HOUSE BILL NO. 4935
August 24, 2023, Introduced by Rep. Phil Green and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16170a, 16222, 16231, 16238, and 17201 (MCL
333.16170a, 333.16222, 333.16231, 333.16238, and 333.17201),
section 16170a as amended by 2013 PA 268, section 16222 as amended
by 2014 PA 97, section 16231 as amended by 2017 PA 249, section
16238 as added by 1993 PA 79, and section 17201 as amended by 2016
PA 499, and by adding sections 16187, 17225, and 17225a.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
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1 Sec. 16170a. (1) The identity of an individual submitting
2 information to the committee or the department regarding the
3 suspected impairment of a health professional is confidential.
4 (2) The identity of a health professional who participates in
5 the health professional recovery program is confidential and is not
6 subject to disclosure under discovery or subpoena or the freedom of
7 information act, 1976 PA 442, MCL 15.231 to 15.246, unless the
8 health professional fails to satisfactorily participate in and
9 complete a treatment plan prescribed under the health professional
10 recovery program or violates section 16170(3) or the information is
11 required to be disclosed for purposes of the nurse licensure
12 compact enacted in section . 16187.
13 (3) If a health professional successfully participates in and
14 completes a treatment plan prescribed under the health professional
15 recovery program, as determined by the committee, the department
16 shall destroy all records pertaining to the impairment of the
17 health professional, including records pertaining to the health
18 professional's participation in the treatment plan, upon on the
19 expiration of 5 years after the date of the committee's
20 determination. This subsection does not apply to records pertaining
21 to a violation of this article, article 7, or article 8 or a rule
22 promulgated under this article, article 7, or article 8.
23 Sec. 16187. (1) The nurse licensure compact is enacted into
24 law and entered into by this state as a party state with all other
25 jurisdictions that legally join in the compact, in the form
26 substantially as follows:
27 NURSE LICENSURE COMPACT
28 ARTICLE I
29 FINDINGS AND DECLARATION OF PURPOSE
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1 a. The party states find that:
2 1. The health and safety of the public are affected by the
3 degree of compliance with and the effectiveness of enforcement
4 activities related to state nurse licensure laws;
5 2. Violations of nurse licensure and other laws regulating the
6 practice of nursing may result in injury or harm to the public;
7 3. The expanded mobility of nurses and the use of advanced
8 communication technologies as part of our nation's health care
9 delivery system require greater coordination and cooperation among
10 states in the areas of nurse licensure and regulation;
11 4. New practice modalities and technology make compliance with
12 individual state nurse licensure laws difficult and complex;
13 5. The current system of duplicative licensure for nurses
14 practicing in multiple states is cumbersome and redundant for both
15 nurses and states; and
16 6. Uniformity of nurse licensure requirements throughout the
17 states promotes public safety and public health benefits.
18 b. The general purposes of this Compact are to:
19 1. Facilitate the states' responsibility to protect the
20 public's health and safety;
21 2. Ensure and encourage the cooperation of party states in the
22 areas of nurse licensure and regulation;
23 3. Facilitate the exchange of information between party states
24 in the areas of nurse regulation, investigation and adverse
25 actions;
26 4. Promote compliance with the laws governing the practice of
27 nursing in each jurisdiction;
28 5. Invest all party states with the authority to hold a nurse
29 accountable for meeting all state practice laws in the state in
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1 which the patient is located at the time care is rendered through
2 the mutual recognition of party state licenses;
3 6. Decrease redundancies in the consideration and issuance of
4 nurse licenses; and
5 7. Provide opportunities for interstate practice by nurses who
6 meet uniform licensure requirements.
7 ARTICLE II
8 DEFINITIONS
9 As used in this Compact:
10 a. "Adverse action" means any administrative, civil, equitable
11 or criminal action permitted by a state's laws which is imposed by
12 a licensing board or other authority against a nurse, including
13 actions against an individual's license or multistate licensure
14 privilege such as revocation, suspension, probation, monitoring of
15 the licensee, limitation on the licensee's practice, or any other
16 encumbrance on licensure affecting a nurse's authorization to
17 practice, including issuance of a cease and desist action.
18 b. "Alternative program" means a non-disciplinary monitoring
19 program approved by a licensing board.
20 c. "Coordinated licensure information system" means an
21 integrated process for collecting, storing and sharing information
22 on nurse licensure and enforcement activities related to nurse
23 licensure laws that is administered by a nonprofit organization
24 composed of and controlled by licensing boards.
25 d. "Current significant investigative information" means:
26 1. Investigative information that a licensing board, after a
27 preliminary inquiry that includes notification and an opportunity
28 for the nurse to respond, if required by state law, has reason to
29 believe is not groundless and, if proved true, would indicate more
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1 than a minor infraction; or
2 2. Investigative information that indicates that the nurse
3 represents an immediate threat to public health and safety
4 regardless of whether the nurse has been notified and had an
5 opportunity to respond.
6 e. "Encumbrance" means a revocation or suspension of, or any
7 limitation on, the full and unrestricted practice of nursing
8 imposed by a licensing board.
9 f. "Home state" means the party state which is the nurse's
10 primary state of residence.
11 g. "Licensing board" means a party state's regulatory body
12 responsible for issuing nurse licenses.
13 h. "Multistate license" means a license to practice as a
14 registered or a licensed practical/vocational nurse (LPN/VN) issued
15 by a home state licensing board that authorizes the licensed nurse
16 to practice in all party states under a multistate licensure
17 privilege.
18 i. "Multistate licensure privilege" means a legal
19 authorization associated with a multistate license permitting the
20 practice of nursing as either a registered nurse (RN) or LPN/VN in
21 a remote state.
22 j. "Nurse" means RN or LPN/VN, as those terms are defined by
23 each party state's practice laws.
24 k. "Party state" means any state that has adopted this
25 Compact.
26 l. "Remote state" means a party state, other than the home
27 state.
28 m. "Single-state license" means a nurse license issued by a
29 party state that authorizes practice only within the issuing state
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1 and does not include a multistate licensure privilege to practice
2 in any other party state.
3 n. "State" means a state, territory or possession of the
4 United States and the District of Columbia.
5 o. "State practice laws" means a party state's laws, rules and
6 regulations that govern the practice of nursing, define the scope
7 of nursing practice, and create the methods and grounds for
8 imposing discipline. "State practice laws" do not include
9 requirements necessary to obtain and retain a license, except for
10 qualifications or requirements of the home state.
11 ARTICLE III
12 GENERAL PROVISIONS AND JURISDICTION
13 a. A multistate license to practice registered or licensed
14 practical/vocational nursing issued by a home state to a resident
15 in that state will be recognized by each party state as authorizing
16 a nurse to practice as a registered nurse (RN) or as a licensed
17 practical/vocational nurse (LPN/VN), under a multistate licensure
18 privilege, in each party state.
19 b. A state must implement procedures for considering the
20 criminal history records of applicants for initial multistate
21 license or licensure by endorsement. Such procedures shall include
22 the submission of fingerprints or other biometric-based information
23 by applicants for the purpose of obtaining an applicant's criminal
24 history record information from the Federal Bureau of Investigation
25 and the agency responsible for retaining that state's criminal
26 records.
27 c. Each party state shall require the following for an
28 applicant to obtain or retain a multistate license in the home
29 state:
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1 1. Meets the home state's qualifications for licensure or
2 renewal of licensure, as well as, all other applicable state laws;
3 2. i. Has graduated or is eligible to graduate from a
4 licensing board-approved RN or LPN/VN prelicensure education
5 program; or
6 ii. Has graduated from a foreign RN or LPN/VN prelicensure
7 education program that (a) has been approved by the authorized
8 accrediting body in the applicable country and (b) has been
9 verified by an independent credentials review agency to be
10 comparable to a licensing board-approved prelicensure education
11 program;
12 3. Has, if a graduate of a foreign prelicensure education
13 program not taught in English or if English is not the individual's
14 native language, successfully passed an English proficiency
15 examination that includes the components of reading, speaking,
16 writing and listening;
17 4. Has successfully passed an NCLEX-RN® or NCLEX-PN®
18 Examination or recognized predecessor, as applicable;
19 5. Is eligible for or holds an active, unencumbered license;
20 6. Has submitted, in connection with an application for
21 initial licensure or licensure by endorsement, fingerprints or
22 other biometric data for the purpose of obtaining criminal history
23 record information from the Federal Bureau of Investigation and the
24 agency responsible for retaining that state's criminal records;
25 7. Has not been convicted or found guilty, or has entered into
26 an agreed disposition, of a felony offense under applicable state
27 or federal criminal law;
28 8. Has not been convicted or found guilty, or has entered into
29 an agreed disposition, of a misdemeanor offense related to the
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1 practice of nursing as determined on a case-by-case basis;
2 9. Is not currently enrolled in an alternative program;
3 10. Is subject to self-disclosure requirements regarding
4 current participation in an alternative program; and
5 11. Has a valid United States Social Security number.
6 d. All party states shall be authorized, in accordance with
7 existing state due process law, to take adverse action against a
8 nurse's multistate licensure privilege such as revocation,
9 suspension, probation or any other action that affects a nurse's
10 authorization to practice under a multistate licensure privilege,
11 including cease and desist actions. If a party state takes such
12 action, it shall promptly notify the administrator of the
13 coordinated licensure information system. The administrator of the
14 coordinated licensure information system shall promptly notify the
15 home state of any such actions by remote states.
16 e. A nurse practicing in a party state must comply with the
17 state practice laws of the state in which the client is located at
18 the time service is provided. The practice of nursing is not
19 limited to patient care, but shall include all nursing practice as
20 defined by the state practice laws of the party state in which the
21 client is located. The practice of nursing in a party state under a
22 multistate licensure privilege will subject a nurse to the
23 jurisdiction of the licensing board, the courts and the laws of the
24 party state in which the client is located at the time service is
25 provided.
26 f. Individuals not residing in a party state shall continue to
27 be able to apply for a party state's single-state license as
28 provided under the laws of each party state. However, the single-
29 state license granted to these individuals will not be recognized
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1 as granting the privilege to practice nursing in any other party
2 state. Nothing in this Compact shall affect the requirements
3 established by a party state for the issuance of a single-state
4 license.
5 g. Any nurse holding a home state multistate license, on the
6 effective date of this Compact, may retain and renew the multistate
7 license issued by the nurse's then-current home state, provided
8 that:
9 1. A nurse, who changes primary state of residence after this
10 Compact's effective date, must meet all applicable Article III.c.
11 requirements to obtain a multistate license from a new home state.
12 2. A nurse who fails to satisfy the multistate licensure
13 requirements in Article III.c. due to a disqualifying event
14 occurring after this Compact's effective date shall be ineligible
15 to retain or renew a multistate license, and the nurse's multistate
16 license shall be revoked or deactivated in accordance with
17 applicable rules adopted by the Interstate Commission of Nurse
18 Licensure Compact Administrators ("Commission").
19 ARTICLE IV
20 APPLICATIONS FOR LICENSURE IN A PARTY STATE
21 a. Upon application for a multistate license, the licensing
22 board in the issuing party state shall ascertain, through the
23 coordinated licensure information system, whether the applicant has
24 ever held, or is the holder of, a license issued by any other
25 state, whether there are any encumbrances on any license or
26 multistate licensure privilege held by the applicant, whether any
27 adverse action has been taken against any license or multistate
28 licensure privilege held by the applicant and whether the applicant
29 is currently participating in an alternative program.
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1 b. A nurse may hold a multistate license, issued by the home
2 state, in only one party state at a time.
3 c. If a nurse changes primary state of residence by moving
4 between two party states, the nurse must apply for licensure in the
5 new home state, and the multistate license issued by the prior home
6 state will be deactivated in accordance with applicable rules
7 adopted by the Commission.
8 1. The nurse may apply for licensure in advance of a change in
9 primary state of residence.
10 2. A multistate license shall not be issued by the new home
11 state until the nurse provides satisfactory evidence of a change in
12 primary state of residence to the new home state and satisfies all
13 applicable requirements to obtain a multistate license from the new
14 home state.
15 d. If a nurse changes primary state of residence by moving
16 from a party state to a non-party state, the multistate license
17 issued by the prior home state will convert to a single-state
18 license, valid only in the former home state.
19 ARTICLE V
20 ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING BOARDS
21 a. In addition to the other powers conferred by state law, a
22 licensing board shall have the authority to:
23 1. Take adverse action against a nurse's multistate licensure
24 privilege to practice within that party state.
25 i. Only the home state shall have the power to take adverse
26 action against a nurse's license issued by the home state.
27 ii. For purposes of taking adverse action, the home state
28 licensing board shall give the same priority and effect to reported
29 conduct received from a remote state as it would if such conduct
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1 had occurred within the home state. In so doing, the home state
2 shall apply its own state laws to determine appropriate action.
3