Citations Affected: 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. (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.
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
collaboration with or referral to other health professionals;
(5) executing regimens delegated by a physician with an
unlimited license to practice medicine or osteopathic medicine, a
licensed dentist, a licensed chiropractor, a licensed optometrist,
or a licensed podiatrist;
(6) teaching, administering, supervising, delegating, and
evaluating nursing practice;
(7) delegating tasks which assist in implementing the nursing,
medical, or dental regimen; or
(8) performing acts which are approved by the board or by the
board in collaboration with the medical licensing board of
Indiana.
(c) As used in this chapter, "assessing health conditions" means the
collection of data through means such as interviews, observation, and
inspection for the purpose of:
(1) deriving a nursing diagnosis;
(2) identifying the need for additional data collection by nursing
personnel; and
(3) identifying the need for additional data collection by other
health professionals.
(d) As used in this chapter, "nursing regimen" means preventive,
restorative, maintenance, and promotion activities which include
meeting or assisting with self-care needs, counseling, and teaching.
(e) As used in this chapter, "nursing diagnosis" means the
identification of needs which are amenable to nursing regimen.
sanction under IC 25-1-9; or
(B) a crime that has a direct bearing on the person's ability to
practice competently;
(2) have completed:
(A) the prescribed curriculum and met the graduation
requirements of a state accredited program of practical 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 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.
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
(2) cease and desist and other injunctive or equitable orders
issued by remote states or the licensing boards of remote
states.
Sec. 14. "State" means a state, territory, or possession of the
United States, the District of Columbia, or the Commonwealth of
Puerto Rico.
Sec. 15. "State practice laws" means the individual party state's
laws and rules 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 licensure or requirements necessary to obtain
and retain a license, except for qualifications or requirements of
the home state.
Chapter 2. General Provisions and Jurisdiction
Sec. 1. A license to practice registered nursing issued by a home
state to a resident in that state shall be recognized by each party
state as authorizing a multistate licensure privilege to practice as
a registered nurse in the party state. A license to practice licensed
practical/vocational nursing issued by a home state to a resident in
that state shall be recognized by each party state as authorizing a
multistate licensure privilege to practice as a licensed
practical/vocational nurse in the party state. To obtain or retain a
license, an applicant must meet the home state's qualifications for
licensure and license renewal and all other applicable state laws.
Sec. 2. Party states may, in accordance with state due process
laws, limit or revoke the multistate licensure privilege of any nurse
to practice in their state and may take any other actions under
their applicable state laws necessary to protect the health and
safety of their citizens. If a party state takes such an 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.
Sec. 3. 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 rendered. In addition, the practice of nursing is not
limited to patient care, but includes all nursing practice as defined
by the state practice laws of a party state. The practice of nursing
subjects a nurse to the jurisdiction of the nurse licensing board, the
courts, and the laws in that party state.
Sec. 4. This compact does not affect additional requirements
imposed by states for advanced practice registered nursing.
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 nurse changes primary state of residence by:
(1) 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;
(2) 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; or
(3) 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 nurse who is licensed in a party state and who attains
employment as a nurse in Indiana must file a multistate licensure
privilege form with the health professions bureau and pay the fee
established by the bureau.
Chapter 4. Adverse Actions
Sec. 1. This chapter applies in addition to IC 25-23.2-2.
Sec. 2. The licensing board or the attorney general 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 database 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 or attorney generals 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.