Bill Text: TX HB4404 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to the Advanced Practice Registered Nurse Compact.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2023-04-17 - Left pending in committee [HB4404 Detail]
Download: Texas-2023-HB4404-Introduced.html
88R12979 BEE-D | ||
By: Guillen | H.B. No. 4404 |
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relating to the Advanced Practice Registered Nurse Compact. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle E, Title 3, Occupations Code, is | ||
amended by adding Chapter 305 to read as follows: | ||
CHAPTER 305. ADVANCED PRACTICE REGISTERED NURSE COMPACT | ||
Sec. 305.001. ADVANCED PRACTICE REGISTERED NURSE COMPACT. | ||
The Advanced Practice Registered Nurse Compact is enacted and | ||
entered into with all other jurisdictions that legally join in the | ||
compact, which reads as follows: | ||
Advanced Practice Registered Nurse 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 APRN licensure requirements and the | ||
effectiveness of enforcement activities related to state APRN | ||
licensure laws; | ||
2. Violations of APRN licensure and other laws | ||
regulating the practice of nursing may result in injury or harm to | ||
the public; | ||
3. The expanded mobility of APRNs and the use of | ||
advanced communication and intervention technologies as part of our | ||
nation's health care delivery system require greater coordination | ||
and cooperation among states in the areas of APRN licensure and | ||
regulation; | ||
4. New practice modalities and technology make | ||
compliance with individual state APRN licensure laws difficult and | ||
complex; | ||
5. The current system of duplicative APRN licensure | ||
for APRNs practicing in multiple states is cumbersome and redundant | ||
for healthcare delivery systems, payors, state licensing boards, | ||
regulators and APRNs; | ||
6. Uniformity of APRN licensure requirements | ||
throughout the states promotes public safety and public health | ||
benefits as well as providing a mechanism to increase access to | ||
care. | ||
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 APRN licensure and regulation, including | ||
promotion of uniform licensure requirements; | ||
3. Facilitate the exchange of information between | ||
party states in the areas of APRN regulation, investigation and | ||
adverse actions; | ||
4. Promote compliance with the laws governing APRN | ||
practice in each jurisdiction; | ||
5. Invest all party states with the authority to hold | ||
an APRN 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 privileges to practice; | ||
6. Decrease redundancies in the consideration and | ||
issuance of APRN licenses; and | ||
7. Provide opportunities for interstate practice by | ||
APRNs who meet uniform licensure requirements. | ||
ARTICLE II | ||
Definitions | ||
As used in this Compact: | ||
a. "Advanced practice registered nurse" or "APRN" means a | ||
registered nurse who has gained additional specialized knowledge, | ||
skills and experience through a program of study recognized or | ||
defined by the Interstate Commission of APRN Compact Administrators | ||
("Commission"), and who is licensed to perform advanced nursing | ||
practice. An advanced practice registered nurse is licensed in an | ||
APRN role that is congruent with an APRN educational program, | ||
certification, and Commission rules. | ||
b. "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 an APRN, | ||
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 an APRN's | ||
authorization to practice, including the issuance of a cease and | ||
desist action. | ||
c. "Alternative program" means a, non-disciplinary | ||
monitoring program approved by a licensing board. | ||
d. "APRN licensure" means the regulatory mechanism used by a | ||
party state to grant legal authority to practice as an APRN. | ||
e. "APRN uniform licensure requirements" means the minimum | ||
uniform licensure, education and examination requirements set | ||
forth in Article III.b of this Compact. | ||
f. "Coordinated licensure information system" means an | ||
integrated process for collecting, storing and sharing information | ||
on APRN licensure and enforcement activities related to APRN | ||
licensure laws that is administered by a nonprofit organization | ||
composed of and controlled by licensing boards. | ||
g. "Current significant investigatory information" means: | ||
1. Investigative information that a licensing board, | ||
after a preliminary inquiry that includes notification and an | ||
opportunity for the APRN to respond, if required by state law, has | ||
reason to believe is not groundless and, if proved true, would | ||
indicate more than a minor infraction; or | ||
2. Investigative information that indicates that the | ||
APRN represents an immediate threat to public health and safety | ||
regardless of whether the APRN has been notified and had an | ||
opportunity to respond. | ||
h. "Encumbrance" means a revocation or suspension of, or any | ||
limitation on, the full and unrestricted practice of nursing | ||
imposed by a licensing board in connection with a disciplinary | ||
proceeding. | ||
i. "Home state" means the party state that is the APRN's | ||
primary state of residence. | ||
j. "Licensing board" means a party state's regulatory body | ||
responsible for regulating the practice of advanced practice | ||
registered nursing. | ||
k. "Multistate license" means an APRN license to practice as | ||
an APRN issued by a home state licensing board that authorizes the | ||
APRN to practice as an APRN in all party states under a multistate | ||
licensure privilege, in the same role and population focus as the | ||
APRN is licensed in the home state. | ||
l. "Multistate licensure privilege" means a legal | ||
authorization associated with an APRN multistate license that | ||
permits an APRN to practice as an APRN in a remote state, in the same | ||
role and population focus as the APRN is licensed in the home state. | ||
m. "Non-controlled prescription drug" means a device or drug that | ||
is not a controlled substance and is prohibited under state or | ||
federal law from being dispensed without a prescription. The term | ||
includes a device or drug that bears or is required to bear the | ||
legend "Caution: federal law prohibits dispensing without | ||
prescription" or "prescription only" or other legend that complies | ||
with federal law. | ||
n. "Party state" means any state that has adopted this | ||
Compact. | ||
o. "Population focus" means one of the six population foci | ||
of family/individual across the lifespan, adult-gerontology, | ||
pediatrics, neonatal, women's health/gender-related and | ||
psych/mental health. | ||
p. "Prescriptive authority" means the legal authority to | ||
prescribe medications and devices as defined by party state laws. | ||
q. "Remote state" means a party state that is not the home | ||
state. | ||
r. "Role" means one of the four recognized roles of | ||
certified registered nurse anesthetists (CRNA), certified | ||
nurse-midwives (CNM), clinical nurse specialists (CNS) and | ||
certified nurse practitioners (CNP). | ||
s. "Single-state license" means an APRN 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. | ||
t. "State" means a state, territory or possession of the | ||
United States and the District of Columbia. | ||
u. "State practice laws" means a party state's laws, rules, | ||
and regulations that govern APRN practice, define the scope of | ||
advanced nursing practice and create the methods and grounds for | ||
imposing discipline except that prescriptive authority shall be | ||
treated in accordance with Article III.f and g of this Compact. | ||
"State practice laws" does not include: | ||
1. A party state's laws, rules, and regulations | ||
requiring supervision or collaboration with a healthcare | ||
professional, except for laws, rules, and regulations regarding | ||
prescribing controlled substances; | ||
2. the requirements necessary to obtain and retain an | ||
APRN license, except for qualifications or requirements of the home | ||
state. | ||
ARTICLE III | ||
General Provisions and Jurisdiction | ||
a. A state must implement procedures for considering the | ||
criminal history records of applicants for initial APRN licensure | ||
or APRN licensure by endorsement. Such procedures shall include | ||
the submission of fingerprints or other biometric-based | ||
information by APRN 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. | ||
b. Each party state shall require an applicant to satisfy | ||
the following APRN uniform licensure requirements 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 completed an accredited graduate-level | ||
education program that prepares the applicant for one of the four | ||
recognized roles and population foci; or | ||
ii. Has completed a foreign APRN education | ||
program for one of the four recognized roles and population foci | ||
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 APRN education program; | ||
3. Has, if a graduate of a foreign APRN 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 a national certification | ||
examination that measures APRN, role and population-focused | ||
competencies and maintains continued competence as evidenced by | ||
recertification in the role and population focus through the | ||
national certification program; | ||
5. Holds an active, unencumbered license as a | ||
registered nurse and an active, unencumbered authorization to | ||
practice as an APRN; | ||
6. Has successfully passed an NCLEX-RN® examination | ||
or recognized predecessor, as applicable; | ||
7. Has practiced for at least 2,080 hours as an APRN in | ||
a role and population focus congruent with the applicant's | ||
education and training. For purposes of this section, practice | ||
shall not include hours obtained as part of enrollment in an APRN | ||
education program; | ||
8. 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 or, if applicable, | ||
foreign country's criminal records; | ||
9. Has not been convicted or found guilty, or has | ||
entered into an agreed disposition, of a felony offense under | ||
applicable state, federal or foreign criminal law. | ||
10. 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 by factors set | ||
forth in rules adopted by the Commission; | ||
11. Is not currently enrolled in an alternative | ||
program; | ||
12. Is subject to self-disclosure requirements | ||
regarding current participation in an alternative program; and | ||
13. Has a valid United States Social Security number. | ||
c. An APRN issued a multistate license shall be licensed in | ||
an approved role and at least one approved population focus. | ||
d. An APRN multistate license issued by a home state to a | ||
resident in that state will be recognized by each party state as | ||
authorizing the APRN to practice as an APRN in each party state, | ||
under a multistate licensure privilege, in the same role and | ||
population focus as the APRN is licensed in the home state. | ||
e. Nothing in this Compact shall affect the requirements | ||
established by a party state for the issuance of a single-state | ||
license, except that an individual may apply for a single-state | ||
license, instead of a multistate license, even if otherwise | ||
qualified for the multistate license. However, the failure of such | ||
an individual to affirmatively opt for a single state license may | ||
result in the issuance of a multistate license. | ||
f. Issuance of an APRN multistate license shall include | ||
prescriptive authority for noncontrolled prescription drugs. | ||
g. For each state in which an APRN seeks authority to | ||
prescribe controlled substances, the APRN shall satisfy all | ||
requirements imposed by such state in granting and/or renewing such | ||
authority. | ||
h. An APRN issued a multistate license is authorized to | ||
assume responsibility and accountability for patient care | ||
independent of any supervisory or collaborative relationship. This | ||
authority may be exercised in the home state and in any remote state | ||
in which the APRN exercises a multistate licensure privilege. | ||
i. All party states shall be authorized, in accordance with | ||
state due process laws, to take adverse action against an APRN's | ||
multistate licensure privilege such as revocation, suspension, | ||
probation or any other action that affects an APRN'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. | ||
j. Except as otherwise expressly provided in this Compact, | ||
an APRN 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. APRN practice is not limited to patient | ||
care, but shall include all advanced nursing practice as defined by | ||
the state practice laws of the party state in which the client is | ||
located. APRN practice in a party state under a multistate | ||
licensure privilege will subject the APRN 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. | ||
k. Except as otherwise expressly provided in this Compact, | ||
this Compact does not affect additional requirements imposed by | ||
states for advanced practice registered nursing. However, a | ||
multistate licensure privilege to practice registered nursing | ||
granted by a party state shall be recognized by other party states | ||
as satisfying any state law requirement for registered nurse | ||
licensure as a precondition for authorization to practice as an | ||
APRN in that state. | ||
l. Individuals not residing in a party state shall continue | ||
to be able to apply for a party state's single- state APRN 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 as an APRN in any | ||
other party state. | ||
ARTICLE IV | ||
Applications for APRN Licensure in a Party State | ||
a. Upon application for an APRN 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 licensed | ||
practical/vocational nursing license, a registered nursing license | ||
or an advanced practice registered nurse 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. An APRN may hold a multistate APRN license, issued by the | ||
home state, in only one party state at a time. | ||
c. If an APRN changes primary state of residence by moving | ||
between two party states, the APRN must apply for APRN licensure in | ||
the new home state, and the multistate license issued by the prior | ||
home state shall be deactivated in accordance with applicable | ||
Commission rules. | ||
1. The APRN may apply for licensure in advance of a | ||
change in primary state of residence. | ||
2. A multistate APRN license shall not be issued by the | ||
new home state until the APRN 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 APRN | ||
license from the new home state. | ||
d. If an APRN changes primary state of residence by moving | ||
from a party state to a non-party state, the APRN 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 an APRN's multistate | ||
licensure privilege to practice within that party state. | ||
i. Only the home state shall have power to take | ||
adverse action against an APRN'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 that occurred outside of the home 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 an APRN's authority to practice within that party | ||
state. | ||
3. Complete any pending investigations of an APRN 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 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 party state licensing board for the attendance and | ||
testimony of witnesses and/or the production of evidence from | ||
another party state shall be enforced in the latter state by any | ||
court of competent jurisdiction, according to that court's practice | ||
and procedure in considering subpoenas issued in its own | ||
proceedings. The issuing licensing board shall pay any witness | ||
fees, travel expenses, mileage and other fees required by the | ||
service statutes of the state in which the witnesses and/or | ||
evidence are located. | ||
5. Obtain and submit, for an APRN licensure applicant, | ||
fingerprints 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 APRN the costs of investigations and disposition of | ||
cases resulting from any adverse action taken against that APRN. | ||
7. Take adverse action based on the factual findings | ||
of another party state, provided that the licensing board follows | ||
its own procedures for taking such adverse action. | ||
b. If adverse action is taken by a home state against an | ||
APRN's multistate licensure, the privilege to practice in all other | ||
party states under a multistate licensure privilege shall be | ||
deactivated until all encumbrances have been removed from the | ||
APRN's multistate license. All home state disciplinary orders that | ||
impose adverse action against an APRN's multistate license shall | ||
include a statement that the APRN'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 APRN for the duration of the APRN'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 APRNs, licensed registered | ||
nurses and licensed practical/vocational nurses. This system will | ||
include information on the licensure and disciplinary history of | ||
each APRN, as submitted by party states, to assist in the | ||
coordinated administration of APRN 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 APRN | ||
participation in alternative programs known to the licensing board | ||
regardless of whether such participation is deemed nonpublic and/or | ||
confidential under state law. | ||
d. 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 disclosed to other entities or | ||
individuals without the express permission of the contributing | ||
state. | ||
e. 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. | ||
f. Any information contributed to the coordinated licensure | ||
information system that is subsequently required to be expunged by | ||
the laws of the party state contributing the information shall be | ||
removed from the coordinated licensure information system. | ||
g. 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 information; and | ||
4. Other information that may facilitate the | ||
administration of this Compact, as determined by Commission rules. | ||
h. The Compact administrator of a party state shall provide | ||
all investigative documents and information requested by another | ||
party state. | ||
ARTICLE VII | ||
Establishment of the Interstate Commission of APRN Compact | ||
Administrators | ||
a. The party states hereby create and establish a joint | ||
public agency known as the Interstate Commission of APRN 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 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 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 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 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; | ||
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 and/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; and | ||
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 strive to avoid any appearance of | ||
impropriety and/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 strive to 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 issue advisory opinions; | ||
14. To provide and receive information from, and to | ||
cooperate with, law enforcement agencies; | ||
15. To adopt and use an official seal; and | ||
16. To perform such other functions as may be | ||
necessary or appropriate to achieve the purposes of this Compact | ||
consistent with the state regulation of APRN 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 by 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 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 and/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 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 | ||
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, 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 established 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 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 and/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, 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 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 | ||
action in the United States 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 come into limited effect at such time | ||
as this Compact has been enacted into law in seven (7) party states | ||
for the sole purpose of establishing and convening the Commission | ||
to adopt rules relating to its operation. | ||
b. Any state that joins this Compact subsequent to the | ||
Commission's initial adoption of the APRN uniform licensure | ||
requirements shall be subject to all rules that have been | ||
previously adopted by the Commission. | ||
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 APRN licensure agreement or other | ||
cooperative arrangement between a party state and a non-party state | ||
that does not conflict with the 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 | ||
any party state 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 | ||
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. | ||
Sec. 305.002. ADMINISTRATION OF COMPACT. The Texas Board | ||
of Nursing is the Advanced Practice Registered Nurse Compact | ||
administrator for this state. | ||
Sec. 305.003. RULES. The Texas Board of Nursing may adopt | ||
rules necessary to implement this chapter. | ||
SECTION 2. This Act takes effect September 1, 2023. |