OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
S.B. 3 Final Analysis
134th General Assembly
Click here for S.B. 3’s Fiscal Note
Version: As Passed by the General Assembly
Primary Sponsor: Sen. Roegner
Effective date: September 30, 2021; most Nurse Licensure Compact provisions effective
January 1, 2023
Effective Date:
Elizabeth Molnar, Attorney
SUMMARY
 Enters Ohio into the Nurse Licensure Compact, which allows a nurse to practice across
participating states under a multistate license issued by the nurse’s home state.
 Exempts certain certificates issued by the Department of Developmental Disabilities
from the Fresh Start Act, the law prohibiting a state licensing authority from refusing to
issue an initial license or other authorization based on an applicant’s criminal
background.
DETAILED ANALYSIS
Nurse Licensure Compact
Beginning January 1, 2023, the act enters Ohio as a party to the Nurse Licensure
Compact.1 The Compact is an agreement that allows nurses to practice across states that have
joined the Compact without having to obtain additional licenses. At least 34 states have joined
the Compact.2
Multistate license to practice
Under the Compact, a multistate license to practice issued by a nurse’s home state will
be recognized by each state that is a party to the Compact (party state) as authorizing the nurse
to practice as a registered nurse (RN) or licensed practical/vocational nurse (LPN/VN) under a
1 R.C. 4723.11 and Section 3.
2 NCSBN, Nurse Licensure Compact (NLC), link to list of participating states available at:
https://www.ncsbn.org/nlcmemberstates.pdf.
August 23, 2021
Office of Research and Drafting LSC Legislative Budget Office
multistate licensure privilege in each party state.3 The Compact defines “multistate license” as a
license to practice as an RN or LPN/VN issued by a home state (a nurse’s primary state of
residence that is a party to the Compact) licensing board that authorizes the licensed nurse to
practice in all party states under a multistate licensure privilege.4
Compliance with state practice laws
The Compact provides that a nurse practicing in a party state must comply with state
practice laws of the state in which the client is located at the time the service is provided. The
practice of nursing in a party state under a multistate licensure privilege subjects a nurse to the
jurisdiction of the licensing board, courts, and laws of the party state where the client is located
when the service is performed.5
Requirements for issuance of multistate license
An applicant to obtain or retain a multistate license in a home state must:6
1. Meet the home state’s qualifications for licensure or license renewal, as well as other
state laws;
2. Graduate or be eligible to graduate from an approved prelicensure education program,
including foreign programs if the program meets specified criteria;
3. Have passed an English proficiency examination if the applicant’s education program
was not in English or if English is not the individual’s native language;
4. Have passed the NCLEX-RN or NCLEX-PN examination;
5. Hold an active, unencumbered license or be eligible to do so;
6. Have submitted, as part of a licensure application, fingerprints or other biometric data
to obtain federal and state criminal histories;
7. Not have convictions or findings of guilt for felony offenses under applicable state or
federal criminal law;
8. Not have convictions or findings of guilt for misdemeanor offenses related to the
practice of nursing;
9. Not currently be enrolled in an alternative program, which is defined by the Compact as
a nondisciplinary monitoring program approved by a licensing board;7
10. Be subject to self-disclosure of participation in an alternative program; and
3 Article III.a. (Citations in this analysis to “Article” refer to the Articles of the Compact.)
4 Article II.h.
5 Article III.e.; see also Article II.o.
6 Article III.c.
7 Article II.b.
P a g e |2 S.B. 3
As Passed by the General Assembly
Office of Research and Drafting LSC Legislative Budget Office
11. Have a valid Social Security number.
Applications for multistate license
When a nurse applies for a multistate license, the licensing board in the issuing party
state must ascertain whether (1) the applicant has ever held, or is the holder of, a license issued
by any other state, (2) there are any encumbrances (such as a revocation, suspension, or
limitation on the full, unrestricted practice of nursing) on a license or multistate license held by
the applicant, (3) any adverse action has been taken against any license or multistate license,
and (4) the applicant is currently participating in an alternative program. 8
The Compact provides that a nurse may hold a multistate license issued by a home state
in only one party state at a time. The Compact contains provisions to address when a nurse
changes the nurse’s primary state of residence, including conversion to a single-state license if
the nurse moves to a nonparty state.9
The act specifies that a multistate license issued pursuant to the Compact is an option
for licensure in addition to a traditional license to practice under Ohio law.10 The Board of
Nursing may charge a fee in excess of the traditional license fee for a multistate license.
Adverse action
The Compact authorizes party states, in accordance with their state due process laws, to
take adverse action against a nurse’s multistate licensure privilege, such as revocation,
suspension, probation, or any other action that affects a nurse’s authorization to practice under
a multistate licensure privilege. Adverse action may be administrative, civil, equitable, or
criminal. A party state taking adverse action must notify the administrator of the coordinated
licensure information system (discussed below), who must notify the home state of any such
actions by remote states, which are party states other than the home state. 11
If adverse action is taken by a home state against a nurse’s multistate license, the
nurse’s multistate licensure privilege to practice in all other party states is deactivated until all
encumbrances have been removed from the multistate license. Home state disciplinary orders
that impose adverse action against a nurse’s multistate license must include a statement that
the nurse’s multistate licensure privilege is deactivated in all party states during the pendency
of the order.12
The Compact provides that is does not override a party state’s decision that
participation in a program of monitoring should be used in lieu of adverse action. A nurse’s
8 Article IV.a.; see also Article II.e.
9 Article IV.b. to d.; see also Article II.m.
10 R.C. 4723.112; see also R.C. 4723.09, not in the act.
11 Article III.d.; see also Article II.a. and II.l.
12 Article V.b.
P a g e |3 S.B. 3
As Passed by the General Assembly
Office of Research and Drafting LSC Legislative Budget Office
multistate licensure privilege is to be deactivated during the period of participation in such an
alternative program.13
Party state licensing boards
The Compact defines “licensing board” as a party state’s regulatory body responsible for
issuing nursing licenses.14 In addition to other powers conferred by state law, the Compact
provides that licensing boards have various authorities, including taking action against a nurse’s
multistate license to practice within that party state. Only the home state has the power to take
adverse action against a nurse’s license issued by the home state. Home state licensing boards
must give the same priority and effect to reported conduct from a remote state as it would if
the conduct occurred in the home state. The home state laws are to be applied in determining
appropriate action.15 Other actions licensing boards may take include issuing cease and desist
orders, imposing encumbrances on a nurse’s authority to practice within a party state,
completing any pending investigations, issuing subpoenas for witnesses and evidence, receiving
information for and conducting background checks, and recovering costs of investigations.16
Coordinated licensure information system
The Compact requires all party states to participate in a coordinated licensure
information system of all licensed RNs and LPNs/VNs. The system includes information on the
licensure and disciplinary history of each nurse, as submitted by party states, to assist in the
coordination of nurse licensure and enforcement efforts.17 All licensing boards must promptly
report to the system any adverse action, significant investigative information (as specified in
the Compact), denials of applications, and nurse participation in alternative programs.18 A party
state licensing board may designate information provided that may not be shared with
nonparty states or disclosed to other entities or individuals without express permission of the
contributing state.19
The Compact administrator of each party state must provide a uniform data set to the
Compact administrator of each other party state, including the following:20
1. Identifying information;
2. Licensure data;
13 Article V.c.
14 Article II.g.
15 Article V.a.1.
16 Article V.a.2. to 7.
17 Article VI.a.; see also Article II.c.
18 Article VI.c.; see also Article II.d.
19 Article VI.e.
20 Article VI.h.
P a g e |4 S.B. 3
As Passed by the General Assembly
Office of Research and Drafting LSC Legislative Budget Office
3. Information related to alternative program participation;
4. Other information that may facilitate administration of the Compact.
Interstate Commission of Nurse Licensure Compact Administrators
The Compact establishes the Interstate Commission of Nurse Licensure Compact
Administrators. The Commission is a joint public entity and an instrumentality of the party
states.21
Membership, voting, and meetings
Each party state is to have one administrator, who is generally the head of the state
licensing board or a designee. The act requires the Board of Nursing to select an individual to
serve as Ohio’s administrator not later than 30 days after Ohio enters the Compact on
January 1, 2023.22
Each administrator has one vote regarding rules and bylaws. Administrators may be
removed or suspended, and vacancies are to be filled, as provided in state law. The act provides
that a vacancy for the Ohio administrator must be filled not later than 30 days after the vacancy
occurs.23
The Commission is required to meet at least once each calendar year. The meetings
must be open to the public, with public notice of meetings provided. The Compact, however,
specifies certain circumstances when closed, nonpublic meetings may occur, such as to discuss
party state noncompliance, litigation, or trade secrets.24
Bylaws
The Commission, by a majority vote of the administrators, is required to prescribe
bylaws to govern its conduct. The bylaws must be published on the Commission’s website.25
Powers
The Compact provides the Commission various powers. Examples include promulgating
rules, bringing and prosecuting legal proceedings, hiring employees, obtaining property,
borrowing money, and appointing committees.26
Financing
The Commission is required to pay for reasonable expenses associated with its
establishment, organization, and ongoing activities. To do so, the Commission may levy and
21 Article VII.a.
22 R.C. 4723.111, Article VII.b.1., and Section 3.
23 R.C. 4723.111 and Article VII.b.1. and 2.
24 Article VII.b.3. to 6.
25 Article VII.c. and d.
26 Article VII.g.
P a g e |5 S.B. 3
As Passed by the General Assembly
Office of Research and Drafting LSC Legislative Budget Office
collect an annual assessment from each party state. The Compact has additional provisions
regarding obligations and accounting for receipts and disbursements.27
Qualified immunity, defense, and indemnification
The Compact provides immunity associated with acts occurring within the scope of
Commission employment, duties, or responsibilities, as long as the loss was not caused by
intentional, willful, or wanton misconduct. The Commission is required to defend and indemnify
persons in actions seeking to impose liability arising out of acts associated with Commission
employment, duties, or responsibilities, except in the case of intentional, willful, or wanton
misconduct.28
Rulemaking
The Commission is required to exercise rulemaking in accordance with the Compact. The
Commission must provide 60-days’ advance notice on its website prior to a final rule being
adopted. The notice must also be filed on the website of each party state licensing board. The
notice must include information about the meeting where the rule will be considered and voted
on, the text of the rule and the reason for it, a request for comments, and information
regarding how interested persons may attend and provide comments. For Ohio, the act
requires the Commission to offer a teleconference option for oral comments.29
The Compact also provides a procedure for the adoption of emergency rules without
prior notice.30
Oversight, enforcement, and dispute resolution
Each party state is required to enforce the Compact and take all necessary actions to
effectuate its purposes and intent.31
The Commission is responsible for taking action if it determines that a party state has
defaulted in the performance of its obligations or responsibilities. In that case, the Commission
must provide written notice of the default, the proposed means of curing it, and remedial
training and technical assistance. If the state does not cure the default, its membership in the
Compact may be terminated upon an affirmative vote of a majority of the administrators.32
In the event of a dispute related to the Compact, the Commission is required to attempt
to find a resolution. Commission rules must provide for both mediation and binding dispute
27 Article VII.h.
28 Article VII.i.
29 Article VIII and R.C. 4723.113.
30 Article VIII.k.
31 Article IX.a. and d.
32 Article IX.b.
P a g e |6 S.B. 3
As Passed by the General Assembly
Office of Research and Drafting LSC Legislative Budget Office
resolution. If the Commission cannot resolve a dispute, the party states may submit the issues
to an arbitration panel.33
Withdrawal and amendment
Any party state may withdraw from the Compact by repealing the statute that enacted
it. The withdrawal does not take effect until six months after the repeal.34
The Compact provides that it does not 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 the Compact.35
The Compact may be amended by the party states if the amendment is enacted into law
by all party states.36
Ohio employer notices and reporting
The act establishes specific duties for persons and government entities in Ohio that hire
out-of-state nurses with multistate licenses issued under the Compact. Such an employer must
report to the Board of Nursing the name of each nurse holding a multistate license, and any
other information required in Board rules. The employer also must provide each nurse with a
copy of the information that the act requires the Board to develop concerning laws and rules
specific to the practice of nursing in Ohio. The act also authorizes the Board to adopt rules
related to these employer requirements.37
The act requires an Ohio employer of a nurse holding a multistate license to report to
the Board any conduct on the part of the nurse that the employer knows or has reason to
believe would be grounds for disciplinary action by the Board. Employers also must engage in
such reporting under continuing law for nurses holding traditional Ohio nursing licenses.38
Collective bargaining
The act specifies that its provisions cannot be construed to limit, alter, or modify any of
the terms, conditions, or provisions of a collective bargaining agreement entered into by a
hospital.39
33 Article IX.c.
34 Article X.c.
35 Article X.e.