of this compact and its promulgated | ||
rules and bylaws. The relief sought may include both injunctive | ||
relief and damages. In the event judicial enforcement is | ||
necessary, the prevailing party shall be awarded all costs of such | ||
litigation, including reasonable attorneys' fees. | ||
(3) The remedies herein shall not be the exclusive | ||
remedies of the commission. The commission may pursue any other | ||
remedies available under federal or state law. | ||
ARTICLE X. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENTS | ||
(a) This compact shall become effective and binding on the | ||
earlier of the date of legislative enactment of this compact into | ||
law by no less than twenty-six (26) states or December 31, 2018. All | ||
party states to this compact that also were parties to the prior | ||
Nurse Licensure Compact, superseded by this compact ("prior | ||
compact"), shall be deemed to have withdrawn from said prior | ||
compact within six (6) months after the effective date of this | ||
compact. | ||
(b) Each party state to this compact shall continue to | ||
recognize a nurse's multistate licensure privilege to practice in | ||
that party state issued under the prior compact until the party | ||
state has withdrawn from the prior compact. | ||
(c) Any party state may withdraw from this compact by | ||
enacting a statute repealing the same. A party state's withdrawal | ||
shall not take effect until six (6) months after enactment of the | ||
repealing statute. | ||
(d) A party state's withdrawal or termination shall not | ||
affect the continuing requirement of the withdrawing or terminated | ||
state's licensing board to report adverse actions and significant | ||
investigations occurring prior to the effective date of such | ||
withdrawal or termination. | ||
(e) Nothing contained in this compact shall be construed to | ||
invalidate or prevent any nurse licensure agreement or other | ||
cooperative arrangement between a party state and a nonparty state | ||
that is made in accordance with the other provisions of this | ||
compact. | ||
(f) This compact may be amended by the party states. No | ||
amendment to this compact shall become effective and binding upon | ||
the party states unless and until it is enacted into the laws of all | ||
party states. | ||
(g) Representatives of nonparty states to this compact | ||
shall be invited to participate in the activities of the | ||
commission, on a nonvoting basis, prior to the adoption of this | ||
compact by all states. | ||
ARTICLE XI. CONSTRUCTION AND SEVERABILITY | ||
This compact shall be liberally construed so as to effectuate | ||
the purposes thereof. The provisions of this compact shall be | ||
severable, and if any phrase, clause, sentence, or provision of | ||
this compact is declared to be contrary to the constitution of any | ||
party state or the United States, or if the applicability thereof to | ||
any government, agency, person, or circumstance is held invalid, | ||
the validity of the remainder of this compact and the applicability | ||
thereof to any government, agency, person, or circumstance shall | ||
not be affected thereby. If this compact shall be held to be | ||
contrary to the constitution of any party state, this compact shall | ||
remain in full force and effect as to the remaining party states and | ||
in full force and effect as to the party state affected as to all | ||
severable matters. | ||
SECTION 17 | ||
. Chapter 304, Occupations Code, is amended by | ||
adding Section 304.0025 to read as follows: | ||
Sec. 304.0025. RULES ADOPTED UNDER COMPACT. The Interstate | ||
Commission of Nurse Licensure Compact Administrators established | ||
under the Nurse Licensure Compact under Section 304.0015 may not | ||
adopt rules that alter the requirements or scope of practice of a | ||
license issued under Chapter 301. Any rule adopted by the | ||
Interstate Commission of Nurse Licensure Compact Administrators | ||
that purports to alter the requirements or scope of practice of a | ||
license issued under Chapter 301 is not enforceable. | ||
SECTION 18. Section 304.006(a), Occupations Code, is | ||
amended to read as follows: | ||
(a) On request and payment of a reasonable fee, the Texas | ||
Board of Nursing shall provide a registered or vocational nurse | ||
licensed by this state with a copy of information regarding the | ||
nurse maintained by the coordinated licensure information system | ||
under Article VI [ |
||
SECTION 19. Section 304.008(a), Occupations Code, is | ||
amended to read as follows: | ||
(a) In reporting information to the coordinated licensure | ||
information system under Article VI [ |
||
Compact, the Texas Board of Nursing may disclose personally | ||
identifiable information about the nurse, including the nurse's | ||
social security number. | ||
SECTION 20. (a) Sections 301.160 and 301.163, Occupations | ||
Code, are repealed. | ||
(b) Effective December 31, 2018, Sections 304.001 and | ||
304.009, Occupations Code, are repealed. | ||
SECTION 21. (a) Except as provided by Subsection (b) of | ||
this section, Section 301.059, Occupations Code, as amended by this | ||
Act, applies to a member of the Texas Board of Nursing appointed | ||
before, on, or after the effective date of this Act. | ||
(b) A member of the Texas Board of Nursing who, before the | ||
effective date of this Act, completed the training program required | ||
by Section 301.059, Occupations Code, as that law existed before | ||
the effective date of this Act, is required to complete additional | ||
training only on subjects added to the training program required by | ||
Section 301.059, Occupations Code, as amended by this Act. A board | ||
member described by this subsection may not vote, deliberate, or be | ||
counted as a member in attendance at a meeting of the board held on | ||
or after December 1, 2017, until the member completes the | ||
additional training. | ||
SECTION 22. (a) Not later than May 31, 2018, the Texas | ||
Board of Nursing shall adopt the rules necessary to implement the | ||
changes in law made by this Act to Section 301.157, Occupations | ||
Code. In adopting rules under this subsection, the board shall | ||
provide an opportunity for public comment and, through the board's | ||
Advisory Committee on Education, seek comment from interested | ||
parties. The rules must: | ||
(1) clearly define substantially equivalent education | ||
standards for purposes of recognizing a school of nursing or | ||
educational program operated in another state; and | ||
(2) establish a process for enabling students enrolled | ||
in an out-of-state school of nursing or educational program that | ||
does not meet standards substantially equivalent to the board's | ||
standards to apply for initial licensure under Chapter 301, | ||
Occupations Code. | ||
(b) Not later than March 1, 2018, the Texas Board of Nursing | ||
shall adopt the rules necessary to implement the changes in law made | ||
by this Act to Sections 301.252 and 301.452, Occupations Code. In | ||
adopting rules under this subsection, the board shall seek comments | ||
from relevant interested parties. | ||
(c) Section 301.157(d-11), Occupations Code, as amended by | ||
this Act, applies beginning with the passage rates available in | ||
January 2018, reflecting the passage rates for the preceding year. | ||
If the passage rate for a clinical competency assessment program | ||
available in January 2018 does not meet the Texas Board of Nursing's | ||
required passage rate for students of approved in-state programs, | ||
the clinical competency assessment program shall complete the | ||
self-study required under Section 301.157(d-11)(1), Occupations | ||
Code, as amended by this Act, not later than May 31, 2018. | ||
(d) Sections 301.301(b) and 301.461, Occupations Code, as | ||
amended by this Act, apply only to the assessment of the | ||
administrative costs of conducting a hearing to determine a | ||
violation on or after the effective date of this Act. The | ||
assessment of the administrative costs of conducting a hearing to | ||
determine a violation before the effective date of this Act is | ||
governed by the law in effect on the date the administrative costs | ||
were assessed, and the former law is continued in effect for that | ||
purpose. | ||
(e) Section 301.459, Occupations Code, as amended by this | ||
Act, applies only to a contested case for which an administrative | ||
law judge employed by the State Office of Administrative Hearings | ||
issues written findings of fact and conclusions of law on or after | ||
the effective date of this Act. A contested case for which an | ||
administrative law judge employed by the State Office of | ||
Administrative Hearings issues written findings of fact and | ||
conclusions of law before the effective date of this Act is governed | ||
by the law in effect on the date the findings of fact and | ||
conclusions of law were issued, and the former law is continued in | ||
effect for that purpose. | ||
SECTION 23. Section 301.355, Occupations Code, as added by | ||
this Act, applies only to a prescription issued on or after | ||
September 1, 2018. A prescription issued before September 1, 2018, | ||
is governed by the law in effect on the date the prescription was | ||
issued, and the former law is continued in effect for that purpose. | ||
SECTION 24. Except as otherwise provided by this Act, this | ||
Act takes effect September 1, 2017. |