State Codes and Statutes
Statutes > Utah > Title-58 > Chapter-31d > 58-31d-10258-31d-102. Advanced Practice Registered Nurse Compact.
The Advanced Practice Registered Nurse Compact is hereby enacted and entered intowith all other jurisdictions that legally join in the compact, which is, in form, substantially asfollows:
(1) The party states find that:
(a) the health and safety of the public are affected by the degree of compliance withAPRN licensure/authority to practice requirements and the effectiveness of enforcementactivities related to state APRN licensure/authority to practice laws;
(b) violations of APRN licensure/authority to practice and other laws regulating thepractice of nursing may result in injury or harm to the public;
(c) the expanded mobility of APRNs and the use of advanced communicationtechnologies as part of our nation's health care delivery system require greater coordination andcooperation among states in the areas of APRN licensure/authority to practice and regulation;
(d) new practice modalities and technology make compliance with individual stateAPRN licensure/authority to practice laws difficult and complex;
(e) the current system of duplicative APRN licensure/authority to practice for APRNspracticing in multiple states is cumbersome and redundant to both APRNs and states;
(f) uniformity of APRN requirements throughout the states promotes public safety andpublic health benefits; and
(g) access to APRN services increases the public's access to health care, particularly inrural and underserved areas.
(2) The general purposes of this compact are to:
(a) facilitate the states' responsibilities to protect the public's health and safety;
(b) ensure and encourage the cooperation of party states in the areas of APRNlicensure/authority to practice and regulation, including promotion of uniform licensurerequirements;
(c) facilitate the exchange of information between party states in the areas of APRNregulation, investigation, and adverse actions;
(d) promote compliance with the laws governing APRN practice in each jurisdiction; and
(e) invest all party states with the authority to hold an APRN accountable for meeting allstate practice laws in the state in which the patient is located at the time care is rendered throughthe mutual recognition of party state licenses.
As used in this compact:
(1) "Advanced practice registered nurse" or "APRN" means a nurse anesthetist, nursepractitioner, nurse midwife, or clinical nurse specialist to the extent a party state licenses orgrants authority to practice in that APRN role and title.
(2) "Adverse action" means a home or remote state disciplinary action.
(3) "Alternative program" means a voluntary, nondisciplinary monitoring programapproved by a licensing board.
(4) "APRN Licensure/Authority to Practice" means the regulatory mechanism used by a
party state to grant legal authority to practice as an APRN.
(5) "APRN Uniform Licensure/Authority to Practice Requirements" means thoseminimum uniform licensure, education, and examination requirements as agreed to by thecompact administrators and adopted by licensing boards for the recognized APRN role and title.
(6) "Coordinated licensure information system" means an integrated process forcollecting, storing, and sharing information on APRN licensure/authority to practice andenforcement activities related to APRN licensure/authority to practice laws, which isadministered by a nonprofit organization composed of and controlled by state licensing boards.
(7) "Current significant investigative information" means:
(a) investigative information that a licensing board, after a preliminary inquiry thatincludes notification and an opportunity for the APRN to respond if required by state law, hasreason to believe is not groundless and, if proved true, would indicate more than a minorinfraction; or
(b) investigative information that indicates that the APRN represents an immediate threatto public health and safety regardless of whether the APRN has been notified and had anopportunity to respond.
(8) "Home state" means the party state that is the APRN's primary state of residence.
(9) "Home state action" means any administrative, civil, equitable, or criminal actionpermitted by the home state's laws which are imposed on an APRN by the home state's licensingboard or other authority including actions against an individual's license/authority to practicesuch as: revocation, suspension, probation, or any other action which affects an APRN'sauthorization to practice.
(10) "Licensing board" means a party state's regulatory body responsible for issuingAPRN licensure/authority to practice.
(11) (a) "Multistate advanced practice privilege" means current authority from a remotestate permitting an APRN to practice in that state in the same role and title as the APRN islicensed/authorized to practice in the home state to the extent that the remote state laws recognizesuch APRN role and title.
(b) 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 anyother action that affects an APRN's multistate privilege to practice.
(12) "Party state" means any state that has adopted this compact.
(13) "Prescriptive authority" means the legal authority to prescribe medications anddevices as defined by party state laws.
(14) "Remote state" means a party state, other than the home state:
(a) where the patient is located at the time APRN care is provided; or
(b) in the case of APRN practice not involving a patient, in the party state where therecipient of APRN practice is located.
(15) "Remote state action" means:
(a) any administrative, civil, equitable, or criminal action permitted by a remote state'slaws 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 remotestate; and
(b) cease and desist and other injunctive or equitable orders issued by remote states orthe licensing boards of those states.
(16) "State" means a state, territory, or possession of the United States.
(17) (a) "State practice laws" means a party state's laws and regulations that governAPRN practice, define the scope of advanced nursing practice including prescriptive authority,and create the methods and grounds for imposing discipline.
(b) State practice laws do not include the requirements necessary to obtain and retainAPRN licensure/authority to practice as an APRN, except for qualifications or requirements ofthe home state.
(18) "Unencumbered" means that a state has no current disciplinary action against anAPRN's license/authority to practice.
(1) All party states shall participate in the Nurse Licensure Compact for registered nursesand licensed practical/vocational nurses in order to enter into the APRN Compact.
(2) No state shall enter the APRN Compact until the state adopts, at a minimum, theAPRN Uniform Licensure/Authority to Practice Requirements for each APRN role and titlerecognized by the state seeking to enter the APRN Compact.
(3) (a) APRN Licensure/Authority to practice issued by a home state to a resident in thatstate will be recognized by each party state as authorizing a multistate advanced practiceprivilege to the extent that the role and title are recognized by each party state.
(b) To obtain or retain APRN licensure/authority to practice as an APRN, an applicantmust meet the home state's qualifications for authority or renewal of authority as well as all otherapplicable state laws.
(4) (a) The APRN multistate advanced practice privilege does not include prescriptiveauthority, and does not affect any requirements imposed by states to grant to an APRN initial andcontinuing prescriptive authority according to state practice laws.
(b) A party state may grant prescriptive authority to an individual on the basis of amultistate advanced practice privilege to the extent permitted by state practice laws.
(5) (a) A party state may, in accordance with state due process laws, limit or revoke themultistate advanced practice privilege in the party state and may take any other necessary actionsunder the party state's applicable laws to protect the health and safety of the party state's citizens.
(b) If a party state takes action, the party state shall promptly notify the administrator ofthe coordinated licensure information system.
(c) The administrator of the coordinated licensure information system shall promptlynotify the home state of any such actions by remote states.
(6) (a) An APRN practicing in a party state must comply with the state practice laws ofthe state in which the patient is located at the time care is provided.
(b) The APRN practice includes patient care and all advanced nursing practice definedby the party state's practice laws.
(c) The APRN practice will subject an APRN to the jurisdiction of the licensing board,the courts, and the laws of the party state.
(7) (a) Individuals not residing in a party state may apply for APRN licensure/authority topractice as an APRN under the laws of a party state.
(b) The authority to practice granted to these individuals will not be recognized asgranting the privilege to practice as an APRN in any other party state unless explicitly agreed toby that party state.
(1) (a) Once an application for APRN licensure/authority to practice is submitted, a partystate shall ascertain, through the Coordinated Licensure Information System, whether:
(i) the applicant has held or is the holder of a nursing license/authority to practice issuedby another state;
(ii) the applicant has had a history of previous disciplinary action by any state;
(iii) an encumbrance exists on any license/authority to practice; and
(iv) any other adverse action by any other state has been taken against a license/authorityto practice.
(b) This information may be used in approving or denying an application for APRNlicensure/authority to practice.
(2) An APRN in a party state shall hold APRN licensure/authority to practice in only oneparty state at a time, issued by the home state.
(3) (a) An APRN who intends to change primary state of residence may apply for APRNlicensure/authority to practice in the new home state in advance of the change.
(b) New licensure/authority to practice will not be issued by a party state until after anAPRN provides evidence of change in primary state of residence satisfactory to the new homestate's licensing board.
(4) When an APRN changes primary state of residence by:
(a) moving between two party states, and obtains APRN licensure/authority to practicefrom the new home state, the APRN licensure/authority to practice from the former home state isno longer valid;
(b) moving from a nonparty state to a party state, and obtains APRN licensure/authorityto practice from the new home state, the individual state license issued by the nonparty state isnot affected and will remain in full force if so provided by the laws of the nonparty state;
(c) moving from a party state to a nonparty state, the APRN licensure/authority topractice issued by the prior home state converts to an individual state license, valid only in theformer home state, without the multistate licensure privilege to practice in other party states.
In addition to the general provisions described in Article III, the following provisionsapply:
(1) (a) The licensing board of a remote state shall promptly report to the administrator ofthe coordinated licensure information system any remote state actions including the factual andlegal basis for the action, if known.
(b) The licensing board of a remote state shall also promptly report any significant,current investigative information yet to result in a remote state action.
(c) The administrator of the coordinated licensure information system shall promptlynotify the home state of any such reports.
(2) (a) The licensing board of a party state shall have the authority to complete anypending investigations for an APRN who changes primary state of residence during the course ofthose investigations.
(b) It shall also have the authority to take appropriate action, and shall promptly reportthe conclusions of the investigations to the administrator of the coordinated licensure information
system.
(c) The administrator of the coordinated licensure information system shall promptlynotify the new home state of the actions.
(3) (a) A remote state may take adverse action affecting the multistate advanced practiceprivilege to practice within that party state.
(b) Only the home state shall have the power to impose adverse action against the APRNlicensure/authority to practice issued by the home state.
(4) (a) For purposes of imposing adverse action, the licensing board of the home stateshall give the same priority and effect to reported conduct received from a remote state as itwould if that conduct had occurred within the home state.
(b) In so doing, it shall apply its own state laws to determine appropriate action.
(5) The home state may take adverse action based on the factual findings of the remotestate, so long as each state follows its own procedures for imposing the adverse action.
(6) (a) Nothing in this compact shall override a party state's decision that participation inan alternative program may be used in lieu of adverse action and that the participation shallremain nonpublic if required by the party state's laws.
(b) Party states must require APRNs who enter any alternative programs to agree not topractice in any other party state during the term of the alternative program without priorauthorization from the other party state.
(7) (a) All home state licensing board disciplinary orders, agreed or otherwise, whichlimit the scope of the APRN's practice or require monitoring of the APRN as a condition of theorder, shall include the requirements that the APRN will limit the APRN's practice to the homestate during the pendency of the order.
(b) This requirement may allow the APRN to practice in other party states with priorwritten authorization from both the home state and party state licensing boards.
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 ofinvestigations and disposition of cases resulting from any adverse action taken against thatAPRN;
(2) (a) issue subpoenas for both hearings and investigations, which require the attendanceand testimony of witnesses, and the production of evidence;
(b) subpoenas issued by a licensing board in a party state for the attendance andtestimony of witnesses, and/or the production of evidence from another party state shall beenforced in the latter state by any court of competent jurisdiction, according to the practice andprocedure of that court applicable to subpoenas issued in proceedings pending before it;
(c) the issuing authority shall pay any witness fees, travel expenses, mileage, and otherfees required by the service statutes of the state where the witnesses or evidence or both arelocated;
(3) issue cease and desist orders to limit or revoke an APRN's privilege orlicensure/authority to practice in their state; and
(4) promulgate uniform rules and regulations as provided for in Article VIII (3).
(1) (a) All party states shall participate in a cooperative effort to create a coordinateddatabase of all APRNs.
(b) This system will include information on the APRN licensure/authority to practice anddisciplinary history of each APRN, as contributed by party states, to assist in the coordination ofAPRN licensure/authority to practice and enforcement efforts.
(2) Notwithstanding any other provision of law, all party states' licensing boards shallpromptly report adverse actions, actions against multistate advanced practice privileges, anycurrent significant investigative information yet to result in adverse action, denials ofapplications, and the reasons for those denials to the coordinated licensure information system.
(3) Current significant investigative information shall be transmitted through thecoordinated licensure information system only to party state licensing boards.
(4) Notwithstanding any other provision of law, all party states' licensing boardscontributing information to the coordinated licensure information system may designateinformation that may not be shared with nonparty states or disclosed to other entities orindividuals without the express permission of the contributing state.
(5) Any personally identifiable information obtained by a party state's licensing boardfrom the coordinated licensure information system may not be shared with nonparty states ordisclosed to other entities or individuals except to the extent permitted by the laws of the partystate contributing the information.
(6) Any information contributed to the coordinated licensure information system that issubsequently required to be expunged by the laws of the party state contributing that informationshall also be expunged from the coordinated licensure information system.
(7) The compact administrators, acting jointly with each other and in consultation withthe administrator of the coordinated licensure information system, shall formulate necessary andproper procedures for the identification, collection, and exchange of information under thiscompact.
(1) The head of the licensing board, or his or her designee, of each party state shall be theadministrator of this compact for his or her state.
(2) The compact administrator of each party state shall furnish to the compactadministrator of each other party state any information and documents including, but not limitedto, a uniform data set of investigations, identifying information, licensure data, and disclosablealternative program participation information to facilitate the administration of this compact.
(3) (a) Compact administrators shall have the authority to develop uniform rules tofacilitate and coordinate implementation of this compact.
(b) These uniform rules shall be adopted by party states, under the authority investedunder Article VI (4).
(1) No party state or the officers or employees or agents of a party state's licensing boardwho acts in accordance with the provisions of this compact shall be liable on account of any actor omission in good faith while engaged in the performance of their duties under this compact.
(2) Good faith in this article shall not include willful misconduct, gross negligence, orrecklessness.
(1) (a) This compact shall enter into force and become effective as to any state when ithas been enacted into the laws of that state.
(b) Any party state may withdraw from this compact by enacting a statute repealing thecompact, but no withdrawal shall take effect until six months after the withdrawing state hasgiven notice of the withdrawal to the executive heads of all other party states.
(2) No withdrawal shall affect the validity or applicability by the licensing boards ofstates remaining party to the compact of any report of adverse action occurring prior to thewithdrawal.
(3) Nothing contained in this compact shall be construed to invalidate or prevent anyAPRN licensure/authority to practice agreement or other cooperative arrangement between aparty state and a nonparty state that is made in accordance with the other provisions of thiscompact.
(4) (a) This compact may be amended by the party states.
(b) No amendment to this compact shall become effective and binding upon the partystates unless and until it is enacted into the laws of all party states.
(1) (a) This compact shall be liberally construed so as to effectuate its purposes.
(b) 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 ofthe United States or its applicability to any government, agency, person, or circumstance is heldinvalid, the validity of the remainder of this compact and its applicability to any government,agency, person, or circumstance shall not be affected thereby.
(c) If this compact shall be held contrary to the constitution of any state party to thecompact, the compact shall remain in full force and effect as to the remaining party states and infull force and effect as to the party state affected as to all severable matters.
(2) (a) In the event party states find a need for settling disputes arising under thiscompact, the party states may submit the issues in dispute to an arbitration panel which will becomprised of an individual appointed by the compact administrator in the home state, anindividual appointed by the compact administrator in the remote state involved, and an individualmutually agreed upon by the compact administrators of all the party states involved in thedispute.
(b) The decision of a majority of the arbitrators shall be final and binding.
Enacted by Chapter 15, 2004 General Session
