House File 394 - Introduced HOUSE FILE 394 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HSB 98) A BILL FOR An Act relating to the nurse licensure compact, including 1 provisions for assessments against party states, and 2 including effective date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1078HV (1) 87 tr/nh
H.F. 394 Section 1. Section 152E.1, Code 2017, is amended by striking 1 the section and inserting in lieu thereof the following: 2 152E.1 Form of compact. 3 1. Article I —— Findings and declaration of purpose. 4 a. The party states find that: 5 (1) The health and safety of the public are affected by the 6 degree of compliance with and the effectiveness of enforcement 7 activities related to state nurse licensure laws. 8 (2) Violations of nurse licensure and other laws regulating 9 the practice of nursing may result in injury or harm to the 10 public. 11 (3) The expanded mobility of nurses and the use of advanced 12 communication technologies as part of our nation’s health care 13 delivery system require greater coordination and cooperation 14 among states in the areas of nurse licensure and regulation. 15 (4) New practice modalities and technology make compliance 16 with individual state nurse licensure laws difficult and 17 complex. 18 (5) The current system of duplicative licensure for nurses 19 practicing in multiple states is cumbersome and redundant for 20 both nurses and states. 21 (6) Uniformity of nurse licensure requirements throughout 22 the states promotes public safety and public health benefits. 23 b. The general purposes of this compact are to: 24 (1) Facilitate the states’ responsibility to protect the 25 public’s health and safety. 26 (2) Ensure and encourage the cooperation of party states in 27 the areas of nurse licensure and regulation. 28 (3) Facilitate the exchange of information between party 29 states in the areas of nurse regulation, investigation, and 30 adverse actions. 31 (4) Promote compliance with the laws governing the practice 32 of nursing in each jurisdiction. 33 (5) Invest all party states with the authority to hold 34 a nurse accountable for meeting all state practice laws in 35 -1- LSB 1078HV (1) 87 tr/nh 1/ 25
H.F. 394 the state in which the patient is located at the time care 1 is rendered through the mutual recognition of party state 2 licenses. 3 (6) Decrease redundancies in the consideration and issuance 4 of nurse licenses. 5 (7) Provide opportunities for interstate practice by nurses 6 who meet uniform licensure requirements. 7 2. Article II —— Definitions. As used in this compact: 8 a. “Adverse action” means any administrative, civil, 9 equitable, or criminal action permitted by a state’s laws which 10 is imposed by a licensing board or other authority against a 11 nurse, including actions against an individual’s license or 12 multistate licensure privilege such as revocation, suspension, 13 probation, monitoring of the licensee, limitation on the 14 licensee’s practice, or any other encumbrance on licensure 15 affecting a nurse’s authorization to practice, including 16 issuance of a cease and desist action. 17 b. “Alternative program” means a nondisciplinary monitoring 18 program approved by a licensing board. 19 c. “Coordinated licensure information system” means an 20 integrated process for collecting, storing, and sharing 21 information on nurse licensure and enforcement activities 22 related to nurse licensure laws that is administered by a 23 nonprofit organization composed of and controlled by licensing 24 boards. 25 d. “Current significant investigative information” means 26 either of the following: 27 (1) Investigative information that a licensing board, 28 after a preliminary inquiry that includes notification and an 29 opportunity for the nurse to respond, if required by state law, 30 has reason to believe is not groundless and, if proved true, 31 would indicate more than a minor infraction. 32 (2) Investigative information that indicates that the nurse 33 represents an immediate threat to public health and safety 34 regardless of whether the nurse has been notified and had an 35 -2- LSB 1078HV (1) 87 tr/nh 2/ 25
H.F. 394 opportunity to respond. 1 e. “Encumbrance” means a revocation or suspension of, or any 2 limitation on, the full and unrestricted practice of nursing 3 imposed by a licensing board. 4 f. “Home state” means the party state which is the nurse’s 5 primary state of residence. 6 g. “Licensing board” means a party state’s regulatory body 7 responsible for issuing nurse licenses. 8 h. “Multistate license” means a license to practice as a 9 registered or a licensed practical or vocational nurse issued 10 by a home state licensing board that authorizes the licensed 11 nurse to practice in all party states under a multistate 12 licensure privilege. 13 i. “Multistate licensure privilege” means a legal 14 authorization associated with a multistate license permitting 15 the practice of nursing as either a registered nurse or a 16 licensed practical or vocational nurse in a remote state. 17 j. “Nurse” means a registered nurse or licensed practical 18 or vocational nurse, as those terms are defined by each party 19 state’s practice laws. 20 k. “Party state” means any state that has adopted this 21 compact. 22 l. “Remote state” means a party state other than the home 23 state. 24 m. “Single-state license” means a nurse license issued by a 25 party state that authorizes practice only within the issuing 26 state and does not include a multistate licensure privilege to 27 practice in any other party state. 28 n. “State” means a state, territory, or possession of the 29 United States and the District of Columbia. 30 o. “State practice laws” means a party state’s laws, 31 rules, and regulations that govern the practice of nursing, 32 define the scope of nursing practice, and create the methods 33 and grounds for imposing discipline. “State practice laws” 34 does not include the initial qualifications for licensure or 35 -3- LSB 1078HV (1) 87 tr/nh 3/ 25
H.F. 394 requirements necessary to obtain and retain a license, except 1 for qualifications or requirements of the home state. 2 3. Article III —— General provisions and jurisdiction. 3 a. A multistate license to practice registered or licensed 4 practical or vocational nursing issued by a home state to a 5 resident in that state will be recognized by each party state 6 as authorizing a nurse to practice as a registered nurse or as 7 a licensed practical or vocational nurse, under a multistate 8 licensure privilege, in each party state. 9 b. A state must implement procedures for considering the 10 criminal history records of applicants for initial multistate 11 license or licensure by endorsement. Such procedures shall 12 include the submission of fingerprints or other biometric-based 13 information by applicants for the purpose of obtaining an 14 applicant’s criminal history record information from the 15 federal bureau of investigation and the agency responsible for 16 retaining that state’s criminal records. 17 c. Each party state shall require all of the following for 18 an applicant to obtain or retain a multistate license in the 19 home state: 20 (1) Meets the home state’s qualifications for licensure or 21 renewal of licensure, as well as all other applicable state 22 laws. 23 (2) Either of the following: 24 (a) Has graduated or is eligible to graduate from a 25 licensing board-approved registered nurse or licensed practical 26 or vocational nurse prelicensure education program. 27 (b) Has graduated from a foreign registered nurse or 28 licensed practical or vocational nurse prelicensure program 29 that meets both of the following requirements: 30 (i) Has been approved by the authorized accrediting body in 31 the applicable country. 32 (ii) Has been verified by an independent credentials 33 review agency to be comparable to a licensing board-approved 34 prelicensure education program. 35 -4- LSB 1078HV (1) 87 tr/nh 4/ 25
H.F. 394 (3) Has, if a graduate of a foreign prelicensure education 1 program not taught in English or if English is not the 2 individual’s native language, successfully passed an English 3 proficiency examination that includes the components of 4 reading, speaking, writing, and listening. 5 (4) Has successfully passed a national council licensure 6 examination —— registered nurse or national council licensure 7 examination —— practical nurse examination or recognized 8 predecessor, as applicable. 9 (5) Is eligible for or holds an active, unencumbered 10 license. 11 (6) Has submitted in connection with an application for 12 initial licensure or licensure by endorsement, fingerprints 13 or other biometric data for the purpose of obtaining criminal 14 history record information from the federal bureau of 15 investigation and the agency responsible for retaining that 16 state’s criminal records. 17 (7) Has not been convicted or found guilty, or has 18 entered into an agreed disposition, of a felony offense under 19 applicable state or federal criminal law. 20 (8) Has not been convicted or found guilty, or has entered 21 into an agreed disposition, of a misdemeanor offense related to 22 the practice of nursing as determined on a case-by-case basis. 23 (9) Is not currently enrolled in an alternative program. 24 (10) Is subject to self-disclosure requirements regarding 25 current participation in an alternative program. 26 (11) Has a valid United States social security number. 27 d. All party states shall be authorized, in accordance 28 with existing state due process law, to take adverse action 29 against a nurse’s multistate licensure privilege such as 30 revocation, suspension, probation, or any other action that 31 affects a nurse’s authorization to practice under a multistate 32 licensure privilege, including cease and desist actions. If 33 a party state takes such action, it shall promptly notify the 34 administrator of the coordinated licensure information system. 35 -5- LSB 1078HV (1) 87 tr/nh 5/ 25
H.F. 394 The administrator of the coordinated licensure information 1 system shall promptly notify the home state of any such actions 2 by remote states. 3 e. A nurse practicing in a party state must comply with the 4 state practice laws of the state in which the client is located 5 at the time service is provided. The practice of nursing is 6 not limited to patient care, but shall include all nursing 7 practice as defined by the state practice laws of the party 8 state in which the client is located. The practice of nursing 9 in a party state under a multistate licensure privilege will 10 subject a nurse to the jurisdiction of the licensing board, the 11 courts, and the laws of the party state in which the client is 12 located at the time service is provided. 13 f. Individuals not residing in a party state shall continue 14 to be able to apply for a party state’s single-state license 15 as provided under the laws of each party state. However, the 16 single-state license granted to these individuals will not be 17 recognized as granting the privilege to practice nursing in any 18 other party state. Nothing in this compact shall affect the 19 requirements established by a party state for the issuance of 20 a single-state license. 21 g. Any nurse holding a home state multistate license on 22 the effective date of this compact may retain and renew the 23 multistate license issued by the nurse’s then-current home 24 state, provided that: 25 (1) A nurse who changes primary state of residence after 26 this compact’s effective date must meet all applicable 27 requirements in article III, paragraph “c” , to obtain a 28 multistate license from a new home state. 29 (2) A nurse who fails to satisfy the multistate licensure 30 requirements in article III, paragraph “c” , due to a 31 disqualifying event occurring after this compact’s effective 32 date shall be ineligible to retain or renew a multistate 33 license, and the nurse’s multistate license shall be revoked or 34 deactivated in accordance with applicable rules adopted by the 35 -6- LSB 1078HV (1) 87 tr/nh 6/ 25
H.F. 394 commission. 1 4. Article IV —— Applications for licensure in a party state. 2 a. Upon application for a multistate license, the licensing 3 board in the issuing party state shall ascertain, through the 4 coordinated licensure information system, whether the applicant 5 has ever held, or is the holder of, a license issued by any 6 other state, whether there are any encumbrances on any license 7 or multistate licensure privilege held by the applicant, 8 whether any adverse action has been taken against any license 9 or multistate licensure privilege held by the applicant 10 and whether the applicant is currently participating in an 11 alternative program. 12 b. A nurse may hold a multistate license, issued by the home 13 state, in only one party state at a time. 14 c. If a nurse changes primary state of residence by moving 15 between two party states, the nurse must apply for licensure 16 in the new home state, and the multistate license issued by 17 the prior home state will be deactivated in accordance with 18 applicable rules adopted by the commission. 19 (1) The nurse may apply for licensure in advance of a change 20 in the primary state of residence. 21 (2) A multistate license shall not be issued by the new 22 home state until the nurse provides satisfactory evidence of a 23 change in primary state of residence to the new home state and 24 satisfies all applicable requirements to obtain a multistate 25 license from the new home state. 26 d. If a nurse changes primary state of residence by moving 27 from a party state to a nonparty state, the multistate license 28 issued by the prior home state will convert to a single-state 29 license, valid only in the former home state. 30 5. Article V —— Additional authorities invested in party 31 state licensing boards. 32 a. In addition to the other powers conferred by state law, 33 a licensing board shall have the authority to do all of the 34 following: 35 -7- LSB 1078HV (1) 87 tr/nh 7/ 25
H.F. 394 (1) Take adverse action against a nurse’s multistate 1 licensure privilege to practice within that party state. 2 (a) Only the home state shall have the power to take adverse 3 action against a nurse’s license issued by the home state. 4 (b) For purposes of taking adverse action, the home state 5 licensing board shall give the same priority and effect to 6 reported conduct received from a remote state as it would if 7 such conduct had occurred within the home state. In so doing, 8 the home state shall apply its own state laws to determine 9 appropriate action. 10 (2) Issue cease and desist orders or impose an encumbrance 11 on a nurse’s authority to practice within that party state. 12 (3) Complete any pending investigations of a nurse who 13 changes primary state of residence during the course of such 14 investigations. The licensing board shall also have the 15 authority to take appropriate action and shall promptly report 16 the conclusions of such investigations to the administrator 17 of the coordinated licensure information system. The 18 administrator of the coordinated licensure information system 19 shall promptly notify the new home state of any such actions. 20 (4) Issue subpoenas for both hearings and investigations 21 that require the attendance and testimony of witnesses, as well 22 as the production of evidence. Subpoenas issued by a licensing 23 board in a party state for the attendance and testimony of 24 witnesses or the production of evidence from another party 25 state shall be enforced in the latter state by any court of 26 competent jurisdiction, according to the practice and procedure 27 of that court applicable to subpoenas issued in proceedings 28 pending before it. The issuing authority shall pay any witness 29 fees, travel expenses, mileage, and other fees required by 30 the service statutes of the state in which the witnesses or 31 evidence are located. 32 (5) Obtain and submit, for each nurse licensure applicant, 33 fingerprint or other biometric-based information to the federal 34 bureau of investigation for criminal background checks, receive 35 -8- LSB 1078HV (1) 87 tr/nh 8/ 25
H.F. 394 the results of the federal bureau of investigation record 1 search on criminal background checks, and use the results in 2 making licensure decisions. 3 (6) If otherwise permitted by state law, recover from the 4 affected nurse the costs of investigations and disposition of 5 cases resulting from any adverse action taken against that 6 nurse. 7 (7) Take adverse action based on the factual findings of the 8 remote state, provided that the licensing board follows its own 9 procedures for taking such adverse action. 10 b. If adverse action is taken by the home state against a 11 nurse’s multistate license, the nurse’s multistate licensure 12 privilege to practice in all other party states shall be 13 deactivated until all encumbrances have been removed from the 14 multistate license. All home state disciplinary orders that 15 impose adverse action against a nurse’s multistate license 16 shall include a statement that the nurse’s multistate licensure 17 privilege is deactivated in all party states during the 18 pendency of the order. 19 c. Nothing in this compact shall override a party state’s 20 decision that participation in an alternative program may be 21 used in lieu of adverse action. The home state licensing board 22 shall deactivate the multistate licensure privilege under the 23 multistate license of any nurse for the duration of the nurse’s 24 participation in an alternative program. 25 6. Article VI —— Coordinated licensure information system and 26 exchange of information. 27 a. All party states shall participate in a coordinated 28 licensure information system of all licensed registered nurses 29 and licensed practical or vocational nurses. This system will 30 include information on the licensure and disciplinary history 31 of each nurse, as submitted by party states, to assist in the 32 coordination of nurse licensure and enforcement efforts. 33 b. The commission, in consultation with the administrator of 34 the coordinated licensure information system, shall formulate 35 -9- LSB 1078HV (1) 87 tr/nh 9/ 25
H.F. 394 necessary and proper procedures for the identification, 1 collection, and exchange of information under this compact. 2 c. All licensing boards shall promptly report to the 3 coordinated licensure information system any adverse action, 4 any current significant investigative information, denials 5 of applications with the reasons for such denials and nurse 6 participation in alternative programs known to the licensing 7 board regardless of whether such participation is deemed 8 nonpublic or confidential under state law. 9 d. Current significant investigative information and 10 participation in nonpublic or confidential alternative 11 programs shall be transmitted through the coordinated licensure 12 information system only to party state licensing boards. 13 e. Notwithstanding any other provision of law, all 14 party state licensing boards contributing information to 15 the coordinated licensure information system may designate 16 information that may not be shared with nonparty states or 17 disclosed to other entities or individuals without the express 18 permission of the contributing state. 19 f. Any personally identifiable information obtained from 20 the coordinated licensure information system by a party state 21 licensing board shall not be shared with nonparty states or 22 disclosed to other entities or individuals except to the extent 23 permitted by the laws of the party state contributing the 24 information. 25 g. Any information contributed to the coordinated licensure 26 information system that is subsequently required to be expunged 27 by the laws of the party state contributing that information 28 shall also be expunged from the coordinated licensure 29 information system. 30 h. The compact administrator of each party state shall 31 furnish a uniform data set to the compact administrator of each 32 other party state, which shall include but not be limited to 33 the following: 34 (1) Identifying information. 35 -10- LSB 1078HV (1) 87 tr/nh 10/ 25
H.F. 394 (2) Licensure data. 1 (3) Information related to alternative program 2 participation. 3 (4) Other information that may facilitate the 4 administration of this compact, as determined by commission 5 rules. 6 i. The compact administrator of a party state shall provide 7 all investigative documents and information requested by 8 another party state. 9 7. Article VII —— Establishment of the interstate commission 10 of nurse licensure compact administrators. 11 a. The party states hereby create and establish a joint 12 public entity known as the interstate commission of nurse 13 licensure compact administrators. 14 (1) The commission is an instrumentality of the party 15 states. 16 (2) Venue is proper, and judicial proceedings by or against 17 the commission shall be brought solely and exclusively, in a 18 court of competent jurisdiction where the principal office of 19 the commission is located. The commission may waive venue and 20 jurisdictional defenses to the extent it adopts or consents to 21 participate in alternative dispute resolution proceedings. 22 (3) Nothing in this compact shall be construed to be a 23 waiver of sovereign immunity. 24 b. Membership, voting, and meetings. 25 (1) Each party state shall have and be limited to one 26 administrator. The head of the state licensing board or 27 designee shall be the administrator of this compact for each 28 party state. Any administrator may be removed or suspended 29 from office as provided by the law of the state from which 30 the administrator is appointed. Any vacancy occurring in the 31 commission shall be filled in accordance with the laws of the 32 party state in which the vacancy exists. 33 (2) Each administrator shall be entitled to one vote with 34 regard to the promulgation of rules and creation of bylaws 35 -11- LSB 1078HV (1) 87 tr/nh 11/ 25
H.F. 394 and shall otherwise have an opportunity to participate in the 1 business and affairs of the commission. An administrator 2 shall vote in person or by such other means as provided in 3 the bylaws. The bylaws may provide for an administrator’s 4 participation in meetings by telephone or other means of 5 communication. 6 (3) The commission shall meet at least once during each 7 calendar year. Additional meetings shall be held as set forth 8 in the bylaws or rules of the commission. 9 (4) All meetings shall be open to the public, and public 10 notice of meetings shall be given in the same manner as 11 required under the rulemaking provisions in article VIII. 12 (5) The commission may convene in a closed, nonpublic 13 meeting if the commission must discuss any of the following: 14 (a) Noncompliance of a party state with its obligations 15 under this compact. 16 (b) The employment, compensation, discipline, or other 17 personnel matters, practices, or procedures related to specific 18 employees or other matters related to the commission’s internal 19 personnel practices and procedures. 20 (c) Current, threatened, or reasonably anticipated 21 litigation. 22 (d) Negotiation of contracts for the purchase or sale of 23 goods, services, or real estate. 24 (e) Accusing any person of a crime or formally censuring any 25 person. 26 (f) Disclosure of trade secrets or commercial or financial 27 information that is privileged or confidential. 28 (g) Disclosure of information of a personal nature where 29 disclosure would constitute a clearly unwarranted invasion of 30 personal privacy. 31 (h) Disclosure of investigatory records compiled for law 32 enforcement purposes. 33 (i) Disclosure of information related to any reports 34 prepared by or on behalf of the commission for the purpose of 35 -12- LSB 1078HV (1) 87 tr/nh 12/ 25
H.F. 394 investigation of compliance with this compact. 1 (j) Matters specifically exempted from disclosure by 2 federal or state statute. 3 (6) If a meeting, or portion of a meeting, is closed 4 pursuant to this provision, the commission’s legal counsel or 5 designee shall certify that the meeting may be closed and shall 6 reference each relevant exempting provision. The commission 7 shall keep minutes that fully and clearly describe all matters 8 discussed in a meeting and shall provide a full and accurate 9 summary of actions taken, and the reasons therefor, including a 10 description of the views expressed. All documents considered 11 in connection with an action shall be identified in such 12 minutes. All minutes and documents of a closed meeting shall 13 remain under seal, subject to release by a majority vote of the 14 commission or order of a court of competent jurisdiction. 15 c. The commission shall, by a majority vote of the 16 administrators, prescribe bylaws or rules to govern its conduct 17 as may be necessary or appropriate to carry out the purposes 18 and exercise the powers of this compact, including but not 19 limited to any of the following: 20 (1) Establishing the fiscal year of the commission. 21 (2) Providing reasonable standards and procedures for both 22 of the following: 23 (a) The establishment and meetings of other committees. 24 (b) Governing any general or specific delegation of any 25 authority or function of the commission. 26 (3) Providing reasonable procedures for calling and 27 conducting meetings of the commission, ensuring reasonable 28 advance notice of all meetings, and providing an opportunity 29 for attendance of such meetings by interested parties, 30 with enumerated exceptions designed to protect the public’s 31 interest, the privacy of individuals, and proprietary 32 information, including trade secrets. The commission may meet 33 in closed session only after a majority of the administrators 34 vote to close a meeting in whole or in part. As soon as 35 -13- LSB 1078HV (1) 87 tr/nh 13/ 25
H.F. 394 practicable, the commission must make public a copy of the vote 1 to close the meeting revealing the vote of each administrator, 2 with no proxy votes allowed. 3 (4) Establishing the titles, duties, and authority and 4 reasonable procedures for the election of the officers of the 5 commission. 6 (5) Providing reasonable standards and procedures for the 7 establishment of the personnel policies and programs of the 8 commission. Notwithstanding any civil service or other similar 9 laws of any party state, the bylaws shall exclusively govern 10 the personnel policies and programs of the commission. 11 (6) Providing a mechanism for winding up the operations 12 of the commission and the equitable disposition of any 13 surplus funds that may exist after the termination of this 14 compact after the payment or reserving of all of its debts and 15 obligations. 16 d. The commission shall publish its bylaws and rules, and 17 any amendments thereto, in a convenient form on the internet 18 site of the commission. 19 e. The commission shall maintain its financial records in 20 accordance with the bylaws. 21 f. The commission shall meet and take such actions as are 22 consistent with the provisions of this compact and the bylaws. 23 g. The commission shall have the following powers: 24 (1) To promulgate uniform rules to facilitate and 25 coordinate implementation and administration of this compact. 26 The rules shall have the force and effect of law and shall be 27 binding in all party states. 28 (2) To bring and prosecute legal proceedings or actions in 29 the name of the commission, provided that the standing of any 30 licensing board to sue or be sued under applicable law shall 31 not be affected. 32 (3) To purchase and maintain insurance and bonds. 33 (4) To borrow, accept, or contract for services of 34 personnel, including but not limited to employees of a party 35 -14- LSB 1078HV (1) 87 tr/nh 14/ 25
H.F. 394 state or nonprofit organizations. 1 (5) To cooperate with other organizations that administer 2 state compacts related to the regulation of nursing, including 3 but not limited to sharing administrative or staff expenses, 4 office space or other resources. 5 (6) To hire employees, elect or appoint officers, fix 6 compensation, define duties, grant such individuals appropriate 7 authority to carry out the purposes of this compact, and to 8 establish the commission’s personnel policies and programs 9 relating to conflicts of interest, qualifications of personnel, 10 and other related personnel matters. 11 (7) To accept any and all appropriate donations, grants and 12 gifts of money, equipment, supplies, materials, and services, 13 and to receive, utilize, and dispose of the same; provided 14 that at all times the commission shall avoid any appearance of 15 impropriety or conflict of interest. 16 (8) To lease, purchase, accept appropriate gifts or 17 donations of, or otherwise to own, hold, improve, or use, any 18 property, whether real, personal, or mixed; provided that 19 at all times the commission shall avoid any appearance of 20 impropriety. 21 (9) To sell, convey, mortgage, pledge, lease, exchange, 22 abandon, or otherwise dispose of any property, whether real, 23 personal, or mixed. 24 (10) To establish a budget and make expenditures. 25 (11) To borrow money. 26 (12) To appoint committees, including advisory committees 27 comprised of administrators, state nursing regulators, 28 state legislators or their representatives, and consumer 29 representatives, and other such interested persons. 30 (13) To provide and receive information from, and to 31 cooperate with, law enforcement agencies. 32 (14) To adopt and use an official seal. 33 (15) To perform such other functions as may be necessary or 34 appropriate to achieve the purposes of this compact consistent 35 -15- LSB 1078HV (1) 87 tr/nh 15/ 25
H.F. 394 with the state regulation of nurse licensure and practice. 1 h. Financing of the commission. 2 (1) The commission shall pay, or provide for the payment of, 3 the reasonable expenses of its establishment, organization, and 4 ongoing activities. 5 (2) The commission may also levy on and collect an annual 6 assessment from each party state to cover the cost of its 7 operations, activities, and staff in its annual budget as 8 approved each year. The aggregate annual assessment amount, if 9 any, shall be allocated based upon a formula to be determined 10 by the commission, which shall promulgate a rule that is 11 binding upon all party states. 12 (3) The commission shall not incur obligations of any kind 13 prior to securing the funds adequate to meet the same; nor 14 shall the commission pledge the credit of any of the party 15 states, except by, and with the authority of, such party state. 16 (4) The commission shall keep accurate accounts of all 17 receipts and disbursements. The receipts and disbursements of 18 the commission shall be subject to the audit and accounting 19 procedures established under its bylaws. However, all receipts 20 and disbursements of funds handled by the commission shall be 21 audited yearly by a certified or licensed public accountant, 22 and the report of the audit shall be included in and become 23 part of the annual report of the commission. 24 i. Qualified immunity, defense, and indemnification. 25 (1) The administrators, officers, executive director, 26 employees, and representatives of the commission shall be 27 immune from suit and liability, either personally or in their 28 official capacity, for any claim for damage to or loss of 29 property or personal injury or other civil liability caused by 30 or arising out of any actual or alleged act, error, or omission 31 that occurred, or that the person against whom the claim is 32 made had a reasonable basis for believing occurred, within the 33 scope of commission employment, duties, or responsibilities; 34 provided that nothing in this paragraph “i” shall be construed 35 -16- LSB 1078HV (1) 87 tr/nh 16/ 25
H.F. 394 to protect any such person from suit or liability for any 1 damage, loss, injury, or liability caused by the intentional, 2 willful, or wanton misconduct of that person. 3 (2) The commission shall defend any administrator, 4 officer, executive director, employee, or representative of 5 the commission in any civil action seeking to impose liability 6 arising out of any actual or alleged act, error, or omission 7 that occurred within the scope of commission employment, 8 duties, or responsibilities, or that the person against 9 whom the claim is made had a reasonable basis for believing 10 occurred within the scope of commission employment, duties, 11 or responsibilities; provided that nothing herein shall be 12 construed to prohibit that person from retaining the person’s 13 own counsel; and provided further that the actual or alleged 14 act, error, or omission did not result from that person’s 15 intentional, willful, or wanton misconduct. 16 (3) The commission shall indemnify and hold harmless 17 any administrator, officer, executive director, employee, 18 or representative of the commission for the amount of any 19 settlement or judgment obtained against that person arising 20 out of any actual or alleged act, error, or omission that 21 occurred within the scope of commission employment, duties, 22 or responsibilities, or that such person had a reasonable 23 basis for believing occurred within the scope of commission 24 employment, duties, or responsibilities, provided that the 25 actual or alleged act, error, or omission did not result from 26 the intentional, willful, or wanton misconduct of that person. 27 8. Article VIII —— Rulemaking. 28 a. The commission shall exercise its rulemaking powers 29 pursuant to the criteria set forth in this article and the 30 rules adopted thereunder. Rules and amendments shall become 31 binding as of the date specified in each rule or amendment and 32 shall have the same force and effect as provisions of this 33 compact. 34 b. Rules or amendments to the rules shall be adopted at a 35 -17- LSB 1078HV (1) 87 tr/nh 17/ 25
H.F. 394 regular or special meeting of the commission. 1 c. Prior to promulgation and adoption of a final rule or 2 rules by the commission, and at least sixty days in advance 3 of the meeting at which the rule will be considered and voted 4 upon, the commission shall file a notice of proposed rulemaking 5 on the internet site of the commission and on the internet site 6 of each licensing board or the publication in which each state 7 would otherwise publish proposed rules. 8 d. The notice of proposed rulemaking shall include all of 9 the following: 10 (1) The proposed time, date, and location of the meeting in 11 which the rule will be considered and voted upon. 12 (2) The text of the proposed rule or amendment, and the 13 reason for the proposed rule. 14 (3) A request for comments on the proposed rule from any 15 interested person. 16 (4) The manner in which interested persons may submit notice 17 to the commission of their intention to attend the public 18 hearing and any written comments. 19 e. Prior to adoption of a proposed rule, the commission 20 shall allow persons to submit written data, facts, opinions, 21 and arguments, which shall be made available to the public. 22 f. The commission shall grant an opportunity for a public 23 hearing before it adopts a rule or amendment. 24 g. The commission shall publish the place, time, and date of 25 the scheduled public hearing. 26 (1) Hearings shall be conducted in a manner providing each 27 person who wishes to comment a fair and reasonable opportunity 28 to comment orally or in writing. All hearings will be 29 recorded, and a copy will be made available upon request. 30 (2) Nothing in this article shall be construed as requiring 31 a separate hearing on each rule. Rules may be grouped for the 32 convenience of the commission at hearings required by this 33 article. 34 h. If no one appears at the public hearing, the commission 35 -18- LSB 1078HV (1) 87 tr/nh 18/ 25
H.F. 394 may proceed with promulgation of the proposed rule. 1 i. Following the scheduled hearing date, or by the close 2 of business on the scheduled hearing date if the hearing was 3 not held, the commission shall consider all written and oral 4 comments received. 5 j. The commission shall, by majority vote of all 6 administrators, take final action on the proposed rule and 7 shall determine the effective date of the rule, if any, based 8 on the rulemaking record and the full text of the rule. 9 k. Upon determination that an emergency exists, the 10 commission may consider and adopt an emergency rule without 11 prior notice, opportunity for comment or hearing, provided that 12 the usual rulemaking procedures provided in this compact and 13 in this article shall be retroactively applied to the rule as 14 soon as reasonably possible, in no event later than ninety days 15 after the effective date of the rule. For the purposes of 16 this provision, an emergency rule is one that must be adopted 17 immediately in order to do any of the following: 18 (1) Meet an imminent threat to public health, safety, or 19 welfare. 20 (2) Prevent a loss of commission or party state funds. 21 (3) Meet a deadline for the promulgation of an 22 administrative rule that is required by federal law or rule. 23 l. The commission may direct revisions to a previously 24 adopted rule or amendment for purposes of correcting 25 typographical errors, errors in format, errors in consistency, 26 or grammatical errors. Public notice of any revisions shall be 27 posted on the internet site of the commission. The revision 28 shall be subject to challenge by any person for a period of 29 thirty days after posting. The revision may be challenged only 30 on grounds that the revision results in a material change to 31 a rule. A challenge shall be made in writing, and delivered 32 to the commission, prior to the end of the notice period. If 33 no challenge is made, the revision will take effect without 34 further action. If the revision is challenged, the revision 35 -19- LSB 1078HV (1) 87 tr/nh 19/ 25
H.F. 394 may not take effect without the approval of the commission. 1 9. Article IX —— Oversight, dispute resolution, and 2 enforcement. 3 a. Oversight. 4 (1) Each party state shall enforce this compact and take all 5 actions necessary and appropriate to effectuate this compact’s 6 purposes and intent. 7 (2) The commission shall be entitled to receive service 8 of process in any proceeding that may affect the powers, 9 responsibilities, or actions of the commission, and shall have 10 standing to intervene in such a proceeding for all purposes. 11 Failure to provide service of process in such proceeding to 12 the commission shall render a judgment or order void as to the 13 commission, this compact, or promulgated rules. 14 b. Default, technical assistance, and termination. 15 (1) If the commission determines that a party state 16 has defaulted in the performance of its obligations or 17 responsibilities under this compact or the promulgated rules, 18 the commission shall do both of the following: 19 (a) Provide written notice to the defaulting state and other 20 party states of the nature of the default, the proposed means 21 of curing the default, or any other action to be taken by the 22 commission. 23 (b) Provide remedial training and specific technical 24 assistance regarding the default. 25 (2) If a state in default fails to cure the default, the 26 defaulting state’s membership in this compact may be terminated 27 upon an affirmative vote of a majority of the administrators, 28 and all rights, privileges, and benefits conferred by this 29 compact may be terminated on the effective date of termination. 30 A cure of the default does not relieve the offending state 31 of obligations or liabilities incurred during the period of 32 default. 33 (3) Termination of membership in this compact shall be 34 imposed only after all other means of securing compliance have 35 -20- LSB 1078HV (1) 87 tr/nh 20/ 25
H.F. 394 been exhausted. Notice of intent to suspend or terminate shall 1 be given by the commission to the governor of the defaulting 2 state and to the executive officer of the defaulting state’s 3 licensing board and each of the party states. 4 (4) A state whose membership in this compact has been 5 terminated is responsible for all assessments, obligations, and 6 liabilities incurred through the effective date of termination, 7 including obligations that extend beyond the effective date of 8 termination. 9 (5) The commission shall not bear any costs related to a 10 state that is found to be in default or whose membership in 11 this compact has been terminated unless agreed upon in writing 12 between the commission and the defaulting state. 13 (6) The defaulting state may appeal the action of the 14 commission by petitioning the United States district court 15 for the District of Columbia or the federal district in which 16 the commission has its principal offices. The prevailing 17 party shall be awarded all costs of such litigation, including 18 reasonable attorneys’ fees. 19 c. Dispute resolution. 20 (1) Upon request by a party state, the commission shall 21 attempt to resolve disputes related to the compact that arise 22 among party states and between party and nonparty states. 23 (2) The commission shall promulgate a rule providing for 24 both mediation and binding dispute resolution for disputes, as 25 appropriate. 26 (3) In the event the commission cannot resolve disputes 27 among party states arising under this compact: 28 (a) The party states may submit the issues in dispute to 29 an arbitration panel, which will be comprised of individuals 30 appointed by the compact administrator in each of the affected 31 party states and an individual mutually agreed upon by the 32 compact administrators of all the party states involved in the 33 dispute. 34 (b) The decision of a majority of the arbitrators shall be 35 -21- LSB 1078HV (1) 87 tr/nh 21/ 25
H.F. 394 final and binding. 1 d. Enforcement. 2 (1) The commission, in the reasonable exercise of its 3 discretion, shall enforce the provisions and rules of this 4 compact. 5 (2) By majority vote, the commission may initiate legal 6 action in the United States district court for the District of 7 Columbia or the federal district in which the commission has 8 its principal offices against a party state that is in default 9 to enforce compliance with the provisions of this compact 10 and its promulgated rules and bylaws. The relief sought may 11 include both injunctive relief and damages. In the event 12 judicial enforcement is necessary, the prevailing party shall 13 be awarded all costs of such litigation, including reasonable 14 attorneys’ fees. 15 (3) The remedies herein shall not be the exclusive remedies 16 of the commission. The commission may pursue any other 17 remedies available under federal or state law. 18 10. Article X —— Effective date, withdrawal, and amendment. 19 a. This compact shall become effective and binding on the 20 earlier of the date of legislative enactment of this compact 21 into law by no less than twenty-six states or December 31, 22 2018. All party states to this compact, that also were parties 23 to the prior nurse licensure compact, superseded by this 24 compact, shall be deemed to have withdrawn from said prior 25 compact within six months after the effective date of this 26 compact. 27 b. Each party state to this compact shall continue to 28 recognize a nurse’s multistate licensure privilege to practice 29 in that party state issued under the prior nurse licensure 30 compact until such party state has withdrawn from the prior 31 nurse licensure compact. 32 c. Any party state may withdraw from this compact by 33 enacting a statute repealing the same. A party state’s 34 withdrawal shall not take effect until six months after 35 -22- LSB 1078HV (1) 87 tr/nh 22/ 25
H.F. 394 enactment of the repealing statute. 1 d. 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 such withdrawal or termination. 6 e. Nothing contained in this compact shall be construed to 7 invalidate or prevent any nurse licensure agreement or other 8 cooperative arrangement between a party state and a nonparty 9 state that is made in accordance with the other provisions of 10 this compact. 11 f. This compact may be amended by the party states. No 12 amendment to this compact shall become effective and binding 13 upon the party states unless and until it is enacted into the 14 laws of all party states. 15 g. 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 thereof. The provisions of this 22 compact shall be severable, and if any phrase, clause, 23 sentence, or provision of this compact is declared to 24 be contrary to the constitution of any party state or of 25 the United States, or if the applicability thereof to any 26 government, agency, person, or circumstance is held invalid, 27 the validity of the remainder of this compact and the 28 applicability thereof to any government, agency, person, or 29 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 Sec. 2. Section 152E.2, Code 2017, is amended to read as 35 -23- LSB 1078HV (1) 87 tr/nh 23/ 25
H.F. 394 follows: 1 152E.2 Compact administrator. 2 The executive director of the board of nursing, as provided 3 for in section 152.2 , shall serve as the compact administrator 4 identified in article VIII VII , paragraph “a” “b” , of the 5 nurse licensure compact contained in section 152E.1 and as the 6 compact administrator identified in article VIII, paragraph 7 “a” , of the advanced practice registered nurse compact 8 contained in section 152E.3 . 9 Sec. 3. EFFECTIVE DATE. This Act takes effect upon the 10 earlier of the date of adoption of the revised nurse licensure 11 compact contained in this Act by no less than twenty-six states 12 or December 31, 2018. The executive director of the board 13 of nursing shall notify the Code editor upon adoption of the 14 compact by the requisite number of states. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill adopts a revised version of the nurse licensure 19 compact in Code chapter 152E. The new compact creates an 20 interstate commission of nurse licensure compact administrators 21 that will have the power to adopt rules binding on its members, 22 or “party states”, bring legal action in its own name, purchase 23 insurance and bonds, hire and compensate employees, and rent or 24 purchase property. 25 The commission may also levy on and collect an annual 26 assessment from this state and all other party states to cover 27 the cost of its operations, activities, and staff in its annual 28 budget as approved each year. The aggregate annual assessment 29 amount, if any, shall be allocated based upon a formula to be 30 determined by the commission, which shall adopt a rule that 31 is binding upon all party states. In this state, the compact 32 administrator shall be the executive director of the board of 33 nursing. 34 The bill becomes effective upon its adoption by no less than 35 -24- LSB 1078HV (1) 87 tr/nh 24/ 25
H.F. 394 26 states or on December 31, 2018, whichever is earlier. 1 -25- LSB 1078HV (1) 87 tr/nh 25/ 25