CHAPTER 304. NURSE LICENSURE COMPACT
OCCUPATIONS CODE
TITLE 3. HEALTH PROFESSIONS
SUBTITLE E. REGULATION OF NURSING
CHAPTER 304. NURSE LICENSURE COMPACT
Sec. 304.001. NURSE LICENSURE COMPACT. 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, Sec. 14.130(a), eff.
Sept. 1, 2001.
Sec. 304.002. ADMINISTRATION OF COMPACT. The executive director
of the Texas Board of Nursing is the Nurse Licensure Compact
administrator for this state.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.022, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 39, eff. September 1, 2007.
Sec. 304.003. RULES. The Texas Board of Nursing may adopt rules
necessary to implement this chapter.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.023, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 39, eff. September 1, 2007.
Sec. 304.004. GENERAL PROVISIONS. (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 Texas Board of Nursing.
(c) The Texas Board of Nursing 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, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.024, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 40, eff. September 1, 2007.
Sec. 304.005. ENFORCEMENT. The Texas Board of Nursing 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, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.025, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 41, eff. September 1, 2007.
Sec. 304.006. INFORMATION MAINTAINED UNDER COMPACT. (a) On
request and payment of a reasonable fee, the Texas Board of
Nursing shall provide a registered or vocational nurse licensed
by this state with a copy of information regarding the nurse
maintained by the coordinated licensure information system under
Article 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, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.026, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 42, eff. September 1, 2007.
Sec. 304.007. ACCESS TO PRACTICE-RELATED INFORMATION.
Practice-related information provided by the Texas Board of
Nursing 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, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.027, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 43, eff. September 1, 2007.
Sec. 304.008. DISCLOSURE OF PERSONAL INFORMATION. (a) In
reporting information to the coordinated licensure information
system under Article 7 of the Nurse Licensure Compact, the Texas
Board of Nursing 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, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.028, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 44, eff. September 1, 2007.
Sec. 304.009. WITHDRAWAL FROM COMPACT. (a) The governor may
withdraw this state from the Nurse Licensure Compact if the Texas
Board of Nursing 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, Sec. 14.130(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.
2.029, eff. Feb. 1, 2004.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 45, eff. September 1, 2007.