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SPONSOR SUBSTITUTE FOR SENATE BILL NO. 130
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-THIRD LEGISLATURE - FIRST SESSION
BY SENATOR OLSON
Introduced: 5/3/23
Referred: Labor & Commerce, Finance
A BILL
FOR AN ACT ENTITLED
1 "An Act relating to the licensure of nursing professionals; relating to a multistate nurse
2 licensure compact; and providing for an effective date."
3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
4 * Section 1. AS 08.01.065(c) is amended to read:
5 (c) Except as provided in (f) - (l) [(f) - (k)] of this section, the department shall
6 establish fee levels under (a) of this section so that the total amount of fees collected
7 for an occupation approximately equals the actual regulatory costs for the occupation.
8 The department shall annually review each fee level to determine whether the
9 regulatory costs of each occupation are approximately equal to fee collections related
10 to that occupation. If the review indicates that an occupation's fee collections and
11 regulatory costs are not approximately equal, the department shall calculate fee
12 adjustments and adopt regulations under (a) of this section to implement the
13 adjustments. In January of each year, the department shall report on all fee levels and
14 revisions for the previous year under this subsection to the office of management and
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1 budget. If a board regulates an occupation covered by this chapter, the department
2 shall consider the board's recommendations concerning the occupation's fee levels and
3 regulatory costs before revising fee schedules to comply with this subsection. In this
4 subsection, "regulatory costs" means costs of the department that are attributable to
5 regulation of an occupation plus
6 (1) all expenses of the board that regulates the occupation if the board
7 regulates only one occupation;
8 (2) the expenses of a board that are attributable to the occupation if the
9 board regulates more than one occupation.
10 * Sec. 2. AS 08.01.065 is amended by adding a new subsection to read:
11 (l) Notwithstanding (c) of this section, the department shall establish fee levels
12 under (a) of this section so that the total amount of fees collected by the department
13 for individuals issued a
14 (1) single-state license under AS 08.68.190 or 08.68.200 to practice
15 nursing approximately equals the total regulatory costs to the department and the
16 Board of Nursing for the practice of nursing in the state under that license type; and
17 (2) multistate license to practice nursing under AS 08.68.500 or
18 practicing under a multistate licensure privilege under AS 08.68.500 approximately
19 equals the total regulatory costs to the department and the Board of Nursing for the
20 practice of nursing under that license type or privilege.
21 * Sec. 3. AS 08.68.100(a) is amended to read:
22 (a) The board shall
23 (1) adopt regulations necessary to implement this chapter, including
24 regulations
25 (A) pertaining to practice as an advanced practice registered
26 nurse, including requirements for an advanced practice registered nurse to
27 practice as a certified registered nurse anesthetist, certified clinical nurse
28 specialist, certified nurse practitioner, or certified nurse midwife; regulations
29 for an advanced practice registered nurse who holds a valid federal Drug
30 Enforcement Administration registration number must address training in pain
31 management and opioid use and addiction;
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1 (B) necessary to implement AS 08.68.331 - 08.68.336 relating
2 to certified nurse aides in order to protect the health, safety, and welfare of
3 clients served by nurse aides;
4 (C) pertaining to retired nurse status;
5 (D) establishing criteria for approval of practical nurse
6 education programs that are not accredited by a national nursing accrediting
7 body; [AND]
8 (E) establishing guidelines for rendering a diagnosis, providing
9 treatment, or prescribing, dispensing, or administering a prescription drug to a
10 person without conducting a physical examination under AS 08.68.710; the
11 guidelines must include a nationally recognized model policy for standards of
12 care of a patient who is at a different location than the advanced practice
13 registered nurse; and
14 (F) necessary to implement the Multistate Nurse Licensure
15 Compact under AS 08.68.500;
16 (2) approve curricula and adopt standards for basic education programs
17 that prepare persons for licensing under AS 08.68.190;
18 (3) provide for surveys of the basic nursing education programs in the
19 state at the times it considers necessary;
20 (4) approve education programs that meet the requirements of this
21 chapter and of the board, and deny, revoke, or suspend approval of education
22 programs for failure to meet the requirements;
23 (5) examine, license, and renew the licenses of [QUALIFIED]
24 applicants;
25 (6) prescribe requirements for competence before a former registered,
26 advanced practice registered, or licensed practical nurse may resume the practice of
27 nursing under this chapter;
28 (7) define by regulation the qualifications and duties of the executive
29 administrator and delegate authority to the executive administrator that is necessary to
30 conduct board business;
31 (8) develop reasonable and uniform standards for nursing practice;
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1 (9) publish advisory opinions regarding whether nursing practice
2 procedures or policies comply with acceptable standards of nursing practice as defined
3 under this chapter;
4 (10) require applicants under this chapter to submit fingerprints and the
5 fees required by the Department of Public Safety under AS 12.62.160 for criminal
6 justice information and a national criminal history record check; the department shall
7 submit the fingerprints and fees to the Department of Public Safety for a report of
8 criminal justice information under AS 12.62 and a national criminal history record
9 check under AS 12.62.400;
10 (11) require that a licensed advanced practice registered nurse who has
11 a federal Drug Enforcement Administration registration number register with the
12 controlled substance prescription database under AS 17.30.200(n);
13 (12) appoint the executive administrator of the board to serve as
14 the state administrator of the Interstate Commission Nurse Licensure Compact
15 Administrators under AS 08.68.500.
16 * Sec. 4. AS 08.68.160 is amended to read:
17 Sec. 08.68.160. License or multistate licensure privilege required. A person
18 practicing or offering to practice registered, advanced practice registered, or practical
19 nursing in the state shall submit evidence of qualification to practice and shall be
20 licensed under this chapter or hold a multistate licensure privilege under
21 AS 08.68.500.
22 * Sec. 5. AS 08.68.220 is amended by adding a new subsection to read:
23 (b) The Department of Commerce, Community, and Economic Development
24 shall set fees under AS 08.01.065 for a multistate license to practice registered nursing
25 or practical nursing issued under AS 08.68.500.
26 * Sec. 6. AS 08.68 is amended by adding new sections to read:
27 Article 5A. Multistate Nurse Licensure Compact.
28 Sec. 08.68.500. Compact enacted. The Multistate Nurse Licensure Compact
29 as contained in this section is enacted into law and entered into on behalf of the state
30 with all other states and jurisdictions legally joining it in a form substantially as
31 follows:
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1 ARTICLE I
2 Findings and Declaration of Purpose
3 (a) The legislature finds that:
4 (1) The health and safety of the public are affected by the degree of
5 compliance with and the effectiveness of enforcement activities related to state nurse
6 licensure laws;
7 (2) Violations of nurse licensure and other laws regulating the practice
8 of nursing may result in injury or harm to the public;
9 (3) The expanded mobility of nurses and the use of advanced
10 communication technologies as part of our nation's health care delivery system require
11 greater coordination and cooperation among states in the areas of nurse licensure and
12 regulation;
13 (4) New practice modalities and technology make compliance with
14 individual state nurse licensure laws difficult and complex;
15 (5) The current system of duplicative licensure for nurses practicing in
16 multiple states is cumbersome and redundant for both nurses and states; and
17 (6) Uniformity of nurse licensure requirements throughout the states
18 promotes public safety and public health benefits.
19 (b) The general purposes of this Compact are to:
20 (1) Facilitate the states' responsibility to protect the public's health and
21 safety;
22 (2) Ensure and encourage the cooperation of party states in the areas of
23 nurse licensure and regulation;
24 (3) Facilitate the exchange of information between party states in the
25 areas of nurse regulation, investigation and adverse 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 accountable
29 for meeting all state practice laws in the state in which the patient is located at the time
30 care is rendered through the mutual recognition of party state licenses;
31 (6) Decrease redundancies in the consideration and issuance of nurse
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1 licenses; and
2 (7) Provide opportunities for interstate practice by nurses who meet
3 uniform licensure requirements.
4 ARTICLE II
5 Definitions
6 As used in this compact, unless the context clearly requires a different construction,
7 (1) "Adverse action" means any administrative, civil, equitable or
8 criminal action permitted by a state's laws which is imposed by a licensing board or
9 other authority against a nurse, including actions against an individual's license or
10 multistate licensure privilege such as revocation, suspension, probation, monitoring of
11 the licensee, limitation on the licensee's practice, or any other encumbrance on
12 licensure affecting a nurse's authorization to practice, including issuance of a cease
13 and desist action.
14 (2) "Alternative program" means a non-disciplinary monitoring
15 program approved by a licensing board.
16 (3) "Coordinated licensure information system" means an integrated
17 process for collecting, storing and sharing information on nurse licensure and
18 enforcement activities related to nurse licensure laws that is administered by a
19 nonprofit organization composed of and controlled by licensing boards.
20 (4) "Current significant investigative information" means:
21 (A) Investigative information that a licensing board, after a
22 preliminary inquiry that includes notification and an opportunity for the nurse
23 to respond, if required by state law, has reason to believe is not groundless and,
24 if proved true, would indicate more than a minor infraction; or
25 (B) Investigative information that indicates that the nurse
26 represents an immediate threat to public health and safety regardless of
27 whether the nurse has been notified and had an opportunity to respond.
28 (5) "Encumbrance" means a revocation or suspension of, or any
29 limitation on, the full and unrestricted practice of nursing imposed by a licensing
30 board.
31 (6) "Home state" means the party state which is the nurse's primary
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1 state of residence.
2 (7) "Licensing board" means a party state's regulatory body
3 responsible for issuing nurse licenses.
4 (8) "Multistate license" means a license to practice as a registered or a
5 licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board
6 that authorizes the licensed nurse to practice in all party states under a multistate
7 licensure privilege.
8 (9) "Multistate licensure privilege" means a legal authorization
9 associated with a multistate license permitting the practice of nursing as either a
10 registered nurse (RN) or LPN/VN in a remote state.
11 (10) "Nurse" means RN or LPN/VN, as those terms are defined by
12 each party state's practice laws.
13 (11) "Party state" means any state that has adopted this Compact.
14 (12) "Remote state" means a party state, other than the home state.
15 (13) "Single-state license" means a nurse license issued by a party state
16 that authorizes practice only within the issuing state and does not include a multistate
17 licensure privilege to practice in any other party state.
18 (14) "State" means a state, territory or possession of the United States
19 and the District of Columbia.
20 (15) "State practice laws" means a party state's laws, rules and
21 regulations that govern the practice of nursing, define the scope of nursing practice,
22 and create the methods and grounds for imposing discipline. "State practice laws" do
23 not include requirements necessary to obtain and retain a license, except for
24 qualifications or requirements of the home state.
25 ARTICLE III
26 General Provisions and Jurisdiction
27 (a) A multistate license to practice registered or licensed practical/vocational
28 nursing issued by a home state to a resident in that state will be recognized by each
29 party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed
30 practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each
31 party state.
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1 (b) A state must implement procedures for considering the criminal history
2 records of applic