SB417,7,2318 441.06 (1c) The board shall grant a multistate license, as defined in s. 441.51
19(2) (h), to an applicant for a multistate registered nurse license under s. 441.51.
20Subject to s. 441.07 (1g), the requirements under sub. (1) shall apply to such an
21applicant, except that the requirements under s. 441.51 (3) (c) for granting a
22multistate license shall supersede the requirements under sub. (1) to the extent of
23any conflict.
SB417,19 24Section 19. 441.06 (4) of the statutes is amended to read:
SB417,8,10
1441.06 (4) Except as provided in s. 257.03, no person may practice or attempt
2to practice professional nursing, nor use the title, letters, or anything else to indicate
3that he or she is a registered or professional nurse unless he or she is licensed under
4this section. Except as provided in s. 257.03, no person not so licensed may use in
5connection with his or her nursing employment or vocation any title or anything else
6to indicate that he or she is a trained, certified or graduate nurse. This subsection
7does not apply to any person registered nurse who is licensed to practice nursing
8holds a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction,
9other than this state, that has adopted the enhanced nurse licensure compact under
10s. 441.50 441.51.
SB417,20 11Section 20. 441.10 (1c) of the statutes is created to read:
SB417,8,1712 441.10 (1c) The board shall grant a multistate license, as defined in s. 441.51
13(2) (h), to an applicant for a multistate licensed practical nurse license under s.
14441.51. Subject to s. 441.07 (1g), the requirements under sub. (1) shall apply to such
15an applicant, except that the requirements under s. 441.51 (3) (c) for granting a
16multistate license shall supersede the requirements under sub. (1) to the extent of
17any conflict.
SB417,21 18Section 21. 441.10 (7) of the statutes is amended to read:
SB417,9,719 441.10 (7) No license is required for practical nursing, but, except as provided
20in s. 257.03, no person without a license may hold himself or herself out as a licensed
21practical nurse or licensed attendant, use the title or letters “Trained Practical
22Nurse" or “T.P.N.", “Licensed Practical Nurse" or “L.P.N.", “ Licensed Attendant" or
23“L.A.", “Trained Attendant" or “T.A.", or otherwise seek to indicate that he or she is
24a licensed practical nurse or licensed attendant. No licensed practical nurse or
25licensed attendant may use the title, or otherwise seek to act as a registered, licensed,

1graduate or professional nurse. Anyone violating this subsection shall be subject to
2the penalties prescribed by s. 441.13. The board shall grant without examination a
3license as a licensed practical nurse to any person who was on July 1, 1949, a licensed
4attendant. This subsection does not apply to any person licensed practical nurse who
5is licensed to practice practical nursing holds a multistate license, as defined in s.
6441.51 (2) (h), issued
by a jurisdiction, other than this state, that has adopted the
7enhanced nurse licensure compact under s. 441.50 441.51.
SB417,22 8Section 22. 441.115 (2) (a) of the statutes is amended to read:
SB417,9,179 441.115 (2) (a) In this subsection, “nursing credential" means a license, permit
10or certificate of registration or certification that is granted to a person by another
11state or territory or by a foreign country or province and that authorizes or qualifies
12the person holding the credential to perform acts that are substantially the same as
13those performed by a person licensed as a registered nurse or licensed practical nurse
14under this subchapter. In this paragraph, “state or territory" excludes any state or
15territory that has adopted the nurse licensure compact under
, except that “nursing
16credential” does not include a multistate license, as defined in s. 441.51 (2) (h), issued
17by a party state, as defined in
s. 441.50 441.51 (2) (k).
SB417,23 18Section 23. 441.15 (3) (a) (intro.) of the statutes is amended to read:
SB417,9,2319 441.15 (3) (a) (intro.) Subject to s. 441.07 (1g), the board shall grant a license
20to engage in the practice of nurse-midwifery to any person registered nurse who is
21licensed as a registered nurse under this subchapter or who holds a multistate
22license, as defined in s. 441.51 (2) (h), issued
in a party state, as defined in s. 441.50
23441.51 (2) (j) (k), who does all of the following:
SB417,24 24Section 24. Subchapter II (title) of chapter 441 [precedes 441.50] of the
25statutes is amended to read:
SB417,10,1
1CHAPTER 441
SB417,10,32 SUBCHAPTER II
3ENHANCED NURSE LICENSURE COMPACT
SB417,25 4Section 25. 441.50 of the statutes is repealed.
SB417,26 5Section 26. 441.51 of the statutes is created to read:
SB417,10,7 6441.51 Enhanced nurse licensure compact. (1) Article I — Findings and
7declaration of purpose.
(a) The party states find all of the following:
SB417,10,108 1. That the health and safety of the public are affected by the degree of
9compliance with and the effectiveness of enforcement activities related to state nurse
10licensure laws.
SB417,10,1211 2. That violations of nurse licensure and other laws regulating the practice of
12nursing may result in injury or harm to the public.
SB417,10,1613 3. That the expanded mobility of nurses and the use of advanced
14communication technologies as part of our nation's health care delivery system
15require greater coordination and cooperation among states in the areas of nurse
16licensure and regulation.
SB417,10,1817 4. That new practice modalities and technology make compliance with
18individual state nurse licensure laws difficult and complex.
SB417,10,2019 5. That the current system of duplicative licensure for nurses practicing in
20multiple states is cumbersome and redundant for both nurses and states.
SB417,10,2221 6. That uniformity of nurse licensure requirements throughout the states
22promotes public safety and public health benefits.
SB417,10,2323 (b) The general purposes of this compact are as follows:
SB417,10,2424 1. To facilitate the states' responsibility to protect the public's health and safety.
SB417,11,2
12. To ensure and encourage the cooperation of party states in the areas of nurse
2licensure and regulation.
SB417,11,43 3. To facilitate the exchange of information between party states in the areas
4of nurse regulation, investigation, and adverse actions.
SB417,11,65 4. To promote compliance with the laws governing the practice of nursing in
6each jurisdiction.
SB417,11,97 5. To invest all party states with the authority to hold a nurse accountable for
8meeting all state practice laws in the state in which the patient is located at the time
9care is rendered through the mutual recognition of party state licenses.
SB417,11,1110 6. To decrease redundancies in the consideration and issuance of nurse
11licenses.
SB417,11,1312 7. To provide opportunities for interstate practice by nurses who meet uniform
13licensure requirements.
SB417,11,14 14(2) Article II — Definitions. As used in this compact:
SB417,11,2115 (a) “Adverse action” means any administrative, civil, equitable, or criminal
16action permitted by a state's laws which is imposed by a licensing board or other
17authority against a nurse, including actions against an individual's license or
18multistate licensure privilege such as revocation, suspension, probation, monitoring
19of the licensee, limitation on the licensee's practice, or any other encumbrance on
20licensure affecting a nurse's authorization to practice, including issuance of a cease
21and desist action.
SB417,11,2322 (b) “Alternative program” means a nondisciplinary monitoring program
23approved by a licensing board.
SB417,12,224 (c) “Coordinated licensure information system” means an integrated process
25for collecting, storing, and sharing information on nurse licensure and enforcement

1activities related to nurse licensure laws that is administered by a nonprofit
2organization composed of and controlled by licensing boards.
SB417,12,33 (d) “Current significant investigative information” means any of the following:
SB417,12,74 1. Investigative information that a licensing board, after a preliminary inquiry
5that includes notification and an opportunity for the nurse to respond, if required by
6state law, has reason to believe is not groundless and, if proved true, would indicate
7more than a minor infraction.
SB417,12,108 2. Investigative information that indicates that the nurse represents an
9immediate threat to public health and safety regardless of whether the nurse has
10been notified and had an opportunity to respond.
SB417,12,1211 (e) “Encumbrance” means a revocation or suspension of, or any limitation on,
12the full and unrestricted practice of nursing imposed by a licensing board.
SB417,12,1413 (f) “Home state” means the party state which is the nurse's primary state of
14residence.
SB417,12,1615 (g) “Licensing board” means a party state's regulatory body responsible for
16issuing nurse licenses.
SB417,12,1917 (h) “Multistate license” means a license to practice as a registered or a licensed
18practical/vocational nurse issued by a home state licensing board that authorizes the
19licensed nurse to practice in all party states under a multistate licensure privilege.
SB417,12,2220 (i) “Multistate licensure privilege” means a legal authorization associated with
21a multistate license permitting the practice of nursing as either a registered nurse
22or licensed practical/vocational nurse in a remote state.
SB417,12,2423 (j) “Nurse” means registered nurse or licensed practical/vocational nurse, as
24those terms are defined by each party state's practice laws.
SB417,12,2525 (k) “Party state” means any state that has adopted this compact.
SB417,13,1
1(L) “Remote state” means a party state, other than the home state.
SB417,13,42 (m) “Single-state license” means a nurse license issued by a party state that
3authorizes practice only within the issuing state and does not include a multistate
4licensure privilege to practice in any other party state.
SB417,13,65 (n) “State” means a state, territory, or possession of the United States and the
6District of Columbia.
SB417,13,117 (o) “State practice laws” means a party state's laws, rules, and regulations that
8govern the practice of nursing, define the scope of nursing practice, and create the
9methods and grounds for imposing discipline. “State practice laws” does not include
10requirements necessary to obtain and retain a license, except for qualifications or
11requirements of the home state.
SB417,13,16 12(3) Article III — General provisions and jurisdiction. (a) A multistate license
13to practice registered or licensed practical/vocational nursing issued by a home state
14to a resident in that state will be recognized by each party state as authorizing a
15nurse to practice as a registered nurse or as a licensed practical/vocational nurse,
16under a multistate licensure privilege, in each party state.
SB417,13,2217 (b) A state must implement procedures for considering the criminal history
18records of applicants for initial multistate license or licensure by endorsement. Such
19procedures shall include the submission of fingerprints or other biometric-based
20information by applicants for the purpose of obtaining an applicant's criminal
21history record information from the federal bureau of investigation and the agency
22responsible for retaining that state's criminal records.
SB417,13,2423 (c) Each party state shall require all of the following for an applicant to obtain
24or retain a multistate license in the home state:
SB417,14,2
11. Meets the home state's qualifications for licensure or renewal of licensure,
2as well as, all other applicable state laws.
SB417,14,33 2. Satisfies one of the following:
SB417,14,64 a. Has graduated or is eligible to graduate from a licensing board-approved
5registered nurse or licensed practical/vocational nurse prelicensure education
6program.
SB417,14,117 b. Has graduated from a foreign registered nurse or licensed
8practical/vocational nurse prelicensure education program that has been approved
9by the authorized accrediting body in the applicable country and has been verified
10by an independent credentials review agency to be comparable to a licensing
11board-approved prelicensure education program.
SB417,14,1512 3. Has, if a graduate of a foreign prelicensure education program not taught
13in English or if English is not the individual's native language, successfully passed
14an English proficiency examination that includes the components of reading,
15speaking, writing, and listening.
SB417,14,1716 4. Has successfully passed an NCLEX-RN or NCLEX-PN Examination or
17recognized predecessor, as applicable.
SB417,14,1818 5. Is eligible for or holds an active, unencumbered license.
SB417,14,2219 6. Has submitted, in connection with an application for initial licensure or
20licensure by endorsement, fingerprints or other biometric data for the purpose of
21obtaining criminal history record information from the federal bureau of
22investigation and the agency responsible for retaining that state's criminal records.
SB417,14,2423 7. Has not been convicted or found guilty, or has entered into an agreed
24disposition, of a felony offense under applicable state or federal criminal law.
SB417,15,3
18. Has not been convicted or found guilty, or has entered into an agreed
2disposition, of a misdemeanor offense related to the practice of nursing as
3determined on a case-by-case basis.
SB417,15,44 9. Is not currently enrolled in an alternative program.
SB417,15,65 10. Is subject to self-disclosure requirements regarding current participation
6in an alternative program.
SB417,15,77 11. Has a valid United States social security number.
SB417,15,158 (d) All party states shall be authorized, in accordance with existing state due
9process law, to take adverse action against a nurse's multistate licensure privilege
10such as revocation, suspension, probation or any other action that affects a nurse's
11authorization to practice under a multistate licensure privilege, including cease and
12desist actions. If a party state takes such action, it shall promptly notify the
13administrator of the coordinated licensure information system. The administrator
14of the coordinated licensure information system shall promptly notify the home state
15of any such actions by remote states.
SB417,15,2216 (e) A nurse practicing in a party state must comply with the state practice laws
17of the state in which the client is located at the time service is provided. The practice
18of nursing is not limited to patient care, but shall include all nursing practice as
19defined by the state practice laws of the party state in which the client is located.
20The practice of nursing in a party state under a multistate licensure privilege will
21subject a nurse to the jurisdiction of the licensing board, the courts, and the laws of
22the party state in which the client is located at the time service is provided.
SB417,16,323 (f) Individuals not residing in a party state shall continue to be able to apply
24for a party state's single-state license as provided under the laws of each party state.
25However, the single-state license granted to these individuals will not be recognized

1as granting the privilege to practice nursing in any other party state. Nothing in this
2compact shall affect the requirements established by a party state for the issuance
3of a single-state license.
SB417,16,64 (g) Any nurse holding a home state multistate license, on the effective date of
5this compact, may retain and renew the multistate license issued by the nurse's
6then-current home state, provided that:
SB417,16,97 1. A nurse, who changes primary state of residence after this compact's effective
8date, must meet all applicable requirements under par. (c) to obtain a multistate
9license from a new home state.
SB417,16,1410 2. A nurse who fails to satisfy the multistate licensure requirements in par. (c)
11due to a disqualifying event occurring after this compact's effective date shall be
12ineligible to retain or renew a multistate license, and the nurse's multistate license
13shall be revoked or deactivated in accordance with applicable rules adopted by the
14interstate commission of nurse licensure compact administrators (“commission”).
SB417,16,22 15(4) Article IV — Applications for licensure in a party state. (a) Upon
16application for a multistate license, the licensing board in the issuing party state
17shall ascertain, through the coordinated licensure information system, whether the
18applicant has ever held, or is the holder of, a license issued by any other state,
19whether there are any encumbrances on any license or multistate licensure privilege
20held by the applicant, whether any adverse action has been taken against any license
21or multistate licensure privilege held by the applicant, and whether the applicant is
22currently participating in an alternative program.
SB417,16,2423 (b) A nurse may hold a multistate license, issued by the home state, in only one
24party state at a time.
SB417,17,4
1(c) 1. If a nurse changes primary state of residence by moving between 2 party
2states, the nurse must apply for licensure in the new home state, and the multistate
3license issued by the prior home state will be deactivated in accordance with
4applicable rules adopted by the commission.
SB417,17,65 2. The nurse may apply for licensure in advance of a change in primary state
6of residence.
SB417,17,107 3. A multistate license shall not be issued by the new home state until the nurse
8provides satisfactory evidence of a change in primary state of residence to the new
9home state and satisfies all applicable requirements to obtain a multistate license
10from the new home state.
SB417,17,1311 (d) If a nurse changes primary state of residence by moving from a party state
12to a non-party state, the multistate license issued by the prior home state will
13convert to a single-state license, valid only in the former home state.
SB417,17,16 14(5) Article V — Additional authorities invested in party state licensing
15boards.
(a) In addition to the other powers conferred by state law, a licensing board
16shall have the authority to do any of the following:
SB417,17,1817 1. Take adverse action against a nurse's multistate licensure privilege to
18practice within that party state, subject to all of the following:
SB417,17,2019 a. Only the home state shall have the power to take adverse action against a
20nurse's license issued by the home state.
SB417,17,2421 b. For purposes of taking adverse action, the home state licensing board shall
22give the same priority and effect to reported conduct received from a remote state as
23it would if such conduct had occurred within the home state. In so doing, the home
24state shall apply its own state laws to determine appropriate action.
SB417,18,2
12. Issue cease and desist orders or impose an encumbrance on a nurse's
2authority to practice within that party state.
SB417,18,83 3. Complete any pending investigations of a nurse who changes primary state
4of residence during the course of such investigations. The licensing board shall also
5have the authority to take appropriate action and shall promptly report the
6conclusions of such investigations to the administrator of the coordinated licensure
7information system. The administrator of the coordinated licensure information
8system shall promptly notify the new home state of any such actions.
SB417,18,179 4. Issue subpoenas for both hearings and investigations that require the
10attendance and testimony of witnesses, as well as, the production of evidence.
11Subpoenas issued by a licensing board in a party state for the attendance and
12testimony of witnesses or the production of evidence from another party state shall
13be enforced in the latter state by any court of competent jurisdiction, according to the
14practice and procedure of that court applicable to subpoenas issued in proceedings
15pending before it. The issuing authority shall pay any witness fees, travel expenses,
16mileage, and other fees required by the service statutes of the state in which the
17witnesses or evidence are located.
SB417,18,2218 5. Obtain and submit, for each nurse licensure applicant, fingerprint or other
19biometric-based information to the federal bureau of investigation for criminal
20background checks, receive the results of the federal bureau of investigation record
21search on criminal background checks, and use the results in making licensure
22decisions.
SB417,18,2523 6. If otherwise permitted by state law, recover from the affected nurse the costs
24of investigations and disposition of cases resulting from any adverse action taken
25against that nurse.
SB417,19,3
17. Take adverse action based on the factual findings of the remote state,
2provided that the licensing board follows its own procedures for taking such adverse
3action.
SB417,19,94 (b) If adverse action is taken by the home state against a nurse's multistate
5license, the nurse's multistate licensure privilege to practice in all other party states
6shall be deactivated until all encumbrances have been removed from the multistate
7license. All home state disciplinary orders that impose adverse action against a
8nurse's multistate license shall include a statement that the nurse's multistate
9licensure privilege is deactivated in all party states during the pendency of the order.
SB417,19,1410 (c) Nothing in this compact shall override a party state's decision that
11participation in an alternative program may be used in lieu of adverse action. The
12home state licensing board shall deactivate the multistate licensure privilege under
13the multistate license of any nurse for the duration of the nurse's participation in an
14alternative program.
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