CHAPTER 304. NURSE LICENSURE COMPACT

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OCCUPATIONS CODE

TITLE 3. HEALTH PROFESSIONS

SUBTITLE E. REGULATION OF NURSING

CHAPTER 304. NURSE LICENSURE COMPACT

Sec. 304.001. NURSE LICENSURE COMPACT. The Nurse Licensure

Compact is enacted and entered into with all other jurisdictions

that legally join in the compact, which is as follows:

NURSE LICENSURE COMPACT

ARTICLE 1. FINDINGS AND DECLARATION OF PURPOSE

(a) The party states find that:

(1) the health and safety of the public are affected by the

degree of compliance with and the effectiveness of enforcement

activities related to state nurse licensing laws;

(2) violations of nurse licensing and other laws regulating the

practice of nursing may result in injury or harm to the public;

(3) the expanded mobility of nurses and the use of advanced

communication technologies as part of our nation's health care

delivery system require greater coordination and cooperation

among states in the areas of nurse licensing and regulation;

(4) new practice modalities and technology make compliance with

each state nurse licensing laws difficult and complex; and

(5) the current system of the duplicative licensing of nurses

practicing in multiple states is cumbersome and redundant to both

nurses and the states.

(b) The general purposes of this compact are to:

(1) facilitate the states' responsibilities to protect the

public's health and safety;

(2) ensure and encourage the cooperation of party states in the

areas of nurse licensing and regulation;

(3) facilitate the exchange of information between party states

in the areas of nurse regulation, investigation, and adverse

action;

(4) promote compliance with the laws governing the practice of

nursing in each jurisdiction; and

(5) invest all party states with the authority to hold a nurse

accountable for meeting all state practice laws in the state in

which the patient is located at the time care is provided through

the mutual recognition of party state licenses.

ARTICLE 2. DEFINITIONS

In this compact:

(a) "Adverse action" means a home or remote state action.

(b) "Alternative program" means a voluntary, nondisciplinary

monitoring program approved by a nurse licensing board.

integrated process for collecting, storing, and sharing

information on nurse licensing and enforcement activities related

to nurse licensing laws, which is administered by a nonprofit

organization composed of and controlled by state nurse licensing

boards.

(d) "Current significant investigative information" means:

(1) investigative information that a licensing board, after a

preliminary inquiry that includes notification and an opportunity

for the nurse to respond if required by state law, has reason to

believe is not groundless and, if proved true, would indicate

more than a minor infraction; or

(2) investigative information that indicates that a nurse

represents an immediate threat to public health and safety

regardless of whether the nurse has been notified and had an

opportunity to respond.

(e) "Home state" means the party state that is the nurse's

primary state of residence.

(f) "Home state action" means any administrative, civil,

equitable, or criminal action permitted by the home state's laws

that are imposed on a nurse by the home state's licensing board

or other authority, including actions against an individual's

license such as revocation, suspension, probation, or any other

action that affects a nurse's authorization to practice.

(g) "Licensing board" means a party state's regulatory body

responsible for issuing nurse licenses.

(h) "Multistate licensing privilege" means current, official

authority from a remote state permitting the practice of nursing

as a registered nurse, licensed practical nurse, or licensed

vocational nurse in the party state. All party states have the

authority, in accordance with existing state due process laws, to

take actions against the nurse's privilege, including revocation,

suspension, probation, or any other action that affects a nurse's

authorization to practice.

(i) "Nurse" means a registered nurse, licensed practical nurse,

or licensed vocational nurse as those terms are defined by each

party state's practice laws.

(j) "Party state" means any state that has enacted this compact.

(k) "Remote state" means a party state, other than the home

state, in which:

(1) a patient is located at the time nursing care is provided;

(2) in the case of the practice of nursing not involving a

patient, the recipient of nursing practice is located.

(l) "Remote state action" means:

(1) an administrative, civil, equitable, or criminal action

permitted by a remote state's laws that are imposed on a nurse by

the remote state's licensing board or other authority, including

an action against an individual's multistate licensing privilege

to practice in the remote state; and

(2) a cease and desist order and other injunctive or equitable

orders issued by remote states or the licensing boards of remote

states.

(m) "State" means a state, territory, possession of the United

States, the District of Columbia, or the Commonwealth of Puerto

Rico.

(n) "State practice laws" means a party state's laws and

regulations that govern the practice of nursing, define the scope

of nursing practice, and create the methods and grounds for

imposing discipline. The term does not include the initial

qualifications for licensing or requirements necessary to obtain

and retain a license, except for qualifications or requirements

of the home state.

ARTICLE 3. GENERAL PROVISIONS AND JURISDICTION

(a) A license to practice registered nursing issued by a home

state to a resident in that state will be recognized by each

party state as authorizing a multistate licensing privilege to

practice as a registered nurse in the party state. A license to

practice licensed practical nursing or licensed vocational

nursing issued by a home state to a resident in that state will

be recognized by each party state as authorizing a multistate

licensing privilege to practice as a licensed practical nurse or

vocational nurse in the party state. To obtain or retain a

license, an applicant must meet the home state's qualifications

for a license and license renewal as well as all other applicable

state laws.

(b) A party state may, in accordance with state due process

laws, limit or revoke the multistate licensing privilege of any

nurse to practice in the party state and may take any other

necessary actions under the party state's applicable laws to

protect the health and safety of the party state's citizens. If a

party state takes this action, the party state shall promptly

notify the administrator of the coordinated licensure information

system. The administrator of the coordinated licensure

information system shall promptly notify the home state of any

such actions by remote states.

state practice laws of the state in which the patient is located

at the time care is provided. The practice of nursing includes

patient care and all nursing practice defined by the party

state's practice laws. The practice of nursing will subject a

nurse to the jurisdiction of the nurse licensing board, the

courts, and the laws of the party state.

(d) This compact does not affect additional requirements imposed

by states for advanced practice registered nursing. However, a

multistate licensing privilege to practice registered nursing

granted by a party state shall be recognized by another party

state as a license to practice registered nursing if the state's

law requires the license as a precondition for qualifying for

advanced practice registered nurse authorization.

(e) Individuals not residing in a party state may apply for a

nurse license under the laws of a party state. However, the

license granted to these individuals will not be recognized as

granting the privilege to practice nursing in any other party

state unless explicitly agreed to by that party state.

ARTICLE 4. APPLICATION FOR LICENSE IN A PARTY STATE

(a) Once an application for a license is submitted, the

licensing board in a party state shall ascertain, through the

coordinated licensure information system, whether:

(1) the applicant has held or is the holder of a license issued

by another state;

(2) a restriction exists on the multistate licensing privilege;

and

(3) any other adverse action by any state has been taken against

the license.

(b) A nurse in a party state shall hold a license that is issued

by the home state in only one party state at a time.

residence may apply for a license in the new home state in

advance of the change. However, a new license will not be issued

by a party state until a nurse provides satisfactory evidence to

the new home state's licensing board of a change in the nurse's

primary state of residence.

(d) When a nurse changes the nurse's primary state of residence

by moving from:

(1) a party state to another party state and obtains a license

from the new home state, the license from the former home state

is no longer valid;

(2) a non-party state to a party state and obtains a license

from the new home state, the individual state license issued by

the non-party state is not affected and remains in full force if

provided by the laws of the non-party state; and

(3) a party state to a non-party state, the license issued by

the prior home state converts to a state license valid only in

the former home state and does not entitle the nurse to the

multistate licensing privilege to practice in other party states.

ARTICLE 5. ADVERSE ACTIONS

(a) The licensing board of a remote state shall promptly report

to the administrator of the coordinated licensure information

system a remote state action and the factual and legal basis for

the action, if known. The licensing board of a remote state shall

promptly report any significant current investigative information

yet to result in a remote state action. The administrator of the

coordinated licensure information system shall promptly notify

the home state of these reports.

(b) The licensing board of a party state shall have the

authority to complete a pending investigation of a nurse who

changes the nurse's primary state of residence during the course

of the investigation and to take appropriate action. The

licensing board shall promptly report the conclusions of the

investigations to the administrator of the coordinated licensure

information system. The administrator of the coordinated

licensure information system shall promptly notify the new home

state of any action.

multistate licensing privilege to practice in that party state.

However, only the home state has the power to impose adverse

action against the license issued by the home state.

(d) For purposes of imposing adverse action, the licensing board

of the home state shall give the same priority and effect to

reported conduct received from a remote state as it would to

conduct occurring in the home state. In so doing, the licensing

board shall apply its state laws to determine appropriate action.

(e) The home state may take adverse action based on the factual

findings of the remote state only if each state follows its own

procedures for imposing the adverse action.

(f) This compact does not affect a party state's decision that

participation in an alternative program may be used instead of

licensing action and that the participation shall remain

non-public if required by the party state's laws. Party states

must require a nurse who enters an alternative program to agree

not to practice in any other party state during the term of the

alternative program without prior authorization from the other

party state.

ARTICLE 6. ADDITIONAL AUTHORITIES OF PARTY STATE NURSE LICENSING

BOARDS

(a) Notwithstanding any other powers, party state nurse

licensing boards have the authority to:

(1) if otherwise permitted by state law, recover from the

affected nurse the costs of investigations and disposition of

cases resulting from any adverse action taken against the nurse;

(2) issue subpoenas for hearings and investigations that require

the attendance and testimony of witnesses and the production of

evidence;

(3) issue a cease and desist order to limit or revoke a nurse's

authority to practice in the state; and

(4) adopt uniform rules as provided under Article 8(c) of this

compact.

(b) A subpoena issued by a nurse licensing board in a party

state for the attendance and testimony of witnesses or the

production of evidence from another party state shall be enforced

in the non-issuing party state by a court of competent

jurisdiction in accordance with the practice and procedure

applicable to subpoenas issued in proceedings pending before the

court. The issuing authority shall pay any witness fees, travel

expenses, mileage, and other fees required by the service

statutes of the state in which a witness or evidence is located.

ARTICLE 7. COORDINATED LICENSURE INFORMATION SYSTEM

(a) All party states shall participate in a cooperative effort

to create a coordinated database of all licensed registered

nurses, licensed practical nurses, and licensed vocational

nurses. This system will include information on the licensing and

disciplinary history of each nurse, as contributed by party

states, to assist in the coordination of nurse licensing and

enforcement efforts.

(b) Notwithstanding any other provision of law, all party

states' licensing boards shall promptly report to the coordinated

licensure information system adverse actions, actions against

multistate licensing privileges, any current significant

investigative information yet to result in adverse action, and

denials of applications and the reasons for the denials.

transmitted only to party state licensing boards through the

coordinated licensure information system.

(d) Notwithstanding any other provision of law, all party

states' licensing boards that contribute information to the

coordinated licensure information system may designate

information that may not be shared with non-party states or

disclosed to other entities or individuals without the express

permission of the contributing state.

(e) Any personally identifiable information obtained by a party

state's licensing board from the coordinated licensure

information system may not be shared with non-party states or

disclosed to other entities or individuals except to the extent

permitted by the laws of the party state contributing the

information.

(f) Information contributed to the coordinated licensure

information system that is subsequently required to be expunged

by the laws of the party state contributing that information

shall be expunged from the coordinated licensure information

system.

(g) Each compact administrator shall act jointly and in

consultation with the administrator of the coordinated licensure

information system to formulate necessary and proper procedures

for the identification, collection, and exchange of information

under this compact.

ARTICLE 8. COMPACT ADMINISTRATION AND EXCHANGE OF INFORMATION

(a) The presiding officer of the nurse licensing board of a

party state or the presiding officer's designee shall be the

administrator of this compact for the state.

(b) The compact administrator of each party state shall furnish

to the compact administrator of each other party state

information and documents including a uniform data set of

investigations, identifying information, licensing data, and

disclosable alternative program participation information to

facilitate the administration of this compact.

rules to facilitate and coordinate implementation of this

compact. The uniform rules shall be adopted by party states under

Article 6(a)(4) of this compact.

ARTICLE 9. IMMUNITY

A party state or an officer, employee, or agent of a party

state's nurse licensing board who acts in accordance with the

provisions of this compact is not liable for any good faith act

or omission that occurs while the person is performing the

person's duties under this compact. Good faith in this article

does not include wilful misconduct, gross negligence, or

recklessness.

ARTICLE 10. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT

(a) This compact enters into force and takes effect for a state

when the state enacts this compact as law. A party state may

withdraw from the compact by enacting a statute repealing the

compact, but a withdrawal takes effect six months after the date

the withdrawing state gives notice of the withdrawal to the

executive heads of all other party states.

(b) No withdrawal shall affect the validity or applicability by

the licensing boards of states remaining party to the compact of

any report of adverse action occurring prior to the withdrawal.

licensing agreement or other cooperative arrangement between a

party state and a non-party state that is made in accordance with

the other provisions of this compact.

(d) This compact may be amended by the party states. An

amendment to this compact is not effective or binding on the

party states unless and until all party states enact the

amendment into the law of each state.

ARTICLE 11. CONSTRUCTION AND SEVERABILITY

(a) This compact shall be liberally construed to effectuate the

compact's purposes.

(b) This compact is severable. If a phrase, clause, sentence, or

provision of this compact is declared to be contrary to the

constitution of a party state or the United States or the

applicability of this compact to a government, agency, person, or

circumstance is held invalid, the validity and applicability of

the remainder of the compact to a government, agency, person, or

circumstance is not affected. If this compact is held to be

contrary to the constitution of a party state, the compact

remains in full force and effect for the other party states and

in full force and effect for the party state affected for all

severable matters.

compact the party states may submit the issues in dispute to an

arbitration panel comprised of:

(A) an individual appointed by the compact administrator in the

home state;

(B) an individual appointed by the compact administrator in each

remote state involved; and

administrators of each party state involved in the dispute.

(d) The decision of a majority of the arbitrators shall be final

and binding.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001.

Sec. 304.002. ADMINISTRATION OF COMPACT. The executive director

of the Texas Board of Nursing is the Nurse Licensure Compact

administrator for this state.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.022, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 39, eff. September 1, 2007.

Sec. 304.003. RULES. The Texas Board of Nursing may adopt rules

necessary to implement this chapter.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.023, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 39, eff. September 1, 2007.

Sec. 304.004. GENERAL PROVISIONS. (a) The terms "nurse,"

"registered nurse," and "vocational nurse" include nurses

licensed as registered nurses or vocational nurses by a state

that is a party to the Nurse Licensure Compact.

(b) Unless the context indicates otherwise or doing so would be

inconsistent with the Nurse Licensure Compact, nurses practicing

in this state under a license issued by a state that is a party

to the Nurse Licensure Compact have the same rights and

obligations as imposed by the laws of this state on license

holders of the Texas Board of Nursing.

whether a right or obligation imposed on license holders applies

to nurses practicing in this state under a license issued by a

state that is a party to the Nurse Licensure Compact unless that

determination is inconsistent with the Nurse Licensure Compact.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.024, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 40, eff. September 1, 2007.

Sec. 304.005. ENFORCEMENT. The Texas Board of Nursing is the

state agency responsible for taking action against registered and

vocational nurses practicing in this state under a license issued

by a state that is a party to the Nurse Licensure Compact as

authorized by the Nurse Licensure Compact. The action shall be

taken in accordance with the same procedures for taking action

against registered and vocational nurses licensed by this state.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.025, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 41, eff. September 1, 2007.

Sec. 304.006. INFORMATION MAINTAINED UNDER COMPACT. (a) On

request and payment of a reasonable fee, the Texas Board of

Nursing shall provide a registered or vocational nurse licensed

by this state with a copy of information regarding the nurse

maintained by the coordinated licensure information system under

Article 7 of the Nurse Licensure Compact.

(b) A board is not obligated to provide information not

available to the board or information that is not available to

the nurse under the laws of the state contributing the

information to the coordinated licensure information system.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.026, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 42, eff. September 1, 2007.

Sec. 304.007. ACCESS TO PRACTICE-RELATED INFORMATION.

Practice-related information provided by the Texas Board of

Nursing to registered or vocational nurses licensed by this state

shall be made available by the board on request and at a

reasonable cost to nurses practicing in this state under a

license issued by a state that is a party to the Nurse Licensure

Compact.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.027, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 43, eff. September 1, 2007.

Sec. 304.008. DISCLOSURE OF PERSONAL INFORMATION. (a) In

reporting information to the coordinated licensure information

system under Article 7 of the Nurse Licensure Compact, the Texas

Board of Nursing may disclose personally identifiable information

about the nurse, including social security number.

(b) The coordinated licensure information system may not share

personally identifiable information with a state not a party to

the compact unless the state agrees not to disclose that

information to other persons.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.028, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 44, eff. September 1, 2007.

Sec. 304.009. WITHDRAWAL FROM COMPACT. (a) The governor may

withdraw this state from the Nurse Licensure Compact if the Texas

Board of Nursing notifies the governor that a state that is party

to the compact changed, after January 1, 1999, the state's

requirements for licensing a nurse and that the state's

requirements, as changed, are substantially lower than the

requirements for licensing a nurse in this state.

(b) The governor may completely withdraw this state from the

Nurse Licensure Compact or may limit withdrawal to the

application of the compact to registered nurses or vocational

nurses.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.130(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec.

2.029, eff. Feb. 1, 2004.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

889, Sec. 45, eff. September 1, 2007.

State Codes and Statutes

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