Bill Text: IL HB4988 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Nurse Practice Act. Ratifies and approves the Nurse Licensure Compact, which allows for the issuance of multistate licenses that allow nurses to practice in their home state and other compact states. Provides that the Compact does not supersede existing State labor laws. Provides that the State may not share with or disclose to the Interstate Commission of Nurse Licensure Compact Administrators or any other state any of the contents of a nationwide criminal history records check conducted for the purpose of multistate licensure under the Nurse Licensure Compact. Makes conforming changes.

Spectrum: Partisan Bill (Republican 4-0)

Status: (Introduced) 2024-04-05 - Rule 19(a) / Re-referred to Rules Committee [HB4988 Detail]

Download: Illinois-2023-HB4988-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB4988 Introduced , by Rep. Ryan Spain SYNOPSIS AS INTRODUCED:
225 ILCS 65/50-10 was 225 ILCS 65/5-10
225 ILCS 65/50-15 was 225 ILCS 65/5-15
225 ILCS 65/Art. 85 heading new
225 ILCS 65/85-5 new
225 ILCS 65/85-10 new
225 ILCS 65/85-15 new
Amends the Nurse Practice Act. Ratifies and approves the Nurse Licensure Compact, which allows for the issuance of multistate licenses that allow nurses to practice in their home state and other compact states. Provides that the Compact does not supersede existing State labor laws. Provides that the State may not share with or disclose to the Interstate Commission of Nurse Licensure Compact Administrators or any other state any of the contents of a nationwide criminal history records check conducted for the purpose of multistate licensure under the Nurse Licensure Compact. Makes conforming changes.
LRB103 36089 SPS 66178 b
A BILL FOR
HB4988 LRB103 36089 SPS 66178 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Nurse Practice Act is amended by changing
Sections 50-10 and 50-15 and by adding Article 85 as follows:
(225 ILCS 65/50-10) (was 225 ILCS 65/5-10)
(Section scheduled to be repealed on January 1, 2028)
Sec. 50-10. Definitions. Each of the following terms, when
used in this Act, shall have the meaning ascribed to it in this
Section, except where the context clearly indicates otherwise:
"Academic year" means the customary annual schedule of
courses at a college, university, or approved school,
customarily regarded as the school year as distinguished from
the calendar year.
"Address of record" means the designated address recorded
by the Department in the applicant's or licensee's application
file or license file as maintained by the Department's
licensure maintenance unit.
"Advanced practice registered nurse" or "APRN" means a
person who has met the qualifications for a (i) certified
nurse midwife (CNM); (ii) certified nurse practitioner (CNP);
(iii) certified registered nurse anesthetist (CRNA); or (iv)
clinical nurse specialist (CNS) and either has been licensed

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by the Department or holds a multistate license issued by a
party state, as those terms are defined in Article 85. All
advanced practice registered nurses licensed and practicing in
the State of Illinois shall use the title APRN and may use
specialty credentials CNM, CNP, CRNA, or CNS after their name.
All advanced practice registered nurses may only practice in
accordance with national certification and this Act.
"Advisory Board" means the Illinois Nursing Workforce
Center Advisory Board.
"Approved program of professional nursing education" and
"approved program of practical nursing education" are programs
of professional or practical nursing, respectively, approved
by the Department under the provisions of this Act.
"Board" means the Board of Nursing appointed by the
Secretary.
"Center" means the Illinois Nursing Workforce Center.
"Collaboration" means a process involving 2 or more health
care professionals working together, each contributing one's
respective area of expertise to provide more comprehensive
patient care.
"Competence" means an expected and measurable level of
performance that integrates knowledge, skills, abilities, and
judgment based on established scientific knowledge and
expectations for nursing practice.
"Comprehensive nursing assessment" means the gathering of
information about the patient's physiological, psychological,

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sociological, and spiritual status on an ongoing basis by a
registered professional nurse and is the first step in
implementing and guiding the nursing plan of care.
"Consultation" means the process whereby an advanced
practice registered nurse seeks the advice or opinion of
another health care professional.
"Credentialed" means the process of assessing and
validating the qualifications of a health care professional.
"Dentist" means a person licensed to practice dentistry
under the Illinois Dental Practice Act.
"Department" means the Department of Financial and
Professional Regulation.
"Email address of record" means the designated email
address recorded by the Department in the applicant's
application file or the licensee's license file, as maintained
by the Department's licensure maintenance unit.
"Focused nursing assessment" means an appraisal of an
individual's status and current situation, contributing to the
comprehensive nursing assessment performed by the registered
professional nurse or advanced practice registered nurse or
the assessment by the physician assistant, physician, dentist,
podiatric physician, or other licensed health care
professional, as determined by the Department, supporting
ongoing data collection, and deciding who needs to be informed
of the information and when to inform.
"Full practice authority" means the authority of an

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advanced practice registered nurse licensed in Illinois and
certified as a nurse practitioner, clinical nurse specialist,
or nurse midwife to practice without a written collaborative
agreement and:
(1) to be fully accountable to patients for the
quality of advanced nursing care rendered;
(2) to be fully accountable for recognizing limits of
knowledge and experience and for planning for the
management of situations beyond the advanced practice
registered nurse's expertise; the full practice authority
for advanced practice registered nurses includes accepting
referrals from, consulting with, collaborating with, or
referring to other health care professionals as warranted
by the needs of the patient; and
(3) to possess the authority to prescribe medications,
including Schedule II through V controlled substances, as
provided in Section 65-43.
"Hospital affiliate" means a corporation, partnership,
joint venture, limited liability company, or similar
organization, other than a hospital, that is devoted primarily
to the provision, management, or support of health care
services and that directly or indirectly controls, is
controlled by, or is under common control of the hospital. For
the purposes of this definition, "control" means having at
least an equal or a majority ownership or membership interest.
A hospital affiliate shall be 100% owned or controlled by any

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combination of hospitals, their parent corporations, or
physicians licensed to practice medicine in all its branches
in Illinois. "Hospital affiliate" does not include a health
maintenance organization regulated under the Health
Maintenance Organization Act.
"Impaired nurse" means a nurse licensed under this Act who
is unable to practice with reasonable skill and safety because
of a physical or mental disability as evidenced by a written
determination or written consent based on clinical evidence,
including loss of motor skills, abuse of drugs or alcohol, or a
psychiatric disorder, of sufficient degree to diminish his or
her ability to deliver competent patient care.
"License-pending advanced practice registered nurse" means
a registered professional nurse who has completed all
requirements for licensure as an advanced practice registered
nurse except the certification examination and has applied to
take the next available certification exam and received a
temporary permit from the Department.
"License-pending registered nurse" means a person who has
passed the Department-approved registered nurse licensure exam
and has applied for a license from the Department. A
license-pending registered nurse shall use the title "RN lic
pend" on all documentation related to nursing practice.
"Nursing intervention" means any treatment based on
clinical nursing judgment or knowledge that a nurse performs.
An individual or entity shall not mandate that a registered

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professional nurse delegate nursing interventions if the
registered professional nurse determines it is inappropriate
to do so. A nurse shall not be subject to disciplinary or any
other adverse action for refusing to delegate a nursing
intervention based on patient safety.
"Physician" means a person licensed to practice medicine
in all its branches under the Medical Practice Act of 1987.
"Podiatric physician" means a person licensed to practice
podiatry under the Podiatric Medical Practice Act of 1987.
"Practical nurse" or "licensed practical nurse" means a
person who practices practical nursing as defined in this Act
and either is licensed as a practical nurse under this Act or
holds a multistate license issued by a party state, as those
terms are defined in Article 85 and practices practical
nursing as defined in this Act. Only a practical nurse
licensed under this Act is entitled to use the title "licensed
practical nurse" and the abbreviation "L.P.N.".
"Practical nursing" means the performance of nursing
interventions requiring the nursing knowledge, judgment, and
skill acquired by means of completion of an approved practical
nursing education program. Practical nursing includes
assisting in the nursing process under the guidance of a
registered professional nurse or an advanced practice
registered nurse. The practical nurse may work under the
direction of a licensed physician, dentist, podiatric
physician, or other health care professional determined by the

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Department.
"Privileged" means the authorization granted by the
governing body of a healthcare facility, agency, or
organization to provide specific patient care services within
well-defined limits, based on qualifications reviewed in the
credentialing process.
"Registered Nurse" or "Registered Professional Nurse"
means a person who practices nursing as defined in this Act and
either is licensed as a professional nurse under this Act or
holds a multistate license issued by a party state, as those
terms are defined in Article 85 and practices nursing as
defined in this Act. Only a registered nurse licensed under
this Act is entitled to use the titles "registered nurse" and
"registered professional nurse" and the abbreviation, "R.N.".
"Registered professional nursing practice" means a
scientific process founded on a professional body of knowledge
that includes, but is not limited to, the protection,
promotion, and optimization of health and abilities,
prevention of illness and injury, development and
implementation of the nursing plan of care, facilitation of
nursing interventions to alleviate suffering, care
coordination, and advocacy in the care of individuals,
families, groups, communities, and populations. "Registered
professional nursing practice" does not include the act of
medical diagnosis or prescription of medical therapeutic or
corrective measures.

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"Professional assistance program for nurses" means a
professional assistance program that meets criteria
established by the Board of Nursing and approved by the
Secretary, which provides a non-disciplinary treatment
approach for nurses licensed under this Act whose ability to
practice is compromised by alcohol or chemical substance
addiction.
"Secretary" means the Secretary of Financial and
Professional Regulation.
"Unencumbered license" means a license issued in good
standing.
"Written collaborative agreement" means a written
agreement between an advanced practice registered nurse and a
collaborating physician, dentist, or podiatric physician
pursuant to Section 65-35.
(Source: P.A. 103-154, eff. 6-30-23.)
(225 ILCS 65/50-15) (was 225 ILCS 65/5-15)
(Section scheduled to be repealed on January 1, 2028)
Sec. 50-15. Policy; application of Act.
(a) For the protection of life and the promotion of
health, and the prevention of illness and communicable
diseases, any person practicing or offering to practice
advanced, professional, or practical nursing in Illinois shall
submit evidence that he or she is qualified to practice, and
shall be licensed as provided under this Act. No person shall

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practice or offer to practice advanced, professional, or
practical nursing in Illinois or use any title, sign, card or
device to indicate that such a person is practicing
professional or practical nursing unless such person has been
licensed under the provisions of this Act.
(b) This Act does not prohibit the following:
(1) The practice of nursing in Federal employment in
the discharge of the employee's duties by a person who is
employed by the United States government or any bureau,
division or agency thereof and is a legally qualified and
licensed nurse of another state or territory and not in
conflict with Sections 50-50, 55-10, 60-10, and 70-5 of
this Act.
(2) Nursing that is included in the program of study
by students enrolled in programs of nursing or in current
nurse practice update courses approved by the Department.
(3) The furnishing of nursing assistance in an
emergency.
(4) The practice of nursing by a nurse who holds an
active license in another state when providing services to
patients in Illinois during a bonafide emergency or in
immediate preparation for or during interstate transit.
(5) The incidental care of the sick by members of the
family, domestic servants or housekeepers, or care of the
sick where treatment is by prayer or spiritual means.
(6) Persons from being employed as unlicensed

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assistive personnel in private homes, long term care
facilities, nurseries, hospitals or other institutions.
(7) The practice of practical nursing by one who is a
licensed practical nurse under the laws of another U.S.
jurisdiction and has applied in writing to the Department,
in form and substance satisfactory to the Department, for
a license as a licensed practical nurse and who is
qualified to receive such license under this Act, until
(i) the expiration of 6 months after the filing of such
written application, (ii) the withdrawal of such
application, or (iii) the denial of such application by
the Department.
(7.5) The practice of practical nursing by one who is
a practical nurse under a multistate license issued by a
party state, as those terms are defined in Article 85, and
has applied in writing to the Department, in form and
substance satisfactory to the Department, for a license as
a practical nurse and who is qualified to receive such
license under this Act, until (i) the expiration of 6
months after the filing of such written application, (ii)
the withdrawal of such application, or (iii) the denial of
such application by the Department.
(8) The practice of advanced practice registered
nursing by one who is an advanced practice registered
nurse under the laws of another United States jurisdiction
or a foreign jurisdiction and has applied in writing to

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the Department, in form and substance satisfactory to the
Department, for a license as an advanced practice
registered nurse and who is qualified to receive such
license under this Act, until (i) the expiration of 6
months after the filing of such written application, (ii)
the withdrawal of such application, or (iii) the denial of
such application by the Department.
(8.5) The practice of advanced practice registered
nursing by one who is an advanced practice registered
nurse under a multistate license issued by a party state,
as those terms are defined in Article 85, and has applied
in writing to the Department, in form and substance
satisfactory to the Department, for a license as an
advanced practice registered nurse and who is qualified to
receive such license under this Act, until (i) the
expiration of 6 months after the filing of such written
application, (ii) the withdrawal of such application, or
(iii) the denial of such application by the Department.
(9) The practice of professional nursing by one who is
a registered professional nurse under the laws of another
United States jurisdiction or a foreign jurisdiction and
has applied in writing to the Department, in form and
substance satisfactory to the Department, for a license as
a registered professional nurse and who is qualified to
receive such license under Section 55-10, until (1) the
expiration of 6 months after the filing of such written

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application, (2) the withdrawal of such application, or
(3) the denial of such application by the Department.
(9.5) The practice of professional nursing by one who
is a registered professional nurse under a multistate
license issued by a party state, as those terms are
defined in Article 85, and has applied in writing to the
Department, in form and substance satisfactory to the
Department, for a license as a professional nurse and who
is qualified to receive such license under this Act, until
(i) the expiration of 6 months after the filing of such
written application, (ii) the withdrawal of such
application, or (iii) the denial of such application by
the Department.
(10) The practice of professional nursing that is
included in a program of study by one who is a registered
professional nurse under the laws of another United States
jurisdiction or a foreign jurisdiction and who is enrolled
in a graduate nursing education program or a program for
the completion of a baccalaureate nursing degree in this
State, which includes clinical supervision by faculty as
determined by the educational institution offering the
program and the health care organization where the
practice of nursing occurs.
(10.5) The practice of professional nursing that is
included in a program of study by one who is a registered
professional nurse under a multistate license issued by a

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party state, as those terms are defined in Article 85, and
has applied in writing to the Department, in form and
substance satisfactory to the Department, for a license as
a professional nurse and who is qualified to receive such
license under this Act, until (i) the expiration of 6
months after the filing of such written application, (ii)
the withdrawal of such application, or (iii) the denial of
such application by the Department.
(11) Any person licensed in this State under any other
Act from engaging in the practice for which she or he is
licensed.
(12) Delegation to authorized direct care staff
trained under Section 15.4 of the Mental Health and
Developmental Disabilities Administrative Act consistent
with the policies of the Department.
(13) (Blank).
(14) County correctional personnel from delivering
prepackaged medication for self-administration to an
individual detainee in a correctional facility.
Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician, dentist, or
podiatric physician to a licensed practical nurse, a
registered professional nurse, or other persons.
(Source: P.A. 100-513, eff. 1-1-18.)
(225 ILCS 65/Art. 85 heading new)

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ARTICLE 85. NURSE LICENSURE COMPACT
(225 ILCS 65/85-5 new)
Sec. 85-5. Nurse Licensure Compact. The State of Illinois
ratifies and approves the following Compact:
ARTICLE I
Findings and Declaration of Purpose
a. The party states find that:
1. 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;
2. Violations of nurse licensure and other laws
regulating the practice of nursing may result in injury or
harm to the public;
3. 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;
4. New practice modalities and technology make
compliance with individual state nurse licensure laws
difficult and complex;
5. The current system of duplicative licensure for

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nurses practicing in multiple states is cumbersome and
redundant for both nurses and states; and
6. Uniformity of nurse licensure requirements
throughout the states promotes public safety and public
health benefits.
b. The general purposes of this Compact are to:
1. Facilitate the states' responsibility to protect
the public's health and safety;
2. Ensure and encourage the cooperation of party
states in the areas of nurse licensure and regulation;
3. Facilitate the exchange of information between
party states in the areas of nurse regulation,
investigation and adverse actions;
4. Promote compliance with the laws governing the
practice of nursing in each jurisdiction;
5. 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;
6. Decrease redundancies in the consideration and
issuance of nurse licenses; and
7. Provide opportunities for interstate practice by
nurses who meet uniform licensure requirements.
ARTICLE II

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Definitions
As used in this Compact:
a. "Adverse action" means any administrative, civil,
equitable or criminal action permitted by a state's laws
which is imposed by a licensing board or other authority
against a nurse, including actions against an individual's
license or multistate licensure privilege such as
revocation, suspension, probation, monitoring of the
licensee, limitation on the licensee's practice, or any
other encumbrance on licensure affecting a nurse's
authorization to practice, including issuance of a cease
and desist action.
b. "Alternative program" means a non-disciplinary
monitoring program approved by a licensing board.
c. "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 that is administered by a
nonprofit organization composed of and controlled by
licensing boards.
d. "Current significant investigative information"
means:
1. Investigative information that a licensing
board, after a preliminary inquiry that includes
notification and an opportunity for the nurse to

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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
2. 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.
e. "Encumbrance" means a revocation or suspension of,
or any limitation on, the full and unrestricted practice
of nursing imposed by a licensing board.
f. "Home state" means the party state which is the
nurse's primary state of residence.
g. "Licensing board" means a party state's regulatory
body responsible for issuing nurse licenses.
h. "Multistate license" means a license to practice as
a registered or a licensed practical/vocational nurse
(LPN/VN) issued by a home state licensing board that
authorizes the licensed nurse to practice in all party
states under a multistate licensure privilege.
i. "Multistate licensure privilege" means a legal
authorization associated with a multistate license
permitting the practice of nursing as either a registered
nurse (RN) or LPN/VN in a remote state.
j. "Nurse" means RN or LPN/VN, as those terms are
defined by each party state's practice laws.
k. "Party state" means any state that has adopted this

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Compact.
l. "Remote state" means a party state, other than the
home state.
m. "Single-state license" means a nurse license issued
by a party state that authorizes practice only within the
issuing state and does not include a multistate licensure
privilege to practice in any other party state.
n. "State" means a state, territory or possession of
the United States and the District of Columbia.
o. "State practice laws" means a party state's laws,
rules 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" do not include requirements necessary to
obtain and retain a license, except for qualifications or
requirements of the home state.
ARTICLE III
General Provisions and Jurisdiction
a. A multistate license to practice registered or 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 nurse to practice as a registered nurse (RN)
or as a licensed practical/vocational nurse (LPN/VN), under a
multistate licensure privilege, in each party state.

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b. A state must implement procedures for considering the
criminal history records of applicants for initial multistate
license or licensure by endorsement. Such procedures shall
include the submission of fingerprints or other
biometric-based information by applicants for the purpose of
obtaining an applicant's criminal history record information
from the Federal Bureau of Investigation and the agency
responsible for retaining that state's criminal records.
c. Each party state shall require the following for an
applicant to obtain or retain a multistate license in the home
state:
1. Meets the home state's qualifications for licensure
or renewal of licensure, as well as, all other applicable
state laws;
2. i. Has graduated or is eligible to graduate from a
licensing board-approved RN or LPN/VN prelicensure
education program; or
ii. Has graduated from a foreign RN or LPN/VN
prelicensure education program that (a) has been approved
by the authorized accrediting body in the applicable
country and (b) has been verified by an independent
credentials review agency to be comparable to a licensing
board-approved prelicensure education program;
3. Has, if a graduate of a foreign prelicensure
education program not taught in English or if English is
not the individual's native language, successfully passed

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an English proficiency examination that includes the
components of reading, speaking, writing and listening;
4. Has successfully passed an NCLEX-RN® or NCLEX-PN®
Examination or recognized predecessor, as applicable;
5. Is eligible for or holds an active, unencumbered
license;
6. Has submitted, in connection with an application
for initial licensure or licensure by endorsement,
fingerprints or other biometric data for the purpose of
obtaining criminal history record information from the
Federal Bureau of Investigation and the agency responsible
for retaining that state's criminal records;
7. Has not been convicted or found guilty, or has
entered into an agreed disposition, of a felony offense
under applicable state or federal criminal law;
8. Has not been convicted or found guilty, or has
entered into an agreed disposition, of a misdemeanor
offense related to the practice of nursing as determined
on a case-by-case basis;
9. Is not currently enrolled in an alternative
program;
10. Is subject to self-disclosure requirements
regarding current participation in an alternative program;
and
11. Has a valid United States Social Security number.
d. All party states shall be authorized, in accordance

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with existing state due process law, to take adverse action
against a nurse's multistate licensure privilege such as
revocation, suspension, probation or any other action that
affects a nurse's authorization to practice under a multistate
licensure privilege, including cease and desist actions. 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.
e. A nurse practicing in a party state must comply with the
state practice laws of the state in which the client is located
at the time service is provided. The practice of nursing is not
limited to patient care, but shall include all nursing
practice as defined by the state practice laws of the party
state in which the client is located. The practice of nursing
in a party state under a multistate licensure privilege will
subject a nurse to the jurisdiction of the licensing board,
the courts and the laws of the party state in which the client
is located at the time service is provided.
f. Individuals not residing in a party state shall
continue to be able to apply for a party state's single-state
license as provided under the laws of each party state.
However, the single-state license granted to these individuals
will not be recognized as granting the privilege to practice
nursing in any other party state. Nothing in this Compact

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shall affect the requirements established by a party state for
the issuance of a single-state license.
g. Any nurse holding a home state multistate license, on
the effective date of this Compact, may retain and renew the
multistate license issued by the nurse's then-current home
state, provided that:
1. A nurse, who changes primary state of residence
after this Compact's effective date, must meet all
applicable Article III.c. requirements to obtain a
multistate license from a new home state.
2. A nurse who fails to satisfy the multistate
licensure requirements in Article III.c. due to a
disqualifying event occurring after this Compact's
effective date shall be ineligible to retain or renew a
multistate license, and the nurse's multistate license
shall be revoked or deactivated in accordance with
applicable rules adopted by the Interstate Commission of
Nurse Licensure Compact Administrators ("Commission").
ARTICLE IV
Applications for Licensure in a Party State
a. Upon application for a multistate license, the
licensing board in the issuing party state shall ascertain,
through the coordinated licensure information system, whether
the applicant has ever held, or is the holder of, a license

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issued by any other state, whether there are any encumbrances
on any license or multistate licensure privilege held by the
applicant, whether any adverse action has been taken against
any license or multistate licensure privilege held by the
applicant and whether the applicant is currently participating
in an alternative program.
b. A nurse may hold a multistate license, issued by the
home state, in only one party state at a time.
c. If a nurse changes primary state of residence by moving
between two party states, the nurse must apply for licensure
in the new home state, and the multistate license issued by the
prior home state will be deactivated in accordance with
applicable rules adopted by the Commission.
1. The nurse may apply for licensure in advance of a
change in primary state of residence.
2. A multistate license shall not be issued by the new
home state until the nurse provides satisfactory evidence
of a change in primary state of residence to the new home
state and satisfies all applicable requirements to obtain
a multistate license from the new home state.
d. If a nurse changes primary state of residence by moving
from a party state to a non-party state, the multistate
license issued by the prior home state will convert to a
single-state license, valid only in the former home state.
ARTICLE V

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Additional Authorities Invested in Party State Licensing
Boards
a. In addition to the other powers conferred by state law,
a licensing board shall have the authority to:
1. Take adverse action against a nurse's multistate
licensure privilege to practice within that party state.
i. Only the home state shall have the power to take
adverse action against a nurse's license issued by the
home state.
ii. For purposes of taking adverse action, the
home state licensing board 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, the home state
shall apply its own state laws to determine
appropriate action.
2. Issue cease and desist orders or impose an
encumbrance on a nurse's authority to practice within that
party state.
3. Complete any pending investigations of a nurse who
changes primary state of residence during the course of
such investigations. The licensing board 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

HB4988 - 25 - LRB103 36089 SPS 66178 b
system. The administrator of the coordinated licensure
information system shall promptly notify the new home
state of any such actions.
4. Issue subpoenas for both hearings and
investigations that require the attendance and testimony
of witnesses, as well as, the production of evidence.
Subpoenas issued by a licensing board in a party state for
the attendance and testimony of witnesses 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
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 in which the
witnesses or evidence are located.
5. Obtain and submit, for each nurse licensure
applicant, fingerprint or other biometric-based
information to the Federal Bureau of Investigation for
criminal background checks, receive the results of the
Federal Bureau of Investigation record search on criminal
background checks and use the results in making licensure
decisions.
6. If otherwise permitted by state law, recover from
the affected nurse the costs of investigations and
disposition of cases resulting from any adverse action

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taken against that nurse.
7. Take adverse action based on the factual findings
of the remote state, provided that the licensing board
follows its own procedures for taking such adverse action.
b. If adverse action is taken by the home state against a
nurse's multistate license, the nurse's multistate licensure
privilege to practice in all other party states shall be
deactivated until all encumbrances have been removed from the
multistate license. All home state disciplinary orders that
impose adverse action against a nurse's multistate license
shall include a statement that the nurse's multistate
licensure privilege is deactivated in all party states during
the pendency of the order.
c. Nothing in this Compact shall override a party state's
decision that participation in an alternative program may be
used in lieu of adverse action. The home state licensing board
shall deactivate the multistate licensure privilege under the
multistate license of any nurse for the duration of the
nurse's participation in an alternative program.
ARTICLE VI
Coordinated Licensure Information System and Exchange of
Information
a. All party states shall participate in a coordinated
licensure information system of all licensed registered nurses

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(RNs) and licensed practical/vocational nurses (LPNs/VNs).
This system will include information on the licensure and
disciplinary history of each nurse, as submitted by party
states, to assist in the coordination of nurse licensure and
enforcement efforts.
b. The Commission, 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.
c. All licensing boards shall promptly report to the
coordinated licensure information system any adverse action,
any current significant investigative information, denials of
applications (with the reasons for such denials) and nurse
participation in alternative programs known to the licensing
board regardless of whether such participation is deemed
nonpublic or confidential under state law.
d. Current significant investigative information and
participation in nonpublic or confidential alternative
programs shall be transmitted through the coordinated
licensure information system only to party state licensing
boards.
e. Notwithstanding any other provision of law, all party
state licensing boards contributing information to the
coordinated licensure information system may designate
information that may not be shared with non-party states or

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disclosed to other entities or individuals without the express
permission of the contributing state.
f. Any personally identifiable information obtained from
the coordinated licensure information system by a party state
licensing board shall 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.
g. 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 shall also be expunged from the coordinated
licensure information system.
h. The Compact administrator of each party state shall
furnish a uniform data set to the Compact administrator of
each other party state, which shall include, at a minimum:
1. Identifying information;
2. Licensure data;
3. Information related to alternative program
participation; and
4. Other information that may facilitate the
administration of this Compact, as determined by
Commission rules.
i. The Compact administrator of a party state shall
provide all investigative documents and information requested
by another party state.

HB4988 - 29 - LRB103 36089 SPS 66178 b
ARTICLE VII
Establishment of the Interstate Commission of Nurse Licensure
Compact Administrators
a. The party states hereby create and establish a joint
public entity known as the Interstate Commission of Nurse
Licensure Compact Administrators.
1. The Commission is an instrumentality of the party
states.
2. Venue is proper, and judicial proceedings by or
against the Commission shall be brought solely and
exclusively, in a court of competent jurisdiction where
the principal office of the Commission is located. The
Commission may waive venue and jurisdictional defenses to
the extent it adopts or consents to participate in
alternative dispute resolution proceedings.
3. Nothing in this Compact shall be construed to be a
waiver of sovereign immunity.
b. Membership, Voting and Meetings
1. Each party state shall have and be limited to one
administrator. The head of the state licensing board or
designee shall be the administrator of this Compact for
each party state. Any administrator may be removed or
suspended from office as provided by the law of the state
from which the Administrator is appointed. Any vacancy

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occurring in the Commission shall be filled in accordance
with the laws of the party state in which the vacancy
exists.
2. Each administrator shall be entitled to one (1)
vote with regard to the promulgation of rules and creation
of bylaws and shall otherwise have an opportunity to
participate in the business and affairs of the Commission.
An administrator shall vote in person or by such other
means as provided in the bylaws. The bylaws may provide
for an administrator's participation in meetings by
telephone or other means of communication.
3. The Commission shall meet at least once during each
calendar year. Additional meetings shall be held as set
forth in the bylaws or rules of the commission.
4. All meetings shall be open to the public, and
public notice of meetings shall be given in the same
manner as required under the rulemaking provisions in
Article VIII.
5. The Commission may convene in a closed, nonpublic
meeting if the Commission must discuss:
i. Noncompliance of a party state with its
obligations under this Compact;
ii. The employment, compensation, discipline or
other personnel matters, practices or procedures
related to specific employees or other matters related
to the Commission's internal personnel practices and

HB4988 - 31 - LRB103 36089 SPS 66178 b
procedures;
iii. Current, threatened or reasonably anticipated
litigation;
iv. Negotiation of contracts for the purchase or
sale of goods, services or real estate;
v. Accusing any person of a crime or formally
censuring any person;
vi. Disclosure of trade secrets or commercial or
financial information that is privileged or
confidential;
vii. Disclosure of information of a personal
nature where disclosure would constitute a clearly
unwarranted invasion of personal privacy;
viii. Disclosure of investigatory records compiled
for law enforcement purposes;
ix. Disclosure of information related to any
reports prepared by or on behalf of the Commission for
the purpose of investigation of compliance with this
Compact; or
x. Matters specifically exempted from disclosure
by federal or state statute.
6. If a meeting, or portion of a meeting, is closed
pursuant to this provision, the Commission's legal counsel
or designee shall certify that the meeting may be closed
and shall reference each relevant exempting provision. The
Commission shall keep minutes that fully and clearly

HB4988 - 32 - LRB103 36089 SPS 66178 b
describe all matters discussed in a meeting and shall
provide a full and accurate summary of actions taken, and
the reasons therefor, including a description of the views
expressed. All documents considered in connection with an
action shall be identified in such minutes. All minutes
and documents of a closed meeting shall remain under seal,
subject to release by a majority vote of the Commission or
order of a court of competent jurisdiction.
c. The Commission shall, by a majority vote of the
administrators, prescribe bylaws or rules to govern its
conduct as may be necessary or appropriate to carry out the
purposes and exercise the powers of this Compact, including
but not limited to:
1. Establishing the fiscal year of the Commission;
2. Providing reasonable standards and procedures:
i. For the establishment and meetings of other
committees; and
ii. Governing any general or specific delegation
of any authority or function of the Commission;
3. Providing reasonable procedures for calling and
conducting meetings of the Commission, ensuring reasonable
advance notice of all meetings and providing an
opportunity for attendance of such meetings by interested
parties, with enumerated exceptions designed to protect
the public's interest, the privacy of individuals, and
proprietary information, including trade secrets. The

HB4988 - 33 - LRB103 36089 SPS 66178 b
Commission may meet in closed session only after a
majority of the administrators vote to close a meeting in
whole or in part. As soon as practicable, the Commission
must make public a copy of the vote to close the meeting
revealing the vote of each administrator, with no proxy
votes allowed;
4. Establishing the titles, duties and authority and
reasonable procedures for the election of the officers of
the Commission;
5. Providing reasonable standards and procedures for
the establishment of the personnel policies and programs
of the Commission. Notwithstanding any civil service or
other similar laws of any party state, the bylaws shall
exclusively govern the personnel policies and programs of
the Commission; and
6. Providing a mechanism for winding up the operations
of the Commission and the equitable disposition of any
surplus funds that may exist after the termination of this
Compact after the payment or reserving of all of its debts
and obligations;
d. The Commission shall publish its bylaws and rules, and
any amendments thereto, in a convenient form on the website of
the Commission.
e. The Commission shall maintain its financial records in
accordance with the bylaws.
f. The Commission shall meet and take such actions as are

HB4988 - 34 - LRB103 36089 SPS 66178 b
consistent with the provisions of this Compact and the bylaws.
g. The Commission shall have the following powers:
1. To promulgate uniform rules to facilitate and
coordinate implementation and administration of this
Compact. The rules shall have the force and effect of law
and shall be binding in all party states;
2. To bring and prosecute legal proceedings or actions
in the name of the Commission, provided that the standing
of any licensing board to sue or be sued under applicable
law shall not be affected;
3. To purchase and maintain insurance and bonds;
4. To borrow, accept or contract for services of
personnel, including, but not limited to, employees of a
party state or nonprofit organizations;
5. To cooperate with other organizations that
administer state compacts related to the regulation of
nursing, including but not limited to sharing
administrative or staff expenses, office space or other
resources;
6. To hire employees, elect or appoint officers, fix
compensation, define duties, grant such individuals
appropriate authority to carry out the purposes of this
Compact, and to establish the Commission's personnel
policies and programs relating to conflicts of interest,
qualifications of personnel and other related personnel
matters;

HB4988 - 35 - LRB103 36089 SPS 66178 b
7. To accept any and all appropriate donations, grants
and gifts of money, equipment, supplies, materials and
services, and to receive, utilize and dispose of the same;
provided that at all times the Commission shall avoid any
appearance of impropriety or conflict of interest;
8. To lease, purchase, accept appropriate gifts or
donations of, or otherwise to own, hold, improve or use,
any property, whether real, personal or mixed; provided
that at all times the Commission shall avoid any
appearance of impropriety;
9. To sell, convey, mortgage, pledge, lease, exchange,
abandon or otherwise dispose of any property, whether
real, personal or mixed;
10. To establish a budget and make expenditures;
11. To borrow money;
12. To appoint committees, including advisory
committees comprised of administrators, state nursing
regulators, state legislators or their representatives,
and consumer representatives, and other such interested
persons;
13. To provide and receive information from, and to
cooperate with, law enforcement agencies;
14. To adopt and use an official seal; and
15. To perform such other functions as may be
necessary or appropriate to achieve the purposes of this
Compact consistent with the state regulation of nurse

HB4988 - 36 - LRB103 36089 SPS 66178 b
licensure and practice.
h. Financing of the Commission
1. The Commission shall pay, or provide for the
payment of, the reasonable expenses of its establishment,
organization and ongoing activities.
2. The Commission may also levy on and collect an
annual assessment from each party state to cover the cost
of its operations, activities and staff in its annual
budget as approved each year. The aggregate annual
assessment amount, if any, shall be allocated based upon a
formula to be determined by the Commission, which shall
promulgate a rule that is binding upon all party states.
3. The Commission shall not incur obligations of any
kind prior to securing the funds adequate to meet the
same; nor shall the Commission pledge the credit of any of
the party states, except by, and with the authority of,
such party state.
4. The Commission shall keep accurate accounts of all
receipts and disbursements. The receipts and disbursements
of the Commission shall be subject to the audit and
accounting procedures established under its bylaws.
However, all receipts and disbursements of funds handled
by the Commission shall be audited yearly by a certified
or licensed public accountant, and the report of the audit
shall be included in and become part of the annual report
of the Commission.

HB4988 - 37 - LRB103 36089 SPS 66178 b
i. Qualified Immunity, Defense and Indemnification
1. The administrators, officers, executive director,
employees and representatives of the Commission shall be
immune from suit and liability, either personally or in
their official capacity, for any claim for damage to or
loss of property or personal injury or other civil
liability caused by or arising out of any actual or
alleged act, error or omission that occurred, or that the
person against whom the claim is made had a reasonable
basis for believing occurred, within the scope of
Commission employment, duties or responsibilities;
provided that nothing in this paragraph shall be construed
to protect any such person from suit or liability for any
damage, loss, injury or liability caused by the
intentional, willful or wanton misconduct of that person.
2. The Commission shall defend any administrator,
officer, executive director, employee or representative of
the Commission in any civil action seeking to impose
liability arising out of any actual or alleged act, error
or omission that occurred within the scope of Commission
employment, duties or responsibilities, or that the person
against whom the claim is made had a reasonable basis for
believing occurred within the scope of Commission
employment, duties or responsibilities; provided that
nothing herein shall be construed to prohibit that person
from retaining his or her own counsel; and provided

HB4988 - 38 - LRB103 36089 SPS 66178 b
further that the actual or alleged act, error or omission
did not result from that person's intentional, willful or
wanton misconduct.
3. The Commission shall indemnify and hold harmless
any administrator, officer, executive director, employee
or representative of the Commission for the amount of any
settlement or judgment obtained against that person
arising out of any actual or alleged act, error or
omission that occurred within the scope of Commission
employment, duties or responsibilities, or that such
person had a reasonable basis for believing occurred
within the scope of Commission employment, duties or
responsibilities, provided that the actual or alleged act,
error or omission did not result from the intentional,
willful or wanton misconduct of that person.
ARTICLE VIII
Rulemaking
a. The Commission shall exercise its rulemaking powers
pursuant to the criteria set forth in this Article and the
rules adopted thereunder. Rules and amendments shall become
binding as of the date specified in each rule or amendment and
shall have the same force and effect as provisions of this
Compact.
b. Rules or amendments to the rules shall be adopted at a

HB4988 - 39 - LRB103 36089 SPS 66178 b
regular or special meeting of the Commission.
c. Prior to promulgation and adoption of a final rule or
rules by the Commission, and at least sixty (60) days in
advance of the meeting at which the rule will be considered and
voted upon, the Commission shall file a notice of proposed
rulemaking:
1. On the website of the Commission; and
2. On the website of each licensing board or the
publication in which each state would otherwise publish
proposed rules.
d. The notice of proposed rulemaking shall include:
1. The proposed time, date and location of the meeting
in which the rule will be considered and voted upon;
2. The text of the proposed rule or amendment, and the
reason for the proposed rule;
3. A request for comments on the proposed rule from
any interested person; and
4. The manner in which interested persons may submit
notice to the Commission of their intention to attend the
public hearing and any written comments.
e. Prior to adoption of a proposed rule, the Commission
shall allow persons to submit written data, facts, opinions
and arguments, which shall be made available to the public.
f. The Commission shall grant an opportunity for a public
hearing before it adopts a rule or amendment.
g. The Commission shall publish the place, time and date

HB4988 - 40 - LRB103 36089 SPS 66178 b
of the scheduled public hearing.
1. Hearings shall be conducted in a manner providing
each person who wishes to comment a fair and reasonable
opportunity to comment orally or in writing. All hearings
will be recorded, and a copy will be made available upon
request.
2. Nothing in this section shall be construed as
requiring a separate hearing on each rule. Rules may be
grouped for the convenience of the Commission at hearings
required by this section.
h. If no one appears at the public hearing, the Commission
may proceed with promulgation of the proposed rule.
i. Following the scheduled hearing date, or by the close
of business on the scheduled hearing date if the hearing was
not held, the Commission shall consider all written and oral
comments received.
j. The Commission shall, by majority vote of all
administrators, take final action on the proposed rule and
shall determine the effective date of the rule, if any, based
on the rulemaking record and the full text of the rule.
k. Upon determination that an emergency exists, the
Commission may consider and adopt an emergency rule without
prior notice, opportunity for comment or hearing, provided
that the usual rulemaking procedures provided in this Compact
and in this section shall be retroactively applied to the rule
as soon as reasonably possible, in no event later than ninety

HB4988 - 41 - LRB103 36089 SPS 66178 b
(90) days after the effective date of the rule. For the
purposes of this provision, an emergency rule is one that must
be adopted immediately in order to:
1. Meet an imminent threat to public health, safety or
welfare;
2. Prevent a loss of Commission or party state funds;
or
3. Meet a deadline for the promulgation of an
administrative rule that is required by federal law or
rule.
l. The Commission may direct revisions to a previously
adopted rule or amendment for purposes of correcting
typographical errors, errors in format, errors in consistency
or grammatical errors. Public notice of any revisions shall be
posted on the website of the Commission. The revision shall be
subject to challenge by any person for a period of thirty (30)
days after posting. The revision may be challenged only on
grounds that the revision results in a material change to a
rule. A challenge shall be made in writing, and delivered to
the Commission, prior to the end of the notice period. If no
challenge is made, the revision will take effect without
further action. If the revision is challenged, the revision
may not take effect without the approval of the Commission.
ARTICLE IX
Oversight, Dispute Resolution and Enforcement

HB4988 - 42 - LRB103 36089 SPS 66178 b
a. Oversight
1. Each party state shall enforce this Compact and
take all actions necessary and appropriate to effectuate
this Compact's purposes and intent.
2. The Commission shall be entitled to receive service
of process in any proceeding that may affect the powers,
responsibilities or actions of the Commission, and shall
have standing to intervene in such a proceeding for all
purposes. Failure to provide service of process in such
proceeding to the Commission shall render a judgment or
order void as to the Commission, this Compact or
promulgated rules.
b. Default, Technical Assistance and Termination
1. If the Commission determines that a party state has
defaulted in the performance of its obligations or
responsibilities under this Compact or the promulgated
rules, the Commission shall:
i. Provide written notice to the defaulting state
and other party states of the nature of the default,
the proposed means of curing the default or any other
action to be taken by the Commission; and
ii. Provide remedial training and specific
technical assistance regarding the default.
2. If a state in default fails to cure the default, the
defaulting state's membership in this Compact may be

HB4988 - 43 - LRB103 36089 SPS 66178 b
terminated upon an affirmative vote of a majority of the
administrators, and all rights, privileges and benefits
conferred by this Compact may be terminated on the
effective date of termination. A cure of the default does
not relieve the offending state of obligations or
liabilities incurred during the period of default.
3. Termination of membership in this Compact shall be
imposed only after all other means of securing compliance
have been exhausted. Notice of intent to suspend or
terminate shall be given by the Commission to the governor
of the defaulting state and to the executive officer of
the defaulting state's licensing board and each of the
party states.
4. A state whose membership in this Compact has been
terminated is responsible for all assessments, obligations
and liabilities incurred through the effective date of
termination, including obligations that extend beyond the
effective date of termination.
5. The Commission shall not bear any costs related to
a state that is found to be in default or whose membership
in this Compact has been terminated unless agreed upon in
writing between the Commission and the defaulting state.
6. The defaulting state may appeal the action of the
Commission by petitioning the U.S. District Court for the
District of Columbia or the federal district in which the
Commission has its principal offices. The prevailing party

HB4988 - 44 - LRB103 36089 SPS 66178 b
shall be awarded all costs of such litigation, including
reasonable attorneys' fees.
c. Dispute Resolution
1. Upon request by a party state, the Commission shall
attempt to resolve disputes related to the Compact that
arise among party states and between party and non-party
states.
2. The Commission shall promulgate a rule providing
for both mediation and binding dispute resolution for
disputes, as appropriate.
3. In the event the Commission cannot resolve disputes
among party states arising under this Compact:
i. The party states may submit the issues in
dispute to an arbitration panel, which will be
comprised of individuals appointed by the Compact
administrator in each of the affected party states and
an individual mutually agreed upon by the Compact
administrators of all the party states involved in the
dispute.
ii. The decision of a majority of the arbitrators
shall be final and binding.
d. Enforcement
1. The Commission, in the reasonable exercise of its
discretion, shall enforce the provisions and rules of this
Compact.
2. By majority vote, the Commission may initiate legal

HB4988 - 45 - LRB103 36089 SPS 66178 b
action in the U.S. District Court for the District of
Columbia or the federal district in which the Commission
has its principal offices against a party state that is in
default to enforce compliance with the provisions of this
Compact and its promulgated rules and bylaws. The relief
sought may include both injunctive relief and damages. In
the event judicial enforcement is necessary, the
prevailing party shall be awarded all costs of such
litigation, including reasonable attorneys' fees.
3. The remedies herein shall not be the exclusive
remedies of the Commission. The Commission may pursue any
other remedies available under federal or state law.
ARTICLE X
Effective Date, Withdrawal and Amendment
a. This Compact shall become effective and binding on the
earlier of the date of legislative enactment of this Compact
into law by no less than twenty-six (26) states or December 31,
2018. All party states to this Compact, that also were parties
to the prior Nurse Licensure Compact, superseded by this
Compact, ("Prior Compact"), shall be deemed to have withdrawn
from said Prior Compact within six (6) months after the
effective date of this Compact.
b. Each party state to this Compact shall continue to
recognize a nurse's multistate licensure privilege to practice

HB4988 - 46 - LRB103 36089 SPS 66178 b
in that party state issued under the Prior Compact until such
party state has withdrawn from the Prior Compact.
c. Any party state may withdraw from this Compact by
enacting a statute repealing the same. A party state's
withdrawal shall not take effect until six (6) months after
enactment of the repealing statute.
d. A party state's withdrawal or termination shall not
affect the continuing requirement of the withdrawing or
terminated state's licensing board to report adverse actions
and significant investigations occurring prior to the
effective date of such withdrawal or termination.
e. 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.
f. 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.
g. Representatives of non-party states to this Compact
shall be invited to participate in the activities of the
Commission, on a nonvoting basis, prior to the adoption of
this Compact by all states.
ARTICLE XI

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Construction and Severability
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 if 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 to be contrary to the
constitution of any party state, this 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 all
severable matters.
(225 ILCS 65/85-10 new)
Sec. 85-10. State labor laws. The Nurse Licensure Compact
does not supersede existing State labor laws.
(225 ILCS 65/85-15 new)
Sec. 85-15. Criminal history record checks. The State may
not share with or disclose to the Interstate Commission of
Nurse Licensure Compact Administrators or any other state any
of the contents of a nationwide criminal history records check

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