CHAPTER 305. NCSBN ADVANCED PRACTICE REGISTERED NURSE COMPACT

State Codes and Statutes

Statutes > Texas > Occupations-code > Title-3-health-professions > Chapter-305-ncsbn-advanced-practice-registered-nurse-compact

OCCUPATIONS CODE

TITLE 3. HEALTH PROFESSIONS

SUBTITLE E. REGULATION OF NURSING

CHAPTER 305. NCSBN ADVANCED PRACTICE REGISTERED NURSE COMPACT

For contingent expiration of this chapter, see Section 305.003.

Sec. 305.001. NCSBN ADVANCED PRACTICE REGISTERED NURSE COMPACT.

The NCSBN Advanced Practice Registered Nurse Compact is enacted

and entered into with all other jurisdictions that legally join

in the compact, which is as follows:

NCSBN ADVANCED PRACTICE REGISTERED NURSE 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 APRN licensure/authority to practice

requirements and the effectiveness of enforcement activities

related to state APRN licensure/authority to practice laws;

(2) violations of APRN licensure/authority to practice and other

laws regulating the practice of nursing may result in injury or

harm to the public;

(3) the expanded mobility of APRNs 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 APRN licensure/authority to practice

and regulation;

(4) new practice modalities and technology make compliance with

individual state APRN licensure/authority to practice laws

difficult and complex;

(5) the current system of duplicative APRN licensure/authority

to practice for APRNs practicing in multiple states is cumbersome

and redundant to both APRNs and states;

(6) uniformity of APRN requirements throughout the states

promotes public safety and public health benefits; and

(7) access to APRN services increases the public's access to

health care, particularly in rural and underserved areas.

(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 APRN licensure/authority to practice and regulation,

including promotion of uniform licensure requirements;

(3) facilitate the exchange of information between party states

in the areas of APRN regulation, investigation, and adverse

actions;

(4) promote compliance with the laws governing APRN practice in

each jurisdiction; and

(5) invest all party states with the authority to hold an APRN

accountable for meeting all state practice laws in the state in

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

the mutual recognition of party state licenses.

ARTICLE 2. DEFINITIONS

(a) "Advanced practice registered nurse" or "APRN" means a nurse

anesthetist, nurse practitioner, nurse midwife, or clinical nurse

specialist to the extent a party state licenses or grants

authority to practice in that APRN role and title.

(b) "Adverse action" means a home or remote state disciplinary

action.

monitoring program approved by a licensing board.

(d) "APRN licensure/authority to practice" means the regulatory

mechanism used by a party state to grant legal authority to

practice as an APRN.

(e) "APRN uniform licensure/authority to practice requirements"

means those minimum uniform licensure, education, and examination

requirements as agreed to by the compact administrators and

adopted by licensing boards for the recognized APRN role and

title.

(f) "Coordinated licensure information system" means an

integrated process for collecting, storing, and sharing

information on APRN licensure/authority to practice and

enforcement activities related to APRN licensure/authority to

practice laws, which is administered by a nonprofit organization

composed of and controlled by state licensing boards.

(g) "Current significant investigative information" means:

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

preliminary inquiry that includes notification and an opportunity

for the APRN 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 the APRN

represents an immediate threat to public health and safety

regardless of whether the APRN has been notified and had an

opportunity to respond.

(h) "Home state" means the party state that is the APRN's

primary state of residence.

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

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

which are imposed on an APRN by the home state's licensing board

or other authority, including actions against an individual's

license/authority to practice such as: revocation, suspension,

probation, or any other action which affects an APRN's

authorization to practice.

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

responsible for issuing APRN licensure/authority to practice.

(k) "Multistate advanced practice privilege" means current

authority from a remote state permitting an APRN to practice in

that state in the same role and title as the APRN is

licensed/authorized to practice in the home state to the extent

that the remote state laws recognize such APRN role and title. A

remote state has the authority, in accordance with existing state

due process laws, to take actions against the APRN's privilege,

including revocation, suspension, probation, or any other action

that affects an APRN's multistate privilege to practice.

(l) "Party state" means any state that has adopted this compact.

(m) "Prescriptive authority" means the legal authority to

prescribe medications and devices as defined by party state laws.

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

state:

(1) where the patient is located at the time APRN care is

provided; or

(2) in the case of APRN practice not involving a patient, in

such party state where the recipient of APRN practice is located.

(o) "Remote state action" means:

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

permitted by a remote state's laws which are imposed on an APRN

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

including actions against an individual's multistate advanced

practice privilege in the remote state; and

(2) cease and desist and other injunctive or equitable orders

issued by remote states or the licensing boards thereof.

(p) "State" means a state, territory, or possession of the

United States.

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

regulations that govern APRN practice, define the scope of

advanced nursing practice, including prescriptive authority, and

create the methods and grounds for imposing discipline. State

practice laws do not include the requirements necessary to obtain

and retain APRN licensure/authority to practice as an APRN,

except for qualifications or requirements of the home state.

(r) "Unencumbered" means that a state has no current

disciplinary action against an APRN's license/authority to

practice.

ARTICLE 3. GENERAL PROVISIONS AND JURISDICTION

(a) All party states shall participate in the nurse licensure

compact for registered nurses and licensed practical/vocational

nurses in order to enter into the APRN compact.

(b) No state shall enter the APRN compact until the state

adopts, at a minimum, the APRN uniform licensure/authority to

practice requirements for each APRN role and title recognized by

the state seeking to enter the APRN compact.

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

state as authorizing a multistate advanced practice privilege to

the extent that the role and title are recognized by each party

state. To obtain or retain APRN licensure/authority to practice

as an APRN, an applicant must meet the home state's

qualifications for authority or renewal of authority as well as

all other applicable state laws.

(d) The APRN multistate advanced practice privilege does not

include prescriptive authority, and does not affect any

requirements imposed by states to grant to an APRN initial and

continuing prescriptive authority according to state practice

laws. However, a party state may grant prescriptive authority to

an individual on the basis of a multistate advanced practice

privilege to the extent permitted by state practice laws.

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

laws, limit or revoke the multistate advanced practice privilege

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

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.

(f) An APRN practicing in a party state must comply with the

state practice laws and licensing board rules of the state in

which the patient is located at the time care is provided. The

APRN practice includes patient care and all advanced nursing

practice defined by the party state's practice laws. The APRN

practice will subject an APRN to the jurisdiction of the

licensing board, the courts, and the laws of the party state.

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

licensure/authority to practice as an APRN under the laws of a

party state. However, the authority to practice granted to these

individuals will not be recognized as granting the privilege to

practice as an APRN in any other party state unless explicitly

agreed to by that party state.

ARTICLE 4. APPLICATIONS FOR APRN LICENSURE/AUTHORITY TO PRACTICE

IN A PARTY STATE

(a) Once an application for APRN licensure/authority to practice

is submitted, a party state shall ascertain, through the

coordinated licensure information system, whether:

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

license/authority to practice issued by another state;

(2) the applicant has had a history of previous disciplinary

action by any state;

(3) an encumbrance exists on any license/authority to practice;

and

(4) any other adverse action by any other state has been taken

against a license/authority to practice.

This information may be used in approving or denying an

application for APRN licensure/authority to practice.

(b) An APRN in a party state shall hold APRN licensure/authority

to practice in only one party state at a time, issued by the home

state.

residence may apply for APRN licensure/authority to practice in

the new home state in advance of such change. However, new

licensure/authority to practice will not be issued by a party

state until after an APRN provides evidence of change in primary

state of residence satisfactory to the new home state's licensing

board.

(d) When an APRN changes primary state of residence by:

(1) moving between two party states, and obtains APRN

licensure/authority to practice from the new home state, the APRN

licensure/authority to practice from the former home state is no

longer valid;

(2) moving from a nonparty state to a party state, and obtains

APRN licensure/authority to practice from the new home state, the

individual state license issued by the nonparty state is not

affected and will remain in full force if so provided by the laws

of the nonparty state; and

(3) moving from a party state to a nonparty state, the APRN

licensure/authority to practice issued by the prior home state

converts to an individual state license, valid only in the former

home state, without the multistate licensure 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 any remote state actions, including the factual and legal

basis for such action, if known. The licensing board of a remote

state shall also 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 any such reports.

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

authority to complete any pending investigations for an APRN who

changes primary state of residence during the course of such

investigations. It shall also have the authority to take

appropriate action, and shall promptly report the conclusions of

such 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 such actions.

multistate advanced practice privilege to practice within that

party state. However, only the home state shall have the power

to impose adverse action against the APRN licensure/authority to

practice 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 if such

conduct had occurred within the home state. In so doing, it

shall apply its own state laws to determine appropriate action.

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

findings of the remote state, so long as each state follows its

own procedures for imposing such adverse action.

(f) Nothing in this compact shall override a party state's

decision that participation in an alternative program may be used

in lieu of adverse action and that such participation shall

remain nonpublic if required by the party state's laws. Party

states must require APRNs who enter any alternative programs to

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

the alternative program without prior authorization from such

other party state.

(g) All home state licensing board disciplinary orders, agreed

or otherwise, which limit the scope of the APRN's practice or

require monitoring of the APRN as a condition of the order shall

include the requirements that the APRN will limit her or his

practice to the home state during the pendency of the order.

This requirement may allow the APRN to practice in other party

states with prior written authorization from both the home state

and party state licensing boards.

ARTICLE 6. ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE

LICENSING BOARDS

(a) Notwithstanding any other powers, party state licensing

boards shall have the authority to:

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

affected APRN the costs of investigations and disposition of

cases resulting from any adverse action taken against that APRN;

(2) issue subpoenas for both hearings and investigations, which

require the attendance and testimony of witnesses, and the

production of evidence;

(3) issue cease and desist orders to limit or revoke an APRN's

privilege or licensure/authority to practice in their state; and

(4) promulgate uniform rules and regulations as provided for in

Article 8(c).

(b) Subpoenas issued by a licensing board in a party state for

the attendance and testimony of witnesses, and/or the production

of evidence from another party state, shall be enforced in the

latter state by any court of competent jurisdiction, according to

the practice and procedure of that court applicable to subpoenas

issued in proceedings pending before it. The issuing authority

shall pay any witness fees, travel expenses, mileage, and other

fees required by the service statutes of the state where the

witnesses and/or evidence are located.

ARTICLE 7. COORDINATED LICENSURE INFORMATION SYSTEM

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

to create a coordinated database of all APRNs. This system will

include information on the APRN licensure/authority to practice

and disciplinary history of each APRN, as contributed by party

states, to assist in the coordination of APRN licensure/authority

to practice and enforcement efforts.

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

states' licensing boards shall promptly report adverse actions,

actions against multistate advanced practice privileges, any

current significant investigative information yet to result in

adverse action, denials of applications, and the reasons for such

denials to the coordinated licensure information system.

transmitted through the coordinated licensure information system

only to party state licensing boards.

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

states' licensing boards contributing information to the

coordinated licensure information system may designate

information that may not be shared with nonparty 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

states' licensing board from the coordinated licensure

information system may not be shared with nonparty states or

disclosed to other entities or individuals except to the extent

permitted by the laws of the party state contributing the

information.

(f) Any 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 also be expunged from the coordinated licensure information

system.

(g) The compact administrators, acting jointly with each other

and in consultation with the administrator of the coordinated

licensure information system, shall formulate necessary and

proper procedures for the identification, collection, and

exchange of information under this compact.

ARTICLE 8. COMPACT ADMINISTRATION AND INTERCHANGE OF INFORMATION

(a) The head of the licensing board, or his/her designee, of

each party state shall be the administrator of this compact for

his/her state.

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

to the compact administrator of each other party state any

information and documents including, but not limited to, a

uniform data set of investigations, identifying information,

licensure data, and disclosable alternative program participation

information to facilitate the administration of this compact.

uniform rules to facilitate and coordinate implementation of this

compact. These uniform rules shall be adopted by party states,

under the authority invested under Article 6(a)(4).

ARTICLE 9. IMMUNITY

No party state or the officers or employees or agents of a party

state's licensing board who act in accordance with the provisions

of this compact shall be liable on account of any act or omission

in good faith while engaged in the performance of their duties

under this compact. Good faith in this article shall not include

willful misconduct, gross negligence, or recklessness.

ARTICLE 10. ENTRY INTO FORCE, WITHDRAWAL, AND AMENDMENT

(a) This compact shall enter into force and become effective as

to any state when it has been enacted into the laws of that

state. Any party state may withdraw from this compact by

enacting a statute repealing the same, but no such withdrawal

shall take effect until six months after the withdrawing state

has given 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.

invalidate or prevent any APRN licensure/authority to practice

agreement or other cooperative arrangement between a party state

and a nonparty state that is made in accordance with the other

provisions of this compact.

(d) This compact may be amended by the party states. No

amendment to this compact shall become effective and binding upon

the party states unless and until it is enacted into the laws of

all party states.

ARTICLE 11. CONSTRUCTION AND SEVERABILITY

(a) This compact shall be liberally construed so as to

effectuate the purposes thereof. The provisions of this compact

shall be severable and if any phrase, clause, sentence, or

provision of this compact is declared to be contrary to the

constitution of any party state or of the United States or the

applicability thereof to any government, agency, person, or

circumstance is held invalid, the validity of the remainder of

this compact and the applicability thereof to any government,

agency, person, or circumstance shall not be affected thereby.

If this compact shall be held contrary to the constitution of any

state party thereto, the compact shall remain in full force and

effect as to the remaining party states and in full force and

effect as to the party state affected as to all severable

matters.

(b) In the event party states find a need for settling disputes

arising under this compact:

(1) the party states may submit the issues in dispute to an

arbitration panel which will be composed of an individual

appointed by the compact administrator in the home state, an

individual appointed by the compact administrator in the remote

state involved, and an individual mutually agreed upon by the

compact administrators of all the party states involved in the

dispute; and

(2) the decision of a majority of the arbitrators shall be final

and binding.

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

889, Sec. 30, eff. September 1, 2007.

Sec. 305.002. BOARD AUTHORITY. Notwithstanding any provision of

this chapter, the Texas Board of Nursing may establish criteria

for recognizing advanced practice registered nurses under the

NCSBN APRN Compact.

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

889, Sec. 30, eff. September 1, 2007.

Sec. 305.003. RULES; EXPIRATION OF CHAPTER. (a) The Texas

Board of Nursing may adopt rules necessary to implement this

chapter.

(b) If the board does not adopt rules to implement the compact

under this chapter before December 31, 2011, the board may not

implement the NCSBN APRN Compact and this chapter expires

December 31, 2011.

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

889, Sec. 30, eff. September 1, 2007.

Sec. 305.004. APPLICABILITY OF CHAPTER. If a provision of this

chapter or another state's law under the NCSBN APRN Compact

conflicts with the laws of this state, the laws of this state

prevail.

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

889, Sec. 30, eff. September 1, 2007.

Sec. 305.005. RIGHTS AND OBLIGATIONS. (a) Unless the context

indicates otherwise, or doing so would be inconsistent with the

NCSBN APRN Compact, nurses practicing in this state under a

license issued by a state that is a party to the NCSBN APRN

Compact have the same rights and obligations as imposed by the

laws of this state on license holders of the Texas Board of

Nursing.

(b) The Texas Board of Nursing has the authority to determine

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 NCSBN APRN Compact unless that

determination is inconsistent with the NCSBN APRN Compact.

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

889, Sec. 30, eff. September 1, 2007.

Sec. 305.006. ENFORCEMENT. The Texas Board of Nursing is the

state agency responsible for taking action against nurses

practicing in this state under a license issued by a state that

is a party to the NCSBN APRN Compact as authorized by the NCSBN

APRN Compact. The action shall be taken in accordance with the

same procedures for taking action against nurses licensed by this

state.

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

889, Sec. 30, eff. September 1, 2007.

State Codes and Statutes

State Codes and Statutes

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State Codes and Statutes

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