2015 -- H 5481

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LC000721

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2015

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - NURSES

     

     Introduced By: Representatives Slater, Bennett, Hull, Blazejewski, and Handy

     Date Introduced: February 12, 2015

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 5-34-2 of the General Laws in Chapter 5-34 entitled "Nurses" is

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hereby amended to read as follows:

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     5-34-2. License and registration required to practice nursing or use title. -- It is

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unlawful for any person to practice or offer to practice nursing in this state or to use any title,

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sign, abbreviation, card, or device indicating authority to practice nursing unless that person is

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licensed and registered under the provisions of this chapter or by the compact set forth in chapter

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5-34.3.

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     SECTION 2. Chapter 5-34.3 of the General Laws entitled "Nurse Licensure Compact" is

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hereby repealed in its entirety.

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CHAPTER 5-34.3

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Nurse Licensure Compact

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     5-34.3-1. Short title. -- This chapter may be cited as the "Nurse Licensure Compact Act".

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     5-34.3-2. The Nurse Licensure Compact. -- The nurse licensure compact is hereby

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adopted and entered into with all other jurisdictions that legally join in the compact, which is, in

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form, substantially similar to this chapter.

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     5-34.3-3. Legislative findings. -- (a) The general assembly finds and declares that:

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      (1) The health and safety of the public are affected by the degree of compliance with and

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the effectiveness of enforcement activities related to state nurse licensure laws;

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      (2) Violations of nurse licensure and other laws regulating the practice of nursing may

 

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result in injury or harm to the public;

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      (3) The expanded mobility of nurses and the use of advanced communication

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technologies as part of our nation's healthcare delivery system require greater coordination and

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cooperation among states in the areas of nurse licensure and regulations;

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      (4) New practice modalities and technology make compliance with individual state nurse

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licensure laws difficult and complex; and

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      (5) The current system of duplicative licensure for nurses practicing in multiple states is

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cumbersome and redundant to both nurses and states.

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      (b) The general purposes of this compact are to:

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      (1) Facilitate the states' responsibility to protect the public's health and safety;

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      (2) Ensure and encourage the cooperation of party states in the areas of nurse licensure

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and regulation;

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      (3) Facilitate the exchange of information between party states in the areas of nurse

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regulation, investigation and adverse actions;

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      (4) Promote compliance with the laws governing the practice of nursing in each

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jurisdiction; and

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      (5) Invest all party states with the authority to hold a nurse accountable for meeting all

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state practice laws in the state in which the patient is located at the time care is rendered through

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the mutual recognition of party state licenses.

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     5-34.3-4. Definitions. -- As used in this chapter:

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      (1) "Adverse action" means a home or remote state action.

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      (2) "Alternative program" means a voluntary, non-disciplinary monitoring program

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approved by a nurse licensing board.

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      (3) "Coordinated licensure information system" means an integrated process for

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collecting, storing, and sharing information on nurse licensure and enforcement activities related

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to nurse licensure laws, which is administered by a non-profit organization composed of and

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controlled by state nurse licensing boards.

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      (4) "Current significant investigative information" means investigative information that a

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licensing board, after a preliminary inquiry that includes notification and an opportunity for the

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nurse to respond if required by state law, has reason to believe is not groundless and, if proved

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true, would indicate more than a minor infraction; or investigative information that indicates that

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the nurse represents an immediate treat to public health and safety regardless of whether the nurse

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has been notified and had an opportunity to respond.

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      (5) "Home state" means the party state which is the nurse's primary state of residence.

 

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      (6) "Home state action" means any administrative, civil, equitable or criminal action

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permitted by the home state's laws which are imposed on a nurse by the home state's licensing

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board or other authority including actions against an individual's license such as: revocation,

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suspension, probation or any other action which affects a nurse's authorization to practice.

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      (7) "Licensing board" means a party state's regulatory body responsible for issuing nurse

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licenses.

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      (8) "Multistate licensure privilege" means current, official authority from a remote state

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permitting the practice of nursing as either a registered nurse or a licensed practical/vocational

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nurse in such party state. All party states have the authority, in accordance with existing state due

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process law, to take actions against the nurse's privilege such as: revocation, suspension,

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probation or any other action which affects a nurse's authorization to practice.

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      (9) "Nurse" means a registered nurse or licensed practical/vocational nurse, as those

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terms are defined by each party's state practice laws.

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      (10) "Party state" means any state that has adopted this compact.

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      (11) "Remote state" means a party state, other than the home state, where the patient is

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located at the time nursing care is provided, or, in the case of the practice of nursing not involving

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a patient, in such party state where the recipient of nursing practice is located.

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      (12) "Remote state action" means any administrative, civil, equitable or criminal action

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permitted by a remote state's laws which are imposed on a nurse by the remote state's licensing

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board or other authority including actions against an individual's multistate licensure privilege to

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practice in the remote state, and cease and desist and other injunctive or equitable orders issued

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by remote states or the licensing boards thereof.

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      (13) "State" means a state, territory, or possession of the United States, the District of

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Columbia.

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      (14) "State practice laws" means those individual party's state laws and regulations that

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govern the practice of nursing, define the scope of nursing practice, and create the methods and

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grounds for imposing discipline. It does not include the initial qualifications for licensure or

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requirements necessary to obtain and retain a license, except for qualifications or requirements of

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the home state.

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     5-34.3-5. Permitted activities and jurisdiction. -- (a) A license to practice registered

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nursing issued by a home state to a resident in that state will be recognized by each party state as

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authorizing a multistate licensure privilege to practice as a registered nurse in such party state. A

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license to practice licensed practical/vocational nursing issued by a home state to a resident in

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that state will be recognized by each party state as authorizing a multistate licensure privilege to

 

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practice as a licensed practical/vocational nurse in such party state. In order to obtain or retain a

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license, an applicant must meet the home state's qualifications for licensure and license renewal

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as well as all other applicable state laws.

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      (b) Party states may, in accordance with state due process laws, limit or revoke the

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multistate licensure privilege of any nurse to practice in their state and may take any other actions

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under their applicable state laws necessary to protect the health and safety of their citizens. If a

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party state takes such action, it shall promptly notify the administrator of the coordinated

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licensure information system. The administrator of the coordinated licensure information system

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shall promptly notify the home state of any such actions by remote states.

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      (c) Every nurse practicing in a party state must comply with the state practice laws of the

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state in which the patient is located at the time care is rendered. In addition, the practice of

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nursing is not limited to patient care, but shall include all nursing practice as defined by the state

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practice laws of a party state. The practice of nursing will subject a nurse to the jurisdiction of the

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nurse licensing board and courts, as well as the laws, in that party state.

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      (d) This compact does not affect additional requirements imposed by states for advanced

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practice registered nursing. However, a multistate licensure privilege to practice registered

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nursing granted by a party shall be recognized by other party states as a license to practice

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registered nursing if one is required by state law as a precondition for qualifying for advanced

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practice registered nurse authorization.

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      (e) Individuals not residing in a party state shall continue to be able to apply for nurse

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licensure as provided for under the laws of each party state. However, the license granted to these

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individuals will not be recognized as granting the privilege to practice nursing in any other party

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state unless explicitly agreed to by that party state.

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     5-34.3-6. Applications for licensure in a party state. -- (a) Upon application for a

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license, the licensing board in a party state shall ascertain, through the coordinated licensure

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information system, whether the applicant has ever held, or is the holder of, a license issued by

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any other state, whether there are any restrictions on the multistate licensure privilege, and

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whether any other adverse action by any state has been taken against the license.

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      (b) A nurse in a party state shall hold licensure in only one party state at a time, issued

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by the home state.

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      (c) A nurse who intends to change primary state of residence may apply for licensure in

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the new home state in advance of such change. However, new licenses will not be issued by a

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party state until after a nurse provides evidence of change in primary state of residence

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satisfactory to the new home state's licensing board.

 

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      (d) When a nurse changes primary state of residence by;

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      (1) Moving between two party states, and obtains a license from the new home state, the

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license from the former home state is no longer valid;

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      (2) Moving from a non-party state to a party state, and obtains a license from the new

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home state, the individual state license issued by the non-party state is not affected and will

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remain in full force if so provided by the laws of the non-party state;

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      (3) Moving from a party state to a non-party state, the license issued by the prior home

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state converts to an individual state license, valid only in the former home state, without the

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multistate licensure privilege to practice in other party states.

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     5-34.3-7. Adverse actions. -- In addition to the provisions described in ยง 5-34.3-5, the

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following provisions apply:

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      (1) The licensing board of a remote state shall promptly report to the administrator of the

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coordinated licensure information system any remote state actions including the factual and legal

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basis for such action, if known. The licensing board of a remote state shall also promptly report

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any significant current investigative information yet to result in a remote state action. The

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administrator of the coordinated licensure information system shall promptly notify the home

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state of any such reports.

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      (2) The licensing board of a party state shall have the authority to complete any pending

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investigations for a nurse who changes primary state of residence during the course of such

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investigations. It shall also have the authority to take appropriate action(s), and shall promptly

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report the conclusions of such investigations to the administrator of the coordinated licensure

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information system. The administrator of the coordinated licensure information system shall

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promptly notify the new home state of any such actions.

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      (3) A remote state may take adverse action affecting the multistate licensure privilege to

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practice within that party state. However, only the home state shall have the power to impose

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adverse action against the license issued by the home state.

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      (4) For purposes of imposing adverse action, the licensing board of the home state shall

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give the same priority and effect to reported conduct received from a remote state as it would if

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such conduct had occurred within the home state. In so doing, it shall apply its own state laws to

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determine appropriate action.

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      (5) The home state may take adverse action based on the factual findings of the remote

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state, so long as each state follows its own procedures for imposing such adverse action.

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      (6) Nothing in this compact shall override a party state's decision that participation in an

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alternative program may be used in lieu of licensure action and that such participation shall

 

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remain non-public if required by the party state's laws. Party states must require nurses who enter

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any alternative programs to agree not to practice in any other party state during the term of the

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alternative program without prior authorization from such other party state.

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     5-34.3-8. Additional authorities invested in party state nurse licensing boards. --

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Notwithstanding any other powers, party state nurse licensing boards shall have the authority to:

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      (1) If otherwise, permitted by state law, recover from the affected nurse the costs of

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investigations and disposition of cases resulting from any adverse action taken against that nurse;

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      (2) Issue subpoenas for both hearings and investigations which require the attendance

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and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse

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licensing board in a party state for the attendance and testimony of witnesses, and/or the

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production of evidence from another party state, shall be enforced in the latter state by any court

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of competent jurisdiction, according to the practice and procedure of that court applicable to

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subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness

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fees, travel expenses, mileage and other fees required by the service statutes of the state where the

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witnesses and/or evidence are located.

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      (3) Issue cease and desist orders to limit or revoke a nurse's authority to practice in their

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state;

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      (4) Promulgate uniform rules and regulations as provided for in subsection 5-34.3-10(c).

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     5-34.3-9. Coordinated licensure information system. -- (a) All party states shall

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participate in a cooperative effort to create a coordinated data base of all licensed registered

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nurses and licensed practical/vocational nurses. This system will include information on the

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licensure and disciplinary history of each nurse, as contributed by party states, to assist in the

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coordination of nurse licensure and enforcement efforts.

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      (b) Notwithstanding any other provision of law, all party states' licensing boards shall

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promptly report adverse actions, actions against multistate licensure privileges, any current

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significant investigative information yet to result in adverse action, denials of applications, and

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the reasons for such denials, to the coordinated licensure information system.

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      (c) Current significant investigative information shall be transmitted through the

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coordinated licensure information system only to party state licensing boards.

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      (d) Notwithstanding any other provision of law, all party states' licensing boards

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contributing information to the coordinated licensure information system may designate

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information that may not be shared with non-party states or disclosed to other entities or

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individuals without the express permission of the contributing state.

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      (e) Any personally identifiable information obtained by a party state's licensing board

 

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from the coordinated licensure information system may not be shared with non-party states or

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disclosed to other entities or individuals except to the extent permitted by the laws of the party

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state contributing the information.

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      (f) Any information contributed to the coordinated licensure information system that is

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subsequently required to be expunged by the laws of the party state contributing that information,

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shall also be expunged from the coordinated licensure information system.

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      (g) The compact administrators, acting jointly with each other and in consultation with

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the administrator of the coordinated licensure information system, shall formulate necessary and

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proper procedures for the identification, collection and exchange of information under this

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compact.

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     5-34.3-10. Compact administration and interchange of information. -- (a) The head

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of the nurse licensing board, or his/her designee, of each party state shall be the administrator of

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this compact for his/her state.

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      (b) The compact administrator of each party shall furnish to the compact administrator of

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each other party state any information and documents including, but not limited to, a uniform data

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set of investigations, identifying information, licensure data, and disclosable alternative program

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participation information to facilitate the administration of this compact.

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      (c) Compact administrators shall have the authority to develop uniform rules to facilitate

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and coordinate implementation of this compact. These uniform rules shall be adopted by party

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states, under the authority invested under subsection 5-34.3-8(4).

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     5-34.3-11. Immunity. -- No party state or the officers or employees or agents of a party

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state's nurse licensing board who acts in accordance with the provisions of this compact shall be

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liable on account of any act or omission in good faith while engaged in the performance of their

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duties under this compact. Good faith in this article shall not include willful misconduct, gross

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negligence, or recklessness.

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     5-34.3-12. Entry into force, withdrawal and amendment. -- (a) This compact shall

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enter into force and become effective as to any state when it has been enacted into the laws of that

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state. Any party state may withdraw from this compact by enacting a statute repealing the same,

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but no such withdrawal shall take effect until six (6) months after the withdrawing state has given

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notice of the withdrawal to the executive heads of all other party states.

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      (b) No withdrawal shall affect the validity or applicability by the licensing boards of

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states remaining party to the compact of any report of adverse action occurring prior to the

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withdrawal.

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      (c) Nothing contained in this compact shall be construed to invalidate or prevent any

 

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nurse licensure agreement or other cooperative arrangement between a party state and a non-party

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state that is made in accordance with the other provisions of this compact.

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      (d) This compact may be amended by the party states. No amendment to this compact

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shall become effective and binding upon the party states unless and until it is enacted into the

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laws of all party states.

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     5-34.3-13. Employers. -- This compact is designed to facilitate the regulation of nurses,

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and does not relieve employers from complying with statutorily imposed obligations. This

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compact does not supersede existing state labor laws.

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     5-34.3-14. Construction and severability. -- (a) This compact shall be liberally

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construed so as to effectuate the purposes thereof. The provisions of this compact shall be

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severable and if any phrase, clause, sentence or provision of this compact is declared to be

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contrary to the constitution of any party state or of the United States or the applicability thereof to

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any government, agency, person or circumstance is held invalid, the validity of the remainder of

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this compact and the applicability thereof to any government, agency, person or circumstance

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shall not be affected thereby. If this compact shall be held contrary to the constitution of any state

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party thereto, the compact shall remain in full force and effect as to the remaining party states and

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in full force and effect as to the party state affected as to all severable matters.

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      (b) In the event party states find a need for settling disputes arising under this compact:

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      (1) The party states may submit the issues in dispute to an arbitration panel which will be

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comprised of an individual appointed by the compact administrator in the home state; an

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individual appointed by the compact administrator in the remote state(s) involved; and an

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individual mutually agreed upon by the compact administrators of all the party states involved in

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the dispute.

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      (2) The decision of a majority of the arbitrators shall be final and binding.

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     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - NURSES

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     This act repeals the nurse licensure compact wherein every nurse practicing in a party

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state must comply with the state practice laws in which the patient is located at the time care is

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rendered.

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     This act would take effect upon passage.

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