36-9-92 Interstate Nurse Licensure Compact.
Interstate Nurse Licensure Compact.
The Nurse Licensure Compact is enacted into
law and entered into with all other jurisdictions that legally join the compact, which is substantially
Findings and Declaration of Purpose
(a) The party states find that:
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;
Violations of nurse licensure and other laws regulating the practice of nursing may result
in injury or harm to the public;
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;
New practice modalities and technology make compliance with individual state nurse
licensure laws difficult and complex; and
The current system of duplicative licensure for nurses practicing in multiple states is
cumbersome and redundant to both nurses and states.
(b) The general purposes of this Compact are to:
Facilitate the states' responsibility to protect the public's health and safety;
Ensure and encourage the cooperation of party states in the areas of nurse licensure and
Facilitate the exchange of information between party states in the areas of nurse
regulation, investigation, and adverse actions;
Promote compliance with the laws governing the practice of nursing in each jurisdiction;
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.
Terms used in this Compact mean:
"Adverse action," a home or remote state action.
"Alternative program,'a voluntary, nondisciplinary monitoring program approved by a
nurse licensing board.
"Coordinated licensure information system," an integrated process for collecting, storing,
and sharing information on nurse licensure and enforcement activities related to nurse
licensure laws, which is administered by a nonprofit organization composed of and
controlled by state nurse licensing boards.
"Current significant investigative information,":
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
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.
"Home state," the party state which is the nurse's primary state of residence.
"Home state action," any administrative, civil, equitable, or criminal action permitted by
the home state's laws which 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 which affects a nurse's authorization to
"Licensing board," a party state's regulatory body responsible for issuing nurse licenses.
"Multistate licensure privilege," current, official authority from a remote state permitting
the practice of nursing as either a registered nurse or a licensed practical/vocational nurse
in such party state. All party states have the authority, in accordance with existing state
due process law, to take actions against the nurse's privilege such as: revocation,
suspension, probation, or any other action which affects a nurse's authorization to
"Nurse," a registered nurse or licensed practical/vocational nurse, as those terms are
defined by each party's state practice laws.
"Party state," any state that has adopted this Compact.
"Remote state," a party state, other than the home state:
Where the patient is located at the time nursing care is provided; or
In the case of the practice of nursing not involving a patient, in such party state
where the recipient of nursing practice is located.
"Remote state action,":
Any administrative, civil, equitable, or criminal action permitted by a remote state's
laws which 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
Cease and desist and other injunctive or equitable orders issued by remote states
or the licensing boards thereof.
"State," a state, territory, or possession of the United States, the District of Columbia, or
the Commonwealth of Puerto Rico.
"State practice laws," those individual party's state 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, state practice laws, 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.
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 licensure privilege to practice as a
registered nurse in such party state. A license to practice 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
multistate licensure privilege to practice as a licensed practical/vocational nurse in such party state.
In order to obtain or retain a license, an applicant must meet the home state's qualifications for
licensure and license renewal as well as all other applicable state laws.
(b) 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 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.
(c) Every 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 shall include all nursing practice as defined by the state practice laws of
a party state. The practice of nursing will subject a nurse to the jurisdiction of the nurse licensing
board and the courts, as well as the laws, in that party state.
(d) 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 one is required by state law as a precondition for qualifying for advanced practice
registered nurse authorization.
(e) Individuals not residing in a party state shall 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
will not be recognized as granting the privilege to practice nursing in any other party state unless
explicitly agreed to by that party state.
Applications for Licensure in a Party State
(a) 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 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.
(b) A nurse in a party state shall hold licensure in only one party state at a time, issued by the
(c) A nurse who intends to change primary state of residence may apply for licensure in the new
home state in advance of such change. However, new licenses will not be issued by a party state until
after a nurse provides evidence of change in primary state of residence satisfactory to the new home
state's licensing board.
(d) When a nurse changes primary state of residence by:
Moving between two party states, and obtains a license from the new home state, the
license from the former home state is no longer valid;
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 will
remain in full force if so provided by the laws of the nonparty state;
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.
In addition to the General Provisions described in Article III, the following provisions apply:
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 also
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.
The licensing board of a party state shall have the authority to complete any pending
investigations for a nurse who changes primary state of residence during the course of
such investigations. It shall also have the 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.
A remote state may take adverse action affecting the multistate licensure privilege to
practice within that party state. However, only the home state shall have the power to
impose adverse action against the license issued by the home state.
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.
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.
Nothing in this Compact shall override a party state's decision that participation in an
alternative program may be used in lieu of licensure action and that such participation
shall remain non-public 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 such other
Additional Authorities Invested in Party State Nurse Licensing Boards
Notwithstanding any other powers, party state nurse licensing boards shall have the authority to:
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
Issue subpoenas for both hearings and investigations which 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/r 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 where the witnesses and/r evidence are located.
Issue cease and desist orders to limit or revoke a nurse's authority to practice in their state;
Promulgate uniform rules and regulations as provided for in Article VIII(c).
Coordinated Licensure Information System
(a) 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 will include
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.
(b) Notwithstanding any other provision of 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.
(c) Current significant investigative information shall be transmitted through the coordinated
licensure information system only to party state licensing boards.
(d) Notwithstanding any other provision of 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.
(e) Any personally identifiable information obtained by a party states' 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
(f) 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.
(g) The Compact administrators, acting jointly with each other 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.
Compact Administration and Interchange of Information
(a) The head of the nurse licensing board, or his or her designee, of each party state shall be the
administrator of this Compact for his or her state.
(b) 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.
(c) Compact administrators shall have the authority to develop uniform rules to facilitate and
coordinate implementation of this Compact. These uniform rules shall be adopted by party states,
under the authority invested under Article VI(d).
No party state or the officers or employees or agents of a party state's nurse licensing board who
acts in accordance with the provisions of this Compact is liable on account of any act or omission
in good faith while engaged in the performance of their duties under this Compact. Good faith in this
article does not include willful misconduct, gross negligence, or recklessness.
Entry into Force, Withdrawal, and Amendment
(a) This Compact shall enter into force and become effective as to any state when it has been
enacted into the laws of that state. Any party state may withdraw from this Compact by enacting a
statute repealing the same, but no such withdrawal shall take effect until six months after the
withdrawing state has given notice of the withdrawal to the executive heads of all other party states.
(b) 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 prior to the withdrawal.
(c) Nothing contained in this Compact may 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 the other provisions of this Compact.
(d) 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
Construction and Severability
(a) 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
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 may not be 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 all severable
(b) In the event party states find a need for settling disputes arising under this Compact:
The party states may submit the issues in dispute to an arbitration panel which will be
comprised of an individual appointed by the Compact administrator in the home state; an
individual appointed by the Compact administrator in the remote state or states involved;
and an individual mutually agreed upon by the Compact administrators of all the party
states involved in the dispute; and
The decision of a majority of the arbitrators shall be final and binding.
SL 2000, ch 192, § 1.