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ARIZONA STATE SENATE
RESEARCH STAFF
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JASON BEZOZO ASSISTANT
RESEARCH STAFF
DIRECTOR HEALTH COMMITTEE Telephone: (602) 542-3171 Facsimile: (602) 542-7833 |
HEALTH COMMITTEE
DATE: March 2, 2001
SUBJECT: Strike Everything Amendment
to S.B. 1321
Purpose
Codifies an interstate compact for the mutual recognition for nursing regulation.
Background
In 1997, the National Council of State Boards of Nursing (NCSBN) adopted a model act for the mutual recognition for nursing regulation, which allows a nurse to have one license in the state of residency and have a multistate licensure privilege in other party states as long as the nurse complies with the states’ practice laws and discipline. According to the NCSBN, the one license concept simplifies governmental processes by reducing barriers to interstate practice, improving tracking for disciplinary purposes, promoting cost-effectiveness and simplicity for the licensee and acting as an undisputed listing of licensed nurses.
Under mutual recognition, practice across state lines is allowed, whether physical or electronic, unless the nurse is under discipline or a monitoring agreement that restricts practice across state lines. With respect to disciplinary action, both the state of residency (home state) and the state where the patient is located (remote state) may take disciplinary action to address the behavior of the out-of-state nurse; the home state may take action against the nurse’s license and the remote state may take action to limit or deny the nurse’s multistate licensure privilege to practice in that remote state. To achieve mutual recognition, each state is required to enter into an interstate compact that allows nurses to practice in more than one state.
According to the NCSBN, as of January 26, 2001, 12 states adopted the interstate nurse licensure compact. These states include Arkansas, Delaware, Iowa, Maine, Maryland, Mississippi, Nebraska, North Carolina, South Dakota, Texas, Utah and Wisconsin. The strike everything amendment to S.B. 1321 allows Arizona to achieve mutual recognition by including the interstate compact.
The Arizona State Board of Nursing (Board) may experience costs relating to the investigation and adjudication of complaints against out-of-state nurses practicing in Arizona; however, the compact authorizes the Board to recoup these costs from the affected nurse. According to the Board, it may lose revenue relating to the approximately 7,000 nurses who are currently licensed in more than one state. Under mutual recognition, out-of-state nurses are not required to pay a renewal fee. If all states adopted the interstate compact this year, the revenue loss to the Board would be approximately $194,000.
Provisions
1. Requires party states to recognize licenses for registered nurses and practical/vocational nurses that are issued by a home state.
2. Requires the nurse to meet the home state’s qualifications for licensure and license renewals.
3. Allows a party state to limit, revoke or take other action against the multistate licensure privilege of a nurse in order to protect the public.
4. Requires a party state to report an action against the multistate licensure privilege to the administrator of the coordinated licensure information system. Requires the administrator to notify the home state of the action.
5. Requires a nurse to comply with a state’s practice laws in which the care is rendered.
6. Specifies the practice of nursing includes all nursing practice as defined by the party state.
7. Specifies the compact does not affect requirements for advanced practice registered nursing.
8. Requires party states to recognize a multistate licensure privilege to practice advanced practice registered nursing if advanced practice registered nursing authorization is required by the state’s law.
9. Prohibits a license granted by a party state to a nonresident from being recognized by any other party state unless agreed to by that party state.
10. Requires a party state to verify through the coordinated licensure information system whether an applicant for licensure has held or holds a license, whether there are any restrictions on the multistate licensure privilege and whether any adverse action has been taken against the license.
11. Requires a nurse in a party state to hold a license in only the home state.
12. Allows a nurse who changes the state of residence to apply for licensure in the new home state in advance of the change.
13. Stipulates conditions on a multistate licensure privilege when a nurse changes the primary state of residence.
14. Requires a remote state to report investigative information and actions to the administrator of the coordinated licensure information system. Requires the administrator to notify the home state of the reports.
15. Requires a party state to have the authority to complete investigations for and take action against a nurse who changes the primary state of residence during the investigation. Requires the party state to notify the administrator of the coordinated licensure information system.
16. Allows a remote state to take adverse action affecting a multistate licensure privilege to practice within that state. Allows only the home state to take adverse action against a license.
17. Requires the licensing board of a home state to give an adverse action taken by a remote state the same priority as an adverse action taken by the home state.
18. Authorizes a home state to take adverse action based on the findings of the remote state.
19. Stipulates the compact does not override a party state’s decision that participation in an alternative program may be used in lieu of licensure action. Prohibits a nurse in an alternative program from practicing in another party state without prior authorization from that party state.
20. Requires state party boards to have the authority to: (a) recover the costs of investigations and disposition of cases from the affected nurse; (b) issue subpoenas for hearings and investigations; (c) issue cease and desist orders to limit or revoke a nurse’s authority to practice in that party state; and (d) promulgate uniform rules and regulations to implement the compact.
21. Requires all party states to participate in the creation of a coordinated database of all licensed nurses, including information of the licensure and discipline of each nurse.
22. Requires all party states to report adverse actions, actions against multistate licensure privileges, investigative information and denials of applications to the coordinated licensure information system.
23. Requires investigative information to be sent to the party states only through the coordinated licensure information system.
24. Allows a party state contributing information to the coordinated licensure information system to designate information that cannot be shared with nonparty states or other entities.
25. Prohibits the disclosure of personally identifiable information obtained by a party state from the coordinated licensure information system.
26. Requires the coordinated licensure information system to expunge information if the contributing state requires the information to be expunged.
27. Requires the administrator for the coordinated licensure information system and the compact administrators to formulate procedures for the identification, collection and exchange of information.
28. Requires the head of a party state’s nurse licensing board or that person’s designee to be the compact administrator for that party state.
29. Requires each party state’s compact administrator to furnish information and documents to other party states to facilitate the administration of the compact.
30. Releases the party state, its officers and employees from liability for any act or omission in good faith while performing the duties under the compact.
31. Allows a party state to withdraw from the compact by repealing the enabling legislation. Delays the withdrawal until six months after notice is provided to the other party states.
32. Specifies the withdrawal of a party state does not affect the validity or applicability of any adverse action occurring prior to the withdrawal.
33. Allows the party states to amend the compact by amending the statutes of each party state.
34. Prescribes a process for settling disputes arising under the compact.
35. Contains definitions.
36. Contains a severability clause.
37. Contains a finding and purpose clause.
38. Provides for a general effective date.
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