1.1                          A bill for an act 
  1.2             relating to health occupations; enacting the Nurse 
  1.3             Licensure Compact; amending Minnesota Statutes 2000, 
  1.4             section 214.10, subdivision 8; proposing coding for 
  1.5             new law in Minnesota Statutes, chapter 148.  
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [148.2115] [INTERSTATE NURSE LICENSURE 
  1.8   COMPACT.] 
  1.9      The Nurse Licensure Compact is enacted into law and entered 
  1.10  into with all other jurisdictions that legally join the compact, 
  1.11  in the form as follows: 
  1.12                             ARTICLE 1
  1.13                FINDINGS AND DECLARATION OF PURPOSE
  1.14     (a) The party states find that: 
  1.15     (1) the health and safety of the public are affected by the 
  1.16  degree of compliance with and the effectiveness of enforcement 
  1.17  activities related to state nurse licensure laws; 
  1.18     (2) violations of nurse licensure and other laws regulating 
  1.19  the practice of nursing may result in injury or harm to the 
  1.20  public; 
  1.21     (3) the expanded mobility of nurses and the use of advanced 
  1.22  communication technologies as part of our nation's healthcare 
  1.23  delivery system require greater coordination and cooperation 
  1.24  among states in the areas of nurse licensure and regulation; 
  1.25     (4) new practice modalities and technology make compliance 
  2.1   with individual state nurse licensure laws difficult and 
  2.2   complex; and 
  2.3      (5) the current system of duplicative licensure for nurses 
  2.4   practicing in multiple states is cumbersome and redundant to 
  2.5   both nurses and states. 
  2.6      (b) The general purposes of this compact are to: 
  2.7      (1) facilitate the states' responsibility to protect the 
  2.8   public's health and safety; 
  2.9      (2) ensure and encourage the cooperation of party states in 
  2.10  the areas of nurse licensure and regulation; 
  2.11     (3) facilitate the exchange of information between party 
  2.12  states in the areas of nurse regulation, investigation, and 
  2.13  adverse actions; 
  2.14     (4) promote compliance with the laws governing the practice 
  2.15  of nursing in each jurisdiction; and 
  2.16     (5) invest all party states with the authority to hold a 
  2.17  nurse accountable for meeting all state practice laws in the 
  2.18  state in which the patient is located at the time care is 
  2.19  rendered through the mutual recognition of party state licenses. 
  2.20                             ARTICLE 2
  2.21                            DEFINITIONS
  2.22     As used in this compact the following terms have the 
  2.23  meanings given to them. 
  2.24     (a) "Adverse action" means a home or remote state action. 
  2.25     (b) "Alternative program" means a voluntary, 
  2.26  nondisciplinary monitoring program approved by a nurse licensing 
  2.27  board. 
  2.28     (c) "Coordinated licensure information system" means an 
  2.29  integrated process for collecting, storing, and sharing 
  2.30  information on nurse licensure and enforcement activities 
  2.31  related to nurse licensure laws, which is administered by a 
  2.32  nonprofit organization composed of and controlled by state nurse 
  2.33  licensing boards. 
  2.34     (d) "Current significant investigative information" means: 
  2.35     (1) investigative information that a licensing board, after 
  2.36  a preliminary inquiry that includes notification and an 
  3.1   opportunity for the nurse to respond if required by state law, 
  3.2   has reason to believe is not groundless and, if proved true, 
  3.3   would indicate more than a minor infraction; or 
  3.4      (2) investigative information that indicates that the nurse 
  3.5   represents an immediate threat to public health and safety 
  3.6   regardless of whether the nurse has been notified and had an 
  3.7   opportunity to respond. 
  3.8      (e) "Home state" means the party state which is the nurse's 
  3.9   primary state of residence. 
  3.10     (f) "Home state action" means any administrative, civil, 
  3.11  equitable, or criminal action permitted by the home state's laws 
  3.12  which are imposed on a nurse by the home state's licensing board 
  3.13  or other authority, including actions against a nurse's license, 
  3.14  such as revocation, suspension, probation, or any other action 
  3.15  which affects a nurse's authorization to practice. 
  3.16     (g) "Licensing board" means a party state's regulatory body 
  3.17  responsible for issuing nurse licenses. 
  3.18     (h) "Multistate licensure privilege" means current, 
  3.19  official authority from a remote state permitting the practice 
  3.20  of nursing as either a registered nurse or a licensed 
  3.21  practical/vocational nurse in such party state.  All party 
  3.22  states have the authority, in accordance with existing state due 
  3.23  process law, to take actions against the nurse's privilege such 
  3.24  as:  revocation, suspension, probation, or any other action 
  3.25  which affects a nurse's authorization to practice. 
  3.26     (i) "Nurse" means a registered nurse or licensed 
  3.27  practical/vocational nurse, as those terms are defined by each 
  3.28  party's state practice laws. 
  3.29     (j) "Party state" means any state that has adopted this 
  3.30  compact. 
  3.31     (k) "Remote state" means a party state, other than the home 
  3.32  state: 
  3.33     (1) where the patient is located at the time nursing care 
  3.34  is provided; or 
  3.35     (2) in the case of the practice of nursing not involving a 
  3.36  patient, in a party state where the recipient of nursing 
  4.1   practice is located. 
  4.2      (l) "Remote state action" means: 
  4.3      (1) any administrative, civil, equitable, or criminal 
  4.4   action permitted by a remote state's laws which are imposed on a 
  4.5   nurse by the remote state's licensing board or other authority, 
  4.6   including actions against an individual's multistate licensure 
  4.7   privilege to practice in the remote state; or 
  4.8      (2) cease and desist and other injunctive or equitable 
  4.9   orders issued by remote states or the licensing boards thereof. 
  4.10     (m) "State" means a state, territory, or possession of the 
  4.11  United States, the District of Columbia, or the Commonwealth of 
  4.12  Puerto Rico. 
  4.13     (n) "State practice laws" means those individual party's 
  4.14  state laws and regulations that govern the practice of nursing, 
  4.15  define the scope of nursing practice, and create the methods and 
  4.16  grounds for imposing discipline.  "State practice laws" does not 
  4.17  include the initial qualifications for licensure or requirements 
  4.18  necessary to obtain and retain a license, except for 
  4.19  qualifications or requirements of the home state. 
  4.20                             ARTICLE 3
  4.21                GENERAL PROVISIONS AND JURISDICTION
  4.22     (a) A license to practice registered nursing issued by a 
  4.23  home state to a resident in that state will be recognized by 
  4.24  each party state as authorizing a multistate licensure privilege 
  4.25  to practice as a registered nurse in such party state.  A 
  4.26  license to practice licensed practical/vocational nursing issued 
  4.27  by a home state to a resident in that state will be recognized 
  4.28  by each party state as authorizing a multistate licensure 
  4.29  privilege to practice as a licensed practical/vocational nurse 
  4.30  in such party state.  In order to obtain or retain a license, an 
  4.31  applicant must meet the home state's qualifications for 
  4.32  licensure and license renewal as well as all other applicable 
  4.33  state laws. 
  4.34     (b) Party states may, in accordance with state due process 
  4.35  laws, limit or revoke the multistate licensure privilege of any 
  4.36  nurse to practice in their state and may take any other actions 
  5.1   under their applicable state laws necessary to protect the 
  5.2   health and safety of their citizens.  If a party state takes 
  5.3   such action, it shall promptly notify the administrator of the 
  5.4   coordinated licensure information system.  The administrator of 
  5.5   the coordinated licensure information system shall promptly 
  5.6   notify the home state of any such actions by remote states. 
  5.7      (c) Every nurse practicing in a party state must comply 
  5.8   with the state practice laws of the state in which the patient 
  5.9   is located at the time care is rendered.  In addition, the 
  5.10  practice of nursing is not limited to patient care, but shall 
  5.11  include all nursing practice as defined by the state practice 
  5.12  laws of a party state.  The practice of nursing will subject a 
  5.13  nurse to the jurisdiction of the nurse licensing board and the 
  5.14  courts, as well as the laws, in that party state. 
  5.15     (d) This compact does not affect additional requirements 
  5.16  imposed by states for advanced practice registered nursing. 
  5.17  However, a multistate licensure privilege to practice registered 
  5.18  nursing granted by a party state shall be recognized by other 
  5.19  party states as a license to practice registered nursing if one 
  5.20  is required by state law as a precondition for qualifying for 
  5.21  advanced practice registered nurse authorization. 
  5.22     (e) Individuals not residing in a party state shall 
  5.23  continue to be able to apply for nurse licensure as provided for 
  5.24  under the laws of each party state.  However, the license 
  5.25  granted to these individuals will not be recognized as granting 
  5.26  the privilege to practice nursing in any other party state 
  5.27  unless explicitly agreed to by that party state. 
  5.28                             ARTICLE 4
  5.29            APPLICATIONS FOR LICENSURE IN A PARTY STATE
  5.30     (a) Upon application for a license, the licensing board in 
  5.31  a party state shall ascertain, through the coordinated licensure 
  5.32  information system, whether the applicant has ever held, or is 
  5.33  the holder of, a license issued by any other state; whether 
  5.34  there are any restrictions on the multistate licensure 
  5.35  privilege; and whether any other adverse action by any state has 
  5.36  been taken against the license. 
  6.1      (b) A nurse in a party state shall hold licensure in only 
  6.2   one party state at a time, issued by the home state. 
  6.3      (c) A nurse who intends to change primary state of 
  6.4   residence may apply for licensure in the new home state in 
  6.5   advance of such change.  However, new licenses will not be 
  6.6   issued by a party state until after a nurse provides evidence of 
  6.7   change in primary state of residence satisfactory to the new 
  6.8   home state's licensing board. 
  6.9      (d) When a nurse changes primary state of residence by: 
  6.10     (1) moving between two party states, and obtains a license 
  6.11  from the new home state, the license from the former home state 
  6.12  is no longer valid; 
  6.13     (2) moving from a nonparty state to a party state, and 
  6.14  obtains a license from the new home state, the individual state 
  6.15  license issued by the nonparty state is not affected and will 
  6.16  remain in full force if so provided by the laws of the nonparty 
  6.17  state; 
  6.18     (3) moving from a party state to a nonparty state, the 
  6.19  license issued by the prior home state converts to an individual 
  6.20  state license, valid only in the former home state, without the 
  6.21  multistate licensure privilege to practice in other party states.
  6.22                             ARTICLE 5
  6.23                          ADVERSE ACTIONS
  6.24     In addition to the general provisions described in article 
  6.25  3, the following provisions apply. 
  6.26     (a) The licensing board of a remote state shall promptly 
  6.27  report to the administrator of the coordinated licensure 
  6.28  information system any remote state actions, including the 
  6.29  factual and legal basis for such action, if known.  The 
  6.30  licensing board of a remote state shall also promptly report any 
  6.31  significant current investigative information yet to result in a 
  6.32  remote state action.  The administrator of the coordinated 
  6.33  licensure information system shall promptly notify the home 
  6.34  state of any such reports. 
  6.35     (b) The licensing board of a party state shall have the 
  6.36  authority to complete any pending investigations for a nurse who 
  7.1   changes primary state of residence during the course of such 
  7.2   investigations.  It shall also have the authority to take 
  7.3   appropriate action(s), and shall promptly report the conclusions 
  7.4   of such investigations to the administrator of the coordinated 
  7.5   licensure information system.  The administrator of the 
  7.6   coordinated licensure information system shall promptly notify 
  7.7   the new home state of any such actions. 
  7.8      (c) A remote state may take adverse action affecting the 
  7.9   multistate licensure privilege to practice within that party 
  7.10  state.  However, only the home state shall have the power to 
  7.11  impose adverse action against the license issued by the home 
  7.12  state. 
  7.13     (d) For purposes of imposing adverse action, the licensing 
  7.14  board of the home state shall give the same priority and effect 
  7.15  to reported conduct received from a remote state as it would if 
  7.16  such conduct had occurred within the home state.  In so doing, 
  7.17  it shall apply its own state laws to determine appropriate 
  7.18  action. 
  7.19     (e) The home state may take adverse action based on the 
  7.20  factual findings of the remote state, so long as each state 
  7.21  follows its own procedures for imposing such adverse action. 
  7.22     (f) Nothing in this compact shall override a party state's 
  7.23  decision that participation in an alternative program may be 
  7.24  used in lieu of licensure action and that such participation 
  7.25  shall remain nonpublic if required by the party state's laws. 
  7.26  Party states must require nurses who enter any alternative 
  7.27  programs to agree not to practice in any other party state 
  7.28  during the term of the alternative program without prior 
  7.29  authorization from such other party state. 
  7.30                             ARTICLE 6
  7.31                 ADDITIONAL AUTHORITIES INVESTED IN 
  7.32                 PARTY STATE NURSE LICENSING BOARDS
  7.33     Notwithstanding any other powers, party state nurse 
  7.34  licensing boards shall have the authority to: 
  7.35     (1) if otherwise permitted by state law, recover from the 
  7.36  affected nurse the costs of investigations and disposition of 
  8.1   cases resulting from any adverse action taken against that 
  8.2   nurse; 
  8.3      (2) issue subpoenas for hearings and investigations which 
  8.4   require the attendance and testimony of witnesses, and for the 
  8.5   production of evidence.  Subpoenas issued by a nurse licensing 
  8.6   board in a party state for the attendance and testimony of 
  8.7   witnesses, or the production of evidence from another party 
  8.8   state, shall be enforced in the latter state by any court of 
  8.9   competent jurisdiction, according to the practice and procedure 
  8.10  of that court applicable to subpoenas issued in proceedings 
  8.11  pending before it.  The issuing authority shall pay any witness 
  8.12  fees, travel expenses, mileage, and other fees required by the 
  8.13  service statutes of the state where the witnesses and/or 
  8.14  evidence are located; 
  8.15     (3) issue cease and desist orders to limit or revoke a 
  8.16  nurse's authority to practice in the nurse's state; and 
  8.17     (4) promulgate uniform rules and regulations as provided 
  8.18  for in article 8, paragraph (c). 
  8.19                             ARTICLE 7
  8.20              COORDINATED LICENSURE INFORMATION SYSTEM
  8.21     (a) All party states shall participate in a cooperative 
  8.22  effort to create a coordinated database of all licensed 
  8.23  registered nurses and licensed practical/vocational nurses.  
  8.24  This system shall include information on the licensure and 
  8.25  disciplinary history of each nurse, as contributed by party 
  8.26  states, to assist in the coordination of nurse licensure and 
  8.27  enforcement efforts. 
  8.28     (b) Notwithstanding any other provision of law, all party 
  8.29  states' licensing boards shall promptly report adverse actions, 
  8.30  actions against multistate licensure privileges, any current 
  8.31  significant investigative information yet to result in adverse 
  8.32  action, denials of applications, and the reasons for such 
  8.33  denials, to the coordinated licensure information system. 
  8.34     (c) Current significant investigative information shall be 
  8.35  transmitted through the coordinated licensure information system 
  8.36  only to party state licensing boards. 
  9.1      (d) Notwithstanding any other provision of law, all party 
  9.2   states' licensing boards contributing information to the 
  9.3   coordinated licensure information system may designate 
  9.4   information that may not be shared with nonparty states or 
  9.5   disclosed to other entities or individuals without the express 
  9.6   permission of the contributing state. 
  9.7      (e) Any personally identifiable information obtained by a 
  9.8   party state's licensing board from the coordinated licensure 
  9.9   information system may not be shared with nonparty states or 
  9.10  disclosed to other entities or individuals except to the extent 
  9.11  permitted by the laws of the party state contributing the 
  9.12  information. 
  9.13     (f) Any information contributed to the coordinated 
  9.14  licensure information system that is subsequently required to be 
  9.15  expunged by the laws of the party state contributing that 
  9.16  information, shall also be expunged from the coordinated 
  9.17  licensure information system. 
  9.18     (g) The compact administrators, acting jointly with each 
  9.19  other and in consultation with the administrator of the 
  9.20  coordinated licensure information system, shall formulate 
  9.21  necessary and proper procedures for the identification, 
  9.22  collection, and exchange of information under this compact. 
  9.23                             ARTICLE 8
  9.24                     COMPACT ADMINISTRATION AND 
  9.25                     INTERCHANGE OF INFORMATION
  9.26     (a) The head of the nurse licensing board, or a designee, 
  9.27  of each party state shall be the administrator of this compact 
  9.28  for that state. 
  9.29     (b) The compact administrator of each party state shall 
  9.30  furnish to the compact administrator of each other party state 
  9.31  any information and documents including, but not limited to, a 
  9.32  uniform data set of investigations, identifying information, 
  9.33  licensure data, and disclosable alternative program 
  9.34  participation information to facilitate the administration of 
  9.35  this compact. 
  9.36     (c) Compact administrators shall have the authority to 
 10.1   develop uniform rules to facilitate and coordinate 
 10.2   implementation of this compact.  These uniform rules shall be 
 10.3   adopted by party states, under the authority invested under 
 10.4   article 6, clause (4). 
 10.5                              ARTICLE 9
 10.6                               IMMUNITY
 10.7      No party state or the officers, employees, or agents of a 
 10.8   party state's nurse licensing board who act in accordance with 
 10.9   the provisions of this compact shall be liable for any act or 
 10.10  omission in good faith while engaged in the performance of their 
 10.11  duties under this compact.  Good faith in this article shall not 
 10.12  include willful misconduct, gross negligence, or recklessness. 
 10.13                             ARTICLE 10
 10.14            ENTRY INTO FORCE, WITHDRAWAL, AND AMENDMENT
 10.15     (a) This compact shall enter into force and become 
 10.16  effective as to any state when it has been enacted into the laws 
 10.17  of that state.  Any party state may withdraw from this compact 
 10.18  by enacting a statute repealing the same, but no such withdrawal 
 10.19  shall take effect until six months after the withdrawing state 
 10.20  has given notice of the withdrawal to the executive heads of all 
 10.21  other party states. 
 10.22     (b) No withdrawal shall affect the validity or 
 10.23  applicability by the licensing boards of states remaining party 
 10.24  to the compact of any report of adverse action occurring prior 
 10.25  to the withdrawal. 
 10.26     (c) Nothing contained in this compact shall be construed to 
 10.27  invalidate or prevent any nurse licensure agreement or other 
 10.28  cooperative arrangement between a party state and a nonparty 
 10.29  state that is made in accordance with the other provisions of 
 10.30  this compact. 
 10.31     (d) This compact may be amended by the party states.  No 
 10.32  amendment to this compact shall become effective and binding 
 10.33  upon the party states unless and until it is enacted into the 
 10.34  laws of all party states. 
 10.35                             ARTICLE 11
 10.36                   CONSTRUCTION AND SEVERABILITY
 11.1      (a) This compact shall be liberally construed so as to 
 11.2   effectuate the purposes thereof.  The provisions of this compact 
 11.3   shall be severable and if any phrase, clause, sentence, or 
 11.4   provision of this compact is declared to be contrary to the 
 11.5   constitution of any party state or of the United States or the 
 11.6   applicability thereof to any government, agency, person, or 
 11.7   circumstance is held invalid, the validity of the remainder of 
 11.8   this compact and the applicability thereof to any government, 
 11.9   agency, person, or circumstance shall not be affected thereby.  
 11.10  If this compact shall be held contrary to the constitution of 
 11.11  any state party thereto, the compact shall remain in full force 
 11.12  and effect as to the remaining party states and in full force 
 11.13  and effect as to the party state affected as to all severable 
 11.14  matters. 
 11.15     (b) In the event party states find a need for settling 
 11.16  disputes arising under this compact: 
 11.17     (1) the party states may submit the issues in dispute to an 
 11.18  arbitration panel which shall be comprised of an individual 
 11.19  appointed by the compact administrator in the home state, an 
 11.20  individual appointed by the compact administrator in the remote 
 11.21  state or states involved, and an individual mutually agreed upon 
 11.22  by the compact administrators of all the party states involved 
 11.23  in the dispute; and 
 11.24     (2) the decision of a majority of the arbitrators shall be 
 11.25  final and binding. 
 11.26     Sec. 2.  Minnesota Statutes 2000, section 214.10, 
 11.27  subdivision 8, is amended to read: 
 11.28     Subd. 8.  [SPECIAL REQUIREMENTS FOR HEALTH-RELATED 
 11.29  LICENSING BOARDS.] In addition to the provisions of this section 
 11.30  that apply to all examining and licensing boards, the 
 11.31  requirements in this subdivision apply to all health-related 
 11.32  licensing boards, except the board of veterinary medicine. 
 11.33     (a) If the executive director or consulted board member 
 11.34  determines that a communication received alleges a violation of 
 11.35  statute or rule that involves sexual contact with a patient or 
 11.36  client, the communication shall be forwarded to the designee of 
 12.1   the attorney general for an investigation of the facts alleged 
 12.2   in the communication.  If, after an investigation it is the 
 12.3   opinion of the executive director or consulted board member that 
 12.4   there is sufficient evidence to justify disciplinary action, the 
 12.5   board shall conduct a disciplinary conference or hearing.  If, 
 12.6   after a hearing or disciplinary conference the board determines 
 12.7   that misconduct involving sexual contact with a patient or 
 12.8   client occurred, the board shall take disciplinary action.  
 12.9   Notwithstanding subdivision 2, a board may not attempt to 
 12.10  correct improper activities or redress grievances through 
 12.11  education, conciliation, and persuasion, unless in the opinion 
 12.12  of the executive director or consulted board member there is 
 12.13  insufficient evidence to justify disciplinary action.  The board 
 12.14  may settle a case by stipulation prior to, or during, a hearing 
 12.15  if the stipulation provides for disciplinary action. 
 12.16     (b) A board member who has a direct current or former 
 12.17  financial connection or professional relationship to a person 
 12.18  who is the subject of board disciplinary activities must not 
 12.19  participate in board activities relating to that case. 
 12.20     (c) Each health-related licensing board shall establish 
 12.21  procedures for exchanging information with other Minnesota state 
 12.22  boards, agencies, and departments responsible for regulating 
 12.23  health-related occupations, facilities, and programs, and for 
 12.24  coordinating investigations involving matters within the 
 12.25  jurisdiction of more than one regulatory body.  The procedures 
 12.26  must provide for the forwarding to other regulatory bodies of 
 12.27  all information and evidence, including the results of 
 12.28  investigations, that are relevant to matters within that 
 12.29  licensing body's regulatory jurisdiction.  Each health-related 
 12.30  licensing board shall have access to any data of the department 
 12.31  of human services relating to a person subject to the 
 12.32  jurisdiction of the licensing board.  The data shall have the 
 12.33  same classification under chapter 13, the Minnesota Government 
 12.34  Data Practices Act, in the hands of the agency receiving the 
 12.35  data as it had in the hands of the department of human services. 
 12.36     (d) Each health-related licensing board shall establish 
 13.1   procedures for exchanging information with other states 
 13.2   regarding disciplinary actions against licensees.  The 
 13.3   procedures must provide for the collection of information from 
 13.4   other states about disciplinary actions taken against persons 
 13.5   who are licensed to practice in Minnesota or who have applied to 
 13.6   be licensed in this state and the dissemination of information 
 13.7   to other states regarding disciplinary actions taken in 
 13.8   Minnesota.  The board of nursing shall also establish procedures 
 13.9   for exchanging information with other states who are parties to 
 13.10  the Nurse Licensure Compact and for providing information to the 
 13.11  coordinated licensure information system, as defined in section 
 13.12  148.2115, regarding disciplinary actions against multistate 
 13.13  licensure privileges; investigative data on any current, 
 13.14  significant investigation that has not yet resulted in a 
 13.15  disciplinary action; data on participation in alternative 
 13.16  programs; and denials of applications for licensure and the 
 13.17  reasons for such denials.  In addition to any authority in 
 13.18  chapter 13 permitting the dissemination of data, the board may, 
 13.19  in its discretion, disseminate data to other states regardless 
 13.20  of its classification under chapter 13.  Before transferring any 
 13.21  data that is not public, the board shall obtain reasonable 
 13.22  assurances from the receiving state that the data will not be 
 13.23  made public.