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H0405........................................................by MR. SPEAKER Requested by: Board of Nursing NURSING BOARD - Amends and adds to existing law to authorize the board to enter into multistate agreements or compacts; to clarify authority of the board to submit significant investigative information to the coordinated licensure information system for use by parties to agreements or compacts; and to adopt the Nurse Licensure Compact. 01/17 House intro - 1st rdg - to printing Rpt prt - to Health/Wel
H0405|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-fifth Legislature Second Regular Session - 2000IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 405 BY MR. SPEAKER Requested by: Board of Nursing 1 AN ACT 2 RELATING TO THE IDAHO BOARD OF NURSING; AMENDING SECTION 54-1404, IDAHO CODE, 3 TO AUTHORIZE THE BOARD TO ENTER INTO MULTISTATE AGREEMENTS OR COMPACTS; 4 AMENDING SECTION 54-1413, IDAHO CODE, TO CLARIFY AUTHORITY OF THE BOARD TO 5 SUBMIT SIGNIFICANT INVESTIGATIVE INFORMATION TO THE COORDINATED LICENSURE 6 INFORMATION SYSTEM FOR USE BY PARTIES TO AGREEMENTS OR COMPACTS; AMENDING 7 CHAPTER 14, TITLE 54, IDAHO CODE, BY THE ADDITION OF A NEW SECTION 8 54-1418, IDAHO CODE, TO PROVIDE ADOPTION OF THE NURSE LICENSURE COMPACT; 9 AND PROVIDING AN EFFECTIVE DATE. 10 Be It Enacted by the Legislature of the State of Idaho: 11 SECTION 1. That Section 54-1404, Idaho Code, be, and the same is hereby 12 amended to read as follows: 13 54-1404. BOARD OF NURSING -- POWERS AND DUTIES. The board shall have all 14 powers and duties necessary and incident to regulation of nursing and to 15 enforcement of this act, including but not limited to, the power and duty: 16 (1) To license qualified persons for practice of nursing in Idaho; to 17 renew licenses; to limit, restrict, amend, deny, suspend or revoke licenses; 18 and to accept the voluntary surrender of a license; 19 (2) To establish standards, criteria, conditions and requirements for 20 licensure and to investigate and determine eligibility and qualifications for 21 licensure, and to administer examinations for licensure; 22 (3) To establish standards of conduct and practice and to regulate the 23 use of titles, abbreviations and designations for the practice of nursing; 24 (4) To establish standards, criteria, and requirements for curricula for 25 nursing education programs and to evaluate, survey, review and approve nursing 26 education programs subject to the provisions of section 54-1406, Idaho Code; 27 (5) To evaluate continuing competency of persons licensed pursuant to 28 this act and to develop standards which will advance the competency of licen- 29 sees in accordance with developing scientific understanding and methods relat- 30 ing to the practice of nursing; 31 (6) To receive and collect license and renewal fees assessed pursuant to 32 this act and to assess, receive and collect additional reasonable fees for the 33 administration of examinations, investigations and evaluations of applicants, 34 issuance of temporary licenses, duplication and verification of records, sur- 35 veying and evaluating nursing education programs, and administrative fines not 36 to exceed one hundred dollars ($100) for each count or separate offense of 37 practicing nursing without current licensure, to be deposited in the state 38 board of nursing account in the manner provided by this act; 39 (7) To employ personnel necessary to administer this act and rules pro- 40 mulgated pursuant to this act and perform such other duties as the board may 41 require. Such personnel shall include an executive director, who shall be 42 currently licensed to practice professional nursing in Idaho and who shall not 43 be a member of the board; 2 1 (8) To maintain a record of board proceedings, annually report to the 2 governor and maintain a public register of names and addresses of licensed 3 nurses; 4 (9) To enter into interstate compacts, contracts or agreements to facili- 5 tate the practice and regulation of nursing in this state; 6 (10) To make, adopt and publish rules pursuant to chapter 52, title 67, 7 Idaho Code, as may be necessary or appropriate to carry out the provisions and 8 purposes of this act. 9 SECTION 2. That Section 54-1413, Idaho Code, be, and the same is hereby 10 amended to read as follows: 11 54-1413. DISCIPLINARY ACTION. (1) Grounds for discipline. The board shall 12 have the power to deny any application for or renewal of license, to revoke, 13 suspend or amend any license issued pursuant to this act and to limit or 14 restrict the practice of any licensee, upon a determination by the board that 15 the person: 16 (a) Made, or caused to be made, a false, fraudulent or forged statement 17 or representation in procuring or attempting to procure a license to prac- 18 tice nursing; or 19 (b) Practiced nursing under a false or assumed name; or 20 (c) Is convicted of a felony or of any offense involving moral turpitude; 21 or 22 (d) Is or has been grossly negligent or reckless in performing nursing 23 functions; or 24 (e) Habitually uses alcoholic beverages or narcotic, hypnotic or halluci- 25 nogenic drugs; or 26 (f) Is physically or mentally unfit to practice nursing; or 27 (g) Violates the provisions of this act or rules and standards of conduct 28 and practice as may be adopted by the board; or 29 (h) Otherwise engages in conduct of a character likely to deceive, 30 defraud or endanger patients or the public; or 31 (i) Has had a license to practice nursing suspended or revoked in any 32 jurisdiction. A certified copy of the order of suspension or revocation 33 shall be prima facie evidence of such suspension or revocation. 34 (2) (a) Proceedings. The executive director shall conduct such investi- 35 gations and initiate such proceedings as necessary to insure compliance 36 with this section. The board may accept the voluntary surrender of a 37 license from any nurse under investigation and accordingly enter an order 38 revoking or suspending such license and/or imposing such conditions, limi- 39 tations, or restrictions on the practice of any such nurse as may be 40 appropriate in the discretion of the board. Otherwise, every person sub- 41 ject to disciplinary proceedings shall be afforded an opportunity for 42 hearing after reasonable notice. All proceedings hereunder shall be in 43 accordance with chapter 52, title 67, Idaho Code. 44 (b) Hearings shall be conducted by the board or by persons appointed by 45 the board to conduct hearings and receive evidence. The board and any per- 46 son duly appointed by the board to conduct hearings shall have all powers 47 as are necessary and incident to orderly and effective receipt of evidence 48 including, but not limited to, the power to administer oaths, and to com- 49 pel by subpoena attendance of witnesses and production of books, records 50 and things at the hearing or at a deposition taken by a party in accor- 51 dance with the Idaho rules of civil procedure. Any party shall be entitled 52 to the use of subpoena upon application therefor. 53 (c) In the event any person fails to comply with a subpoena personally 3 1 served upon him or refuses to testify to any matter regarding which he may 2 be lawfully interrogated, the board shall petition the district court in 3 the county where such failure or refusal occurred or where such person 4 resides, to enforce such subpoena or compel such testimony. Proceedings 5 before the district court shall be for contempt in the same nature as 6 contempt of court for failure or refusal to comply with an order of the 7 court and the court shall have the same powers to secure compliance with 8 subpoena and testimony or to impose penalties as in contempt of court pro- 9 ceedings. 10 (3) Probation/Subsequent review. Any order of the board entered under 11 this section may be withheld or suspended for a probationary period to be 12 fixed by the board upon such terms and conditions as may be appropriate in 13 order to regulate, monitor and/or supervise the practice of nursing by the 14 licensee subject to such order for the prescribed probationary period. Any 15 order of the board entered under this section may be withdrawn, reversed, mod- 16 ified or amended upon a showing by the person subject to the order that the 17 grounds for discipline no longer exist or that he is rehabilitated, qualified 18 and competent to practice nursing and that he is not likely to violate this 19 act or rules adopted hereunder in the future. The board may, as a condition 20 to withdrawal, reversal, modification or amendment of the order, require the 21 person to pay all or part of the costs incurred by the board in proceedings 22 upon which the order was entered. 23 (4) Reporting investigative information. Nothing in section 9-340C(8) and 24 (9), Idaho Code, shall be construed as limiting the authority of the board to 25 report current significant investigative information to the coordinated licen- 26 sure information system for transmission to states that are parties to any 27 multistate agreements or compacts regarding nurse licensure. 28 SECTION 3. That Chapter 14, Title 54, Idaho Code, be, and the same is 29 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 30 ignated as Section 54-1418, Idaho Code, and to read as follows: 31 54-1418. NURSE LICENSURE COMPACT. The terms and conditions of the nurse 32 licensure compact are hereby enacted in substantially the following form: 33 NURSE LICENSURE COMPACT 34 ARTICLE I 35 FINDINGS AND DECLARATION OF PURPOSE 36 (1) The party states find that: 37 (a) The health and safety of the public are affected by the degree of 38 compliance with and the effectiveness of enforcement activities related to 39 state nurse licensure laws; 40 (b) Violations of nurse licensure and other laws regulating the practice 41 of nursing may result in injury or harm to the public; 42 (c) The expanded mobility of nurses and the use of advanced communication 43 technologies as part of our nation's health care delivery system require 44 greater coordination and cooperation among states in the areas of nurse 45 licensure and regulation; 46 (d) New practice modalities and technology make compliance with individ- 47 ual state nurse licensure laws difficult and complex; and 48 (e) The current system of duplicative licensure for nurses practicing in 49 multiple states is cumbersome and redundant to both nurses and states. 50 (2) The general purposes of this compact are to: 51 (a) Facilitate the states' responsibility to protect the public's health 52 and safety; 4 1 (b) Ensure and encourage the cooperation of party states in the areas of 2 nurse licensure and regulation; 3 (c) Facilitate the exchange of information between party states in the 4 areas of nurse regulation, investigation and adverse actions; 5 (d) Promote compliance with the laws governing the practice of nursing in 6 each jurisdiction; and 7 (e) Invest all party states with the authority to hold a nurse account- 8 able for meeting all state practice laws in the state in which the patient 9 is located at the time care is rendered through the mutual recognition of 10 party state licenses. 11 ARTICLE II 12 DEFINITIONS 13 As used in this compact: 14 (1) "Adverse action" means a home or remote state action. 15 (2) "Alternative program" means a voluntary, nondisciplinary monitoring 16 program approved by a nurse licensing board. 17 (3) "Coordinated licensure information system" means an integrated proc- 18 ess for collecting, storing and sharing information on nurse licensure and 19 enforcement activities related to nurse licensure laws, which is administered 20 by a nonprofit organization composed of and controlled by state nurse licens- 21 ing boards. 22 (4) "Current significant investigative information" means: 23 (a) Investigative information that a licensing board, after a preliminary 24 inquiry that includes notification and an opportunity for the nurse to 25 respond if required by state law, has reason to believe is not groundless 26 and, if proved true, would indicate more than a minor infraction; or 27 (b) Investigative information that indicates that the nurse represents an 28 immediate threat to public health and safety regardless of whether the 29 nurse has been notified and had an opportunity to respond. 30 (5) "Home state" means the party state which is the nurse's primary state 31 of residence. 32 (6) "Home state action" means any administrative, civil, equitable or 33 criminal action permitted by the home state's laws which are imposed on a 34 nurse by the home state's licensing board or other authority including actions 35 against an individual's license such as: revocation, suspension, probation, or 36 any other action which affects a nurse's authorization to practice. 37 (7) "Licensing board" means a party state's regulatory body responsible 38 for issuing nurse licenses. 39 (8) "Multistate licensure privilege" means current, official authority 40 from a remote state permitting the practice of nursing as either a registered 41 nurse or a licensed practical/vocational nurse in such party state. All party 42 states have the authority, in accordance with existing state due process law, 43 to take actions against the nurse's privilege such as: revocation, suspension, 44 probation, or any other action which affects a nurse's authorization to prac- 45 tice. 46 (9) "Nurse" means a registered nurse or licensed practical/vocational 47 nurse, as those terms are defined by each party's state practice laws. 48 (10) "Party state" means any state that has adopted this compact. 49 (11) "Remote state" means a party state, other than the home state: 50 (a) Where the patient is located at the time nursing care is provided; or 51 (b) In the case of the practice of nursing not involving a patient, in 52 such party state where the recipient of nursing practice is located. 53 (12) "Remote state action" means: 54 (a) Any administrative, civil, equitable or criminal action permitted by 5 1 a remote state's laws which are imposed on a nurse by the remote state's 2 licensing board or other authority including actions against an 3 individual's multistate licensure privilege to practice in the remote 4 state; and 5 (b) Cease and desist and other injunctive or equitable orders issued by 6 remote states or the licensing boards thereof. 7 (13) "State" means a state, territory, or possession of the United States, 8 the District of Columbia, or the Commonwealth of Puerto Rico. 9 (14) "State practice laws" means those individual party's state laws and 10 rules or regulations that govern the practice of nursing, define the scope of 11 nursing practice, and create the methods and grounds for imposing discipline. 12 "State practice laws" does not include the initial qualifications for licen- 13 sure or requirements necessary to obtain and retain a license, except for 14 qualifications or requirements of the home state. 15 ARTICLE III 16 GENERAL PROVISIONS AND JURISDICTION 17 (1) A license to practice registered nursing issued by a home state to a 18 resident in that state will be recognized by each party state as authorizing a 19 multistate licensure privilege to practice as a registered nurse in such party 20 state. A license to practice licensed practical/vocational nursing issued by a 21 home state to a resident in that state will be recognized by each party state 22 as authorizing a multistate licensure privilege to practice as a licensed 23 practical/vocational nurse in such party state. In order to obtain or retain a 24 license, an applicant must meet the home state's qualifications for licensure 25 and license renewal as well as all other applicable state laws. 26 (2) Party states, in accordance with state due process laws, may limit or 27 revoke the multistate licensure privilege of any nurse to practice in their 28 state and may take any other actions under their applicable state laws neces- 29 sary to protect the health and safety of their citizens. If a party state 30 takes such action, it shall promptly notify the administrator of the coordi- 31 nated licensure information system. The administrator of the coordinated 32 licensure information system shall promptly notify the home state of any such 33 actions by remote states. 34 (3) Every nurse practicing in a party state must comply with the state 35 practice laws of the state in which the patient is located at the time care is 36 rendered. In addition, the practice of nursing is not limited to patient care, 37 but shall include all nursing practice as defined by the state practice laws 38 of a party state. The practice of nursing will subject a nurse to the juris- 39 diction of the nurse licensing board and the courts, as well as the laws, in 40 that party state. 41 (4) This compact does not affect additional requirements imposed by 42 states for advanced practice registered nursing. However, a multistate licen- 43 sure privilege to practice registered nursing granted by a party state shall 44 be recognized by other party states as a license to practice registered nurs- 45 ing if one is required by state law as a precondition for qualifying for 46 advanced practice registered nurse authorization. 47 (5) Individuals not residing in a party state shall continue to be able 48 to apply for nurse licensure as provided for under the laws of each party 49 state. However, the license granted to these individuals will not be recog- 50 nized as granting the privilege to practice nursing in any other party state 51 unless explicitly agreed to by that party state. 6 1 ARTICLE IV 2 APPLICATIONS FOR LICENSURE IN A PARTY STATE 3 (1) Upon application for a license, the licensing board in a party state 4 shall ascertain, through the coordinated licensure information system, whether 5 the applicant has ever held, or is the holder of, a license issued by any 6 other party state, whether there are any restrictions on the multistate licen- 7 sure privilege, and whether any other adverse action by any state has been 8 taken against the license. 9 (2) A nurse in a party state shall hold licensure in only one (1) party 10 state at a time, issued by the home state. 11 (3) A nurse who intends to change primary state of residence may apply 12 for licensure in the new home state in advance of such change. However, new 13 licenses will not be issued by a party state until after a nurse provides evi- 14 dence of change in primary state of residence satisfactory to the new home 15 state's licensing board. 16 (4) When a nurse changes primary state of residence by: 17 (a) Moving between two (2) party states, and obtains a license from the 18 new home state, the license from the former home state is no longer valid; 19 (b) Moving from a nonparty state to a party state, and obtains a license 20 from the new home state, the individual state license issued by the 21 nonparty state is not affected and will remain in full force if so pro- 22 vided by the laws of the nonparty state; 23 (c) Moving from a party state to a nonparty state, the license issued by 24 the prior home state converts to an individual state license, valid only 25 in the former home state, without the multistate licensure privilege to 26 practice in other party states. 27 ARTICLE V 28 ADVERSE ACTIONS 29 In addition to the general provisions described in article III, the following 30 provisions apply: 31 (1) The licensing board of a remote state shall promptly report to the 32 administrator of the coordinated licensure information system any remote state 33 actions including the factual and legal basis for such action, if known. The 34 licensing board of a remote state shall also promptly report any significant 35 current investigative information yet to result in a remote state action. The 36 administrator of the coordinated licensure information system shall promptly 37 notify the home state of any such reports. 38 (2) The licensing board of a party state shall have the authority to com- 39 plete any pending investigations for a nurse who changes primary state of res- 40 idence during the course of such investigations. It shall also have the 41 authority to take appropriate action(s), and shall promptly report the conclu- 42 sions of such investigations to the administrator of the coordinated licensure 43 information system. The administrator of the coordinated licensure information 44 system shall promptly notify the new home state of any such actions. 45 (3) A remote state may take adverse action affecting the multistate 46 licensure privilege to practice within that party state. However, only the 47 home state shall have the power to impose adverse action against the license 48 issued by the home state. 49 (4) For purposes of imposing adverse action, the licensing board of the 50 home state shall give the same priority and effect to reported conduct 51 received from a remote state as it would if such conduct had occurred within 52 the home state. In so doing, it shall apply its own state laws to determine 53 appropriate action. 54 (5) The home state may take adverse action based on the factual findings 7 1 of the remote state, so long as each state follows its own procedures for 2 imposing such adverse action. 3 (6) Nothing in this compact shall override a party state's decision that 4 participation in an alternative program may be used in lieu of licensure 5 action and that such participation shall remain nonpublic if required by the 6 party state's laws. Party states must require nurses who enter any alternative 7 programs to agree not to practice in any other party state during the term of 8 the alternative program without prior authorization from such other party 9 state. 10 ARTICLE VI 11 ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE NURSE LICENSING BOARDS 12 Notwithstanding any other powers, party state nurse licensing boards shall 13 have the authority to: 14 (1) If otherwise permitted by state law, recover from the affected nurse 15 the costs of investigations and disposition of cases resulting from any 16 adverse action taken against that nurse; 17 (2) Issue subpoenas for both hearings and investigations which require 18 the attendance and testimony of witnesses and the production of evidence. Sub- 19 poenas issued by a nurse licensing board in a party state for the attendance 20 and testimony of witnesses, and/or the production of evidence from another 21 party state, shall be enforced in the latter state by any court of competent 22 jurisdiction, according to the practice and procedure of that court applicable 23 to subpoenas issued in proceedings pending before it. The issuing authority 24 shall pay any witness fees, travel expenses, mileage, and other fees required 25 by the service statutes of the state where the witnesses and/or evidence are 26 located; 27 (3) Issue cease and desist orders to limit or revoke a nurse's authority 28 to practice in their state; and 29 (4) Promulgate uniform rules and regulations as provided for in article 30 VIII(3). 31 ARTICLE VII 32 COORDINATED LICENSURE INFORMATION SYSTEM 33 (1) All party states shall participate in a cooperative effort to create 34 a coordinated database of all licensed registered nurses and licensed 35 practical/vocational nurses. This system will include information on the 36 licensure and disciplinary history of each nurse, as contributed by party 37 states, to assist in the coordination of nurse licensure and enforcement 38 efforts. 39 (2) Notwithstanding any other provision of law, all party states' licens- 40 ing boards shall promptly report adverse actions, actions against multistate 41 licensure privileges, any current significant investigative information yet to 42 result in adverse action, denials of applications, and the reasons for such 43 denials, to the coordinated licensure information system. 44 (3) Current significant investigative information shall be transmitted 45 through the coordinated licensure information system only to party states' 46 licensing boards. 47 (4) Notwithstanding any other provision of law, all party states' licens- 48 ing boards contributing information to the coordinated licensure information 49 system may designate information that may not be shared with nonparty states 50 or disclosed to other entities or individuals without the express permission 51 of the contributing state. 52 (5) Any personally indentifiable information obtained by a party states' 53 licensing board from the coordinated licensure information system may not be 8 1 shared with nonparty states or disclosed to other entities or individuals 2 except to the extent permitted by the laws of the party state contributing the 3 information. 4 (6) Any information contributed to the coordinated licensure information 5 system that is subsequently required to be expunged by the laws of the party 6 state contributing that information, shall also be expunged from the coordi- 7 nated licensure information system. 8 (7) The compact administrators, acting jointly with each other and in 9 consultation with the administrator of the coordinated licensure information 10 system, shall formulate necessary and proper procedures for the identifica- 11 tion, collection, and exchange of information under this compact. 12 ARTICLE VIII 13 COMPACT ADMINISTRATION AND INTERCHANGE OF INFORMATION 14 (1) The head of the nurse licensing board, or his/her designee, of each 15 party state shall be the administrator of this compact for his/her state. 16 (2) The compact administrator of each party state shall furnish to the 17 compact administrator of each other party state any information and documents 18 including, but not limited to, a uniform data set of investigations, identify- 19 ing information, licensure data, and disclosable alternative program partici- 20 pation information to facilitate the administration of this compact. 21 (3) Compact administrators shall have the authority to develop uniform 22 rules to facilitate and coordinate implementation of this compact. These uni- 23 form rules shall be adopted by party states under the authority invested under 24 article VI(4). 25 ARTICLE IX 26 IMMUNITY 27 No party state or the officers or employees or agents of a party state's 28 nurse licensing board who acts in accordance with the provisions of this com- 29 pact shall be liable on account of any act or omission in good faith while 30 engaged in the performance of their duties under this compact. Good faith in 31 this article shall not include willful misconduct, gross negligence or reck- 32 lessness. 33 ARTICLE X 34 ENTRY INTO FORCE, WITHDRAWAL AND AMENDMENT 35 (1) This compact shall enter into force and become effective as to any 36 state when it has been enacted into the laws of that state. Any party state 37 may withdraw from this compact by enacting a statute repealing the same, but 38 no such withdrawal shall take effect until six (6) months after the withdraw- 39 ing state has given notice of the withdrawal to the executive heads of all 40 other party states. 41 (2) No withdrawal shall affect the validity or applicability by the 42 licensing boards of states remaining party to the compact of any report of 43 adverse action occurring prior to the withdrawal. 44 (3) Nothing contained in this compact shall be construed to invalidate or 45 prevent any nurse licensure agreement or other cooperative arrangement between 46 a party state and a nonparty state that is made in accordance with the other 47 provisions of this compact. 48 (4) This compact may be amended by the party states. No amendment to this 49 compact shall become effective and binding upon the party states unless and 50 until it is enacted into the laws of all party states. 51 ARTICLE XI 9 1 CONSTRUCTION AND SEVERABILITY 2 (1) This compact shall be liberally construed so as to effectuate the 3 purposes thereof. The provisions of this compact shall be severable and if any 4 phrase, clause, sentence, or provision of this compact is declared to be con- 5 trary to the constitution of any party state or of the United States or the 6 applicability thereof to any government, agency, person, or circumstance is 7 held invalid, the validity of the remainder of this compact and the applica- 8 bility thereof to any government, agency, person, or circumstance shall not be 9 affected thereby. If this compact shall be held contrary to the constitution 10 of any state party thereto, the compact shall remain in full force and effect 11 as to the remaining party states and in full force and effect as to the party 12 state affected as to a severable matter. 13 (2) In the event party states find a need for settling disputes arising 14 under this compact: 15 (a) The party states may submit the issues in dispute to an arbitration 16 panel which will be comprised of an individual appointed by the compact 17 administrator in the home state; an individual appointed by the compact 18 administrator in the remote state(s) involved; and an individual mutually 19 agreed upon by the compact administrators of all the party states involved 20 in the dispute; and 21 (b) The decision of a majority of the arbitrators shall be final and 22 binding. 23 SECTION 4. This act shall be in full force and effect on and after July 24 1, 2000.
STATEMENT OF PURPOSE RS09327 The purpose of this proposed legislation is to adopt the Interstate Compact for Mutual Recognition of Licensure and provide authority for the Board of Nursing to become a signatory party. FISCAL IMPACT There may be a negative impact. It is anticipated that multi-state regulation will reduce the number of applications and licenses, which will reduce payments of licensing and application fees. CONTACT: Sandra Evans, Executive Director Idaho State Board of Nursing 334-3110