KRS § 314.475 — KY Code / Title XXVI / Chapter 314 / Section 314.475
314.475 Nurse Licensure Compact
Status: in_force

314.475 Nurse Licensure Compact.

The Nurse Licensure Compact is hereby enacted and entered into with all other

jurisdictions that legally join in the Compact, which is, in form, substantially as follows:

ARTICLE I

Findings and Declaration of Purpose

a. The party states find that:

1. The health and safety of the public are affected by the degree of compliance

with and the effectiveness of enforcement activities related to state nurse

licensure laws;

2. Violations of nurse licensure and other laws regulating the practice of nursing

may result in injury or harm to the public;

3. The expanded mobility of nurses and the use of advanced communication

technologies as part of our nation's health care delivery system require greater

coordination and cooperation among states in the areas of nurse licensure and

regulation;

4. New practice modalities and technology make compliance with individual

state nurse licensure laws difficult and complex;

5. The current system of duplicative licensure for nurses practicing in multiple

states is cumbersome and redundant for both nurses and states; and

6. Uniformity of nurse licensure requirements throughout the states promotes

public safety and public health benefits.

b. The general purposes of this Compact are to:

1. Facilitate the states' responsibility to protect the public's health and safety;

2. Ensure and encourage the cooperation of party states in the areas of nurse

licensure and regulation;

3. Facilitate the exchange of information between party states in the areas of

nurse regulation, investigation and adverse actions;

4. Promote compliance with the laws governing the practice of nursing in each

jurisdiction;

5. Invest all party states with the authority to hold a nurse accountable for

meeting all state practice laws in the state in which the patient is located at the

time care is rendered through the mutual recognition of party state licenses;

6. Decrease redundancies in the consideration and issuance of nurse licenses;

and

7. Provide opportunities for interstate practice by nurses who meet uniform

licensure requirements.

c. The following provisions of this Compact shall apply in this state:

1. By entering into this Compact, this state authorizes the licensing board as

defined in Article II. g. of this Compact and as created by KRS Chapter 314 to

implement the provisions of this Compact.

2. Notwithstanding any provision of this Compact to the contrary:

i. When a rule is adopted pursuant to Article VIII of this Compact, the

licensing board of this state as defined by Article II. g. of this Compact

shall have sixty (60) days to review the rule for the purpose of filing the

rule as an emergency administrative regulation pursuant to KRS

13A.190 and for filing the rule as an accompanying ordinary

administrative regulation, following the requirements of KRS Chapter

13A. Failure by the licensing board of this state as defined by Article II.

g. of this Compact to promulgate a rule adopted by the Interstate

Commission of Nurse Licensure Compact Administrators as an

administrative regulation pursuant to KRS Chapter 13A shall result in

the initiation of the process for withdrawal as set forth in Article X of

this Compact. Nothing in these provisions shall negate the applicability

and effect of Article VIII. j. of this Compact to this state.

ii. If the proposed administrative regulation is found deficient and the

deficiency is not resolved pursuant to KRS 13A.330 or 13A.335, the

provisions of Article IX of this Compact shall apply. In the event that

the procedures under Article IX of this Compact fail to resolve an issue,

the provisions of Article X of this Compact shall apply.

iii. In the event the Interstate Commission of Nurse Licensure Compact

Administrators created by Article VII of this Compact exercises its

rulemaking authority in a manner that is beyond the scope of the

purposes of this Compact, or the powers granted hereunder, then such an

action by the Commission shall be invalid and have no force or effect.

3. Article VII. h. of this Compact pertaining to the financing of the Commission

shall not be interpreted to obligate the general fund of this state. Any funds

used to finance this Compact shall be from money collected pursuant to KRS

314.161.

4. This Compact shall apply only to those nurses who hold a multistate license.

5. The term "head of the state licensing board" as used in Article VII. b. of this

Compact refers to the executive director of the Kentucky Board of Nursing.

ARTICLE II

Definitions

As used in this Compact:

a. "Adverse action" means any administrative, civil, equitable or criminal action

permitted by a state's laws which is imposed by a licensing board or other authority

against a nurse, including actions against an individual's license or multistate

licensure privilege such as revocation, suspension, probation, monitoring of the

licensee, limitation on the licensee's practice, or any other encumbrance on licensure

affecting a nurse's authorization to practice, including issuance of a cease and desist

action.

b. "Alternative program" means a non-disciplinary monitoring program approved by a

licensing board.

c. "Coordinated licensure information system" means an integrated process for

collecting, storing and sharing information on nurse licensure and enforcement

activities related to nurse licensure laws that is administered by a nonprofit

organization composed of and controlled by licensing boards.

d. "Current significant investigative information" means:

1. Investigative information that a licensing board, after a preliminary inquiry

that includes notification and an opportunity for the nurse to respond, if

required by state law, has reason to believe is not groundless and, if proved

true, would indicate more than a minor infraction; or

2. Investigative information that indicates that the nurse represents an immediate

threat to public health and safety regardless of whether the nurse has been

notified and had an opportunity to respond.

e. "Encumbrance" means a revocation or suspension of, or any limitation on, the full

and unrestricted practice of nursing imposed by a licensing board.

f. "Home state" means the party state which is the nurse's primary state of residence.

g. "Licensing board" means a party state's regulatory body responsible for issuing

nurse licenses.

h. "Multistate license" means a license to practice as a registered or a licensed

practical/vocational nurse (LPN/VN) issued by a home state licensing board that

authorizes the licensed nurse to practice in all party states under a multistate

licensure privilege.

i. "Multistate licensure privilege" means a legal authorization associated with a

multistate license permitting the practice of nursing as either a registered nurse

(RN) or LPN/VN in a remote state.

j. "Nurse" means RN or LPN/VN, as those terms are defined by each party state's

practice laws.

k. "Party state" means any state that has adopted this Compact.

l. "Remote state" means a party state, other than the home state.

m. "Single-state license" means a nurse license issued by a party state that authorizes

practice only within the issuing state and does not include a multistate licensure

privilege to practice in any other party state.

n. "State" means a state, territory or possession of the United States and the District of

Columbia.

o. "State practice laws" means a party state's laws, rules and regulations that govern

the practice of nursing, define the scope of nursing practice, and create the methods

and grounds for imposing discipline. "State practice laws" do not include

requirements necessary to obtain and retain a license, except for qualifications or

requirements of the home state.

ARTICLE III

General Provisions and Jurisdiction

a. A multistate license to practice registered or licensed practical/vocational nursing

issued by a home state to a resident in that state will be recognized by each party

state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed

practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each

party state.

b. A state must implement procedures for considering the criminal history records of

applicants for initial multistate license or licensure by endorsement. Such

procedures shall include the submission of fingerprints or other biometric-based

information by applicants for the purpose of obtaining an applicant's criminal

history record information from the Federal Bureau of Investigation and the agency

responsible for retaining that state's criminal records.

c. Each party state shall require the following for an applicant to obtain or retain a

multistate license in the home state:

1. Meets the home state's qualifications for licensure or renewal of licensure, as

well as all other applicable state laws;

2. i. Has graduated or is eligible to graduate from a licensing board-approved

RN or LPN/VN prelicensure education program; or

ii. Has graduated from a foreign RN or LPN/VN prelicensure education

program that (a) has been approved by the authorized accrediting body

in the applicable country and (b) has been verified by an independent

credentials review agency to be comparable to a licensing board-

approved prelicensure education program;

3. Has, if a graduate of a foreign prelicensure education program, not taught in

English or, if English is not the individual's native language, successfully

passed an English proficiency examination that includes the components of

reading, speaking, writing and listening;

4. Has successfully passed an NCLEX-RN or NCLEX-PN Examination or

recognized predecessor, as applicable;

5. Is eligible for or holds an active, unencumbered license;

6. Has submitted, in connection with an application for initial licensure or

licensure by endorsement, fingerprints or other biometric data for the purpose

of obtaining criminal history record information from the Federal Bureau of

Investigation and the agency responsible for retaining that state's criminal

records;

7. Has not been convicted or found guilty, or has entered into an agreed

disposition, of a felony offense under applicable state or federal criminal law;

8. Has not been convicted or found guilty, or has entered into an agreed

disposition, of a misdemeanor offense related to the practice of nursing as

determined on a case-by-case basis;

9. Is not currently enrolled in an alternative program;

10. Is subject to self-disclosure requirements regarding current participation in an

alternative program; and

11. Has a valid United States Social Security number.

d. All party states shall be authorized, in accordance with existing state due process

law, to take adverse action against a nurse's multistate licensure privilege such as

revocation, suspension, probation or any other action that affects a nurse's

authorization to practice under a multistate licensure privilege, including cease and

desist actions. If a party state takes such action, it shall promptly notify the

administrator of the coordinated licensure information system. The administrator of

the coordinated licensure information system shall promptly notify the home state

of any such actions by remote states.

e. A nurse practicing in a party state must comply with the state practice laws of the

state in which the client is located at the time service is provided. The practice of

nursing is not limited to patient care, but shall include all nursing practice as

defined by the state practice laws of the party state in which the client is located.

The practice of nursing in a party state under a multistate licensure privilege will

subject a nurse to the jurisdiction of the licensing board, the courts and the laws of

the party state in which the client is located at the time service is provided.

f. Individuals not residing in a party state shall continue to be able to apply for a party

state's single-state license as provided under the laws of each party state. However,

the single-state license granted to these individuals will not be recognized as

granting the privilege to practice nursing in any other party state. Nothing in this

Compact shall affect the requirements established by a party state for the issuance

of a single-state license.

g. Any nurse holding a home state multistate license, on the effective date of this

Compact, may retain and renew the multistate license issued by the nurse's then-

current home state, provided that:

1. A nurse, who changes primary state of residence after this Compact's effective

date, must meet all applicable Article III.c. requirements to obtain a multistate

license from a new home state.

2. A nurse who fails to satisfy the multistate licensure requirements in Article III.

c. of this Compact due to a disqualifying event occurring after this Compact's

effective date shall be ineligible to retain or renew a multistate license, and the

nurse's multistate license shall be revoked or deactivated in accordance with

applicable rules adopted by the Interstate Commission of Nurse Licensure

Compact Administrators ("Commission").

ARTICLE IV

Applications for Licensure in a Party State

a. Upon application for a multistate license, the licensing board in the issuing party

state shall ascertain, through the coordinated licensure information system, whether

the applicant has ever held, or is the holder of, a license issued by any other state,

whether there are any encumbrances on any license or multistate licensure privilege

held by the applicant, whether any adverse action has been taken against any license

or multistate licensure privilege held by the applicant and whether the applicant is

currently participating in an alternative program.

b. A nurse may hold a multistate license, issued by the home state, in only one (1)

party state at a time.

c. If a nurse changes primary state of residence by moving between two (2) party

states, the nurse must apply for licensure in the new home state, and the multistate

license issued by the prior home state will be deactivated in accordance with

applicable rules adopted by the Commission.

1. The nurse may apply for licensure in advance of a change in primary state of

residence.

2. A multistate license shall not be issued by the new home state until the nurse

provides satisfactory evidence of a change in primary state of residence to the

new home state and satisfies all applicable requirements to obtain a multistate

license from the new home state.

d. If a nurse changes primary state of residence by moving from a party state to a non-

party state, the multistate license issued by the prior home state will convert to a

single-state license, valid only in the former home state.

ARTICLE V

Additional Authorities Invested in Party State Licensing Boards

a. In addition to the other powers conferred by state law, a licensing board shall have

the authority to:

1. Take adverse action against a nurse's multistate licensure privilege to practice

within that party state.

i. Only the home state shall have the power to take adverse action against a

nurse's license issued by the home state.

ii. For purposes of taking adverse action, the home state licensing board

shall give the same priority and effect to reported conduct received from

a remote state as it would if such conduct had occurred within the home

state. In so doing, the home state shall apply its own state laws to

determine appropriate action.

2. Issue cease and desist orders or impose an encumbrance on a nurse's authority

to practice within that party state.

3. Complete any pending investigations of a nurse who changes primary state of

residence during the course of such investigations. The licensing board shall

also have the authority to take appropriate action(s) and shall promptly report

the conclusions of such investigations to the administrator of the coordinated

licensure information system. The administrator of the coordinated licensure

information system shall promptly notify the new home state of any such

actions.

4. Issue subpoenas for both hearings and investigations that require the

attendance and testimony of witnesses, as well as the production of evidence.

Subpoenas issued by a licensing board in a party state for the attendance and

testimony of witnesses or the production of evidence from another party state

shall be enforced in the latter state by any court of competent jurisdiction,

according to the practice and procedure of that court applicable to subpoenas

issued in proceedings pending before it. The issuing authority shall pay any

witness fees, travel expenses, mileage and other fees required by the service

statutes of the state in which the witnesses or evidence are located.

5. Obtain and submit, for each nurse licensure applicant, fingerprint or other

biometric-based information to the Federal Bureau of Investigation for

criminal background checks, receive the results of the Federal Bureau of

Investigation record search on criminal background checks and use the results

in making licensure decisions.

6. If otherwise permitted by state law, recover from the affected nurse the costs

of investigations and disposition of cases resulting from any adverse action

taken against that nurse.

7. Take adverse action based on the factual findings of the remote state, provided

that the licensing board follows its own procedures for taking such adverse

action.

b. If adverse action is taken by the home state against a nurse's multistate license, the

nurse's multistate licensure privilege to practice in all other party states shall be

deactivated until all encumbrances have been removed from the multistate license.

All home state disciplinary orders that impose adverse action against a nurse's

multistate license shall include a statement that the nurse's multistate licensure

privilege is deactivated in all party states during the pendency of the order.

c. Nothing in this Compact shall override a party state's decision that participation in

an alternative program may be used in lieu of adverse action. The home state

licensing board shall deactivate the multistate licensure privilege under the

multistate license of any nurse for the duration of the nurse's participation in an

alternative program.

ARTICLE VI

Coordinated Licensure Information System and Exchange of Information

a. All party states shall participate in a coordinated licensure information system of all

licensed registered nurses (RNs) and licensed practical/vocational nurses

(LPNs/VNs). This system will include information on the licensure and disciplinary

history of each nurse, as submitted by party states, to assist in the coordination of

nurse licensure and enforcement efforts.

b. The Commission, in consultation with the administrator of the coordinated

licensure information system, shall formulate necessary and proper procedures for

the identification, collection and exchange of information under this Compact.

c. All licensing boards shall promptly report to the coordinated licensure information

system any adverse action, any current significant investigative information, denials

of applications (with the reasons for such denials) and nurse participation in

alternative programs known to the licensing board regardless of whether such

participation is deemed nonpublic or confidential under state law.

d. Current significant investigative information and participation in nonpublic or

confidential alternative programs shall be transmitted through the coordinated

licensure information system only to party state licensing boards.

e. Notwithstanding any other provision of law, all party state licensing boards

contributing information to the coordinated licensure information system may

designate information that may not be shared with non-party states or disclosed to

other entities or individuals without the express permission of the contributing state.

f. Any personally identifiable information obtained from the coordinated licensure

information system by a party state licensing board shall not be shared with non-

party states or disclosed to other entities or individuals except to the extent

permitted by the laws of the party state contributing the information.

g. Any information contributed to the coordinated licensure information system that is

subsequently required to be expunged by the laws of the party state contributing that

information shall also be expunged from the coordinated licensure information

system.

h. The Compact administrator of each party state shall furnish a uniform data set to the

Compact administrator of each other party state, which shall include, at a minimum:

1. Identifying information;

2. Licensure data;

3. Information related to alternative program participation; and

4. Other information that may facilitate the administration of this Compact, as

determined by Commission rules.

i. The Compact administrator of a party state shall provide all investigative

documents and information requested by another party state.

ARTICLE VII

Establishment of the Interstate Commission of Nurse Licensure Compact Administrators

a. The party states hereby create and establish a joint public entity known as the

Interstate Commission of Nurse Licensure Compact Administrators.

1. The Commission is an instrumentality of the party states.

2. Venue is proper, and judicial proceedings by or against the Commission shall

be brought solely and exclusively, in a court of competent jurisdiction where

the principal office of the Commission is located. The Commission may

waive venue and jurisdictional defenses to the extent it adopts or consents to

participate in alternative dispute resolution proceedings.

3. Nothing in this Compact shall be construed to be a waiver of sovereign

immunity.

b. Membership, Voting and Meetings

1. Each party state shall have and be limited to one administrator. The head of

the state licensing board or designee shall be the administrator of this

Compact for each party state. Any administrator may be removed or

suspended from office as provided by the law of the state from which the

Administrator is appointed. Any vacancy 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 of this Compact.

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;

and

6. Providing a mechanism for winding up the operations of the Commission and

the equitable disposition of any surplus funds that may exist after the

termination of this Compact after the payment or reserving of all of its debts

and obligations.

d. The Commission shall publish its bylaws and rules, and any amendments thereto, in

a convenient form on the Web site of the Commission.

e. The Commission shall maintain its financial records in accordance with the bylaws.

f. The Commission shall meet and take such actions as are consistent with the

provisions of this Compact and the bylaws.

g. The Commission shall have the following powers:

1. To promulgate uniform rules to facilitate and coordinate implementation and

administration of this Compact. The rules shall have the force and effect of

law and shall be binding in all party states;

2. To bring and prosecute legal proceedings or actions in the name of the

Commission, provided that the standing of any licensing board to sue or be

sued under applicable law shall not be affected;

3. To purchase and maintain insurance and bonds;

4. To borrow, accept or contract for services of personnel, including but not

limited to employees of a party state or nonprofit organizations;

5. To cooperate with other organizations that administer state compacts related

to the regulation of nursing, including but not limited to sharing

administrative or staff expenses, office space or other resources;

6. To hire employees, elect or appoint officers, fix compensation, define duties,

grant such individuals appropriate authority to carry out the purposes of this

Compact, and to establish the Commission's personnel policies and programs

relating to conflicts of interest, qualifications of personnel and other related

personnel matters;

7. To accept any and all appropriate donations, grants and gifts of money,

equipment, supplies, materials and services, and to receive, utilize and dispose

of the same; provided that at all times the Commission shall avoid any

appearance of impropriety or conflict of interest;

8. To lease, purchase, accept appropriate gifts or donations of, or otherwise to

own, hold, improve or use, any property, whether real, personal or mixed;

provided that at all times the Commission shall avoid any appearance of

impropriety;

9. To sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise

dispose of any property, whether real, personal or mixed;

10. To establish a budget and make expenditures;

11. To borrow money;

12. To appoint committees, including advisory committees comprised of

administrators, state nursing regulators, state legislators or their

representatives, and consumer representatives, and other such interested

persons;

13. To provide and receive information from, and to cooperate with, law

enforcement agencies;

14. To adopt and use an official seal; and

15. To perform such other functions as may be necessary or appropriate to achieve

the purposes of this Compact consistent with the state regulation of nurse

licensure and practice.

h. Financing of the Commission

1. The Commission shall pay, or provide for the payment of, the reasonable

expenses of its establishment, organization and ongoing activities.

2. The Commission may also levy on and collect an annual assessment from

each party state to cover the cost of its operations, activities and staff in its

annual budget as approved each year. The aggregate annual assessment

amount, if any, shall be allocated based upon a formula to be determined by

the Commission, which shall promulgate a rule that is binding upon all party

states.

3. The Commission shall not incur obligations of any kind prior to securing the

funds adequate to meet the same; nor shall the Commission pledge the credit

of any of the party states, except by, and with the authority of, such party state.

4. The Commission shall keep accurate accounts of all receipts and

disbursements. The receipts and disbursements of the Commission shall be

subject to the audit and accounting procedures established under its bylaws.

However, all receipts and disbursements of funds handled by the Commission

shall be audited yearly by a certified or licensed public accountant, and the

report of the audit shall be included in and become part of the annual report of

the Commission.

i. Qualified Immunity, Defense and Indemnification

1. The administrators, officers, executive director, employees and representatives

of the Commission shall be immune from suit and liability, either personally

or in their official capacity, for any claim for damage to or loss of property or

personal injury or other civil liability caused by or arising out of any actual or

alleged act, error or omission that occurred, or that the person against whom

the claim is made had a reasonable basis for believing occurred, within the

scope of Commission employment, duties or responsibilities; provided that

nothing in this paragraph shall be construed to protect any such person from

suit or liability for any damage, loss, injury or liability caused by the

intentional, willful or wanton misconduct of that person.

2. The Commission shall defend any administrator, officer, executive director,

employee or representative of the Commission in any civil action seeking to

impose liability arising out of any actual or alleged act, error or omission that

occurred within the scope of Commission employment, duties or

responsibilities, or that the person against whom the claim is made had a

reasonable basis for believing occurred within the scope of Commission

employment, duties or responsibilities; provided that nothing herein shall be

construed to prohibit that person from retaining his or her own counsel; and

provided 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 Web site of the Commission; and

2. On the Web site 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 shall be recorded, and a copy shall 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 required

by federal law or rule.

l. The Commission may direct revisions to a previously adopted rule or amendment

for purposes of correcting typographical errors, errors in format, errors in

consistency or grammatical errors. Public notice of any revisions shall be posted on

the Web site of the Commission. The revision shall be subject to challenge by any

person for a period of thirty (30) days after posting. The revision may be challenged

only on grounds that the revision results in a material change to a rule. A challenge

shall be made in writing, and delivered to the Commission, prior to the end of the

notice period. If no challenge is made, the revision will take effect without further

action. If the revision is challenged, the revision may not take effect without the

approval of the Commission.

ARTICLE IX

Oversight, Dispute Resolution and Enforcement

a. Oversight

1. Each party state shall enforce this Compact and take all actions necessary and

appropriate to effectuate this Compact's purposes and intent.

2. The Commission shall be entitled to receive service of process in any

proceeding that may affect the powers, responsibilities or actions of the

Commission, and shall have standing to intervene in such a proceeding for all

purposes. Failure to provide service of process in such proceeding to the

Commission shall render a judgment or order void as to the Commission, this

Compact or promulgated rules.

b. Default, Technical Assistance and Termination

1. If the Commission determines that a party state has defaulted in the

performance of its obligations or responsibilities under this Compact or the

promulgated rules, the Commission shall:

i. Provide written notice to the defaulting state and other party states of the

nature of the default, the proposed means of curing the default or any

other action to be taken by the Commission; and

ii. Provide remedial training and specific technical assistance regarding the

default.

2. If a state in default fails to cure the default, the defaulting state's membership

in this Compact may be terminated upon an affirmative vote of a majority of

the administrators, and all rights, privileges and benefits conferred by this

Compact may be terminated on the effective date of termination. A cure of the

default does not relieve the offending state of obligations or liabilities incurred

during the period of default.

3. Termination of membership in this Compact shall be imposed only after all

other means of securing compliance have been exhausted. Notice of intent to

suspend or terminate shall be given by the Commission to the governor of the

defaulting state and to the executive officer of the defaulting state's licensing

board and each of the party states.

4. A state whose membership in this Compact has been terminated is responsible

for all assessments, obligations and liabilities incurred through the effective

date of 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 United States 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 become effective and binding on the earlier of the date of

legislative enactment of this Compact into law by no fewer than twenty-six (26)

states or December 31, 2018. All party states to this Compact that also were parties

to the prior Nurse Licensure Compact, superseded by this Compact ("Prior

Compact"), shall be deemed to have withdrawn from said Prior Compact within six

(6) months after the effective date of this Compact.

b. Each party state to this Compact shall continue to recognize a nurse's multistate

licensure privilege to practice in that party state issued under the Prior Compact

until such party state has withdrawn from the Prior Compact.

c. Any party state may withdraw from this Compact by enacting a statute repealing the

same. A party state's withdrawal shall not take effect until six (6) months after

enactment of the repealing statute.

d. A party state's withdrawal or termination shall not affect the continuing requirement

of the withdrawing or terminated state's licensing board to report adverse actions

and significant investigations occurring prior to the effective date of such

withdrawal or termination.

e. Nothing contained in this Compact shall be construed to invalidate or prevent any

nurse licensure agreement or other cooperative arrangement between a party state

and a non-party state that is made in accordance with the other provisions of this

Compact.

f. This Compact may be amended by the party states. No amendment to this Compact

shall become effective and binding upon the party states unless and until it is

enacted into the laws of all party states.

g. Representatives of non-party states to this Compact shall be invited to participate in

the activities of the Commission, on a nonvoting basis, prior to the adoption of this

Compact by all states.

ARTICLE XI

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.