2022 -- S 2472
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LC004731
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2022
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AN ACT
RELATING TO BUSINESSES AND PROFESSIONS -- NURSE LICENSURE COMPACT
Introduced By: Senator Joshua Miller
Date Introduced: March 01, 2022
Referred To: Senate Health & Human Services
It is enacted by the General Assembly as follows:
1 SECTION 1. Sections 5-34.3-3, 5-34.3-4, 5-34.3-5, 5-34.3-6, 5-34.3-8, 5-34.3-9 and 5-
2 34.3-10 of the General Laws in Chapter 5-34.3 entitled "Nurse Licensure Compact" are hereby
3 amended to read as follows:
4 5-34.3-3. Legislative findings.
5 (a) The general assembly finds and declares that:
6 (1) The health and safety of the public are affected by the degree of compliance with and
7 the effectiveness of enforcement activities related to state nurse licensure laws;
8 (2) Violations of nurse licensure and other laws regulating the practice of nursing may
9 result in injury or harm to the public;
10 (3) The expanded mobility of nurses and the use of advanced communication technologies
11 as part of our nation's healthcare delivery system require greater coordination and cooperation
12 among states in the areas of nurse licensure and regulations;
13 (4) New practice modalities and technology make compliance with individual state nurse
14 licensure laws difficult and complex; and
15 (5) The current system of duplicative licensure for nurses practicing in multiple states is
16 cumbersome and redundant to both nurses and states. ; and
17 (6) Uniformity of nurse licensure requirements throughout the states promotes public safety
18 and public health benefits.
19 (b) The general purposes of this compact are to:
 1 (1) Facilitate the states' responsibility to protect the public's health and safety;
2 (2) Ensure and encourage the cooperation of party states in the areas of nurse licensure and
3 regulation;
4 (3) Facilitate the exchange of information between party states in the areas of nurse
5 regulation, investigation and adverse actions;
6 (4) Promote compliance with the laws governing the practice of nursing in each
7 jurisdiction; and
8 (5) Invest all party states with the authority to hold a nurse accountable for meeting all state
9 practice laws in the state in which the patient is located at the time care is rendered through the
10 mutual recognition of party state licenses. ;
11 (6) Decrease redundancies in the consideration and issuance of nurse licenses; and
12 (7) Provide opportunities for interstate practice by nurses who meet uniform licensure
13 requirements.
14 5-34.3-4. Definitions.
15 As used in this chapter:
16 (1) "Adverse action" means a home or remote state action any administrative, civil,
17 equitable or criminal action permitted by a state's laws which is imposed by a licensing board or
18 other authority against a nurse, including actions against an individual's license or multistate
19 licensure privilege such as revocation, suspension, probation, monitoring of the licensee, limitation
20 on the licensee's practice, or any other encumbrance on licensure affecting a nurse's authorization
21 to practice, including issuance of a cease and desist action.
22 (2) "Alternative program" means a voluntary, nondisciplinary monitoring program
23 approved by a nurse licensing board.
24 (3) "Coordinated licensure information system" means an integrated process for collecting,
25 storing, and sharing information on nurse licensure and enforcement activities related to nurse
26 licensure laws, which is administered by a nonprofit organization composed of and controlled by
27 state nurse licensing boards.
28 (4) "Current significant investigative information" means:
29 (i) Investigative investigative information that a licensing board, after a preliminary inquiry
30 that includes notification and an opportunity for the nurse to respond if required by state law, has
31 reason to believe is not groundless and, if proved true, would indicate more than a minor infraction;
32 or
33 (ii) Investigative investigative information that indicates that the nurse represents an
34 immediate threat to public health and safety regardless of whether the nurse has been notified and
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 1 had an opportunity to respond.
2 (5) "Encumbrance" means a revocation or suspension of, or any limitation placed on, the
3 full and unrestricted practice of nursing imposed by a licensing board.
4 (5)(6) "Home state" means the party state which is the nurse's primary state of residence.
5 (6) "Home state action" means any administrative, civil, equitable or criminal action
6 permitted by the home state's laws which are imposed on a nurse by the home state's licensing
7 board or other authority including actions against an individual's license such as: revocation,
8 suspension, probation or any other action which affects a nurse's authorization to practice.
9 (7) "Licensing board" means a party state's regulatory body responsible for issuing nurse
10 licenses.
11 (8) "Multistate licensure privilege" means current, official authority from a remote state
12 permitting the practice of nursing as either a registered nurse or a licensed practical/vocational
13 nurse in such party state. All party states have the authority, in accordance with existing state due
14 process law, to take actions against the nurse's privilege such as: revocation, suspension, probation
15 or any other action which affects a nurse's authorization to practice a license to practice as a
16 registered nurse (RN) or a licensed practical nurse/vocational nurse (LPN/VN) issued by a home
17 state licensing board, that authorizes the licensed nurse to practice in all party states under a
18 multistate licensure privilege.
19 (9) "Multistate licensure privilege" means a legal authorization associated with a multistate
20 license, permitting the practice of nursing as either a registered nurse (RN) or licensed practical
21 nurse/vocational nurse (LPN/VN) in a remote state.
22 (9)(10) "Nurse" means a registered nurse or licensed practical/vocational nurse, as those
23 terms are defined by each party's state practice laws.
24 (10)(11) "Party state" means any state that has adopted this compact.
25 (11)(12) "Remote state" means a party state, other than the home state, where the patient
26 is located at the time nursing care is provided, or, in the case of the practice of nursing not involving
27 a patient, in such party state where the recipient of nursing practice is located.
28 (12) "Remote state action" means any administrative, civil, equitable or criminal action
29 permitted by a remote state's laws which are imposed on a nurse by the remote state's licensing
30 board or other authority including actions against an individual's multistate licensure privilege to
31 practice in the remote state, and cease and desist and other injunctive or equitable orders issued by
32 remote states or the licensing boards thereof.
33 (13) "Single-state license" means a nurse license issued by a party state that authorizes
34 practice only within the issuing state and does not include a multistate licensure privilege to practice
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 1 in any other party state.
2 (13)(14) "State" means a state, territory, or possession of the United States, and the District
3 of Columbia.
4 (14)(15) "State practice laws" means those individual party's state a party states laws, rules
5 and regulations that govern the practice of nursing, define the scope of nursing practice, and create
6 the methods and grounds for imposing discipline. It does State practice laws do not include the
7 initial qualifications for licensure or requirements necessary to obtain and retain a license, except
8 for qualifications or requirements of the home state.
9 5-34.3-5. Permitted activities and jurisdiction General provisions and jurisdiction.
10 (a) A license to practice registered nursing issued by a home state to a resident in that state
11 will be recognized by each party state as authorizing a multistate licensure privilege to practice as
12 a registered nurse in such party state. A license to practice licensed practical/vocational nursing
13 issued by a home state to a resident in that state will be recognized by each party state as authorizing
14 a multistate licensure privilege to practice as a licensed practical/vocational nurse in such party
15 state. In order to obtain or retain a license, an applicant must meet the home state's qualifications
16 for licensure and license renewal as well as all other applicable state laws.
17 (b) Party states may, in accordance with state due process laws, limit or revoke the
18 multistate licensure privilege of any nurse to practice in their state and may take any other actions
19 under their applicable state laws necessary to protect the health and safety of their citizens. If a
20 party state takes such action, it shall promptly notify the administrator of the coordinated licensure
21 information system. The administrator of the coordinated licensure information system shall
22 promptly notify the home state of any such actions by remote states.
23 (c) Every nurse practicing in a party state must comply with the state practice laws of the
24 state in which the patient is located at the time care is rendered. In addition, the practice of nursing
25 is not limited to patient care, but shall include all nursing practice as defined by the state practice
26 laws of a party state. The practice of nursing will subject a nurse to the jurisdiction of the nurse
27 licensing board and courts, as well as the laws, in that party state.
28 (d) This compact does not affect additional requirements imposed by states for advanced
29 practice registered nursing. However, a multistate licensure privilege to practice registered nursing
30 granted by a party shall be recognized by other party states as a license to practice registered nursing
31 if one is required by state law as a precondition for qualifying for advanced practice registered
32 nurse authorization.
33 (e) Individuals not residing in a party state shall continue to be able to apply for nurse
34 licensure as provided for under the laws of each party state. However, the license granted to these
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 1 individuals will not be recognized as granting the privilege to practice nursing in any other party
2 state unless explicitly agreed to by that party state.
3 (a) A multistate license to practice registered or licensed practical nursing/vocational
4 nursing issued by a home state to a resident in that state will be recognized by each party state as
5 authorizing a nurse to practice as a registered nurse (RN) or as a licensed practical nurse/vocational
6 nurse (LPN/VN), under a multistate licensure privilege, in each party state.
7 (b) A state must implement procedures for considering the criminal history records of
8 applicants for initial multistate license or licensure by endorsement. Such procedures shall include
9 the submission of fingerprints or other biometric-based information by applicants for the purpose
10 of obtaining an applicant's criminal history record information from the Federal Bureau of
11 Investigation, and the agency responsible for maintaining that state's criminal records.
12 (c) Each party state shall require the following for an applicant to obtain or retain a
13 multistate license in the home state:
14 (1) Meets the home state's qualifications for licensure or renewal of licensure, as well as
15 all other applicable state laws;
16 (2)(i) Has graduated or is eligible to graduate from a licensing board-approved RN or
17 LPN/VN prelicensure education program; or
18 (ii) Has graduated from a foreign RN or LPN/VN prelicensure education program that:
19 (A) Has been approved by the authorized accrediting body in the applicable country; and
20 (B) Has been verified by an independent credentials review agency to be comparable to a
21 licensing board-approved prelicensure education program;
22 (3) Has, if a graduate of a foreign prelicensure education program not taught in English or
23 if English is not the individual's native language, successfully passed an English proficiency
24 examination that includes the components of reading, speaking, writing and listening;
25 (4) Has successfully passed an NCLEX-RN® or NCLEX-PN® Examination or recognized
26 predecessor, as applicable;
27 (5) Is eligible for or holds an active, unencumbered license;
28 (6) Has submitted, in connection with an application for initial licensure or licensure by
29 endorsement, fingerprints or other biometric data for the purpose of obtaining criminal history
30 record information from the Federal Bureau of Investigation and the agency responsible for
31 maintaining that state's criminal records;
32 (7) Has not been convicted or found guilty nor entered into an agreed disposition of a felony
33 offense under applicable state or federal criminal law;
34 (8) Has not been convicted or found guilty nor entered into an agreed disposition of a
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 1 misdemeanor offense related to the 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 current participation in an
4 alternative program; and
5 (11) Has a valid United States Social Security number.
6 (d) All party states shall be authorized, in accordance with existing state due process law,
7 to take adverse action against a nurse's multistate licensure privilege such as revocation, suspension,
8 probation or any other action that affects a nurse's authorization to practice under a multistate
9 licensure privilege, including cease and desist actions. If a party state takes such action, it shall
10 promptly notify the administrator of the coordinated licensure information system. The
11 administrator of the coordinated licensure information system shall promptly notify the home state
12 of any such actions by remote states.
13 (e) A nurse practicing in a party state must comply with the state practice laws of the state
14 in which the client is located at the time service is provided. The practice of nursing is not limited
15 to patient care, but shall include all nursing practice as defined by the state practice laws of the
16 party state in which the client is located. The practice of nursing in a party state under a multistate
17 licensure privilege will subject a nurse to the jurisdiction of the licensing board, the courts and the
18 laws of the party state in which the client is located at the time service is provided.
19 (f) Individuals not residing in a party state shall continue to be able to apply for a party
20 state's single-state license as provided under the laws of each party state. However, the single-state
21 license granted to these individuals will not be recognized as granting the privilege to practice
22 nursing in any other party state. Nothing in this compact shall affect the requirements established
23 by a party state for the issuance of a single-state license.
24 (g) Any nurse holding a home state multistate license, on the effective date of this compact,
25 may retain and renew the multistate license issued by the nurse's then-current home state; provided
26 that:
27 (1) A nurse, who changes primary state of residence after this compact's effective date,
28 must meet all applicable requirements pursuant to subsection (c) of this section to obtain a
29 multistate license from a new home state; and
30 (2) A nurse who fails to satisfy the multistate licensure requirements due to a disqualifying
31 event occurring after this compact's effective date shall be ineligible to retain or renew a multistate
32 license, and the nurse's multistate license shall be revoked or deactivated in accordance with
33 applicable rules adopted by the commission.
34 5-34.3-6. Applications for licensure in a party state.
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 1 (a) Upon application for a license, the licensing board in a party state shall ascertain,
2 through the coordinated licensure information system, whether the applicant has ever held, or is the
3 holder of, a license issued by any other state, whether there are any restrictions on the multistate
4 licensure privilege, and whether any other adverse action by any state has been taken against the
5 license.
6 (b) A nurse in a party state shall hold licensure in only one party state at a time, issued by
7 the home state.
8 (c) A nurse who intends to change primary state of residence may apply for licensure in
9 the new home state in advance of such change. However, new licenses will not be issued by a party
10 state until after a nurse provides evidence of change in primary state of residence satisfactory to the
11 new home state's licensing board.
12 (d) When a nurse changes primary state of residence by;
13 (1) Moving between two party states, and obtains a license from the new home state, the
14 license fr