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S.B. 26 Enrolled

                 

NURSE REGISTRATION INTERSTATE COMPACT AMENDMENTS

                 
1999 GENERAL SESSION

                 
STATE OF UTAH

                 
Sponsor: L. Alma Mansell

                  AN ACT RELATING TO OCCUPATIONS AND PROFESSIONS; AMENDING THE NURSE
                  LICENSURE COMPACT REGARDING PARTY STATE AUTHORITY TO TAKE ACTION
                  AGAINST A NURSE'S AUTHORIZATION TO PRACTICE; CLARIFYING WHAT IS
                  ACCEPTABLE PARTY STATE LICENSING BOARD USE OF INFORMATION OBTAINED
                  FROM THE COORDINATED LICENSURE INFORMATION SYSTEM; CLARIFYING
                  EXPUNGEMENT REQUIREMENTS; CLARIFYING INTERSTATE PRACTICE
                  RESTRICTIONS WHEN A LICENSE IS SUBJECT TO DISCIPLINARY ACTION ON THE
                  EFFECTIVE DATE OF THE NURSE LICENSURE COMPACT; AND PROVIDING AN
                  EFFECTIVE DATE.
                  This act affects sections of Utah Code Annotated 1953 as follows:
                  AMENDS:
                      58-31b-401, as enacted by Chapter 288, Laws of Utah 1998
                      58-31c-102 (Effective 01/01/00), as enacted by Chapter 189, Laws of Utah 1998
                  ENACTS:
                      58-31c-103, Utah Code Annotated 1953
                  Be it enacted by the Legislature of the state of Utah:
                      Section 1. Section 58-31b-401 is amended to read:
                       58-31b-401. Grounds for denial of licensure and disciplinary proceedings.
                      (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the license
                  of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee, to issue
                  a public or private reprimand to a licensee, and to issue cease and desist orders shall be in
                  accordance with Section 58-1-401 .
                      (2) (a) If a court of competent jurisdiction determines that a nurse is an "incapacitated
                  person" as defined in Section 75-1-201 , the director shall suspend the license of the nurse upon
                  entry of the judgment, regardless of the pendency of an appeal.


                      (b) If it appears to the board that there is reasonable cause to believe that a nurse, even
                  though the nurse has not been judicially determined to be incompetent, mentally incompetent, or
                  incapable, is unable to practice nursing with reasonable skill and safety to patients because of illness,
                  drunkenness, excessive use of drugs, narcotics, chemical, or any other type of material, or as a result
                  of any mental or physical condition, a complaint in the name of the board shall be served upon the
                  nurse for hearing on the sole issue of the capacity of the nurse to conduct properly the practice of
                  nursing.
                      (c) (i) Failure of a nurse to submit to a mental or physical examination within 30 days when
                  directed by the board in connection with a hearing instituted under Subsection (2)(b) constitutes
                  grounds for immediate suspension of the nurse's license, unless the failure was due to circumstances
                  beyond the control of the nurse.
                      (ii) A licensee who submits to an examination under this Subsection (2) waives all
                  objections to the admissibility of an examining physician's testimony or examination report on the
                  ground that they constitute a privileged communication.
                      (iii) The director may enter an order of suspension of the license without the taking of
                  testimony or the presentation of evidence upon a finding of reasonable cause to believe that an order
                  of suspension is necessary to protect the public health, safety, or welfare, if a hearing is scheduled
                  to occur within 30 days of the order of suspension.
                      (d) A nurse whose license is suspended under Subsection (2) shall, at reasonable intervals
                  defined by rule, be afforded the opportunity to demonstrate that the nurse can resume the competent
                  practice of nursing with reasonable skill and safety to patients.
                      (3) Nothing in Section 63-2-206 may be construed as limiting the authority of the division
                  to report current significant investigative information to the coordinated licensure information
                  system for transmission to party states as required of the division by Article VII of the Nurse
                  Licensure Compact in Section 58-31c-102 .
                      Section 2. Section 58-31c-102 (Effective 01/01/00) is amended to read:
                       58-31c-102 (Effective 01/01/00). Nurse Licensure Compact.
                      The Nurse Licensure Compact is hereby enacted and entered into with all other jurisdictions

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                  that legally join in the compact, which is, in form, substantially as follows:
                 
NURSE LICENSURE COMPACT

                 
ARTICLE I

                 
FINDINGS AND DECLARATION OF PURPOSE

                      (1) The party states find that:
                      (a) the health and safety of the public are affected by the degree of compliance with and the
                  effectiveness of enforcement activities related to state nurse licensure laws;
                      (b) violations of nurse licensure and other laws regulating the practice of nursing may result
                  in injury or harm to the public;
                      (c) the expanded mobility of nurses and the use of advanced communication technologies
                  as part of our nation's health care delivery system require greater coordination and cooperation
                  among states in the areas of nurse licensure and regulation;
                      (d) new practice modalities and technology make compliance with individual state nurse
                  licensure laws difficult and complex; and
                      (e) the current system of duplicative licensure for nurses practicing in multiple states is
                  cumbersome and redundant to both nurses and states.
                      (2) The general purposes of this compact are to:
                      (a) facilitate the states' responsibility to protect the public's health and safety;
                      (b) ensure and encourage the cooperation of party states in the areas of nurse licensure and
                  regulation;
                      (c) facilitate the exchange of information between party states in the areas of nurse
                  regulation, investigation, and adverse actions;
                      (d) promote compliance with the laws governing the practice of nursing in each jurisdiction;
                  and
                      (e) invest all party states with the authority to hold a nurse accountable for meeting all state
                  practice laws in the state in which the patient is located at the time care is rendered through the
                  mutual recognition of party state licenses.
                 
ARTICLE II


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DEFINITIONS

                      As used in this compact:
                      (1) "Adverse action" means a home or remote state action.
                      (2) "Alternative program" means a voluntary, non-disciplinary monitoring program approved
                  by a nurse licensing board.
                      (3) "Coordinated licensure information system" means an integrated process for collecting,
                  storing, and sharing information on nurse licensure and enforcement activities related to nurse
                  licensure laws, which is administered by a non-profit organization composed of and controlled by
                  state nurse licensing boards.
                      (4) "Current significant investigative information" means:
                      (a) investigative information that a licensing board, after a preliminary inquiry that includes
                  notification and an opportunity for the nurse to respond if required by state law, has reason to believe
                  is not groundless and, if proved true, would indicate more than a minor infraction; or
                      (b) investigative information that indicates that the nurse represents an immediate threat to
                  public health and safety regardless of whether the nurse has been notified and had an opportunity to
                  respond.
                      [(4)] (5) "Home state" means the party state which is the nurse's primary state of residence.
                      [(5)] (6) "Home state action" means any administrative, civil, equitable, or criminal action
                  permitted by the home state's laws which are imposed on a nurse by the home state's licensing board
                  or other authority including actions against an individual's license such as: revocation, suspension,
                  probation, or any other action which affects a nurse's authorization to practice.
                      [(6)] (7) "Licensing board" means a party state's regulatory body responsible for issuing
                  nurse licenses.
                      [(7)] (8) "Multistate licensure privilege" means current, official authority from a remote state
                  permitting the practice of nursing as either a registered nurse or a licensed practical/vocational nurse
                  in such party state. All party states have the authority, in accordance with existing state due process
                  law, to take actions against the nurse's privilege such as: revocation, suspension, probation, or any
                  other action which affects a nurse's authorization to practice.

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                      [(8)] (9) "Nurse" means a registered nurse or licensed practical/vocational nurse, as those
                  terms are defined by each party's state practice laws.
                      [(9)] (10) "Party state" means any state that has adopted this compact.
                      [(10)] (11) "Remote state" means a party state, other than the home state:
                      (a) where the patient is located at the time nursing care is provided; or
                      (b) in the case of the practice of nursing not involving a patient, in such party state where
                  the recipient of nursing practice is located.
                      [(11)] (12) "Remote state action" means:
                      (a) any administrative, civil, equitable, or criminal action permitted by a remote state's laws
                  which are imposed on a nurse by the remote state's licensing board or other authority including
                  actions against an individual's multistate licensure privilege to practice in the remote state; and
                      (b) cease and desist and other injunctive or equitable orders issued by remote states or the
                  licensing boards thereof.
                      [(12)] (13) "State" means a state, territory, or possession of the United States, the District
                  of Columbia, or the Commonwealth of Puerto Rico.
                      [(13)] (14) "State practice laws" means those individual party's state laws and regulations
                  that govern the practice of nursing, define the scope of nursing practice, and create the methods and
                  grounds for imposing discipline. "State practice laws" does not include the initial qualifications for
                  licensure or requirements necessary to obtain and retain a license, except for qualifications or
                  requirements of the home state.
                 
ARTICLE III

                 
GENERAL PROVISIONS AND JURISDICTION

                      (1) A license to practice registered nursing issued by a home state to a resident in that state
                  will be recognized by each party state as authorizing a multistate licensure privilege to practice as
                  a registered nurse in such party state. A license to practice licensed practical/vocational nursing
                  issued by a home state to a resident in that state will be recognized by each party state as authorizing
                  a multistate licensure privilege to practice as a licensed practical/vocational nurse in such party state.
                  In order to obtain or retain a license, an applicant must meet the home state's qualifications for

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                  licensure and license renewal as well as all other applicable state laws.
                      (2) Party states, in accordance with state due process laws, may limit or revoke the multistate
                  licensure privilege of any nurse to practice in their state and may take any other [adverse] actions
                  under their applicable state laws necessary to protect the health and safety of their citizens. If a party
                  state takes such action, it shall promptly notify the administrator of the coordinated licensure
                  information system. The administrator of the coordinated licensure information system shall
                  promptly notify the home state of any such actions by remote states.
                      (3) Every nurse practicing in a party state must comply with the state practice laws of the
                  state in which the patient is located at the time care is rendered. In addition, the practice of nursing
                  is not limited to patient care, but shall include all nursing practice as defined by the state practice
                  laws of a party state. The practice of nursing will subject a nurse to the jurisdiction of the nurse
                  licensing board and the courts, as well as the laws, in that party state.
                      (4) This compact does not affect additional requirements imposed by states for advanced
                  practice registered nursing. However, a multistate licensure privilege to practice registered nursing
                  granted by a party state shall be recognized by other party states as a license to practice registered
                  nursing if one is required by state law as a precondition for qualifying for advanced practice
                  registered nurse authorization.
                      (5) Individuals not residing in a party state shall continue to be able to apply for nurse
                  licensure as provided for under the laws of each party state. However, the license granted to these
                  individuals will not be recognized as granting the privilege to practice nursing in any other party                   state
                  unless explicitly agreed to by that party state.
                 
ARTICLE IV

                 
APPLICATIONS FOR LICENSURE IN A PARTY STATE

                      (1) Upon application for a license, the licensing board in a party state shall ascertain, through
                  the coordinated licensure information system, whether the applicant has ever held, or is the holder
                  of, a license issued by any other party state, whether there are any restrictions on the multistate
                  licensure privilege, and whether any other adverse action by any state has been taken against the
                  license.

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                      (2) A nurse in a party state shall hold licensure in only one party state at a time, issued by
                  the home state.
                      (3) A nurse who intends to change primary state of residence may apply for licensure in the
                  new home state in advance of such change. However, new licenses will not be issued by a party state
                  until after a nurse provides evidence of change in primary state of residence satisfactory to the new
                  home state's licensing board.
                      (4) When a nurse changes primary state of residence by:
                      (a) moving between two party states, and obtains a license from the new home state, the
                  license from the former home state is no longer valid;
                      (b) moving from a non-party state to a party state, and obtains a license from the new home
                  state, the individual state license issued by the non-party state is not affected and will remain in full
                  force if so provided by the laws of the non-party state;
                      (c) moving from a party state to a non-party state, the license issued by the prior home state
                  converts to an individual state license, valid only in the former home state, without the multistate
                  licensure privilege to practice in other party states.
                 
ARTICLE V

                 
ADVERSE ACTIONS

                      In addition to the General Provisions described in Article III, the following provisions apply:
                      (1) The licensing board of a remote state shall promptly report to the administrator of the
                  coordinated licensure information system any remote state actions including the factual and legal
                  basis for such action, if known. The licensing board of a remote state shall also promptly report any
                  significant current investigative information yet to result in a remote state action. The administrator
                  of the coordinated licensure information system shall promptly notify the home state of any such
                  reports.
                      (2) The licensing board of a party state shall have the authority to complete any pending
                  investigations for a nurse who changes primary state of residence during the course of such
                  investigations. It shall also have the authority to take appropriate action(s), and shall promptly report
                  the conclusions of such investigations to the administrator of the coordinated licensure information

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                  system. The administrator of the coordinated licensure information system shall promptly notify the
                  new home state of any such actions.
                      (3) A remote state may take adverse action affecting the multistate licensure privilege to
                  practice within that party state. However, only the home state shall have the power to impose
                  adverse action against the license issued by the home state.
                      (4) For purposes of imposing adverse action, the licensing board of the home state shall give
                  the same priority and effect to reported conduct received from a remote state as it would if such
                  conduct had occurred within the home state. In so doing, it shall apply its own state laws to
                  determine appropriate action.
                      (5) The home state may take adverse action based on the factual findings of the remote state,
                  so long as each state follows its own procedures for imposing such adverse action.
                      (6) Nothing in this compact shall override a party state's decision that participation in an
                  alternative program may be used in lieu of licensure action and that such participation shall remain
                  non-public if required by the party state's laws. Party states must require nurses who enter any
                  alternative programs to agree not to practice in any other party state during the term of the alternative
                  program without prior authorization from such other party state.
                 
ARTICLE VI

                 
ADDITIONAL AUTHORITIES INVESTED IN

                 
PARTY STATE NURSE LICENSING BOARDS

                      Notwithstanding any other powers, party state nurse licensing boards shall have the authority
                  to:
                      (1) if otherwise permitted by state law, recover from the affected nurse the costs of
                  investigations and disposition of cases resulting from any adverse action taken against that nurse;
                      (2) issue subpoenas for both hearings and investigations which require the attendance and
                  testimony of witnesses and the production of evidence. Subpoenas issued by a nurse licensing board
                  in a party state for the attendance and testimony of witnesses, and/or the production of evidence from
                  another party state, shall be enforced in the latter state by any court of competent jurisdiction,
                  according to the practice and procedure of that court applicable to subpoenas issued in proceedings

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                  pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and
                  other fees required by the service statutes of the state where the witnesses and/or evidence are
                  located;
                      (3) issue cease and desist orders to limit or revoke a nurse's authority to practice in their
                  state; and
                      (4) promulgate uniform rules and regulations as provided for in Article VIII(3).
                 
ARTICLE VII

                 
COORDINATED LICENSURE INFORMATION SYSTEM

                      (1) All party states shall participate in a cooperative effort to create a coordinated data base
                  of all licensed registered nurses and licensed practical/vocational nurses. This system will include
                  information on the licensure and disciplinary history of each nurse, as contributed by party states,
                  to assist in the coordination of nurse licensure and enforcement efforts.
                      (2) Notwithstanding any other provision of law, all party [states] states' licensing boards
                  shall promptly report adverse actions, [any significant current] actions against multistate licensure
                  privileges, any current significant investigative information yet to result in adverse action, denials
                  of applications, and the reasons for such denials, to the coordinated licensure information system.
                      (3) Current significant investigative information shall be transmitted through the coordinated
                  licensure information system only to party state licensing boards.
                      [(3)] (4) Notwithstanding any other provision of law, all party [states] states' licensing boards
                  contributing information to the coordinated licensure information system may designate information
                  that may not be shared with non-party states or disclosed to other entities or individuals without the
                  express permission of the contributing state.
                      (5) Any personally identifiable information obtained by a party states' licensing board from
                  the coordinated licensure information system may not be shared with non-party states or disclosed
                  to other entities or individuals except to the extent permitted by the laws of the party state
                  contributing the information.
                      (6) Any information contributed to the coordinated licensure information system that is
                  subsequently required to be expunged by the laws of the party state contributing that information,

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                  shall also be expunged from the coordinated licensure information system.
                      [(4)] (7) The compact administrators, acting jointly with each other and in consultation with
                  the administrator of the coordinated licensure information system, shall formulate necessary and
                  proper procedures for the identification, collection, and exchange of information under this compact.
                 
ARTICLE VIII

                 
COMPACT ADMINISTRATION AND INTERCHANGE OF INFORMATION

                      (1) The head of the nurse licensing board, or his/her designee, of each party state shall be
                  the administrator of this compact for his/her state.
                      (2) The compact administrator of each party state shall furnish to the compact administrator
                  of each other party state any information and documents including, but not limited to, a uniform data
                  set of investigations, identifying information, licensure data, and disclosable alternative program
                  participation information to facilitate the administration of this compact.
                      (3) Compact administrators shall have the authority to develop uniform rules to facilitate and
                  coordinate implementation of this compact. These uniform rules shall be adopted by party states
                  under the authority invested under Article VI(4).
                 
ARTICLE IX

                 
IMMUNITY

                      No party state or the officers or employees or agents of a party state's nurse licensing board[,
                  the administrator of the Coordinated Licensure Information System, or any other authority or
                  administrator] who acts in accordance with the provisions of this compact shall be liable on account
                  of any act or omission in good faith while engaged in the performance of their duties under this
                  compact. Good faith in this article shall not include willful misconduct, gross negligence, or
                  recklessness.
                 
ARTICLE X

                 
ENTRY INTO FORCE, WITHDRAWAL, AND AMENDMENT

                      (1) This compact shall enter into force and become effective as to any state when it has been
                  enacted into the laws of that state. Any party state may withdraw from this compact by enacting a
                  statute repealing the same, but no such withdrawal shall take effect until six months after the

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                  withdrawing state has given notice of the withdrawal to the executive heads of all other party states.
                      (2) No withdrawal shall affect the validity or applicability by the licensing boards of states
                  remaining party to the compact of any report of adverse action occurring prior to the withdrawal.
                      (3) Nothing contained in this compact shall be construed to invalidate or prevent any nurse
                  licensure agreement or other cooperative arrangement between a party state and a non-party state that
                  is made in accordance with the other provisions of this compact.
                      (4) This compact may be amended by the party states. No amendment to this compact shall
                  become effective and binding upon the party states unless and until it is enacted into the laws of all
                  party states.
                 
ARTICLE XI

                 
CONSTRUCTION AND SEVERABILITY

                      (1) This compact shall be liberally construed so as to effectuate the purposes thereof. The
                  provisions of this compact shall be severable and if any phrase, clause, sentence, or provision of this
                  compact is declared to be contrary to the constitution of any party state or of the United States or the
                  applicability thereof to any government, agency, person, or circumstance is held invalid, the validity
                  of the remainder of this compact and the applicability thereof to any government, agency, person,
                  or circumstance shall not be affected thereby. If this compact shall be held contrary to the
                  constitution of any state party thereto, the compact shall remain in full force and effect as to the
                  remaining party states and in full force and effect as to the party state affected as to a severable
                  matter.
                      (2) In the event party states find a need for settling disputes arising under this compact:
                      (a) the party states may submit the issues in dispute to an arbitration panel which will be
                  comprised of an individual appointed by the compact administrator in the home state; an individual
                  appointed by the compact administrator in the remote state(s) involved; and an individual mutually
                  agreed upon by the compact administrators of all the party states involved in the dispute; and
                      (b) the decision of a majority of the arbitrators shall be final and binding.
                      Section 3. Section 58-31c-103 is enacted to read:
                      58-31c-103. Pending disciplinary actions.

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                      (1) Notwithstanding Sections 58-31b-308 and 58-31c-102 , a nurse licensed by a party state
                  whose license is in any way restricted or otherwise subject to disciplinary action on January 1, 2000,
                  or the date on which the nurse's home state adopts the Nurse Licensure Compact, may not practice
                  as a registered nurse in this state without the express permission of the division in consultation with
                  the Board of Nursing created in Section 58-31b-201 .
                      (2) Notwithstanding Section 58-31c-102 , unprofessional conduct under Section 58-31b-502
                  includes practicing in a party state without first obtaining the express permission of that state if the
                  nurse's license issued under Section 58-31b-301 is in anyway restricted or otherwise subject to
                  disciplinary action on January 1, 2000.
                      Section 4. Effective date.
                      Sections 58-31c-102 and 58-31c-103 take effect January 1, 2000.

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