Citations Affected: IC 25-1; IC 25-23; IC 25-23.2; noncode.
Synopsis: Interstate nurse licensure compact. Adopts the interstate
nurse licensure compact to allow a registered nurse or licensed
practical nurse who is licensed in another state that is a party to the
compact to practice nursing in Indiana. Provides that the state board of
nursing administers the compact. Provides that the compact may not be
implemented until July 1, 2003. Adds funding sources to the impaired
nurses account. (The introduced version of this bill was prepared by the
health finance commission.)
Effective: July 1, 2002.
January 14, 2002, read first time and referred to Committee on Public Health.
January 23, 2002, amended, reported _ Do Pass.
January 28, 2002, read second time, ordered engrossed. Engrossed.
January 30, 2002, read third time, passed. Yeas 87, nays 2.
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
not disclose or further a disclosure of information concerning the
complaint unless the disclosure is required:
(1) under law; or
(2) for the advancement of an investigation.
(c) Notwithstanding subsections (a) and (b), under IC 25-23.2
the state board of nursing may disclose to the coordinated licensure
information system (as defined by IC 25-23.2-1-4) complaints and
information concerning complaints that the board determines to be
current significant investigative information (as defined by
IC 25-23.2-1-5).
administer oaths to persons giving testimony at hearings.
(8) Cause the prosecution of all persons violating this chapter and
have power to incur necessary expenses for these prosecutions.
(9) Adopt rules under IC 4-22-2 that do the following:
(A) Prescribe standards for the competent practice of
registered, practical, and advanced practice nursing.
(B) Establish with the approval of the medical licensing board
created by IC 25-22.5-2-1 requirements that advanced practice
nurses must meet to be granted authority to prescribe legend
drugs and to retain that authority.
(10) Keep a record of all its proceedings.
(11) Collect and distribute annually demographic information on
the number and type of registered nurses and licensed practical
nurses employed in Indiana.
(12) Notify each registered nurse and licensed practical nurse
residing in Indiana when final rules concerning the practice of
nursing are published in the Indiana register.
(12) Adopt rules and administer the interstate nurse licensure
compact under IC 25-23.2.
(b) The board may do the following:
(1) Create ad hoc subcommittees representing the various nursing
specialties and interests of the profession of nursing. Persons
appointed to a subcommittee serve for terms as determined by the
board.
(2) Utilize the appropriate subcommittees so as to assist the board
with its responsibilities. The assistance provided by the
subcommittees may include the following:
(A) Recommendation of rules necessary to carry out the duties
of the board.
(B) Recommendations concerning educational programs and
requirements.
(C) Recommendations regarding examinations and licensure
of applicants.
(3) Appoint nurses to serve on each of the ad hoc subcommittees.
(4) Withdraw from the interstate compact under IC 25-32.2.
(c) Nurses appointed under subsection (b) must:
(1) be committed to advancing and safeguarding the nursing
profession as a whole; and
(2) represent nurses who practice in the field directly affected by
a subcommittee's actions.
JULY 1, 2002]: Sec. 11. (a) Any person who applies to the board for a
license to practice as a registered nurse must:
(1) not have:
(A) been convicted of a crime that has a direct bearing on the
person's ability to practice competently; or
(B) committed an act that would constitute a ground for a
disciplinary sanction under IC 25-1-9;
(2) have completed:
(A) the prescribed curriculum and met the graduation
requirements of a state accredited program of registered
nursing that only accepts students who have a high school
diploma or its equivalent as determined by the board; or
(B) the prescribed curriculum and graduation requirements of
a nursing education program in a foreign country that is
substantially equivalent to a board approved program as
determined by the board. The board may by rule adopted under
IC 4-22-2 require an applicant under this subsection to
successfully complete an examination approved by the board
to measure the applicant's qualifications and background in the
practice of nursing and proficiency in the English language;
and
(3) be physically and mentally capable of and professionally
competent to safely engage in the practice of nursing as
determined by the board.
The board may not require a person to have a baccalaureate degree in
nursing as a prerequisite for licensure.
(b) The applicant must pass an examination in such subjects as the
board may determine.
(c) The board may issue by endorsement a license to practice as a
registered nurse to an applicant who has been licensed as a registered
nurse, by examination, under the laws of another state if the applicant
presents proof satisfactory to the board that, at the time that the
applicant applies for an Indiana license by endorsement, the applicant
holds a current license in another state and possesses credentials and
qualifications that are substantially equivalent to requirements in
Indiana for licensure by examination. The board may specify by rule
what constitutes substantial equivalence under this subsection.
(d) The board may issue by endorsement a license to practice as a
registered nurse to an applicant who:
(1) has completed the English version of the Canadian Nurse
Association Testing Service Examination;
(2) achieved the passing score required on the examination at the
time the examination was taken;
(3) is currently licensed in a Canadian province or in another
state; and
(4) meets the other requirements under this section.
(e) Each applicant for examination and registration to practice as a
registered nurse shall pay a fee set by the board. The board may set a
proctoring fee to be paid by applicants who are graduates of a state
accredited school in another state. Payment of the fee or fees shall be
made by the applicant prior to the date of examination.
(f) Any person who holds a license to practice as a registered nurse
in:
(1) Indiana; or
(2) a party state (as defined in IC 25-23.2-1-11);
may use the title "Registered Nurse" and the abbreviation "R.N.". No
other person shall practice or advertise as or assume the title of
registered nurse or use the abbreviation of "R.N." or any other words,
letters, signs, or figures to indicate that the person using same is a
registered nurse.
(g) Any person holding a license or certificate of registration to
practice nursing as a registered nurse issued by the board which is valid
on December 1, 1971, shall be considered to be licensed as a registered
nurse under this chapter.
to measure the applicant's qualifications and background in the
practice of nursing and proficiency in the English language;
and
(3) be physically and mentally capable of, and professionally
competent to, safely engage in the practice of practical nursing as
determined by the board.
(b) The applicant must pass an examination in such subjects as the
board may determine.
(c) The board may issue by endorsement a license to practice as a
licensed practical nurse to an applicant who has been licensed as a
licensed practical nurse, by examination, under the laws of another
state if the applicant presents proof satisfactory to the board that, at the
time of application for an Indiana license by endorsement, the applicant
possesses credentials and qualifications that are substantially
equivalent to requirements in Indiana for licensure by examination. The
board may specify by rule what shall constitute substantial equivalence
under this subsection.
(d) Each applicant for examination and registration to practice as a
practical nurse shall pay a fee set by the board. The board may set a
proctoring fee to be paid by applicants who are graduates of a state
accredited school in another state. Payment of the fees shall be made
by the applicant before the date of examination.
(e) Any person who holds a license to practice as a licensed
practical nurse in:
(1) Indiana; or
(2) a party state (as defined in IC 25-23.2-1-11);
may use the title "Licensed Practical Nurse" and the abbreviation
"L.P.N.". No other person shall practice or advertise as or assume the
title of licensed practical nurse or use the abbreviation of "L.P.N." or
any other words, letters, signs, or figures to indicate that the person
using them is a licensed practical nurse.
arrangements with statewide nonprofit professional associations,
or foundations, or other entities specifically devoted to the
rehabilitation of impaired health care professionals to identify
and assist impaired registered nurses and licensed practical
nurses.
(2) Accept and designate grants, public and private financial
assistance, and licensure fees to fund programs under subdivision
(1) to assist impaired registered nurses and licensed practical
nurses.
(d) Except as provided in subsection (f), all:
(1) information furnished to a nonprofit professional association,
or foundation, or other entity specifically devoted to the
rehabilitation of impaired health care professionals, including
interviews, reports, statements, and memoranda; and
(2) findings, conclusions, or recommendations that result from a
proceeding of the professional association, or foundation, or
other entity specifically devoted to the rehabilitation of
impaired health care professionals;
are privileged and confidential.
(e) The records of a proceeding under subsection (d) may be used
only in the exercise of proper functions of the board, and may not
become public records or subject to a subpoena or discovery
proceeding.
(f) Information received by the board from the board designated
rehabilitation program for noncompliance by the registered nurse or
licensed practical nurse may be used by the board in any disciplinary
or criminal proceedings instituted against the impaired registered nurse
or licensed practical nurse.
(g) The board designated rehabilitation program shall:
(1) immediately report to the board the name and results of any
contact or investigation concerning an impaired registered nurse
or licensed practical nurse who the program believes constitutes
a certain, immediate, and impending danger to either the public
or the impaired registered nurse or licensed practical nurse; and
(2) in a timely fashion report to the board an impaired registered
nurse or licensed practical nurse:
(A) who refuses to cooperate with the program;
(B) who refuses to submit to treatment; or
(C) whose impairment is not substantially or significantly
alleviated through treatment, as determined by accepted
medical standards.
FOLLOWS [EFFECTIVE JULY 1, 2002]: Sec. 34. (a) The impaired
nurses account is established within the state general fund for the
purpose of providing money for providing rehabilitation of impaired
registered nurses or licensed practical nurses under this article. The
account shall be administered by the health professions bureau.
(b) Expenses of administering the account shall be paid from money
in the account. The account consists of the following:
(1) The additional fee collected under section 16.1(d) of this
chapter.
(2) Funds collected under section 31(c)(2) of this chapter.
(3) Funds collected under IC 25-23.2-3-5.
(4) Fines collected from registered nurses or licensed practical
nurses under IC 25-1-9-9(a)(6).
(c) The treasurer of state shall invest the money in the account not
currently needed to meet the obligations of the account in the same
manner as other public money may be invested.
(d) Money in the account is appropriated to the board for the
purpose stated in subsection (a).
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.
Sec. 6. "Home state" means the party state that is the nurse's
primary state of residence.
Sec. 7. "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 an action against an individual's license
such as revocation, suspension, probation, or any other action that
affects a nurse's authorization to practice.
Sec. 8. "Licensing board" means a party state's regulatory body
responsible for issuing nurse licenses.
Sec. 9. "Multistate licensure privilege" means current, official
authority from a remote state permitting the practice of nursing as
either a registered nurse or a licensed practical/vocational nurse in
that party state. All party states have the authority, in accordance
with state due process law, to take actions against the nurse's
privilege such as revocation, suspension, probation, or any other
action that affects a nurse's authorization to practice.
Sec. 10. "Nurse" means a registered nurse or licensed
practical/vocational nurse as defined by the state practice laws of
each party state.
Sec. 11. "Party state" means any state that has adopted this
compact.
Sec. 12. "Remote state" means a party state, other than the
home state:
(1) where the patient is located at the time nursing care is
provided; or
(2) in the case of the practice of nursing not involving a
patient, in a party state where the recipient of nursing
practice is located.
Sec. 13. "Remote state action" means:
(1) any 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 actions against an individual's multistate licensure
privilege to practice in the remote state; and
However, a multistate licensure privilege to practice registered
nursing granted by a party state shall be recognized by other party
states as a license to practice registered nursing if a license is
required by state law as a precondition for qualifying for advanced
practice registered nurse authorization.
Sec. 5. Individuals not residing in a party state continue to be
able to apply for nurse licensure as provided for under the laws of
each party state. However, the license granted to these individuals
is not recognized as granting the privilege to practice nursing in
any other party state unless explicitly agreed to by that party state.
Chapter 3. Applications for Licensure in a Party State
Sec. 1. Upon application for a license, the licensing board in a
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 party state, whether there
are any restrictions on the multistate licensure privilege, and
whether any other adverse action by any state has been taken
against the license.
Sec. 2. A nurse in a party state may hold licensure in only one
(1) party state at a time, issued by the home state.
Sec. 3. A nurse who intends to change primary state of residence
may apply for licensure in the new home state before the change.
However, a new license may not be issued by a party state until a
nurse provides evidence of change in primary state of residence
satisfactory to the new home state's licensing board.
Sec. 4. (a) If a nurse changes primary state of residence by
moving between two (2) party states, and obtains a license from the
new home state, the license from the former home state is no longer
valid.
(b) If a nurse changes primary state of residence by moving
from a nonparty state to a party state, and obtains a license from
the new home state, the individual state license issued by the
nonparty state is not affected and remains in force if provided by
the laws of the nonparty state.
(c) If a nurse changes primary state of residence by moving
from a party state to a nonparty state, the license issued by the
prior home state converts to an individual state license, valid only
in the former home state, without the multistate licensure privilege
to practice in other party states.
Sec. 5. (a) A nurse who is licensed in a party state and who
obtains employment as a nurse in Indiana shall file a multistate
licensure privilege form with the health professions bureau and
pay the fee established by the board. Before commencing
employment the nurse shall obtain approval from the board.
(b) Each registered nurse and each licensed practical nurse who
holds a multistate licensure privilege in Indiana shall notify the
board of a change of address within thirty (30) days after the
change.
(c) Notification of multistate licensure privilege as a registered
nurse expires on October 31 in each odd-numbered year. Failure
to update the notification of multistate licensure privilege on or
before the expiration date automatically renders the multistate
licensure privilege invalid without any action by the board.
(d) Notification of multistate licensure privilege to practice as a
licensed practical nurse expires October 31 in each even-numbered
year. Failure to update the notification of multistate licensure
privilege on or before the expiration date automatically renders the
multistate licensure privilege invalid without any action by the
board.
(e) Multistate licensure privileges invalidated under this section
may not be reinstated.
(f) A nurse whose privileges have been invalidated under this
section may obtain new multistate licensure privileges by
complying with subsection (a).
(g) The procedures and fee for updating the multistate licensure
privilege shall be set by the board.
(h) At the time of updating the notification of multistate
licensure privilege, each registered nurse and each licensed
practical nurse shall pay the fee for updating the multistate
licensure privilege.
(i) Sixteen percent (16%) of the amount of fees collected under
this section shall be deposited in the impaired nurses account of the
state general fund established by IC 25-23-1-34.
Chapter 4. Adverse Actions
Sec. 1. This chapter applies in addition to IC 25-23.2-2.
Sec. 2. The licensing board of a remote state shall promptly
report to the administrator of the coordinated licensure
information system any remote state actions, including the factual
and legal basis for such 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 any such reports.
Sec. 3. The licensing board of a party state has authority to
complete any pending investigations for a nurse who changes
primary state of residence during the course of such investigations.
The licensing board also has authority to take appropriate action
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.
Sec. 4. A remote state may take adverse action affecting the
multistate licensure privilege to practice within that party state.
However, only the home state has authority to impose adverse
action against the license issued by the home state.
Sec. 5. 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 if such
conduct had occurred within the home state. In so doing, it shall
apply its own state laws to determine appropriate action.
Sec. 6. The home state may take adverse action based on the
factual findings of the remote state, so long as each state follows its
own procedures for imposing such adverse action.
Sec. 7. Nothing in this compact overrides a party state's decision
that participation in an alternative program may be used instead
of licensure action and that such participation shall remain
nonpublic if required by the party state's laws. Party states must
require nurses who enter any alternative programs 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.
Chapter 5. Additional Authority Invested in Party State Nurse
Licensing Boards
Sec. 1. Notwithstanding any other powers, party state nurse
licensing boards may:
(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 that
nurse;
(2) issue subpoenas for both hearings and investigations that
require the attendance and testimony of witnesses and the
production of evidence. Subpoenas issued by a nurse licensing
board in a party state for the attendance and testimony of
witnesses and the production of evidence from another party
state shall be enforced in the latter state by any court with
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 consistent with
Indiana law;
(3) issue cease and desist orders to limit or revoke a nurse's
authority to practice in their state; and
(4) adopt uniform rules as provided for in IC 25-23.2-7-3.
Chapter 6. Coordinated Licensure Information System
Sec. 1. All party states shall participate in a cooperative effort
to create a coordinated data base of all licensed registered nurses
and licensed practical/vocational nurses. This system includes
information on the licensure and disciplinary history of each nurse,
as contributed by party states, to assist in the coordination of nurse
licensure and enforcement efforts.
Sec. 2. Notwithstanding any other law, all party states' licensing
boards shall promptly report adverse actions, actions against
multistate licensure privileges, any current significant investigative
information yet to result in adverse action, denials of applications,
and the reasons for such denials to the coordinated licensure
information system.
Sec. 3. Current significant investigative information shall be
transmitted through the coordinated licensure information system
only to party state licensing boards.
Sec. 4. Notwithstanding any other law, all party states' licensing
boards contributing information to the coordinated licensure
information system may designate information that may not be
shared with nonparty states or disclosed to other entities or
individuals without the express permission of the contributing
state.
Sec. 5. Any personally identifiable information obtained by a
party state's licensing board from the coordinated licensure
information system may not be shared with nonparty states or
disclosed to other entities or individuals except to the extent
permitted by the laws of the party state contributing the
information.
Sec. 6. 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.
Sec. 7. The compact administrators, acting jointly and 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.
Chapter 7. Compact Administration and Interchange of
Information
Sec. 1. The executive director of the health professions bureau
of each party state, or that person's designee, shall be the
administrator of this compact for that person's state.
Sec. 2. The compact administrator of each party state shall
furnish to the compact administrator of each other party state any
information and documents, including, but not limited to, a
uniform data set of investigations, identifying information,
licensure data, and disclosable alternative program participation
information, to facilitate the administration of this compact.
Sec. 3. Compact administrators may develop uniform rules to
facilitate and coordinate implementation of this compact. These
uniform rules shall be adopted by party states under IC 25-23.2-5.
Chapter 8. Immunity
Sec. 1. Neither a party state nor an officer, employee, or agent
of a party state's nurse licensing board who acts in accordance
with this compact is liable on account of any act or omission in
good faith while engaged in the performance of duties under this
compact. Good faith in this article does not include willful
misconduct, gross negligence, or recklessness.
Chapter 9. Entry Into Force, Withdrawal, and Amendment
Sec. 1. This compact becomes effective as to any state when it
has been enacted into the laws of that state. Any party state may
withdraw from this compact.
Sec. 2. No withdrawal affects the validity or applicability by the
licensing boards of states remaining party to the compact of any
report of adverse action occurring before the withdrawal.
Sec. 3. This compact shall not be construed to invalidate or
prevent any nurse licensure agreement or other cooperative
arrangement between a party state and a nonparty state that is
made in accordance with this compact.
Sec. 4. This compact may be amended by the party states. No
amendment to this compact becomes effective and binding upon
the party states unless and until it is enacted into the laws of all
party states.
Chapter 10. Construction and Severability
Sec. 1. This compact shall be liberally construed to effectuate its
purposes. The provisions of this compact are 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 of this compact to any government,
agency, person, or circumstance is held invalid, the validity of the
remainder of this compact and the applicability of this compact to
any government, agency, person, or circumstance is not affected
thereby. If this compact is held contrary to the constitution of any
state party thereto, the compact remains 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 a severable matter.
Sec. 2. If party states find a need for settling disputes arising
under this compact:
(1) the party states may submit the issues in dispute to an
arbitration panel comprised of an individual appointed by the
compact administrator in the home state, an individual
appointed by the compact administrator in each remote state
involved, and an individual mutually agreed upon by the
compact administrators of all the party states involved in the
dispute; and
(2) the decision of a majority of the arbitrators is final and
binding.
Sec. 3. This article expires July 1, 2006.