OCCUPATIONS CODE
CHAPTER 304. NURSE LICENSURE COMPACT
§ 304.001. NURSE LICENSURE COMPACT.
This section expires December 31, 2005, under the provisions
of § 304.010.
The Nurse Licensure Compact is enacted and entered into with
all other jurisdictions that legally join in the compact, which is
as follows:
NURSE LICENSURE COMPACT
ARTICLE 1. 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 licensing laws;
(2) violations of nurse licensing 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 licensing and regulation;
(4) new practice modalities and technology make
compliance with each state nurse licensing laws difficult and
complex; and
(5) the current system of the duplicative licensing of
nurses practicing in multiple states is cumbersome and redundant to
both nurses and the states.
(b) The general purposes of this compact are to:
(1) facilitate the states' responsibilities to protect
the public's health and safety;
(2) ensure and encourage the cooperation of party
states in the areas of nurse licensing and regulation;
(3) facilitate the exchange of information between
party states in the areas of nurse regulation, investigation, and
adverse action;
(4) promote compliance with the laws governing the
practice of nursing in each jurisdiction; and
(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 provided through
the mutual recognition of party state licenses.
ARTICLE 2. DEFINITIONS
In this compact:
(a) "Adverse action" means a home or remote state
action.
(b) "Alternative program" means a voluntary,
nondisciplinary monitoring program approved by a nurse licensing
board.
(c) "Coordinated licensure information system" means
an integrated process for collecting, storing, and sharing
information on nurse licensing and enforcement activities related
to nurse licensing laws, which is administered by a nonprofit
organization composed of and controlled by state nurse 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 proved true, would
indicate more than a minor infraction; or
(2) investigative information that indicates
that a 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) "Home state" means the party state that is the
nurse's primary state of residence.
(f) "Home state action" means any administrative,
civil, equitable, or criminal action permitted by the home state's
laws that are imposed on a nurse by the home state's licensing board
or other authority, including actions against an individual's
license such as revocation, suspension, probation, or any other
action that affects a nurse's authorization to practice.
(g) "Licensing board" means a party state's regulatory
body responsible for issuing nurse licenses.
(h) "Multistate licensing privilege" means current,
official authority from a remote state permitting the practice of
nursing as a registered nurse, licensed practical nurse, or
licensed vocational nurse in the party state. All party states have
the authority, in accordance with existing state due process laws,
to take actions against the nurse's privilege, including
revocation, suspension, probation, or any other action that affects
a nurse's authorization to practice.
(i) "Nurse" means a registered nurse, licensed
practical nurse, or licensed vocational nurse as those terms are
defined by each party state's practice laws.
(j) "Party state" means any state that has enacted
this compact.
(k) "Remote state" means a party state, other than the
home state, in which:
(1) a patient is located at the time nursing care
is provided; or
(2) in the case of the practice of nursing not
involving a patient, the recipient of nursing practice is located.
(l) "Remote state action" means:
(1) an administrative, civil, equitable, or
criminal action permitted by a remote state's laws that are imposed
on a nurse by the remote state's licensing board or other authority,
including an action against an individual's multistate licensing
privilege to practice in the remote state; and
(2) a cease and desist order and other injunctive
or equitable orders issued by remote states or the licensing boards
of remote states.
(m) "State" means a state, territory, possession of
the United States, the District of Columbia, or the Commonwealth of
Puerto Rico.
(n) "State practice laws" means a party state's laws
and regulations that govern the practice of nursing, define the
scope of nursing practice, and create the methods and grounds for
imposing discipline. The term does not include the initial
qualifications for licensing or requirements necessary to obtain
and retain a license, except for qualifications or requirements of
the home state.
ARTICLE 3. GENERAL PROVISIONS AND JURISDICTION
(a) A license to practice registered nursing issued by a
home state to a resident in that state will be recognized by each
party state as authorizing a multistate licensing privilege to
practice as a registered nurse in the party state. A license to
practice licensed practical nursing or licensed vocational nursing
issued by a home state to a resident in that state will be
recognized by each party state as authorizing a multistate
licensing privilege to practice as a licensed practical nurse or
vocational nurse in the party state. To obtain or retain a license,
an applicant must meet the home state's qualifications for a
license and license renewal as well as all other applicable state
laws.
(b) A party state may, in accordance with state due process
laws, limit or revoke the multistate licensing privilege of any
nurse to practice in the party state and may take any other
necessary actions under the party state's applicable laws to
protect the health and safety of the party state's citizens. If a
party state takes this action, the party state 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.
(c) A nurse practicing in a party state must comply with the
state practice laws of the state in which the patient is located at
the time care is provided. The practice of nursing includes patient
care and all nursing practice defined by the party state's practice
laws. The practice of nursing will subject a nurse to the
jurisdiction of the nurse licensing board, the courts, and the laws
of the party state.
(d) This compact does not affect additional requirements
imposed by states for advanced practice registered nursing.
However, a multistate licensing privilege to practice registered
nursing granted by a party state shall be recognized by another
party state as a license to practice registered nursing if the
state's law requires the license as a precondition for qualifying
for advanced practice registered nurse authorization.
(e) Individuals not residing in a party state may apply for
a nurse license under the laws of a party state. However, the
license granted to these individuals will not be recognized as
granting the privilege to practice nursing in any other party state
unless explicitly agreed to by that party state.
ARTICLE 4. APPLICATION FOR LICENSE IN A PARTY STATE
(a) Once an application for a license is submitted, the
licensing board in a party state shall ascertain, through the
coordinated licensure information system, whether:
(1) the applicant has held or is the holder of a
license issued by another state;
(2) a restriction exists on the multistate licensing
privilege; and
(3) any other adverse action by any state has been
taken against the license.
(b) A nurse in a party state shall hold a license that is
issued by the home state in only one party state at a time.
(c) A nurse who intends to change the nurse's primary state
of residence may apply for a license in the new home state in
advance of the change. However, a new license will not be issued by
a party state until a nurse provides satisfactory evidence to the
new home state's licensing board of a change in the nurse's primary
state of residence.
(d) When a nurse changes the nurse's primary state of
residence by moving from:
(1) a party state to another party state and obtains a
license from the new home state, the license from the former home
state is no longer valid;
(2) a non-party state to a party state and obtains a
license from the new home state, the individual state license
issued by the non-party state is not affected and remains in full
force if provided by the laws of the non-party state; and
(3) a party state to a non-party state, the license
issued by the prior home state converts to a state license valid
only in the former home state and does not entitle the nurse to the
multistate licensing privilege to practice in other party states.
ARTICLE 5. ADVERSE ACTIONS
(a) The licensing board of a remote state shall promptly
report to the administrator of the coordinated licensure
information system a remote state action and the factual and legal
basis for the action, if known. The licensing board of a remote
state shall promptly report any significant current investigative
information yet to result in a remote state action. The
administrator of the coordinated licensure information system
shall promptly notify the home state of these reports.
(b) The licensing board of a party state shall have the
authority to complete a pending investigation of a nurse who
changes the nurse's primary state of residence during the course of
the investigation and to take appropriate action. The licensing
board shall promptly report the conclusions of the 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 action.
(c) A remote state may take adverse action affecting the
multistate licensing privilege to practice in that party state.
However, only the home state has the power to impose adverse action
against the license issued by the home state.
(d) For purposes of imposing adverse action, the licensing
board of the home state shall give the same priority and effect to
reported conduct received from a remote state as it would to conduct
occurring in the home state. In so doing, the licensing board shall
apply its state laws to determine appropriate action.
(e) The home state may take adverse action based on the
factual findings of the remote state only if each state follows its
own procedures for imposing the adverse action.
(f) This compact does not affect a party state's decision
that participation in an alternative program may be used instead of
licensing action and that the participation shall remain non-public
if required by the party state's laws. Party states must require a
nurse who enters an alternative program to agree not to practice in
any other party state during the term of the alternative program
without prior authorization from the other party state.
ARTICLE 6. ADDITIONAL AUTHORITIES OF PARTY STATE NURSE LICENSING
BOARDS
(a) Notwithstanding any other powers, party state nurse
licensing boards have the authority to:
(1) if otherwise permitted by state law, recover from
the affected nurse the costs of investigations and disposition of
cases resulting from any adverse action taken against the nurse;
(2) issue subpoenas for hearings and investigations
that require the attendance and testimony of witnesses and the
production of evidence;
(3) issue a cease and desist order to limit or revoke a
nurse's authority to practice in the state; and
(4) adopt uniform rules as provided under Article 8(c)
of this compact.
(b) A subpoena issued by a nurse 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 non-issuing party state by a court of competent jurisdiction
in accordance with the practice and procedure applicable to
subpoenas issued in proceedings pending before the court. The
issuing authority shall pay any witness fees, travel expenses,
mileage, and other fees required by the service statutes of the
state in which a witness or evidence is located.
ARTICLE 7. COORDINATED LICENSURE INFORMATION SYSTEM
(a) All party states shall participate in a cooperative
effort to create a coordinated database of all licensed registered
nurses, licensed practical nurses, and licensed vocational nurses.
This system will include information on the licensing and
disciplinary history of each nurse, as contributed by party states,
to assist in the coordination of nurse licensing and enforcement
efforts.
(b) Notwithstanding any other provision of law, all party
states' licensing boards shall promptly report to the coordinated
licensure information system adverse actions, actions against
multistate licensing privileges, any current significant
investigative information yet to result in adverse action, and
denials of applications and the reasons for the denials.
(c) Current significant investigative information shall be
transmitted only to party state licensing boards through the
coordinated licensure information system.
(d) Notwithstanding any other provision of law, all party
states' licensing boards that contribute 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 by a
party state's licensing board from the coordinated licensure
information system may not be shared with non-party states or
disclosed to other entities or individuals except to the extent
permitted by the laws of the party state contributing the
information.
(f) 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 be
expunged from the coordinated licensure information system.
(g) Each compact administrator shall act jointly and in
consultation with the administrator of the coordinated licensure
information system to formulate necessary and proper procedures for
the identification, collection, and exchange of information under
this compact.
ARTICLE 8. COMPACT ADMINISTRATION AND EXCHANGE OF INFORMATION
(a) The presiding officer of the nurse licensing board of a
party state or the presiding officer's designee shall be the
administrator of this compact for the state.
(b) The compact administrator of each party state shall
furnish to the compact administrator of each other party state
information and documents including a uniform data set of
investigations, identifying information, licensing data, and
disclosable alternative program participation information to
facilitate the administration of this compact.
(c) Compact administrators have the authority to develop
uniform rules to facilitate and coordinate implementation of this
compact. The uniform rules shall be adopted by party states under
Article 6(a)(4) of this compact.
ARTICLE 9. IMMUNITY
A party state or an officer, employee, or agent of a party
state's nurse licensing board who acts in accordance with the
provisions of this compact is not liable for any good faith act or
omission that occurs while the person is performing the person's
duties under this compact. Good faith in this article does not
include wilful misconduct, gross negligence, or recklessness.
ARTICLE 10. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT
(a) This compact enters into force and takes effect for a
state when the state enacts this compact as law. A party state may
withdraw from the compact by enacting a statute repealing the
compact, but a withdrawal takes effect six months after the date the
withdrawing state gives notice of the withdrawal to the executive
heads of all other party states.
(b) No withdrawal shall affect the validity or
applicability by the licensing boards of states remaining party to
the compact of any report of adverse action occurring prior to the
withdrawal.
(c) This compact does not invalidate or prevent any nurse
licensing agreement or other cooperative arrangement between a
party state and a non-party state that is made in accordance with
the other provisions of this compact.
(d) This compact may be amended by the party states. An
amendment to this compact is not effective or binding on the party
states unless and until all party states enact the amendment into
the law of each state.
ARTICLE 11. CONSTRUCTION AND SEVERABILITY
(a) This compact shall be liberally construed to effectuate
the compact's purposes.
(b) This compact is severable. If a phrase, clause,
sentence, or provision of this compact is declared to be contrary to
the constitution of a party state or the United States or the
applicability of this compact to a government, agency, person, or
circumstance is held invalid, the validity and applicability of the
remainder of the compact to a government, agency, person, or
circumstance is not affected. If this compact is held to be
contrary to the constitution of a party state, the compact remains
in full force and effect for the other party states and in full
force and effect for the party state affected for all severable
matters.
(c) If the party states need to settle a dispute under the
compact the party states may submit the issues in dispute to an
arbitration panel comprised of:
(A) an individual appointed by the compact
administrator in the home state;
(B) an individual appointed by the compact
administrator in each remote state involved; and
(C) an individual mutually agreed upon by the compact
administrators of each party state involved in the dispute.
(d) The decision of a majority of the arbitrators shall be
final and binding.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001.
§ 304.002. ADMINISTRATION OF COMPACT.
This section expires December 31, 2005, under the provisions of
§ 304.010.
The executive director of the Board of Nurse Examiners is the
Nurse Licensure Compact administrator for this state.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.022, eff.
Feb. 1, 2004.
§ 304.003. RULES.
This section expires December 31, 2005, under the provisions of
§ 304.010.
The Board of Nurse Examiners may adopt rules necessary to
implement this chapter.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.023, eff.
Feb. 1, 2004.
§ 304.004. GENERAL PROVISIONS.
This section expires December 31, 2005, under the provisions
of § 304.010.
(a) The terms "nurse," "registered nurse," and "vocational
nurse" include nurses licensed as registered nurses or vocational
nurses by a state that is a party to the Nurse Licensure Compact.
(b) Unless the context indicates otherwise or doing so would
be inconsistent with the Nurse Licensure Compact, nurses practicing
in this state under a license issued by a state that is a party to
the Nurse Licensure Compact have the same rights and obligations as
imposed by the laws of this state on license holders of the Board of
Nurse Examiners.
(c) The Board of Nurse Examiners has the authority to
determine whether a right or obligation imposed on license holders
applies to nurses practicing in this state under a license issued by
a state that is a party to the Nurse Licensure Compact unless that
determination is inconsistent with the Nurse Licensure Compact.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.024, eff.
Feb. 1, 2004.
§ 304.005. ENFORCEMENT.
This section expires December 31, 2005, under the provisions of
§ 304.010.
The Board of Nurse Examiners is the state agency responsible
for taking action against registered and vocational nurses
practicing in this state under a license issued by a state that is a
party to the Nurse Licensure Compact as authorized by the Nurse
Licensure Compact. The action shall be taken in accordance with the
same procedures for taking action against registered and vocational
nurses licensed by this state.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.025, eff.
Feb. 1, 2004.
§ 304.006. INFORMATION MAINTAINED UNDER COMPACT.
This section expires December 31, 2005, under the provisions of
§ 304.010.
(a) On request and payment of a reasonable fee, the Board of
Nurse Examiners 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 7 of the Nurse Licensure Compact.
(b) A board is not obligated to provide information not
available to the board or information that is not available to the
nurse under the laws of the state contributing the information to
the coordinated licensure information system.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.026, eff.
Feb. 1, 2004.
§ 304.007. ACCESS TO PRACTICE-RELATED INFORMATION.
This section expires December 31, 2005, under the provisions of
§ 304.010.
Practice-related information provided by the Board of Nurse
Examiners to registered or vocational nurses licensed by this state
shall be made available by the board on request and at a reasonable
cost to nurses practicing in this state under a license issued by a
state that is a party to the Nurse Licensure Compact.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.027, eff.
Feb. 1, 2004.
§ 304.008. DISCLOSURE OF PERSONAL INFORMATION.
This section expires December 31, 2005, under the provisions of
§ 304.010.
(a) In reporting information to the coordinated licensure
information system under Article 7 of the Nurse Licensure Compact,
the Board of Nurse Examiners may disclose personally identifiable
information about the nurse, including social security number.
(b) The coordinated licensure information system may not
share personally identifiable information with a state not a party
to the compact unless the state agrees not to disclose that
information to other persons.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.028, eff.
Feb. 1, 2004.
§ 304.009. WITHDRAWAL FROM COMPACT.
This section expires December 31, 2005, under the provisions of
§ 304.010.
(a) The governor may withdraw this state from the Nurse
Licensure Compact if the Board of Nurse Examiners notifies the
governor that a state that is party to the compact changed, after
January 1, 1999, the state's requirements for licensing a nurse and
that the state's requirements, as changed, are substantially lower
than the requirements for licensing a nurse in this state.
(b) The governor may completely withdraw this state from the
Nurse Licensure Compact or may limit withdrawal to the application
of the compact to registered nurses or vocational nurses.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, § 2.029, eff.
Feb. 1, 2004.
§ 304.010. EXPIRATION OF COMPACT.
This section expires December 31, 2005, under its own
provisions.
The Nurse Licensure Compact expires on December 31, 2005,
unless this section is repealed or the expiration date is extended.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.130(a), eff. Sept.
1, 2001.
