South Carolina General Assembly
116th Session, 2005-2006

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Bill 3142

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COMMITTEE REPORT

April 20, 2005

H. 3142

Introduced by Reps. White, Davenport, Mahaffey and Owens

S. Printed 4/20/05--S.

Read the first time February 2, 2005.

            

THE COMMITTEE ON MEDICAL AFFAIRS

To whom was referred a Bill (H. 3142) to amend the Code of Laws of South Carolina, 1976, by adding Article 15 to Chapter 33, Title 40 so as to enact the Nurse Licensure Compact which enters, etc., respectfully

REPORT:

That they have duly and carefully considered the same and recommend that the same do pass with amendment:

Amend the bill, as and if amended, Section 40-33-1305 page 2, immediately after line 38 by inserting:

/    (c)    All costs associated with the financial support of the compact operation must be borne by the hiring agencies or agents.

Amend the bill, further, Section 40-33-1315(D)(3) page 5, line 14 immediately before the /./ by inserting:

/, the nurse's current address, and other contact information as requested. A nurse shall maintain at all times a current address and contact information during practice in this State./

Amend the bill, further, Section 40-33-1325(C) page 6, line 37 by deleting /effects/ and inserting /affects/.

Amend the bill, further, by adding an appropriately numbered SECTION to read:

/SECTION___.    The State Board of Nursing shall promulgate regulations to carry out the provisions of Article 15, Chapter 33, Title 40 of the 1976 Code, as added by Section 1 of this act, including regulations requiring employment data, education, and other workforce information consistent with that currently being obtained by the board. The board may provide a form to employers to collect data on the employment of nurses practicing nursing in the State on a compact state license. The board may provide this workplace information to the Office of Research and Statistics in the State Budget and Control Board./

Renumber sections to conform.

Amend title to conform.

HARVEY S. PEELER, JR. for Committee.

            

A BILL

TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING ARTICLE 15 TO CHAPTER 33, TITLE 40 SO AS TO ENACT THE NURSE LICENSURE COMPACT WHICH ENTERS SOUTH CAROLINA INTO A MULTI-STATE NURSE LICENSURE COMPACT TO PROVIDE FOR THE RECIPROCAL PRACTICE OF NURSING AMONG THE STATES THAT ARE PARTIES TO THE COMPACT; TO PROVIDE FOR THE STANDARDS AND PROCEDURES THAT APPLY TO PRACTICING NURSING IN OTHER STATES PURSUANT TO THE COMPACT; TO PROVIDE FOR A COORDINATED LICENSURE INFORMATION SYSTEM FOR SHARING DATA AMONG THE COMPACT STATES AND TO PROVIDE PROCEDURES FOR DISPUTE RESOLUTION AND DISCIPLINARY ACTION; AND TO FURTHER PROVIDE FOR THE REGULATION OF NURSES LICENSED IN STATES THAT ARE PARTIES TO THE COMPACT; AND TO ADD SECTION 40-33-525 SO AS TO REQUIRE, BEGINNING JANUARY 1, 2007, FOREIGN-EDUCATED APPLICANTS FOR LICENSURE AS A REGISTERED NURSE TO PASS THE NATIONAL COUNCIL LICENSURE EXAMINATION AND AN ENGLISH LANGUAGE PROFICIENCY TEST.

Whereas, the General Assembly finds 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 states' nurse licensure laws.

(2)    Violations of nurse licensure 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 licensure and regulation.

(4)    New practice modalities and technology make compliance with individual states' nurse licensure laws difficult and complex.

(5)    The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant to both nurses and states. Now, therefore,

Be it enacted by the General Assembly of the State of South Carolina:

SECTION    1.    This act may be cited as the "Nurse Licensure Compact".

SECTION    2.    Chapter 33, Title 40 of the 1976 Code is amended by adding:

"Article 15

Nurse Licensure Compact

Section 40-33-1305.    (A)    The Nurse Licensure Compact is created and entered into by this State with all other states legally joining in the form substantially as set forth in this article.

(B)    The purposes of this compact are to:

(1)    facilitate the states' responsibility to protect the public's health and safety;

(2)    ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation;

(3)    facilitate the exchange of information between party states in the areas of nurse regulation, investigation, and adverse actions;

(4)    promote compliance with the laws governing the practice of nursing in each jurisdiction;

(5)    through the mutual recognition of party state licenses, grant all party states the authority to hold nurses accountable for meeting all state practice laws in the states in which their patients are located at the time care is rendered.

Section 40-33-1310.    As used in this article:

(1)    'Adverse' action means a home or remote state action.

(2)    'Alternative program' means a voluntary, nondisciplinary monitoring program approved by a nurse licensing board.

(3)    'Coordinated licensure information system' means an integrated process for collecting, storing, and sharing information on nurse licensure and enforcement activities related to nurse licensure laws that is administered by a nonprofit organization composed of and controlled by state nurse licensing boards.

(4)    'Current significant investigative information' means:

(a)    investigative information that a licensing board, after a preliminary inquiry, which includes notification and an opportunity for the nurse to respond, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction; or

(b)    investigative information that indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and had an opportunity to respond.

(5)    'Home state' means the party state that is the nurse's primary state of residence.

(6)    'Home state action' means an administrative, civil, equitable, or criminal action permitted by the home state's laws that is imposed on a nurse by the home state's licensing board or another authority. This term includes the revocation or suspension of a nurse's license, placing a nurse on probation, or any other action that affects a nurse's authorization to practice.

(7)    'Licensee' means a person licensed by the South Carolina Board of Nursing or the nurse licensing board of a party state.

(8)    'Licensing board' means a party state's regulatory agency that is responsible for licensing nurses.

(9)    'Multi-State licensure privilege' means current official authority from a remote state permitting the practice of nursing as either a registered nurse or a licensed practical or vocational nurse in that state. All party states have the authority, in accordance with existing state law, to take actions against a nurse's privilege including, but not limited to, revocation, suspension, probation, or any other action which affects a nurse's authorization to practice.

(10)    'Nurse' means a registered nurse or licensed practical or vocational nurse as those terms are defined by each party state's practice laws.

(11)    'Party state' means any state that has adopted this compact.

(12)    'Remote state' means a party state, other than the home state, where the patient is located at the time nursing care is provided. In the case of the practice of nursing not involving a patient, the term means the party state where the recipient of nursing practice is located.

(13)    'Remote state action' means:

(a)    an administrative, civil, equitable, or criminal action permitted by the laws of a remote state that are imposed on a nurse by the remote state's nurse licensing board or other authority, including actions against a nurse's multi-state licensure privilege to practice in the remote state;

(b)    cease and desist and other injunctive or equitable orders issued by a remote state or its nurse licensing board.

(14)    'State' means a state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico.

(15)    'State practice laws' means the laws and regulations of individual party states that govern the practice of nursing, define the scope of nursing practice, and create the methods and grounds for disciplining nurses. This term does not include the initial qualifications for licensure or the requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.

Section 40-33-1315.    (A)    A license to practice registered nursing that is issued by a home state to a resident in that state must be recognized by each party state as authorizing a multi-state licensure privilege to practice as a registered nurse in each party state. A license to practice practical or vocational nursing that is issued by a home state to a resident in that state must be recognized by each party state as authorizing a multi-state licensure privilege to practice as a licensed practical or vocational nurse in each party state. In order to obtain or retain a license, an applicant must meet the home state's qualifications for licensure and license renewal and all other applicable state laws.

(B)    A party state may, in accordance with that state's due process laws, revoke, suspend, or limit the multi-state licensure privilege of any licensee to practice in its state and may take any other actions under its applicable state laws that are necessary to protect the health and safety of its citizens. If a party state takes an action authorized in this subsection, it shall promptly notify the administrator of the coordinated licensure information system. The administrator shall promptly notify the home state of any actions taken by remote states.

(C)    A licensee practicing in a party state shall comply with the state practice laws of the state in which the patient is located at the time care is rendered. The practice of nursing is not limited to patient care and includes all nursing practice as defined by the state practice laws of a party state. The practice of nursing in a party state shall subject a nurse to the jurisdiction of the nurse licensing board and the laws and the courts in that party state.

(D)(1)    A registered nurse who has been granted multi-state licensing privileges by a party state may practice registered nursing in this State.

(2)    A licensed practical nurse who has been granted multi-state licensing privileges by a party state may practice practical nursing in this State.

(3)    A nurse who has been granted multi-state licensing privileges as provided for in subsection (D)(1) or (2) shall notify the board, on a standard form provided by the board, before commencing any nursing practice in this State, of the identity and location of the nurse's prospective practice location.

(E)    The compact does not effect additional requirements imposed by states for advanced-practice registered nursing. A multi-state licensure privilege to practice registered nursing granted by a party state must be recognized by other party states as a license to practice registered nursing if a license to practice registered nursing is required by state law as a precondition for qualifying for advanced-practice registered nurse authorization.

(F)    A person who does not reside in a party state may continue to apply for nurse licensure in party states as provided for under the laws of each party state. If a license is granted to the person, the license does not grant the privilege to practice nursing in any other party state unless explicitly agreed to by that party state.

Section 40-33-1320.    (A)    Upon receiving an application for a license, the licensing board in a party state shall ascertain through the coordinated licensure information system whether the applicant holds or has ever held a license issued by any other state, whether there are any restrictions on the applicant's multi-state licensure privilege, and whether any other adverse action by any state has been taken against the applicant's license.

(B)    A licensee in a party state shall hold licensure in only one party state at a time. The license must be issued by the home state.

(C)    A licensee who intends to change his or her primary state of residence may apply for licensure in the new home state in advance of the change. However, a new license must not be issued by a party state until after the licensee provides evidence of a change in his or her primary state of residence that is satisfactory to the new home state's licensing board.

(D)    When a licensee changes his or her primary state of residence by moving between two party states and obtaining a license from the new home state, the license from the former home state is no longer valid.

(E)    When a licensee changes his or her primary state of residence by moving from a nonparty state to a party state and obtains a license from the new home state, the license issued by the nonparty state is not affected and shall remain in full force if authorized under the laws of the nonparty state.

(F)    When a licensee changes his or her primary state of residence by moving from a party state to a nonparty state, the license issued by the former home state converts to an individual state license that is valid only in the former home state. The license does not grant the multi-state licensure privilege to practice in other party states.

Section 40-33-1325.    (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 the actions, if known. The licensing board of a remote state shall also promptly report any current significant 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 may complete any pending investigation of a licensee who changes his or her primary state of residence during the course of the investigation. The licensing board of that state also may take appropriate action against a licensee and shall promptly report the conclusion of the investigation 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 taken against a licensee.

(C)    A remote party state may take adverse action that affects the multi-state licensure privilege to practice within that party state. However, only the home state may take adverse action that effects a license that was issued by the home state.

(D)    For the purposes of imposing an adverse action, the licensing board of the home state shall give the same priority and effect to the reported conduct received from a remote party state as it would if the conduct had occurred in the home state. In so doing, the licensing board of the home state shall apply its own state laws to determine appropriate action to be taken against the licensee.

(E)    The home state may take adverse action based upon the factual findings of the remote party state if each state follows its own procedures for imposing the adverse action.

(F)    This compact does not prohibit a party state from allowing a licensee to participate in an alternative program instead of taking adverse action against the licensee. If required by the party state's laws, the licensee's participation in an alternative program is confidential information. A party state shall require a licensee 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.

Section 40-33-1330.    (A)    If a licensing board finds current significant investigative information, the licensing board, after giving the licensee notice and an opportunity to respond, shall conduct a hearing and decide what adverse action, if any, to take against the licensee.

(B)    If a licensing board finds current significant investigative information, the licensing board may take adverse action against the licensee without first providing the licensee notice or an opportunity to respond to the information. A hearing must be promptly commenced and determined.

Section 40-33-1335.    A party state nurse licensing board may:

(1)    if otherwise permitted by state law, recover from licensees the costs of investigating and disposing of cases that result in adverse action;

(2)    issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses and the production of evidence. Subpoenas 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 must be enforced in the other party state by any court of competent jurisdiction according to the practice and procedure of that court. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the laws of the party state where the witnesses or evidence are located;

(3)    issue cease and desist orders to limit or revoke a licensee's authority to practice in the board's state;

(4)    promulgate uniform regulations that are developed by the compact administrators.

Section 40-33-1340.    (A)    A party state shall participate in a cooperative effort to create a coordinated data base of all licensed registered nurses and licensed practical or vocational nurses. This system must include information on the licensure and disciplinary history of each licensee, as contributed by party states, to assist in the coordination of nurse licensure and enforcement efforts.

(B)    Notwithstanding any other provision of law, a party state's licensing board shall promptly report to the coordinated licensure information system any adverse action taken against a licensee, action against multi-state licensure privileges, any current significant investigative information yet to result in adverse action, and any denials of applications for licensure and the reasons for the denials.

(C)    Current significant investigative information must be transmitted through the coordinated licensure information system only to party state licensing boards.

(D)    Notwithstanding any other provision of law, a party state's licensing board, which contributes information to the coordinated licensure information system, may designate information that must not be shared with nonparty states or disclosed to other entities or individuals without the express permission of the contributing party state.

(E)    Any personally identifiable information obtained by a party state licensing board from the coordinated licensure information system must 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 the information must be expunged from the coordinated licensure information system.

(G)    The compact administrators, acting jointly 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.

Section 40-33-1345.    (A)    The administrator or head of the nurse licensing board of each party state or that person's designee must be the administrator of this compact for that state.

(B)    To facilitate the administration of this compact, the compact administrator of each party state shall furnish to the compact administrators of all other party states information and documents concerning each licensee, including a uniform data set of investigations, identifying information, licensure data, and disclosable alternative program participation.

(C)    Compact administrators shall develop uniform rules and regulations to facilitate and coordinate implementation of this compact. These uniform rules and regulations must be adopted by party states as authorized in this article.

Section 40-33-1350.    A party state or the officers, employees, or agents of a party state's nurse licensing board who act in accordance with this compact are not liable for any good faith act or omission committed while engaged in the performance of their duties under this compact. 'Good faith' as used in this section does not include willful misconduct, gross negligence, or recklessness.

Section 40-33-1355.    (A)    This compact becomes effective as to a state when the compact has been enacted into the laws of that state. A party state may withdraw from this compact by enacting a statute repealing the compact, but the withdrawal does not take effect until six months after the withdrawing state has given notice of the withdrawal to the compact administrators of all other party states.

(B)    No withdrawal affects the validity or applicability of any report of adverse action taken by the licensing board of a state that remains a party to the compact if the adverse action occurred before the withdrawal.

(C)    This compact does not invalidate or prevent a nurse licensure agreement or other cooperative arrangement between a party state and a nonparty state that is made in accordance with this compact.

(D)    This compact may be amended by the party states; however an amendment to this compact does not become effective and binding upon the party states unless and until it is enacted into the laws of all party states.

Section 40-33-1360.    If there is a dispute that cannot be resolved by the party states involved, the following procedure must be used:

(1)    The party states may submit the issues in dispute to an arbitration panel that consists of an individual appointed by the compact administrator in the home state, an individual appointed by the compact administrator in the remote states involved, and an individual appointed by the compact administrators of all the party states involved in the dispute.

(2)    The decision of a majority of the arbitrators is final and binding.

Section 40-33-1365.    (A)    This compact must be liberally construed so as to effectuate the purposes as stated in Section 40-43-1305 (B).

(B)    The provisions of this compact are 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 if the applicability of any of them to any government, agency, person, or circumstance is held invalid, the validity of the remainder of this compact and the applicability of it to any government, agency, person, or circumstance is not affected. If this compact is held contrary to the constitution of any party state, the compact remains 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."

SECTION    2.    A nurse whose license has been restricted by the South Carolina Board of Nursing as of this act's effective date must not practice in any other state that has adopted the Nurse Multi-State Licensure Compact, a compact substantially the same as the compact enacted in Section 1 of this act, during the time in which the license is restricted unless the nurse receives prior authorization from another state that is a party to such compact.

SECTION    3.    The South Carolina Board of Nursing shall periodically report to the General Assembly on the implementation of the provisions of the Nurse Licensure Compact, Article 15, Chapter 33 of Title 40 of the 1976 Code, as added by Section 1 of this act, and no later than January 1, 2007.

SECTION    4.    Article 7, Chapter 33, Title 40 of the 1976 Code is amended by adding:

"Section 40-33-525.    Beginning January 1, 2007, the State Board of Nursing shall require foreign-educated candidates for licensing as registered nurses to pass:

(1)    the National Council Licensure Examination (NCLEX); and

(2)    an English language proficiency test that determines whether or not the license applicant is proficient in conversational English with regard to medical terminology and the skills required of a registered nurse."

SECTION    5.    This act takes effect upon approval by the Governor and applies to nursing licenses applied for after September 30, 2006.

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