Senate
Study
Bill
3152
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
MATHIS)
A
BILL
FOR
An
Act
relating
to
the
advanced
practice
registered
nurse
1
interstate
compact.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
6002XC
(4)
86
tr/lh
S.F.
_____
Section
1.
Section
152E.2,
Code
2016,
is
amended
to
read
as
1
follows:
2
152E.2
Compact
administrator.
3
The
executive
director
of
the
board
of
nursing,
as
provided
4
for
in
section
152.2
,
shall
serve
as
the
compact
administrator
5
identified
in
article
VIII
,
paragraph
“a”
,
of
the
nurse
6
licensure
compact
contained
in
section
152E.1
and
as
the
7
compact
administrator
identified
in
article
VIII
VII
,
paragraph
8
“a”
“b”
,
of
the
advanced
practice
registered
nurse
compact
9
contained
in
section
152E.3
.
10
Sec.
2.
Section
152E.3,
Code
2016,
is
amended
by
striking
11
the
section
and
inserting
in
lieu
thereof
the
following:
12
152E.3
Advanced
practice
registered
nurse
compact.
13
The
advanced
practice
registered
nurse
compact
is
entered
14
into
and
enacted
into
law
with
all
jurisdictions
legally
15
joining
therein,
in
the
form
substantially
as
follows:
16
1.
Article
I
——
Findings
and
declaration
of
purpose.
17
a.
The
party
states
find
all
of
the
following:
18
(1)
The
health
and
safety
of
the
public
are
affected
by
the
19
degree
of
compliance
with
advanced
practice
registered
nurse
20
licensure
requirements
and
the
effectiveness
of
enforcement
21
activities
related
to
state
advanced
practice
registered
nurse
22
licensure
laws.
23
(2)
Violations
of
advanced
practice
registered
nurse
24
licensure
and
other
laws
regulating
the
practice
of
nursing
may
25
result
in
injury
or
harm
to
the
public.
26
(3)
The
expanded
mobility
of
advanced
practice
registered
27
nurses
and
the
use
of
advanced
communication
technologies
28
as
part
of
our
nation’s
health
care
delivery
system
require
29
greater
coordination
and
cooperation
among
states
in
the
areas
30
of
advanced
practice
registered
nurse
licensure
and
regulation.
31
(4)
New
practice
modalities
and
technology
make
compliance
32
with
individual
state
advanced
practice
registered
nurse
33
licensure
laws
difficult
and
complex.
34
(5)
The
current
system
of
duplicative
advanced
practice
35
-1-
LSB
6002XC
(4)
86
tr/lh
1/
27
S.F.
_____
registered
nurse
licensure
for
advanced
practice
registered
1
nurses
practicing
in
multiple
states
is
cumbersome
and
2
redundant
for
both
advanced
practice
registered
nurses
and
3
states.
4
(6)
Uniformity
of
advanced
practice
registered
nurse
5
requirements
throughout
the
states
promotes
public
safety
and
6
public
health
benefits.
7
b.
The
general
purposes
of
this
compact
are
to:
8
(1)
Facilitate
the
states’
responsibilities
to
protect
the
9
public’s
health
and
safety.
10
(2)
Ensure
and
encourage
the
cooperation
of
party
11
states
in
the
areas
of
advanced
practice
registered
nurse
12
licensure
regulation,
including
promotion
of
uniform
licensure
13
requirements.
14
(3)
Facilitate
the
exchange
of
information
between
party
15
states
in
the
areas
of
advanced
practice
registered
nurse
16
regulation,
investigation,
and
adverse
actions.
17
(4)
Promote
compliance
with
the
laws
governing
advanced
18
practice
registered
nurse
practice
in
each
jurisdiction.
19
(5)
Invest
all
party
states
with
the
authority
to
hold
an
20
advanced
practice
registered
nurse
accountable
for
meeting
21
all
state
practice
laws
in
the
state
in
which
the
patient
22
is
located
at
the
time
care
is
rendered
through
the
mutual
23
recognition
of
party
state
licenses.
24
(6)
Decrease
redundancies
in
the
consideration
and
issuance
25
of
advanced
practice
registered
nurse
licenses.
26
(7)
Provide
opportunities
for
interstate
practice
by
27
advanced
practice
registered
nurses
who
meet
uniform
licensure
28
requirements.
29
2.
Article
II
——
Definitions.
As
used
in
this
compact:
30
a.
“Advanced
practice
registered
nurse”
means
a
registered
31
nurse
who
has
gained
additional
specialized
knowledge,
skills,
32
and
experience
through
a
program
of
study
recognized
or
defined
33
by
the
commission,
and
who
is
licensed
to
perform
advanced
34
nursing
practice.
An
advanced
practice
registered
nurse
35
-2-
LSB
6002XC
(4)
86
tr/lh
2/
27
S.F.
_____
is
licensed
in
an
advanced
practice
registered
nurse
role
1
that
is
congruent
with
an
advanced
practice
registered
nurse
2
educational
program,
certification,
and
commission
rules.
3
b.
“Advanced
practice
registered
nurse
licensure”
means
4
the
regulatory
mechanism
used
by
a
party
state
to
grant
legal
5
authority
to
practice
as
an
advanced
practice
registered
nurse.
6
c.
“Advanced
practice
registered
nurse
uniform
license
7
requirements”
means
minimum
uniform
licensure,
education,
and
8
examination
requirements
as
adopted
by
the
commission.
9
d.
“Adverse
action”
means
any
administrative,
civil,
10
equitable,
or
criminal
action
permitted
by
a
state’s
laws
which
11
is
imposed
by
a
licensing
board
or
other
authority
against
an
12
advanced
practice
registered
nurse,
including
actions
against
13
an
individual’s
license
or
multistate
licensure
privilege
14
such
as
revocation,
suspension,
probation,
monitoring
of
15
the
licensee,
limitation
on
the
licensee’s
practice,
or
any
16
other
encumbrance
on
licensure
affecting
an
advanced
practice
17
registered
nurse’s
authorization
to
practice,
including
the
18
issuance
of
a
cease
and
desist
action.
19
e.
“Alternative
program”
means
a
nondisciplinary
monitoring
20
program
approved
by
a
licensing
board.
21
f.
“Commission”
means
the
interstate
commission
of
advanced
22
practice
registered
nurse
compact
administrators.
23
g.
“Coordinated
licensure
information
system”
means
an
24
integrated
process
for
collecting,
storing,
and
sharing
25
information
on
advanced
practice
registered
nurse
licensure
and
26
enforcement
activities
related
to
advanced
practice
registered
27
nurse
licensure
laws
that
is
administered
by
a
nonprofit
28
organization
composed
of
and
controlled
by
licensing
boards.
29
h.
“Current
significant
investigative
information”
means
30
either
of
the
following:
31
(1)
Investigative
information
that
a
licensing
board,
32
after
a
preliminary
inquiry
that
includes
notification
and
33
an
opportunity
for
the
advanced
practice
registered
nurse
to
34
respond
if
required
by
state
law,
has
reason
to
believe
is
not
35
-3-
LSB
6002XC
(4)
86
tr/lh
3/
27
S.F.
_____
groundless
and,
if
proved
true,
would
indicate
more
than
a
1
minor
infraction.
2
(2)
Investigative
information
that
indicates
that
the
3
advanced
practice
registered
nurse
represents
an
immediate
4
threat
to
public
health
and
safety
regardless
of
whether
the
5
advanced
practice
registered
nurse
has
been
notified
and
had
an
6
opportunity
to
respond.
7
i.
“Encumbrance”
means
a
revocation
or
suspension
of,
or
any
8
limitation
on,
the
full
and
unrestricted
practice
of
nursing
9
imposed
by
a
licensing
board.
10
j.
“Home
state”
means
the
party
state
that
is
the
advanced
11
practice
registered
nurse’s
primary
state
of
residence.
12
k.
“Licensing
board”
means
a
party
state’s
regulatory
body
13
responsible
for
regulating
the
practice
of
advanced
practice
14
registered
nursing.
15
l.
“Multistate
license”
means
an
advanced
practice
16
registered
nurse
license
to
practice
as
an
advanced
practice
17
registered
nurse
issued
by
a
home
state
licensing
board
that
18
authorizes
the
advanced
practice
registered
nurse
to
practice
19
as
an
advanced
practice
registered
nurse
in
all
party
states
20
under
a
multistate
licensure
privilege,
in
the
same
role
and
21
population
focus
as
the
advanced
practice
registered
nurse
is
22
licensed
in
the
home
state.
23
m.
“Multistate
licensure
privilege”
means
a
legal
24
authorization
associated
with
an
advanced
practice
registered
25
nurse
multistate
license
that
permits
an
advanced
practice
26
registered
nurse
to
practice
as
an
advanced
practice
registered
27
nurse
in
a
remote
state,
in
the
same
role
and
population
focus
28
as
the
advanced
practice
registered
nurse
is
licensed
in
the
29
home
state.
30
n.
“Noncontrolled
prescription
drug”
means
a
device
or
31
drug
that
is
not
a
controlled
substance
and
is
prohibited
32
under
state
or
federal
law
from
being
dispensed
without
a
33
prescription.
The
term
includes
a
device
or
drug
that
bears
or
34
is
required
to
bear
the
legend
“Caution:
federal
law
prohibits
35
-4-
LSB
6002XC
(4)
86
tr/lh
4/
27
S.F.
_____
dispensing
without
prescription”
or
“prescription
only”
or
some
1
other
legend
that
complies
with
federal
law.
2
o.
“Party
state”
means
any
state
that
has
adopted
this
3
compact.
4
p.
“Population
focus”
means
a
specific
patient
population
5
that
is
congruent
with
the
advanced
practice
registered
nurse
6
educational
program,
certification,
and
commission
rules.
7
q.
“Prescriptive
authority”
means
the
legal
authority
to
8
prescribe
medications
and
devices
as
defined
by
party
state
9
laws.
10
r.
“Remote
state”
means
a
party
state
that
is
not
the
home
11
state.
12
s.
“Single-state
license”
means
an
advanced
practice
13
registered
nurse
license
issued
by
a
party
state
that
14
authorizes
practice
only
within
the
issuing
state
and
does
not
15
include
a
multistate
licensure
privilege
to
practice
in
any
16
other
party
state.
17
t.
“State”
means
a
state,
territory,
or
possession
of
the
18
United
States
and
the
District
of
Columbia.
19
u.
“State
practice
laws”
means
a
party
state’s
laws,
rules,
20
and
regulations
that
govern
advanced
practice
registered
nurse
21
practice,
define
the
scope
of
advanced
nursing
practice,
22
including
prescriptive
authority,
and
create
the
methods
and
23
grounds
for
imposing
discipline.
“State
practice
laws”
does
24
not
include
the
requirements
necessary
to
obtain
and
retain
25
an
advanced
practice
registered
nurse
license,
except
for
26
qualifications
or
requirements
of
the
home
state.
27
3.
Article
III
——
General
provisions
and
jurisdiction.
28
a.
A
state
must
implement
procedures
for
considering
the
29
criminal
history
records
of
applicants
for
initial
advanced
30
practice
registered
nurse
licensure
or
advanced
practice
31
registered
nurse
licensure
by
endorsement.
Such
procedures
32
shall
include
the
submission
of
fingerprints
or
other
33
biometric-based
information
by
advanced
practice
registered
34
nurse
applicants
for
the
purpose
of
obtaining
an
applicant’s
35
-5-
LSB
6002XC
(4)
86
tr/lh
5/
27
S.F.
_____
criminal
history
record
information
from
the
federal
bureau
of
1
investigation
and
the
agency
responsible
for
retaining
that
2
state’s
criminal
records.
3
b.
By
rule,
the
commission
shall
adopt
the
advanced
practice
4
registered
nurse
uniform
licensure
requirements.
The
uniform
5
licensure
requirements
shall
provide
the
minimum
requirements
6
for
advanced
practice
registered
nurse
multistate
licensure
7
in
party
states,
provided
that
the
commission
may
adopt
8
rules
whereby
an
advanced
practice
registered
nurse,
with
an
9
unencumbered
license
on
the
effective
date
of
this
compact,
may
10
obtain,
by
endorsement
or
otherwise,
and
retain
a
multistate
11
license
in
a
party
state.
12
c.
In
order
to
obtain
or
retain
a
multistate
license,
an
13
advanced
practice
registered
nurse
must
meet,
in
addition
14
to
the
uniform
licensure
requirements,
the
home
state’s
15
qualifications
for
licensure
or
renewal
of
licensure,
as
well
16
as,
all
other
applicable
home
state
laws.
17
d.
By
rule,
the
commission
shall
identify
the
approved
18
advanced
practice
registered
nurse
roles
and
population
foci
19
for
licensure
as
an
advanced
practice
registered
nurse.
An
20
advanced
practice
registered
nurse
issued
a
multistate
license
21
shall
be
licensed
in
an
approved
advanced
practice
registered
22
nurse
role
and
at
least
one
approved
population
focus.
23
e.
An
advanced
practice
registered
nurse
multistate
license
24
issued
by
a
home
state
to
a
resident
in
that
state
will
be
25
recognized
by
each
party
state
as
authorizing
the
advanced
26
practice
registered
nurse
to
practice
as
an
advanced
practice
27
registered
nurse
in
each
party
state,
under
a
multistate
28
licensure
privilege,
in
the
same
role
and
population
focus
29
as
the
advanced
practice
registered
nurse
is
licensed
in
the
30
home
state.
If
an
applicant
does
not
qualify
for
a
multistate
31
license,
a
single-state
license
may
be
issued
by
a
home
state.
32
f.
Issuance
of
an
advanced
practice
registered
nurse
33
multistate
license
shall
include
prescriptive
authority
for
34
noncontrolled
prescription
drugs,
unless
the
advanced
practice
35
-6-
LSB
6002XC
(4)
86
tr/lh
6/
27
S.F.
_____
registered
nurse
was
licensed
by
the
home
state
prior
to
the
1
home
state’s
adoption
of
this
compact
and
has
not
previously
2
held
prescriptive
authority.
3
(1)
An
advanced
practice
registered
nurse
granted
4
prescriptive
authority
for
noncontrolled
prescription
drugs
5
in
the
home
state
may
exercise
prescriptive
authority
for
6
noncontrolled
prescription
drugs
in
any
remote
state
while
7
exercising
a
multistate
licensure
privilege
under
an
advanced
8
practice
registered
nurse
multistate
license;
the
advanced
9
practice
registered
nurse
shall
not
be
required
to
meet
any
10
additional
eligibility
requirements
imposed
by
the
remote
11
state
in
exercising
prescriptive
authority
for
noncontrolled
12
prescription
drugs.
13
(2)
Prescriptive
authority
in
the
home
state
for
an
advanced
14
practice
registered
nurse
who
was
not
granted
prescriptive
15
authority
at
the
time
of
initial
licensure
by
the
home
state,
16
prior
to
the
adoption
of
this
compact,
shall
be
determined
17
under
home
state
law.
18
(3)
Prescriptive
authority
eligibility
for
an
advanced
19
practice
registered
nurse
holding
a
single-state
license
shall
20
be
determined
under
the
law
of
the
licensing
state.
21
g.
For
each
state
in
which
an
advanced
practice
registered
22
nurse
seeks
authority
to
prescribe
controlled
substances,
23
the
advanced
practice
registered
nurse
shall
satisfy
all
24
requirements
imposed
by
such
state
in
granting
or
renewing
such
25
authority.
26
h.
An
advanced
practice
registered
nurse
issued
a
27
multistate
license
is
authorized
to
assume
responsibility
and
28
accountability
for
patient
care
independent
of
a
supervisory
or
29
collaborative
relationship
with
a
physician.
This
authority
30
may
be
exercised
in
the
home
state
and
in
any
remote
state
31
in
which
the
advanced
practice
registered
nurse
exercises
a
32
multistate
licensure
privilege.
For
an
advanced
practice
33
registered
nurse
issued
a
single-state
license
in
a
party
34
state,
the
requirement
for
a
supervisory
or
collaborative
35
-7-
LSB
6002XC
(4)
86
tr/lh
7/
27
S.F.
_____
relationship
with
a
physician
shall
be
determined
under
1
applicable
party
state
law.
2
i.
All
party
states
shall
be
authorized,
in
accordance
3
with
state
due
process
laws,
to
take
adverse
action
against
4
an
advanced
practice
registered
nurse’s
multistate
licensure
5
privilege
such
as
revocation,
suspension,
probation,
or
any
6
other
action
that
affects
an
advanced
practice
registered
7
nurse’s
authorization
to
practice
under
a
multistate
licensure
8
privilege,
including
cease
and
desist
actions.
If
a
party
9
state
takes
such
action,
the
party
state
shall
promptly
notify
10
the
administrator
of
the
coordinated
licensure
information
11
system.
The
administrator
of
the
coordinated
licensure
12
information
system
shall
promptly
notify
the
home
state
of
any
13
such
actions
by
remote
states.
14
j.
An
advanced
practice
registered
nurse
practicing
in
a
15
party
state
must
comply
with
the
state
practice
laws
of
the
16
state
in
which
the
client
is
located
at
the
time
service
is
17
provided.
Advanced
practice
registered
nurse
practice
is
18
not
limited
to
patient
care,
but
shall
include
all
advanced
19
nursing
practice
as
defined
by
the
state
practice
laws
of
the
20
party
state
in
which
the
client
is
located.
Advanced
practice
21
registered
nurse
practice
in
a
party
state
under
a
multistate
22
licensure
privilege
will
subject
the
advanced
practice
23
registered
nurse
to
the
jurisdiction
of
the
licensing
board,
24
the
courts,
and
the
laws
of
the
party
state
in
which
the
client
25
is
located
at
the
time
service
is
provided.
26
k.
This
compact
does
not
affect
additional
requirements
27
imposed
by
states
for
advanced
practice
registered
nursing.
28
However,
a
multistate
licensure
privilege
to
practice
29
registered
nursing
granted
by
a
party
state
shall
be
recognized
30
by
other
party
states
as
satisfying
any
state
law
requirement
31
for
registered
nurse
licensure
as
a
precondition
for
32
authorization
to
practice
as
an
advanced
practice
registered
33
nurse
in
that
state.
34
l.
Individuals
not
residing
in
a
party
state
shall
continue
35
-8-
LSB
6002XC
(4)
86
tr/lh
8/
27
S.F.
_____
to
be
able
to
apply
for
a
party
state’s
single-state
advanced
1
practice
registered
nurse
license
as
provided
under
the
laws
of
2
each
party
state.
However,
the
single-state
license
granted
3
to
these
individuals
will
not
be
recognized
as
granting
the
4
privilege
to
practice
as
an
advanced
practice
registered
nurse
5
in
any
other
party
state.
6
4.
Article
IV
——
Applications
for
advanced
practice
7
registered
nurse
licensure
in
a
party
state.
8
a.
Upon
receipt
of
an
application
for
an
advanced
practice
9
registered
nurse
multistate
license,
the
licensing
board
in
the
10
issuing
party
state
shall
ascertain,
through
the
coordinated
11
licensure
information
system,
whether
the
applicant
has
ever
12
held
or
is
the
holder
of
a
licensed
practical
or
vocational
13
nursing
license,
a
registered
nursing
license,
or
an
advanced
14
practice
registered
nurse
license
issued
by
any
other
state,
15
whether
there
are
any
encumbrances
on
any
license
or
multistate
16
licensure
privilege
held
by
the
applicant,
whether
any
adverse
17
action
has
been
taken
against
any
license
or
multistate
18
licensure
privilege
held
by
the
applicant,
and
whether
the
19
applicant
is
currently
participating
in
an
alternative
program.
20
b.
An
advanced
practice
registered
nurse
may
hold
a
21
multistate
advanced
practice
registered
nurse
license,
issued
22
by
the
home
state,
in
only
one
party
state
at
a
time.
23
c.
If
an
advanced
practice
registered
nurse
changes
primary
24
state
of
residence
by
moving
between
two
party
states,
the
25
advanced
practice
registered
nurse
must
apply
for
advanced
26
practice
registered
nurse
licensure
in
the
new
home
state,
and
27
the
multistate
license
issued
by
the
prior
home
state
shall
be
28
deactivated
in
accordance
with
applicable
commission
rules.
29
(1)
The
advanced
practice
registered
nurse
may
apply
for
30
licensure
in
advance
of
a
change
in
primary
state
of
residence.
31
(2)
A
multistate
advanced
practice
registered
nurse
license
32
shall
not
be
issued
by
the
new
home
state
until
the
advanced
33
practice
registered
nurse
provides
satisfactory
evidence
of
a
34
change
in
primary
state
of
residence
to
the
new
home
state
and
35
-9-
LSB
6002XC
(4)
86
tr/lh
9/
27
S.F.
_____
satisfies
all
applicable
requirements
to
obtain
a
multistate
1
advanced
practice
registered
nurse
license
from
the
new
home
2
state.
3
d.
If
an
advanced
practice
registered
nurse
changes
primary
4
state
of
residence
by
moving
from
a
party
state
to
a
nonparty
5
state,
the
advanced
practice
registered
nurse
multistate
6
license
issued
by
the
prior
home
state
will
convert
to
a
7
single-state
license,
valid
only
in
the
former
home
state.
8
5.
Article
V
——
Additional
authorities
invested
in
party
9
state
licensing
boards.
10
a.
In
addition
to
the
other
powers
conferred
by
state
law,
a
11
licensing
board
shall
have
the
authority
to:
12
(1)
Take
adverse
action
against
an
advanced
practice
13
registered
nurse’s
multistate
licensure
privilege
to
practice
14
within
that
party
state.
15
(a)
Only
the
home
state
shall
have
power
to
take
adverse
16
action
against
an
advanced
practice
registered
nurse’s
license
17
issued
by
the
home
state.
18
(b)
For
purposes
of
taking
adverse
action,
the
home
state
19
licensing
board
shall
give
the
same
priority
and
effect
to
20
reported
conduct
that
occurred
outside
of
the
home
state
as
21
it
would
if
the
conduct
had
occurred
within
the
home
state.
22
In
so
doing,
the
home
state
shall
apply
its
own
state
laws
to
23
determine
appropriate
action.
24
(2)
Issue
cease
and
desist
orders
or
impose
an
encumbrance
25
on
an
advanced
practice
registered
nurse’s
authority
to
26
practice
within
that
party
state.
27
(3)
Complete
any
pending
investigations
of
an
advanced
28
practice
registered
nurse
who
changes
primary
state
of
29
residence
during
the
course
of
such
investigations.
The
30
licensing
board
shall
also
have
the
authority
to
take
31
appropriate
action
and
shall
promptly
report
the
conclusions
32
of
such
investigations
to
the
administrator
of
the
coordinated
33
licensure
information
system.
The
administrator
of
the
34
coordinated
licensure
information
system
shall
promptly
notify
35
-10-
LSB
6002XC
(4)
86
tr/lh
10/
27
S.F.
_____
the
new
home
state
of
any
such
actions.
1
(4)
Issue
subpoenas
for
both
hearings
and
investigations
2
that
require
the
attendance
and
testimony
of
witnesses,
as
3
well
as
the
production
of
evidence.
Subpoenas
issued
by
a
4
party
state
licensing
board
for
the
attendance
and
testimony
5
of
witnesses
or
the
production
of
evidence
from
another
party
6
state
shall
be
enforced
in
the
latter
state
by
any
court
of
7
competent
jurisdiction,
according
to
that
court’s
practice
8
and
procedure
in
considering
subpoenas
issued
in
its
own
9
proceedings.
The
issuing
licensing
board
shall
pay
any
witness
10
fees,
travel
expenses,
mileage,
and
other
fees
required
by
11
the
service
statutes
of
the
state
in
which
the
witnesses
or
12
evidence
is
located.
13
(5)
Obtain
and
submit,
for
an
advanced
practice
14
registered
nurse
licensure
applicant,
fingerprints
or
15
other
biometric-based
information
to
the
federal
bureau
of
16
investigation
for
criminal
background
checks,
receive
the
17
results
of
the
federal
bureau
of
investigation
record
search
18
on
criminal
background
checks,
and
use
the
results
in
making
19
licensure
decisions.
20
(6)
If
otherwise
permitted
by
state
law,
recover
from
21
the
affected
advanced
practice
registered
nurse
the
costs
of
22
investigations
and
disposition
of
cases
resulting
from
any
23
adverse
action
taken
against
that
advanced
practice
registered
24
nurse.
25
(7)
Take
adverse
action
based
on
the
factual
findings
of
26
another
party
state,
provided
that
the
licensing
board
follows
27
its
own
procedures
for
taking
such
adverse
action.
28
b.
If
adverse
action
is
taken
by
a
home
state
against
an
29
advanced
practice
registered
nurse’s
multistate
licensure,
30
the
privilege
to
practice
in
all
other
party
states
under
a
31
multistate
licensure
privilege
shall
be
deactivated
until
all
32
encumbrances
have
been
removed
from
the
advanced
practice
33
registered
nurse’s
multistate
license.
All
home
state
34
disciplinary
orders
that
impose
adverse
action
against
an
35
-11-
LSB
6002XC
(4)
86
tr/lh
11/
27
S.F.
_____
advanced
practice
registered
nurse’s
multistate
license
shall
1
include
a
statement
that
the
advanced
practice
registered
2
nurse’s
multistate
licensure
privilege
is
deactivated
in
all
3
party
states
during
the
pendency
of
the
order.
4
c.
Nothing
in
this
compact
shall
override
a
party
state’s
5
decision
that
participation
in
an
alternative
program
may
be
6
used
in
lieu
of
adverse
action.
The
home
state
licensing
board
7
shall
deactivate
the
multistate
licensure
privilege
under
the
8
multistate
license
of
any
advanced
practice
registered
nurse
9
for
the
duration
of
the
advanced
practice
registered
nurse’s
10
participation
in
an
alternative
program.
11
6.
Article
VI
——
Coordinated
licensure
information
system
and
12
exchange
of
information.
13
a.
All
party
states
shall
participate
in
a
coordinated
14
licensure
information
system
of
all
advanced
practice
15
registered
nurses,
licensed
registered
nurses,
and
licensed
16
practical
or
vocational
nurses.
This
system
will
include
17
information
on
the
licensure
and
disciplinary
history
of
each
18
advanced
practice
registered
nurse,
as
submitted
by
party
19
states,
to
assist
in
the
coordinated
administration
of
advanced
20
practice
registered
nurse
licensure
and
enforcement
efforts.
21
b.
The
commission,
in
consultation
with
the
administrator
of
22
the
coordinated
licensure
information
system,
shall
formulate
23
necessary
and
proper
procedures
for
the
identification,
24
collection,
and
exchange
of
information
under
this
compact.
25
c.
All
licensing
boards
shall
promptly
report
to
the
26
coordinated
licensure
information
system
any
adverse
action;
27
any
current
significant
investigative
information;
denials
of
28
applications,
with
the
reasons
for
such
denials;
and
advanced
29
practice
registered
nurse
participation
in
alternative
programs
30
known
to
the
licensing
board
regardless
of
whether
such
31
participation
is
deemed
nonpublic
or
confidential
under
state
32
law.
33
d.
Current
significant
investigative
information
and
34
participation
in
nonpublic
or
confidential
alternative
35
-12-
LSB
6002XC
(4)
86
tr/lh
12/
27
S.F.
_____
programs
shall
be
transmitted
through
the
coordinated
licensure
1
information
system
only
to
party
state
licensing
boards.
2
e.
Notwithstanding
any
other
provision
of
law,
all
3
party
state
licensing
boards
contributing
information
to
4
the
coordinated
licensure
information
system
may
designate
5
information
that
may
not
be
shared
with
nonparty
states
or
6
disclosed
to
other
entities
or
individuals
without
the
express
7
permission
of
the
contributing
state.
8
f.
Any
personally
identifiable
information
obtained
from
9
the
coordinated
licensure
information
system
by
a
party
state
10
licensing
board
shall
not
be
shared
with
nonparty
states
or
11
disclosed
to
other
entities
or
individuals
except
to
the
extent
12
permitted
by
the
laws
of
the
party
state
contributing
the
13
information.
14
g.
Any
information
contributed
to
the
coordinated
licensure
15
information
system
that
is
subsequently
required
to
be
expunged
16
by
the
laws
of
the
party
state
contributing
the
information
17
shall
be
removed
from
the
coordinated
licensure
information
18
system.
19
h.
The
compact
administrator
of
each
party
state
shall
20
furnish
a
uniform
data
set
to
the
compact
administrator
of
each
21
other
party
state,
which
shall
include
but
not
be
limited
to
22
all
of
the
following:
23
(1)
Identifying
information.
24
(2)
Licensure
data.
25
(3)
Information
related
to
alternative
program
26
participation
information.
27
(4)
Other
information
that
may
facilitate
the
28
administration
of
this
compact,
as
determined
by
commission
29
rules.
30
i.
The
compact
administrator
of
a
party
state
shall
provide
31
all
investigative
documents
and
information
requested
by
32
another
party
state.
33
7.
ARTICLE
VII
——
Establishment
of
the
interstate
commission
34
of
advanced
practice
registered
nurse
compact
administrators.
35
-13-
LSB
6002XC
(4)
86
tr/lh
13/
27
S.F.
_____
a.
Commission
created.
The
party
states
hereby
create
1
and
establish
a
joint
public
agency
known
as
the
interstate
2
commission
of
advanced
practice
registered
nurse
compact
3
administrators.
4
(1)
The
commission
is
an
instrumentality
of
the
party
5
states.
6
(2)
Venue
is
proper,
and
judicial
proceedings
by
or
against
7
the
commission
shall
be
brought
solely
and
exclusively,
in
a
8
court
of
competent
jurisdiction
where
the
principal
office
of
9
the
commission
is
located.
The
commission
may
waive
venue
and
10
jurisdictional
defenses
to
the
extent
it
adopts
or
consents
to
11
participate
in
alternative
dispute
resolution
proceedings.
12
(3)
Nothing
in
this
compact
shall
be
construed
to
be
a
13
waiver
of
sovereign
immunity.
14
b.
Membership,
voting,
and
meetings.
15
(1)
Each
party
state
shall
have
and
be
limited
to
one
16
administrator.
The
head
of
the
state
licensing
board
or
17
designee
shall
be
the
administrator
of
this
compact
for
each
18
party
state.
Any
administrator
may
be
removed
or
suspended
19
from
office
as
provided
by
the
law
of
the
state
from
which
20
the
administrator
is
appointed.
Any
vacancy
occurring
in
the
21
commission
shall
be
filled
in
accordance
with
the
laws
of
the
22
party
state
in
which
the
vacancy
exists.
23
(2)
Each
administrator
shall
be
entitled
to
one
vote
with
24
regard
to
the
promulgation
of
rules
and
creation
of
bylaws
25
and
shall
otherwise
have
an
opportunity
to
participate
in
the
26
business
and
affairs
of
the
commission.
An
administrator
27
shall
vote
in
person
or
by
such
other
means
as
provided
in
28
the
bylaws.
The
bylaws
may
provide
for
an
administrator’s
29
participation
in
meetings
by
telephone
or
other
means
of
30
communication.
31
(3)
The
commission
shall
meet
at
least
once
during
each
32
calendar
year.
Additional
meetings
shall
be
held
as
set
forth
33
in
the
bylaws
or
rules
of
the
commission.
34
(4)
All
meetings
shall
be
open
to
the
public,
and
public
35
-14-
LSB
6002XC
(4)
86
tr/lh
14/
27
S.F.
_____
notice
of
meetings
shall
be
given
in
the
same
manner
as
1
required
under
the
rulemaking
provisions
in
article
VIII.
2
(5)
The
commission
may
convene
in
a
closed,
nonpublic
3
meeting
if
the
commission
must
discuss
any
of
the
following:
4
(a)
Noncompliance
of
a
party
state
with
its
obligations
5
under
this
compact.
6
(b)
The
employment,
compensation,
discipline
or
other
7
personnel
matters,
practices,
or
procedures
related
to
specific
8
employees;
or
other
matters
related
to
the
commission’s
9
internal
personnel
practices
and
procedures.
10
(c)
Current,
threatened,
or
reasonably
anticipated
11
litigation.
12
(d)
Negotiation
of
contracts
for
the
purchase
or
sale
of
13
goods,
services,
or
real
estate.
14
(e)
Accusations
against
any
person
of
a
crime
or
formal
15
censure
of
any
person.
16
(f)
Disclosure
of
trade
secrets
or
commercial
or
financial
17
information
that
is
privileged
or
confidential.
18
(g)
Disclosure
of
information
of
a
personal
nature
where
19
disclosure
would
constitute
a
clearly
unwarranted
invasion
of
20
personal
privacy.
21
(h)
Disclosure
of
investigatory
records
compiled
for
law
22
enforcement
purposes.
23
(i)
Disclosure
of
information
related
to
any
reports
24
prepared
by
or
on
behalf
of
the
commission
for
the
purpose
of
25
investigation
of
compliance
with
this
compact.
26
(j)
Matters
specifically
exempted
from
disclosure
by
27
federal
or
state
statute.
28
(6)
If
a
meeting,
or
portion
of
a
meeting,
is
closed
29
pursuant
to
this
provision,
the
commission’s
legal
counsel
or
30
designee
shall
certify
that
the
meeting
may
be
closed
and
shall
31
reference
each
relevant
exempting
provision.
The
commission
32
shall
keep
minutes
that
fully
and
clearly
describe
all
matters
33
discussed
in
a
meeting
and
shall
provide
a
full
and
accurate
34
summary
of
actions
taken,
and
the
reasons
therefor,
including
a
35
-15-
LSB
6002XC
(4)
86
tr/lh
15/
27
S.F.
_____
description
of
the
views
expressed.
All
documents
considered
1
in
connection
with
an
action
shall
be
identified
in
such
2
minutes.
All
minutes
and
documents
of
a
closed
meeting
shall
3
remain
under
seal,
subject
to
release
by
a
majority
vote
of
the
4
commission
or
order
of
a
court
of
competent
jurisdiction.
5
c.
Bylaws
and
rules.
The
commission
shall,
by
a
majority
6
vote
of
the
administrators,
prescribe
bylaws
or
rules
to
govern
7
its
conduct
as
may
be
necessary
or
appropriate
to
carry
out
the
8
purposes
and
exercise
the
powers
of
this
compact
including
but
9
not
limited
to
the
following:
10
(1)
Establishing
the
fiscal
year
of
the
commission.
11
(2)
Providing
reasonable
standards
and
procedures
for
the
12
establishment
and
meetings
of
other
committees,
and
governing
13
any
general
or
specific
delegation
of
any
authority
or
function
14
of
the
commission.
15
(3)
Providing
reasonable
procedures
for
calling
and
16
conducting
meetings
of
the
commission,
ensuring
reasonable
17
advance
notice
of
all
meetings,
and
providing
an
opportunity
18
for
attendance
of
such
meetings
by
interested
parties,
19
with
enumerated
exceptions
designed
to
protect
the
public’s
20
interest,
the
privacy
of
individuals,
and
proprietary
21
information,
including
trade
secrets.
The
commission
may
meet
22
in
closed
session
only
after
a
majority
of
the
administrators
23
vote
to
close
a
meeting
in
whole
or
in
part.
As
soon
as
24
practicable,
the
commission
must
make
public
a
copy
of
the
vote
25
to
close
the
meeting
revealing
the
vote
of
each
administrator,
26
with
no
proxy
votes
allowed.
27
(4)
Establishing
the
titles,
duties
and
authority,
and
28
reasonable
procedures
for
the
election
of
the
officers
of
the
29
commission.
30
(5)
Providing
reasonable
standards
and
procedures
for
the
31
establishment
of
the
personnel
policies
and
programs
of
the
32
commission.
Notwithstanding
any
civil
service
or
other
similar
33
laws
of
any
party
state,
the
bylaws
shall
exclusively
govern
34
the
personnel
policies
and
programs
of
the
commission.
35
-16-
LSB
6002XC
(4)
86
tr/lh
16/
27
S.F.
_____
(6)
Providing
a
mechanism
for
winding
up
the
operations
1
of
the
commission
and
the
equitable
disposition
of
any
2
surplus
funds
that
may
exist
after
the
termination
of
this
3
compact
after
the
payment
or
reserving
of
all
of
its
debts
and
4
obligations.
5
d.
Publication
of
bylaws
and
rules.
The
commission
shall
6
publish
its
bylaws
and
rules,
and
any
amendments
thereto,
in
a
7
convenient
form
on
the
website
of
the
commission.
8
e.
Financial
records.
The
commission
shall
maintain
its
9
financial
records
in
accordance
with
the
bylaws.
10
f.
Commission
actions.
The
commission
shall
meet
and
take
11
such
actions
as
are
consistent
with
the
provisions
of
this
12
compact
and
the
bylaws.
13
g.
Powers
of
commission.
The
commission
shall
have
the
14
following
powers:
15
(1)
To
promulgate
uniform
rules
to
facilitate
and
16
coordinate
implementation
and
administration
of
this
compact.
17
The
rules
shall
have
the
force
and
effect
of
law
and
shall
be
18
binding
in
all
party
states.
19
(2)
To
bring
and
prosecute
legal
proceedings
or
actions
in
20
the
name
of
the
commission,
provided
that
the
standing
of
any
21
licensing
board
to
sue
or
be
sued
under
applicable
law
shall
22
not
be
affected.
23
(3)
To
purchase
and
maintain
insurance
and
bonds.
24
(4)
To
borrow,
accept,
or
contract
for
services
of
25
personnel,
including
but
not
limited
to
employees
of
a
party
26
state
or
nonprofit
organizations.
27
(5)
To
cooperate
with
other
organizations
that
administer
28
state
compacts
related
to
the
regulation
of
nursing,
including
29
but
not
limited
to
sharing
administrative
or
staff
expenses,
30
office
space,
or
other
resources.
31
(6)
To
hire
employees,
elect
or
appoint
officers,
fix
32
compensation,
define
duties,
grant
such
individuals
appropriate
33
authority
to
carry
out
the
purposes
of
this
compact,
and
to
34
establish
the
commission’s
personnel
policies
and
programs
35
-17-
LSB
6002XC
(4)
86
tr/lh
17/
27
S.F.
_____
relating
to
conflicts
of
interest,
qualifications
of
personnel,
1
and
other
related
personnel
matters.
2
(7)
To
accept
any
and
all
appropriate
donations,
grants
and
3
gifts
of
money,
equipment,
supplies,
materials
and
services,
4
and
to
receive,
utilize,
and
dispose
of
the
same;
provided
5
that
at
all
times
the
commission
shall
strive
to
avoid
any
6
appearance
of
impropriety
or
conflict
of
interest.
7
(8)
To
lease,
purchase,
accept
appropriate
gifts
or
8
donations
of,
or
otherwise
own,
hold,
improve,
or
use,
any
9
property,
whether
real,
personal,
or
mixed,
provided
that
at
10
all
times
the
commission
shall
strive
to
avoid
any
appearance
11
of
impropriety.
12
(9)
To
sell,
convey,
mortgage,
pledge,
lease,
exchange,
13
abandon,
or
otherwise
dispose
of
any
property,
whether
real,
14
personal,
or
mixed.
15
(10)
To
establish
a
budget
and
make
expenditures.
16
(11)
To
borrow
money.
17
(12)
To
appoint
committees,
including
advisory
committees
18
comprised
of
administrators,
state
nursing
regulators,
state
19
legislators
or
their
representatives,
consumer
representatives,
20
and
other
interested
persons.
21
(13)
To
provide
and
receive
information
from,
and
to
22
cooperate
with,
law
enforcement
agencies.
23
(14)
To
adopt
and
use
an
official
seal.
24
(15)
To
perform
such
other
functions
as
may
be
necessary
or
25
appropriate
to
achieve
the
purposes
of
this
compact
consistent
26
with
the
state
regulation
of
advanced
practice
registered
nurse
27
licensure
and
practice.
28
h.
Financing
of
the
commission.
29
(1)
The
commission
shall
pay,
or
provide
for
the
payment
30
of,
the
reasonable
expenses
of
establishment,
organization,
and
31
ongoing
activities
of
the
commission.
32
(2)
The
commission
may
levy
on
and
collect
an
annual
33
assessment
from
each
party
state
to
cover
the
cost
of
the
34
operations
and
activities
of
the
interstate
commission
and
35
-18-
LSB
6002XC
(4)
86
tr/lh
18/
27
S.F.
_____
commission
staff
which
must
be
in
a
total
amount
sufficient
to
1
cover
its
annual
budget
as
approved
each
year.
The
aggregate
2
annual
assessment
amount
shall
be
allocated
based
upon
a
3
formula
to
be
determined
by
the
commission,
which
shall
4
promulgate
a
rule
that
is
binding
upon
all
party
states.
5
(3)
The
commission
shall
not
incur
obligations
of
any
kind
6
prior
to
securing
the
funds
adequate
to
meet
the
obligations;
7
nor
shall
the
commission
pledge
the
credit
of
any
of
the
party
8
states,
except
by,
and
with
the
authority
of,
such
party
state.
9
(4)
The
commission
shall
keep
accurate
accounts
of
all
10
receipts
and
disbursements.
The
receipts
and
disbursements
of
11
the
commission
shall
be
subject
to
the
audit
and
accounting
12
procedures
established
under
its
bylaws.
However,
all
receipts
13
and
disbursements
of
funds
handled
by
the
commission
shall
be
14
audited
yearly
by
a
certified
or
licensed
public
accountant,
15
and
the
report
of
the
audit
shall
be
included
in
and
become
16
part
of
the
annual
report
of
the
commission.
17
i.
Qualified
immunity,
defense,
and
indemnification.
18
(1)
The
administrators,
officers,
executive
director,
19
employees,
and
representatives
of
the
commission
shall
be
20
immune
from
suit
and
liability,
either
personally
or
in
their
21
official
capacity,
for
any
claim
for
damage
to
or
loss
of
22
property
or
personal
injury
or
other
civil
liability
caused
by
23
or
arising
out
of
any
actual
or
alleged
act,
error,
or
omission
24
that
occurred,
or
that
the
person
against
whom
the
claim
is
25
made
had
a
reasonable
basis
for
believing
occurred,
within
the
26
scope
of
commission
employment,
duties,
or
responsibilities;
27
provided,
that
nothing
in
this
paragraph
shall
be
construed
to
28
protect
any
such
person
from
suit
or
liability
for
any
damage,
29
loss,
injury,
or
liability
caused
by
the
intentional,
willful,
30
or
wanton
misconduct
of
that
person.
31
(2)
The
commission
shall
defend
any
administrator,
32
officer,
executive
director,
employee,
or
representative
of
33
the
commission
in
any
civil
action
seeking
to
impose
liability
34
arising
out
of
any
actual
or
alleged
act,
error,
or
omission
35
-19-
LSB
6002XC
(4)
86
tr/lh
19/
27
S.F.
_____
that
occurred
within
the
scope
of
commission
employment,
1
duties,
or
responsibilities,
or
that
the
person
against
2
whom
the
claim
is
made
had
a
reasonable
basis
for
believing
3
occurred
within
the
scope
of
commission
employment,
duties,
4
or
responsibilities;
provided,
that
nothing
in
this
paragraph
5
shall
be
construed
to
prohibit
that
person
from
retaining
his
6
or
her
own
counsel;
and
provided
further,
that
the
actual
7
or
alleged
act,
error,
or
omission
did
not
result
from
that
8
person’s
intentional,
willful,
or
wanton
misconduct.
9
(3)
The
commission
shall
indemnify
and
hold
harmless
10
any
administrator,
officer,
executive
director,
employee,
11
or
representative
of
the
commission
for
the
amount
of
any
12
settlement
or
judgment
obtained
against
that
person
arising
13
out
of
any
actual
or
alleged
act,
error,
or
omission
that
14
occurred
within
the
scope
of
commission
employment,
duties,
15
or
responsibilities,
or
that
the
person
had
a
reasonable
16
basis
for
believing
occurred
within
the
scope
of
commission
17
employment,
duties,
or
responsibilities,
provided
that
the
18
actual
or
alleged
act,
error,
or
omission
did
not
result
from
19
the
intentional,
willful,
or
wanton
misconduct
of
that
person.
20
8.
Article
VIII
——
Rulemaking.
21
a.
The
commission
shall
exercise
its
rulemaking
powers
22
pursuant
to
the
criteria
set
forth
in
this
article
and
the
23
rules
adopted
pursuant
to
the
criteria.
Rules
and
amendments
24
shall
become
binding
as
of
the
date
specified
in
each
rule
25
or
amendment
and
shall
have
the
same
force
and
effect
as
26
provisions
of
this
compact.
27
b.
Rules
or
amendments
to
the
rules
shall
be
adopted
at
a
28
regular
or
special
meeting
of
the
commission.
29
c.
Prior
to
promulgation
and
adoption
of
a
final
rule
or
30
rules
by
the
commission,
and
at
least
sixty
days
in
advance
31
of
the
meeting
at
which
the
rule
will
be
considered
and
voted
32
upon,
the
commission
shall
file
a
notice
of
proposed
rulemaking
33
on
both
of
the
following:
34
(1)
The
website
of
the
commission.
35
-20-
LSB
6002XC
(4)
86
tr/lh
20/
27
S.F.
_____
(2)
On
the
website
of
each
licensing
board
or
the
1
publication
in
which
each
state
would
otherwise
publish
2
proposed
rules.
3
d.
The
notice
of
proposed
rulemaking
shall
include
all
of
4
the
following:
5
(1)
The
proposed
time,
date,
and
location
of
the
meeting
in
6
which
the
rule
or
amendment
will
be
considered
and
voted
upon.
7
(2)
The
text
of
the
proposed
rule
or
amendment
and
the
8
reason
for
the
proposed
rule.
9
(3)
A
request
for
comments
on
the
proposed
rule
or
amendment
10
from
any
interested
person.
11
(4)
The
manner
in
which
interested
persons
may
submit
notice
12
to
the
commission
of
their
intention
to
attend
the
public
13
hearing
and
submit
any
written
comments.
14
e.
Prior
to
adoption
of
a
proposed
rule,
the
commission
15
shall
allow
persons
to
submit
written
data,
facts,
opinions,
16
and
arguments,
which
shall
be
made
available
to
the
public.
17
f.
The
commission
shall
grant
an
opportunity
for
a
public
18
hearing
before
the
commission
adopts
a
rule
or
amendment.
19
g.
The
commission
shall
publish
the
place,
time,
and
date
of
20
the
scheduled
public
hearing.
21
(1)
Hearings
shall
be
conducted
in
a
manner
providing
22
each
person
who
wishes
to
comment
a
fair
and
reasonable
23
opportunity
to
comment
orally
or
in
writing.
All
hearings
will
24
be
recorded,
and
a
copy
of
the
recording
will
be
made
available
25
upon
request.
26
(2)
Nothing
in
this
section
shall
be
construed
as
requiring
27
a
separate
hearing
on
each
rule.
Rules
may
be
grouped
for
the
28
convenience
of
the
commission
at
the
hearings
required
by
this
29
section.
30
h.
If
no
one
appears
at
the
public
hearing,
the
commission
31
may
proceed
with
promulgation
of
the
proposed
rule.
32
i.
Following
the
scheduled
hearing
date,
or
by
the
close
33
of
business
on
the
scheduled
hearing
date
if
the
hearing
was
34
not
held,
the
commission
shall
consider
all
written
and
oral
35
-21-
LSB
6002XC
(4)
86
tr/lh
21/
27
S.F.
_____
comments
received.
1
j.
The
commission
shall,
by
majority
vote
of
all
2
administrators,
take
final
action
on
the
proposed
rule
and
3
shall
determine
the
effective
date
of
the
rule,
if
any,
based
4
on
the
rulemaking
record
and
the
full
text
of
the
rule.
5
k.
Upon
determination
that
an
emergency
exists,
the
6
commission
may
consider
and
adopt
an
emergency
rule
without
7
prior
notice,
opportunity
for
comment,
or
hearing,
provided
8
that
the
usual
rulemaking
procedures
provided
in
this
compact
9
and
in
this
section
shall
be
retroactively
applied
to
the
rule
10
as
soon
as
reasonably
possible,
and
in
no
event
later
than
11
ninety
days
after
the
effective
date
of
the
rule.
For
the
12
purposes
of
this
provision,
an
emergency
rule
is
one
that
must
13
be
adopted
immediately
in
order
to
do
any
of
the
following:
14
(1)
Meet
an
imminent
threat
to
public
health,
safety,
or
15
welfare.
16
(2)
Prevent
a
loss
of
commission
or
party
state
funds.
17
(3)
Meet
a
deadline
for
the
promulgation
of
an
18
administrative
rule
that
is
established
by
federal
law
or
rule.
19
l.
The
commission
may
direct
revisions
to
a
previously
20
adopted
rule
or
amendment
for
purposes
of
correcting
21
typographical
errors,
errors
in
format,
errors
in
consistency,
22
or
grammatical
errors.
Public
notice
of
any
revisions
shall
be
23
posted
on
the
website
of
the
commission.
The
revision
shall
24
be
subject
to
challenge
by
any
person
for
a
period
of
thirty
25
days
after
posting.
The
revision
may
be
challenged
only
on
26
grounds
that
the
revision
results
in
a
material
change
to
a
27
rule.
A
challenge
shall
be
made
in
writing,
and
delivered
to
28
the
commission,
prior
to
the
end
of
the
notice
period.
If
29
no
challenge
is
made,
the
revision
will
take
effect
without
30
further
action.
If
the
revision
is
challenged,
the
revision
31
shall
not
take
effect
without
the
approval
of
the
commission.
32
9.
Article
IX
——
Oversight,
dispute
resolution,
and
33
enforcement.
34
a.
Oversight.
35
-22-
LSB
6002XC
(4)
86
tr/lh
22/
27
S.F.
_____
(1)
Each
party
state
shall
enforce
this
compact
and
take
all
1
actions
necessary
and
appropriate
to
effectuate
this
compact’s
2
purposes
and
intent.
3
(2)
The
commission
shall
be
entitled
to
receive
service
4
of
process
in
any
proceeding
that
may
affect
the
powers,
5
responsibilities,
or
actions
of
the
commission,
and
shall
have
6
standing
to
intervene
in
such
a
proceeding
for
all
purposes.
7
Failure
to
provide
service
of
process
to
the
commission
shall
8
render
a
judgment
or
order
void
as
to
the
commission,
this
9
compact,
or
promulgated
rules.
10
b.
Default,
technical
assistance,
and
termination.
11
(1)
If
the
commission
determines
that
a
party
state
12
has
defaulted
in
the
performance
of
its
obligations
or
13
responsibilities
under
this
compact
or
the
promulgated
rules,
14
the
commission
shall
do
the
following:
15
(a)
Provide
written
notice
to
the
defaulting
state
and
other
16
party
states
of
the
nature
of
the
default,
the
proposed
means
17
of
curing
the
default,
or
any
other
action
to
be
taken
by
the
18
commission.
19
(b)
Provide
remedial
training
and
specific
technical
20
assistance
regarding
the
default.
21
(2)
If
a
state
in
default
fails
to
cure
the
default,
the
22
defaulting
state’s
membership
in
this
compact
may
be
terminated
23
upon
an
affirmative
vote
of
a
majority
of
the
administrators,
24
and
all
rights,
privileges,
and
benefits
conferred
by
this
25
compact
may
be
terminated
on
the
effective
date
of
termination.
26
A
cure
of
the
default
does
not
relieve
the
offending
state
27
of
obligations
or
liabilities
incurred
during
the
period
of
28
default.
29
(3)
Termination
of
membership
in
this
compact
shall
be
30
imposed
only
after
all
other
means
of
securing
compliance
have
31
been
exhausted.
Notice
of
intent
to
suspend
or
terminate
shall
32
be
given
by
the
commission
to
the
governor
of
the
defaulting
33
state,
the
executive
officer
of
the
defaulting
state’s
34
licensing
board,
the
defaulting
state’s
licensing
board,
and
35
-23-
LSB
6002XC
(4)
86
tr/lh
23/
27
S.F.
_____
each
of
the
party
states.
1
(4)
A
state
whose
membership
in
this
compact
has
been
2
terminated
is
responsible
for
all
assessments,
obligations,
and
3
liabilities
incurred
through
the
effective
date
of
termination,
4
including
obligations
that
extend
beyond
the
effective
date
of
5
termination.
6
(5)
The
commission
shall
not
bear
any
costs
related
to
a
7
state
that
is
found
to
be
in
default
or
whose
membership
in
8
this
compact
has
been
terminated,
unless
agreed
upon
in
writing
9
between
the
commission
and
the
defaulting
state.
10
(6)
The
defaulting
state
may
appeal
the
action
of
the
11
commission
by
petitioning
the
United
States
district
court
12
for
the
District
of
Columbia
or
the
federal
district
in
which
13
the
commission
has
its
principal
offices.
The
prevailing
14
party
shall
be
awarded
all
costs
of
such
litigation,
including
15
reasonable
attorney
fees.
16
c.
Dispute
resolution.
17
(1)
Upon
request
by
a
party
state,
the
commission
shall
18
attempt
to
resolve
disputes
related
to
the
compact
that
arise
19
among
party
states
and
between
party
and
nonparty
states.
20
(2)
The
commission
shall
promulgate
a
rule
providing
for
21
both
mediation
and
binding
dispute
resolution
for
disputes,
as
22
appropriate.
23
(3)
In
the
event
the
commission
cannot
resolve
disputes
24
among
party
states
arising
under
this
compact:
25
(a)
The
party
states
may
submit
the
issues
in
dispute
to
26
an
arbitration
panel,
which
will
be
comprised
of
individuals
27
appointed
by
the
compact
administrator
in
each
of
the
affected
28
party
states
and
an
individual
mutually
agreed
upon
by
the
29
compact
administrators
of
all
the
party
states
involved
in
the
30
dispute.
31
(b)
The
decision
of
a
majority
of
the
arbitrators
shall
be
32
final
and
binding.
33
d.
Enforcement.
34
(1)
The
commission,
in
the
reasonable
exercise
of
its
35
-24-
LSB
6002XC
(4)
86
tr/lh
24/
27
S.F.
_____
discretion,
shall
enforce
the
provisions
and
rules
of
this
1
compact.
2
(2)
By
majority
vote,
the
commission
may
initiate
legal
3
action
in
the
United
States
district
court
for
the
District
of
4
Columbia
or
the
federal
district
in
which
the
commission
has
5
its
principal
offices
against
a
party
state
that
is
in
default
6
to
enforce
compliance
with
the
provisions
of
this
compact
and
7
the
commission’s
promulgated
rules
and
bylaws.
The
relief
8
sought
may
include
both
injunctive
relief
and
damages.
In
9
the
event
judicial
enforcement
is
necessary,
the
prevailing
10
party
shall
be
awarded
all
costs
of
such
litigation,
including
11
reasonable
attorney
fees.
12
(3)
The
remedies
in
this
article
shall
not
be
the
exclusive
13
remedies
of
the
commission.
The
commission
may
pursue
any
14
other
remedies
available
under
federal
or
state
law.
15
10.
ARTICLE
X
——
Effective
date,
withdrawal,
and
amendment.
16
a.
This
compact
shall
come
into
limited
effect
at
such
17
time
as
this
compact
has
been
enacted
into
law
in
ten
party
18
states
for
the
sole
purpose
of
establishing
and
convening
the
19
commission
to
adopt
rules
relating
to
the
operation
of
the
20
compact
and
the
advanced
practice
registered
nurse
uniform
21
licensure
requirements.
22
b.
On
the
date
of
the
commission’s
adoption
of
the
advanced
23
practice
registered
nurse
uniform
licensure
requirements,
all
24
remaining
provisions
of
this
compact,
and
rules
adopted
by
the
25
commission,
shall
come
into
full
force
and
effect
in
all
party
26
states.
27
c.
Any
state
that
joins
this
compact
subsequent
to
the
28
commission’s
initial
adoption
of
the
advanced
practice
29
registered
nurse
uniform
licensure
requirements
shall
be
30
subject
to
all
rules
that
have
been
previously
adopted
by
the
31
commission.
32
d.
Any
party
state
may
withdraw
from
this
compact
by
33
enacting
a
statute
repealing
the
compact.
A
party
state’s
34
withdrawal
shall
not
take
effect
until
six
months
after
35
-25-
LSB
6002XC
(4)
86
tr/lh
25/
27
S.F.
_____
enactment
of
the
repealing
statute.
1
e.
A
party
state’s
withdrawal
or
termination
shall
not
2
affect
the
continuing
requirement
of
the
withdrawing
or
3
terminated
state’s
licensing
board
to
report
adverse
actions
4
and
significant
investigations
occurring
prior
to
the
effective
5
date
of
the
withdrawal
or
termination.
6
f.
Nothing
contained
in
this
compact
shall
be
construed
to
7
invalidate
or
prevent
any
advanced
practice
registered
nurse
8
licensure
agreement
or
other
cooperative
arrangement
between
a
9
party
state
and
a
nonparty
state
that
does
not
conflict
with
10
the
provisions
of
this
compact.
11
g.
This
compact
may
be
amended
by
the
party
states.
No
12
amendment
to
this
compact
shall
become
effective
and
binding
13
upon
any
party
state
until
the
amendment
is
enacted
into
the
14
laws
of
all
party
states.
15
h.
Representatives
of
nonparty
states
to
this
compact
shall
16
be
invited
to
participate
in
the
activities
of
the
commission,
17
on
a
nonvoting
basis,
prior
to
the
adoption
of
this
compact
by
18
all
states.
19
11.
Article
XI
——
Construction
and
severability.
20
This
compact
shall
be
liberally
construed
so
as
to
21
effectuate
the
purposes
of
the
compact.
The
provisions
of
22
this
compact
shall
be
severable,
and
if
any
phrase,
clause,
23
sentence,
or
provision
of
this
compact
is
declared
to
be
24
contrary
to
the
constitution
of
any
party
state
or
of
the
25
United
States,
or
if
the
applicability
of
the
compact
to
26
any
government,
agency,
person,
or
circumstance
is
held
27
invalid,
the
validity
of
the
remainder
of
this
compact
and
the
28
applicability
of
the
compact
to
any
government,
agency,
person,
29
or
circumstance
shall
not
be
affected
thereby.
If
this
compact
30
shall
be
held
to
be
contrary
to
the
constitution
of
any
party
31
state,
this
compact
shall
remain
in
full
force
and
effect
as
to
32
the
remaining
party
states
and
in
full
force
and
effect
as
to
33
the
party
state
affected
as
to
all
severable
matters.
34
EXPLANATION
35
-26-
LSB
6002XC
(4)
86
tr/lh
26/
27
S.F.
_____
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
1
the
explanation’s
substance
by
the
members
of
the
general
assembly.
2
This
bill
updates
the
advanced
practice
registered
nurse
3
interstate
compact,
currently
codified
as
Code
section
152E.3.
4
The
bill
revises
and
provides
new
definitions
for
the
compact.
5
The
bill
sets
forth
an
application
process
for
advanced
6
practice
registered
nurses
to
seek
multistate
licensure
and
7
provides
for
a
coordinated
licensure
information
system
and
8
exchange
of
information
between
party
states
under
the
compact.
9
The
bill
establishes
a
commission
jointly
with
other
states
who
10
have
adopted
the
compact
to
administer
the
compact.
The
bill
11
provides
rulemaking
authority
to
the
commission
and
creates
12
dispute
resolution
and
enforcement
procedures.
The
bill
13
provides
for
withdrawal
from
or
amendment
to
the
compact.
14
-27-
LSB
6002XC
(4)
86
tr/lh
27/
27