Bill Text: TX HB2950 | 2017-2018 | 85th Legislature | Enrolled


Bill Title: Relating to the continuation and functions of the Texas Board of Nursing and to the regulation of the practice of nursing.

Spectrum: Bipartisan Bill

Status: (Passed) 2017-06-09 - See remarks for effective date [HB2950 Detail]

Download: Texas-2017-HB2950-Enrolled.html
 
 
  H.B. No. 2950
 
 
 
 
AN ACT
  relating to the continuation and functions of the Texas Board of
  Nursing and to the regulation of the practice of nursing.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 193.005, Health and Safety Code, is
  amended by amending Subsections (a), (b), and (c) and adding
  Subsection (a-1) to read as follows:
         (a)  A person required to file a death certificate or fetal
  death certificate shall obtain the required medical certification
  from the decedent's [an] attending physician, or, subject to
  Subsection (a-1), an advanced practice registered nurse of the
  decedent, if the death occurred under [medical attendance for] the
  care of the person in connection with the [and] treatment of the
  condition or disease process that contributed to the death.
         (a-1)  An advanced practice registered nurse may only
  complete the medical certification for a death certificate or fetal
  death certificate under this section if:
               (1)  a patient who has executed a written certification
  of a terminal illness has elected to receive hospice care and is
  receiving hospice services, as defined under Chapter 142, from a
  qualified hospice provider; or
               (2)  a patient is receiving palliative care.
         (b)  The attending physician or advanced practice registered
  nurse shall complete the medical certification not later than five
  days after receiving the death certificate.
         (c)  An associate physician, the chief medical officer of the
  institution where the death occurred, or the physician who
  performed an autopsy on the decedent may complete the medical
  certification if:
               (1)  the attending physician and the advanced practice
  registered nurse described by Subsection (a) are [is] unavailable;
               (2)  the attending physician or the advanced practice
  registered nurse described by Subsection (a) approves; and
               (3)  the person completing the medical certification
  has access to the medical history of the case and the death is due to
  natural causes.
         SECTION 2.  Section 671.001(d), Health and Safety Code, is
  amended to read as follows:
         (d)  A registered nurse, including an advanced practice
  registered nurse, or physician assistant may determine and
  pronounce a person dead in situations other than those described by
  Subsection (b) if permitted by written policies of a licensed
  health care facility, institution, or entity providing services to
  that person. Those policies must include physician assistants who
  are credentialed or otherwise permitted to practice at the
  facility, institution, or entity. If the facility, institution, or
  entity has an organized nursing staff and an organized medical
  staff or medical consultant, the nursing staff and medical staff or
  consultant shall jointly develop and approve those policies. The
  executive commissioner of the Health and Human Services Commission
  shall adopt rules to govern policies for facilities, institutions,
  or entities that do not have organized nursing staffs and organized
  medical staffs or medical consultants.
         SECTION 3.  Section 671.002(a), Health and Safety Code, is
  amended to read as follows:
         (a)  A physician who determines death in accordance with
  Section 671.001(b) or a registered nurse, including an advanced
  practice registered nurse, or physician assistant who determines
  death in accordance with Section 671.001(d) is not liable for civil
  damages or subject to criminal prosecution for the physician's,
  registered nurse's, or physician assistant's actions or the actions
  of others based on the determination of death.
         SECTION 4.  Section 301.003, Occupations Code, is amended to
  read as follows:
         Sec. 301.003.  APPLICATION OF SUNSET ACT. The Texas Board of
  Nursing is subject to Chapter 325, Government Code (Texas Sunset
  Act).  Unless continued in existence as provided by that chapter,
  the board is abolished September 1, 2029 [2017].
         SECTION 5.  Subchapter A, Chapter 301, Occupations Code, is
  amended by adding Section 301.006 to read as follows:
         Sec. 301.006.  CLAIM OR DEFENSE FOR PROHIBITED RULE OR
  POLICY. (a) The board may not adopt a rule, regulation, or policy
  that violates Chapter 110, Civil Practice and Remedies Code.
         (b)  A person may assert a violation of Subsection (a) as an
  affirmative defense in an administrative hearing or as a claim or
  defense in a judicial proceeding under Chapter 37, Civil Practice
  and Remedies Code.
         SECTION 6.  Section 301.059, Occupations Code, is amended by
  amending Subsection (b) and adding Subsection (d) to read as
  follows:
         (b)  The training program must provide the person with
  information regarding:
               (1)  the law governing [legislation that created the
  board and] the board's operations;
               (2)  the programs, functions, rules, and budget of the
  board;
               (3)  the scope of and limitations on the board's
  rulemaking authority;
               (4)  the types of board rules, interpretations, and
  enforcement actions that may implicate federal antitrust law by
  limiting competition or impacting prices charged by persons engaged
  in a profession or business the board regulates, including rules,
  interpretations, and enforcement actions that:
                     (A)  regulate the scope of practice of persons in
  a profession or business the board regulates;
                     (B)  restrict advertising by persons in a
  profession or business the board regulates;
                     (C)  affect the price of goods or services
  provided by persons in a profession or business the board
  regulates; and
                     (D)  restrict participation in a profession or
  business the board regulates;
               (5) [(2)]  the results of the most recent formal audit
  of the board;
               (6) [(3)]  the requirements of:
                     (A)  laws relating to open meetings, public
  information, administrative procedure, and disclosing conflicts of
  interest; and
                     (B)  other laws applicable to members of the board
  in performing their duties; and
               (7) [(4)]  any applicable ethics policies adopted by
  the board or the Texas Ethics Commission.
         (d)  The executive director of the board shall create a
  training manual that includes the information required by
  Subsection (b). The executive director shall distribute a copy of
  the training manual annually to each board member. On receipt of
  the training manual, each board member shall sign and submit to the
  executive director a statement acknowledging receipt of the
  training manual.
         SECTION 7.  Section 301.157, Occupations Code, is amended by
  amending Subsections (d-4), (d-8), (d-9), and (d-11) and adding
  Subsection (d-12) to read as follows:
         (d-4)  The board may recognize and accept as approved under
  this section a school of nursing or educational program operated in
  another state and approved by a state board of nursing or other
  regulatory body of that state.  The board shall adopt rules [develop
  policies] to ensure that the other state's standards are
  substantially equivalent to the board's standards.  The board by
  rule shall develop a process for students enrolled in a school of
  nursing or educational program operated in another state that does
  not meet standards substantially equivalent to the board's
  standards to apply for an initial license under this chapter.
         (d-8)  For purposes of Subsection (d-4), a nursing program
  is considered to meet standards substantially equivalent to the
  board's standards if the program:
               (1)  is part of an institution of higher education
  located outside this state that is approved by the appropriate
  regulatory authorities of that state;
               (2)  holds regional accreditation by an accrediting
  body recognized by the United States secretary of education and the
  Council for Higher Education Accreditation;
               (3)  holds specialty accreditation by an accrediting
  body recognized by the United States secretary of education and the
  Council for Higher Education Accreditation[, including the
  National League for Nursing Accrediting Commission];
               (4)  requires program applicants to be a licensed
  practical or vocational nurse, a military service corpsman, or a
  paramedic, or to hold a college degree in a clinically oriented
  health care field with demonstrated experience providing direct
  patient care; and
               (5)  graduates students who:
                     (A)  achieve faculty-determined program outcomes,
  including passing criterion-referenced examinations of nursing
  knowledge essential to beginning a registered nursing practice and
  transitioning to the role of registered nurse;
                     (B)  pass a criterion-referenced summative
  performance examination developed by faculty subject matter
  experts that measures clinical competencies essential to beginning
  a registered nursing practice and that meets nationally recognized
  standards for educational testing, including the educational
  testing standards of the American Educational Research
  Association, the American Psychological Association, and the
  National Council on Measurement in Education; and
                     (C)  pass the National Council Licensure
  Examination for Registered Nurses at a rate equivalent to the
  board's required passage rate for students of approved in-state
  programs.
         (d-9)  A graduate of a clinical competency assessment
  program operated in another state and approved by a state board of
  nursing or other regulatory body of another state is eligible to
  apply for an initial license under this chapter if:
               (1)  [the board allowed graduates of the program to
  apply for an initial license under this chapter continuously during
  the 10-year period preceding January 1, 2007;
               [(2)]  the program does not make any substantial
  changes in the length or content of its clinical competency
  assessment without the board's approval; and
               (2) [(3)]  the program remains in good standing with
  the state board of nursing or other regulatory body in the other
  state[; and
               [(4)     the program participates in the research study
  under Section 105.008, Health and Safety Code].
         (d-11)  If a clinical competency assessment program operated
  in another state graduates students who pass the National Council
  Licensure Examination for Registered Nurses at a rate lower than
  the board's required passage rate for graduating students of
  approved in-state programs, not later than May 31 of the next school
  year the program shall:
               (1)  for the first year the student passage rate is
  lower than the board's required passage rate for students of
  approved in-state programs, complete and submit to the board for
  review and comment a self-study of the program in accordance with
  the board's guidelines;
               (2)  for the second consecutive year the student
  passage rate is lower than the board's required passage rate for
  students of approved in-state programs, allow the board to conduct
  a desk review to evaluate the program using the criteria typically
  used in an on-site visit and make recommendations to improve the
  program; and
               (3)  for the third consecutive year the student passage
  rate is lower than the board's required passage rate for students of
  approved in-state programs, provide notice on the program's
  Internet website that prospective students of the program may need
  to complete additional requirements to apply for an initial license
  in this state because the program has failed to meet the board's
  standards related to the required passage rate on the National
  Council Licensure Examination for Registered Nurses [Subsections
  (d-8), (d-9), (d-10), and (d-11) expire December 31, 2017. As part
  of the first review conducted under Section 301.003 after September
  1, 2009, the Sunset Advisory Commission shall:
               [(1)     recommend whether Subsections (d-8) and (d-9)
  should be extended; and
               [(2)     recommend any changes to Subsections (d-8) and
  (d-9) relating to the eligibility for a license of graduates of a
  clinical competency assessment program operated in another state].
         (d-12)  A clinical competency assessment program operated in
  another state is not considered to meet standards substantially
  equivalent to the board's standards if the program fails to meet the
  applicable requirements under Subsection (d-11) or if the program's
  graduating student passage rate on the National Council Licensure
  Examination for Registered Nurses is lower than the board's
  required passage rate for graduating students of approved in-state
  programs for four consecutive years. A student enrolled in a
  program described by this subsection before December 31 of the
  fourth consecutive year is eligible to apply for an initial license
  under this chapter. The program shall notify a student who enrolls
  in the program after December 31 of the fourth consecutive year that
  the student is required to complete additional requirements
  established by the board under Subsection (d-4) to apply for an
  initial license under this chapter.
         SECTION 8.  Subchapter D, Chapter 301, Occupations Code, is
  amended by adding Section 301.1583 to read as follows:
         Sec. 301.1583.  DISCIPLINARY ACTION. (a) The board shall
  remove a disciplinary action from the nurse licensure verification
  page on the board's Internet website if:
               (1)  the disciplinary action is the only disciplinary
  action taken against the nurse;
               (2)  the disciplinary action was taken by the board for
  a violation that is not related to the practice of nursing;
               (3)  the disciplinary action did not result in the
  suspension or revocation of, or the probation of the suspension or
  revocation of, the nurse's license;
               (4)  the disciplinary action does not provide any
  indication that continued practice by the nurse may risk harm to a
  patient; and
               (5)  the nurse has successfully completed the
  requirements imposed by the board in the disciplinary order related
  to the disciplinary action.
         (b)  A disciplinary action that is removed from the nurse
  licensure verification page on the board's Internet website under
  Subsection (a) shall be removed from the public portion of the
  coordinated licensure information system, as defined by Section
  304.0015 in Article II of the Nurse Licensure Compact.
         SECTION 9.  Section 301.252, Occupations Code, is amended by
  amending Subsection (a) and adding Subsection (a-2) to read as
  follows:
         (a)  Each applicant for a registered nurse license or a
  vocational nurse license must submit to the board a sworn
  application that demonstrates the applicant's qualifications under
  this chapter, accompanied by evidence that the applicant:
               (1)  has good professional character related to the
  practice of nursing;
               (2)  has successfully completed a program of
  professional or vocational nursing education approved under
  Section 301.157(d); and
               (3)  has passed the jurisprudence examination approved
  by the board as provided by Subsection (a-1).
         (a-2)  An applicant who provides satisfactory evidence that
  the applicant has not committed a violation of this chapter or a
  rule adopted under this chapter is considered to have good
  professional character related to the practice of nursing. A
  determination by the board that an applicant does not have good
  professional character related to the practice of nursing must be
  based on a showing by the board of a clear and rational connection
  between a violation of this chapter or a rule adopted under this
  chapter and the applicant's ability to effectively practice
  nursing.
         SECTION 10.  Section 301.257, Occupations Code, is amended
  by adding Subsections (l) and (m) to read as follows:
         (l)  The board may require in a declaratory order under this
  section that a person begin participation in a peer assistance
  program at the time of receipt of an initial license under this
  chapter.  The board shall notify the person that, on issuance of the
  person's initial license, the person may request reevaluation of
  the person's required participation in the peer assistance program.
         (m)  The board by rule shall develop a process to determine
  whether a person should continue to be required to participate in a
  peer assistance program. In making the determination, the board
  shall:
               (1)  review the person's criminal history record
  information and, if applicable, determine whether participation in
  the program is warranted based on the time that has elapsed since
  the conviction or end of community supervision;
               (2)  reevaluate or require a contractor administering a
  peer assistance program to reevaluate the treatment plan or the
  time the person is required to participate in the peer assistance
  program based on the person's individualized needs; and
               (3)  authorize, as appropriate, a waiver of peer
  assistance program completion if the board is satisfied the person
  has achieved a satisfactory period of treatment or documented
  sobriety, as defined by board rules, and continued participation is
  not necessary.
         SECTION 11.  Section 301.301(b), Occupations Code, is
  amended to read as follows:
         (b)  A person may renew an unexpired license issued under
  this chapter on payment to the board of the required renewal fee
  before the expiration date of the license[, payment to the board of
  any costs assessed under Section 301.461,] and compliance with any
  other renewal requirements adopted by the board. A person whose
  license has expired may not engage in activities that require a
  license until the license has been renewed.
         SECTION 12.  Section 301.4106, Occupations Code, is amended
  to read as follows:
         Sec. 301.4106.  PEER ASSISTANCE PROGRAMS. The board by rule
  shall develop guidelines to:
               (1)  outline the roles and responsibilities of the
  board and a peer assistance program established or approved by the
  board under Chapter 467, Health and Safety Code;
               (2)  outline the process for a peer assistance program
  to refer to the board complaints alleging a violation of the
  practice of nursing;
               (3)  establish requirements for successfully
  completing a peer assistance program and for notification of the
  board of the successful completion by a nurse the board has ordered
  to attend or referred to the program; [and]
               (4)  establish a clear procedure based on meaningful
  performance goals for evaluating the success of a peer assistance
  program established or approved by the board under Chapter 467,
  Health and Safety Code;
               (5)  establish individualized requirements for
  participants in a peer assistance program, including the duration
  of participation in a peer assistance program for substance use,
  based on the individual's diagnosis and needs; and
               (6)  ensure that participation requirements and
  treatment plans for peer assistance program participants who are
  referred to peer assistance for similar reasons are administered
  consistently.
         SECTION 13.  Section 301.452, Occupations Code, is amended
  by amending Subsection (b) and adding Subsection (e) to read as
  follows:
         (b)  A person is subject to denial of a license or to
  disciplinary action under this subchapter for:
               (1)  a violation of this chapter, a rule or regulation
  not inconsistent with this chapter, or an order issued under this
  chapter;
               (2)  fraud or deceit in procuring or attempting to
  procure a license to practice professional nursing or vocational
  nursing;
               (3)  a conviction for, or placement on deferred
  adjudication community supervision or deferred disposition for, a
  felony or for a misdemeanor involving moral turpitude;
               (4)  conduct that results in the revocation of
  probation imposed because of conviction for a felony or for a
  misdemeanor involving moral turpitude;
               (5)  use of a nursing license, diploma, or permit, or
  the transcript of such a document, that has been fraudulently
  purchased, issued, counterfeited, or materially altered;
               (6)  impersonating or acting as a proxy for another
  person in the licensing examination required under Section 301.253
  or 301.255;
               (7)  directly or indirectly aiding or abetting an
  unlicensed person in connection with the unauthorized practice of
  nursing;
               (8)  revocation, suspension, or denial of, or any other
  action relating to, the person's license or privilege to practice
  nursing in another jurisdiction or under federal law;
               (9)  intemperate use of alcohol or drugs that the board
  determines endangers or could endanger a patient;
               (10)  unprofessional [or dishonorable] conduct in the
  practice of nursing that[, in the board's opinion,] is likely to
  deceive, defraud, or injure a patient or the public;
               (11)  adjudication of mental incompetency;
               (12)  lack of fitness to practice because of a mental or
  physical health condition that could result in injury to a patient
  or the public; or
               (13)  failure to care adequately for a patient or to
  conform to the minimum standards of acceptable nursing practice in
  a manner that, in the board's opinion, exposes a patient or other
  person unnecessarily to risk of harm.
         (e)  The board shall adopt rules to ensure that license
  denials and disciplinary action under Subsection (b)(10) are based
  on the application of objective criteria that are clearly and
  rationally connected to the applicant's or license holder's conduct
  and that any negative outcome resulting from that conduct is
  determined to affect the person's ability to effectively practice
  nursing.
         SECTION 14.  Section 301.459, Occupations Code, is amended
  by amending Subsection (a) and adding Subsection (a-1) to read as
  follows:
         (a)  The board by rule shall adopt procedures under Chapter
  2001, Government Code, governing formal disposition of a contested
  case. An administrative law judge employed by the [The] State
  Office of Administrative Hearings shall conduct a formal hearing.
  After receiving the administrative law judge's findings of fact and
  conclusions of law for a contested case, the board shall dispose of
  the case by issuing a final order based on the administrative law
  judge's findings of fact and conclusions of law.
         (a-1)  Notwithstanding Section 2001.058(e), Government
  Code, the board in a contested case may not change a finding of fact
  or conclusion of law or vacate or modify an order of the
  administrative law judge. The board may obtain judicial review of
  any finding of fact or conclusion of law issued by the
  administrative law judge as provided by Section 2001.058(f)(5),
  Government Code. For each case, the administrative law judge may
  make a recommendation regarding an appropriate action or sanction.  
  The board has the sole authority and discretion to determine the
  appropriate action or sanction.
         SECTION 15.  Section 301.461, Occupations Code, is amended
  to read as follows:
         Sec. 301.461.  ASSESSMENT OF COSTS PROHIBITED. The board
  may not assess a person who is found to have violated this chapter
  the administrative costs of conducting a hearing to determine the
  violation.
         SECTION 16.  Chapter 304, Occupations Code, is amended by
  adding Section 304.0015 to read as follows:
         Sec. 304.0015.  NURSE LICENSURE COMPACT. The Nurse
  Licensure Compact is enacted and entered into with all other
  jurisdictions that legally join in the compact, which reads as
  follows:
  NURSE LICENSURE 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
  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. DEFINITIONS
         As used in this compact:
         (a)  "Adverse action" means any administrative, civil,
  equitable, or criminal action permitted by a state's laws that 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 nondisciplinary
  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 respond, if required by state law, has
  reason to believe is not groundless and, if proven 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
  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.
         (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 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 a 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 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 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 the
  new home state; or
               (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 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 nonparty 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. 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 investigation of a nurse who
  changes primary state of residence during the course of such
  investigation. 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 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 a
  witness, 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 procedures 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 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
  (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 nonparty states or 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 nonparty 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.
  ARTICLE VII. ESTABLISHMENT OF 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 a 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 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 the 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 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 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 meeting 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 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
  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;
               (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, 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 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 an obligation 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.
         (i)  Qualified Immunity, Defense, and Indemnification
               (1)  The compact administrators, officers, executive
  directors, 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 subdivision shall be construed to protect any such person from
  suit or liability for any damages, loss, injury, or liability
  caused by the intentional, wilful, 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 further that the
  actual or alleged act, error, or omission did not result from that
  person's intentional, wilful, 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, wilful, 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
  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
  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, and in no event later than ninety (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
         (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 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 the 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 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 nonparty 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; and
                     (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 action in the U.S. District Court for the District of Columbia
  or in 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 AMENDMENTS
         (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 in
  that party state issued under the prior compact until the 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 nonparty 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 nonparty 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. 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 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.
         SECTION 17.  Chapter 304, Occupations Code, is amended by
  adding Section 304.0025 to read as follows:
         Sec. 304.0025.  RULES ADOPTED UNDER COMPACT. The Interstate
  Commission of Nurse Licensure Compact Administrators established
  under the Nurse Licensure Compact under Section 304.0015 may not
  adopt rules that alter the requirements or scope of practice of a
  license issued under Chapter 301. Any rule adopted by the
  Interstate Commission of Nurse Licensure Compact Administrators
  that purports to alter the requirements or scope of practice of a
  license issued under Chapter 301 is not enforceable.
         SECTION 18.  Section 304.006(a), Occupations Code, is
  amended to read as follows:
         (a)  On request and payment of a reasonable fee, the Texas
  Board of Nursing shall provide a registered or vocational nurse
  licensed by this state with a copy of information regarding the
  nurse maintained by the coordinated licensure information system
  under Article VI [7] of the Nurse Licensure Compact.
         SECTION 19.  Section 304.008(a), Occupations Code, is
  amended to read as follows:
         (a)  In reporting information to the coordinated licensure
  information system under Article VI [7] of the Nurse Licensure
  Compact, the Texas Board of Nursing may disclose personally
  identifiable information about the nurse, including the nurse's
  social security number.
         SECTION 20.  (a) Sections 301.160 and 301.163, Occupations
  Code, are repealed.
         (b)  Effective December 31, 2018, Sections 304.001 and
  304.009, Occupations Code, are repealed.
         SECTION 21.  (a) Except as provided by Subsection (b) of
  this section, Section 301.059, Occupations Code, as amended by this
  Act, applies to a member of the Texas Board of Nursing appointed
  before, on, or after the effective date of this Act.
         (b)  A member of the Texas Board of Nursing who, before the
  effective date of this Act, completed the training program required
  by Section 301.059, Occupations Code, as that law existed before
  the effective date of this Act, is required to complete additional
  training only on subjects added to the training program required by
  Section 301.059, Occupations Code, as amended by this Act. A board
  member described by this subsection may not vote, deliberate, or be
  counted as a member in attendance at a meeting of the board held on
  or after December 1, 2017, until the member completes the
  additional training.
         SECTION 22.  (a) Not later than May 31, 2018, the Texas
  Board of Nursing shall adopt the rules necessary to implement the
  changes in law made by this Act to Section 301.157, Occupations
  Code. In adopting rules under this subsection, the board shall
  provide an opportunity for public comment and, through the board's
  Advisory Committee on Education, seek comment from interested
  parties. The rules must:
               (1)  clearly define substantially equivalent education
  standards for purposes of recognizing a school of nursing or
  educational program operated in another state; and
               (2)  establish a process for enabling students enrolled
  in an out-of-state school of nursing or educational program that
  does not meet standards substantially equivalent to the board's
  standards to apply for initial licensure under Chapter 301,
  Occupations Code.
         (b)  Not later than March 1, 2018, the Texas Board of Nursing
  shall adopt the rules necessary to implement the changes in law made
  by this Act to Sections 301.252 and 301.452, Occupations Code. In
  adopting rules under this subsection, the board shall seek comments
  from relevant interested parties.
         (c)  Section 301.157(d-11), Occupations Code, as amended by
  this Act, applies beginning with the passage rates available in
  January 2018, reflecting the passage rates for the preceding year.  
  If the passage rate for a clinical competency assessment program
  available in January 2018 does not meet the Texas Board of Nursing's
  required passage rate for students of approved in-state programs,
  the clinical competency assessment program shall complete the
  self-study required under Section 301.157(d-11)(1), Occupations
  Code, as amended by this Act, not later than May 31, 2018.
         (d)  Sections 301.301(b) and 301.461, Occupations Code, as
  amended by this Act, apply only to the assessment of the
  administrative costs of conducting a hearing to determine a
  violation on or after the effective date of this Act. The
  assessment of the administrative costs of conducting a hearing to
  determine a violation before the effective date of this Act is
  governed by the law in effect on the date the administrative costs
  were assessed, and the former law is continued in effect for that
  purpose.
         (e)  Section 301.459, Occupations Code, as amended by this
  Act, applies only to a contested case for which an administrative
  law judge employed by the State Office of Administrative Hearings
  issues written findings of fact and conclusions of law on or after
  the effective date of this Act. A contested case for which an
  administrative law judge employed by the State Office of
  Administrative Hearings issues written findings of fact and
  conclusions of law before the effective date of this Act is governed
  by the law in effect on the date the findings of fact and
  conclusions of law were issued, and the former law is continued in
  effect for that purpose.
         (f)  Not later than March 1, 2019, the Texas Board of Nursing
  shall implement Section 301.1583, Occupations Code, as added by
  this Act, and remove any disciplinary actions from the nurse
  licensure verification page on the board's Internet website that
  meet the requirements of that section.
         SECTION 23.  Except as otherwise provided by this Act, this
  Act takes effect September 1, 2017.
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 2950 was passed by the House on May 3,
  2017, by the following vote:  Yeas 145, Nays 0, 1 present, not
  voting; that the House refused to concur in Senate amendments to
  H.B. No. 2950 on May 24, 2017, and requested the appointment of a
  conference committee to consider the differences between the two
  houses; and that the House adopted the conference committee report
  on H.B. No. 2950 on May 27, 2017, by the following vote:  Yeas 134,
  Nays 11, 2 present, not voting.
 
  ______________________________
  Chief Clerk of the House   
 
         I certify that H.B. No. 2950 was passed by the Senate, with
  amendments, on May 19, 2017, by the following vote:  Yeas 31, Nays
  0; at the request of the House, the Senate appointed a conference
  committee to consider the differences between the two houses; and
  that the Senate adopted the conference committee report on H.B. No.
  2950 on May 28, 2017, by the following vote:  Yeas 31, Nays 0.
 
  ______________________________
  Secretary of the Senate   
  APPROVED: __________________
                  Date       
   
           __________________
                Governor       
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