PRINTER'S NO. 473
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 115
Session of
2021
INTRODUCED BY BOSCOLA, COLLETT, J. WARD, COSTA, FONTANA, MUTH,
GORDNER, BARTOLOTTA, SCAVELLO, MARTIN, KEARNEY, TARTAGLIONE,
BAKER AND STEFANO, MARCH 22, 2021
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
MARCH 22, 2021
AN ACT
1 Making the Commonwealth of Pennsylvania a party to the Nurse
2 Licensure Compact; and providing for the form of the compact.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the Nurse
7 Licensure Compact Act.
8 Section 2. Nurse Licensure Compact.
9 The Nurse Licensure Compact is enacted into law and entered
10 into by the Commonwealth of Pennsylvania with all other states
11 legally joining in the compact in the form substantially as
12 follows:
13 ARTICLE I
14 Findings and Declaration of Purpose
15 a. The party states find that:
16 1. The health and safety of the public are affected by
17 the degree of compliance with and the effectiveness of
 1 enforcement activities related to state nurse licensure laws;
2 2. Violations of nurse licensure and other laws
3 regulating the practice of nursing may result in injury or
4 harm to the public;
5 3. The expanded mobility of nurses and the use of
6 advanced communication technologies as part of our nation's
7 health care delivery system require greater coordination and
8 cooperation among states in the areas of nurse licensure and
9 regulation;
10 4. New practice modalities and technology make
11 compliance with individual state nurse licensure laws
12 difficult and complex;
13 5. The current system of duplicative licensure for
14 nurses practicing in multiple states is cumbersome and
15 redundant for both nurses and states; and
16 6. Uniformity of nurse licensure requirements throughout
17 the 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
22 in the areas of nurse licensure and regulation;
23 3. Facilitate the exchange of information between party
24 states in the areas of nurse regulation, investigation and
25 adverse actions;
26 4. Promote compliance with the laws governing the
27 practice of nursing in each jurisdiction;
28 5. Invest all party states with the authority to hold a
29 nurse accountable for meeting all state practice laws in the
30 state in which the patient is located at the time care is
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 1 rendered through the mutual recognition of party state
2 licenses;
3 6. Decrease redundancies in the consideration and
4 issuance of nurse licenses; and
5 7. Provide opportunities for interstate practice by
6 nurses who meet uniform licensure requirements.
7 ARTICLE II
8 Definitions
9 As used in this Compact:
10 a. "Adverse action" means any administrative, civil,
11 equitable or criminal action permitted by a state's laws which
12 is imposed by a licensing board or other authority against a
13 nurse, including actions against an individual's license or
14 multistate licensure privilege such as revocation, suspension,
15 probation, monitoring of the licensee, limitation on the
16 licensee's practice, or any other encumbrance on licensure
17 affecting a nurse's authorization to practice, including
18 issuance of a cease and desist action.
19 b. "Alternative program" means a non-disciplinary monitoring
20 program approved by a licensing board.
21 c. "Coordinated licensure information system" means an
22 integrated process for collecting, storing and sharing
23 information on nurse licensure and enforcement activities
24 related to nurse licensure laws that is administered by a
25 nonprofit organization composed of and controlled by licensing
26 boards.
27 d. "Current significant investigative information" means:
28 1. Investigative information that a licensing board,
29 after a preliminary inquiry that includes notification and an
30 opportunity for the nurse to respond, if required by state
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 1 law, has reason to believe is not groundless and, if proved
2 true, would indicate more than a minor infraction; or
3 2. Investigative information that indicates that the
4 nurse represents an immediate threat to public health and
5 safety regardless of whether the nurse has been notified and
6 had an opportunity to respond.
7 e. "Encumbrance" means a revocation or suspension of, or any
8 limitation on, the full and unrestricted practice of nursing
9 imposed by a licensing board.
10 f. "Home state" means the party state which is the nurse's
11 primary state of residence.
12 g. "Licensing board" means a party state's regulatory body
13 responsible for issuing nurse licenses.
14 h. "Multistate license" means a license to practice as a
15 registered or a licensed practical/vocational nurse (LPN/VN)
16 issued by a home state licensing board that authorizes the
17 licensed nurse to practice in all party states under a
18 multistate licensure privilege.
19 i. "Multistate licensure privilege" means a legal
20 authorization associated with a multistate license permitting
21 the practice of nursing as either a registered nurse (RN) or
22 LPN/VN in a remote state.
23 j. "Nurse" means RN or LPN/VN, as those terms are defined by
24 each party state's practice laws.
25 k. "Party state" means any state that has adopted this
26 Compact.
27 l. "Remote state" means a party state, other than the home
28 state.
29 m. "Single-state license" means a nurse license issued by a
30 party state that authorizes practice only within the issuing
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 1 state and does not include a multistate licensure privilege to
2 practice 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
6 and regulations that govern the practice of nursing, define the
7 scope of nursing practice, and create the methods and grounds
8 for imposing discipline. "State practice laws" do not include
9 requirements necessary to obtain and retain a license, except
10 for 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
15 resident in that state will be recognized by each party state as
16 authorizing a nurse to practice as a registered nurse (RN) or as
17 a licensed practical/vocational nurse (LPN/VN), under a
18 multistate licensure 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
22 include the submission of fingerprints or other biometric-based
23 information by applicants for the purpose of obtaining an
24 applicant's criminal history record information from the Federal
25 Bureau of Investigation and the agency responsible for retaining
26 that state's criminal 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:
30 1. Meets the home state's qualifications for licensure
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 1 or renewal of licensure, as well as, all other applicable
2 state laws;
3 2. i. Has graduated or is eligible to graduate from a
4 licensing board-approved RN or LPN/VN prelicensure
5 education program; or
6 ii. Has graduated from a foreign RN or LPN/VN
7 prelicensure education program that (a) has been approved
8 by the authorized accrediting body in the applicable
9 country and (b) has been verified by an independent
10 credentials review agency to be comparable to a licensing
11 board-approved prelicensure education program;
12 3. Has, if a graduate of a foreign prelicensure
13 education program not taught in English or if English is not
14 the individual's native language, successfully passed an
15 English proficiency examination that includes the components
16 of reading, speaking, 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
20 license;
21 6. Has submitted, in connection with an application for
22 initial licensure or licensure by endorsement or in
23 connection with an application for a multistate license under
24 this Compact, fingerprints or other biometric data for the
25 purpose of obtaining criminal history record information from
26 the Federal Bureau of Investigation and the agency
27 responsible for retaining that state's criminal records;
28 7. Has not been convicted or found guilty, or has
29 entered into an agreed disposition, of a felony offense under
30 applicable state or federal criminal law;
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 1 8. Has not been convicted or found guilty, or has
2 entered into an agreed disposition, of a misdemeanor offense
3 related to the practice of nursing as determined on a case-
4 by-case basis;
5 9. Is not currently enrolled in an alternative program;
6 10. Is subject to self-disclosure requirements regarding
7 current participation in an alternative program; and
8 11. Has a valid United States Social Security number.
9 d. All party states shall be authorized, in accordance with
10 existing state due process law, to take adverse action against a
11 nurse's multistate licensure privilege such as revocation,
12 suspension, probation or any other action that affects a nurse's
13 authorization to practice under a multistate licensure
14 privilege, including cease and desist actions. If a party state
15 takes such action, it shall promptly notify the administrator of
16 the coordinated licensure information system. The administrator
17 of the coordinated licensure information system shall promptly
18 notify the home state of any such actions by remote states.
19 e. A nurse practicing in a party state must comply with the
20 state practice laws of the state in which the client is located
21 at the time service is provided. The practice of nursing is not
22 limited to patient care, but shall include all nursing practice
23 as defined by the state practice laws of the party state in
24 which the client is located. The practice of nursing in a party
25 state under a multistate licensure privilege will subject a
26 nurse to the jurisdiction of the licensing board, the courts and
27 the laws of the party state in which the client is located at
28 the time service is provided.
29 f. Individuals not residing in a party state shall continue
30 to be able to apply for a party state's single-state license as
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 1 provided under the laws of each party state. However, the
2 single-state license granted to these individuals will not be
3 recognized as granting the privilege to practice nursing in any
4 other party state. Nothing in this Compact shall affect the
5 requirements established by a party state for the issuance of a
6 single-state license.
7 g. Any nurse holding a home state multistate license, on the
8 effective date of this Compact, may retain and renew the
9 multistate license issued by the nurse's then-current home
10 state, provided that:
11 1. A nurse, who changes primary state of residence after
12 this Compact's effective date, must meet all applicable
13 Article III.c. requirements to obtain a multistate license
14 from a new home state.
15 2. A nurse who fails to satisfy the multistate licensure
16 requirements in Article III.c. due to a disqualifying event
17 occurring after this Compact's effective date shall be
18 ineligible to retain or renew a multistate license, and the
19 nurse's multistate license shall be revoked or deactivated in
20 accordance with applicable rules adopted by the Interstate
21 Commission of Nurse Licensure Compact Administrators
22 ("Commission").
23 ARTICLE IV
24 Applications for Licensure in a Party State
25 a. Upon application for a multistate license, the licensing
26 board in the issuing party state shall ascertain, through the
27 coordinated licensure information system, whether the applicant
28 has ever held, or is the holder of, a license issued by any
29 other state, whether there are any encumbrances on any license
30 or multistate licensure privilege held by the applicant, whether
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 1 any adverse action has been taken against any license or
2 multistate licensure privilege held by the applicant and whether
3 the applicant is currently participating in an alternative
4 program.
5 b. A nurse may hold a multistate license, issued by the home
6 state, in only one party state at a time.
7 c. If a nurse changes primary state of residence by moving
8 between two party states, the nurse must apply for licensure in
9 the new home state, and the multistate license issued by the
10 prior home state will be deactivated in accordance with
11 applicable rules adopted by the Commission.
12 1. The nurse may apply for licensure in advance of a
13 change in primary state of residence.
14 2. A multistate license shall not be issued by the new
15 home state until the nurse provides satisfactory evidence of
16 a change in primary state of residence to the new home state
17 and satisfies all applicable requirements to obtain a
18 multistate license from the new home state.
19 d. If a nurse changes primary state of residence by moving
20 from a party state to a non-party state, the multistate license
21 issued by the prior home state will convert to a single-state
22 license, valid only in the former home state.
23 ARTICLE V
24 Additional Authorities Invested in Party State Licensing Boards
25 a. In addition to the other powers conferred by state law, a
26 licensing board shall have the authority to:
27 1. Take adverse action against a nurse's multistate
28 licensure privilege to practice within that party state.
29 i. Only the home state shall have the power to take
30 adverse action against a nurse's license issued by the
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 1 home state.
2 ii. For purposes of taking adverse action, the home
3 state licensing board shall give the same priority and
4 effect to reported conduct received from a remote state
5 as it would if such conduct had occurred within the home
6 state. In so doing, the home state shall apply its own
7 state laws to determine appropriate action.
8 2. Issue cease and desist orders or impose an
9 encumbrance on a nurse's authority to practice within that
10 party state.
11 3. Complete any pending investigations of a nurse who
12 changes primary state of residence during the course of such
13 investigations. The licensing board shall also have the
14 authority to take appropriate action(s) and shall promptly
15 report the conclusions of such investigations to the
16 administrator of the coordinated licensure information
17 system. The administrator of the coordinated licensure
18 information system shall promptly notify the new home state
19 of any such actions.
20 4. Issue subpoenas for both hearings and investigations
21 that require the attendance and testimony of witnesses, as
22 well as, the production of evidence. Subpoenas issued by a
23 licensing board in a party state for the attendance and
24 testimony of witnesses or the production of evidence from
25 another party state shall be enforced in the latter state by
26 any court of competent jurisdiction, according to the
27 practice and procedure of that court applicable to subpoenas
28 issued in proceedings pending before it. The issuing
29 authority shall pay any witness fees, travel expenses,
30 mileage and other fees required by the service statutes of
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 1 the state in which the witnesses or evidence are located.
2