By Moncrief S.B. No. 981 76R8701 GJH-F A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the practice of registered nurses and licensed 1-3 vocational nurses, including the adoption of an interstate compact 1-4 relating to licensing. 1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-6 SECTION 1. Chapter 7, Title 71, Revised Statutes, is amended 1-7 by adding Article 4528b to read as follows: 1-8 Art. 4528b. NURSE LICENSURE COMPACT 1-9 Sec. 1. The Nurse Licensure Compact is enacted and entered 1-10 into with all other jurisdictions that legally join in the compact, 1-11 which is as follows: 1-12 NURSE LICENSURE COMPACT 1-13 ARTICLE 1. FINDINGS AND DECLARATION OF PURPOSE. (a) The 1-14 party states find that: 1-15 (1) the health and safety of the public are affected 1-16 by the degree of compliance with and the effectiveness of 1-17 enforcement activities related to state nurse licensing laws; 1-18 (2) violations of nurse licensing and other laws 1-19 regulating the practice of nursing may result in injury or harm to 1-20 the public; 1-21 (3) the expanded mobility of nurses and the use of 1-22 advanced communication technologies as part of our nation's health 1-23 care delivery system require greater coordination and cooperation 1-24 among states in the areas of nurse licensing and regulation; 2-1 (4) new practice modalities and technology make 2-2 compliance with each state nurse licensing laws difficult and 2-3 complex; and 2-4 (5) the current system of the duplicative licensing of 2-5 nurses practicing in multiple states is cumbersome and redundant to 2-6 both nurses and the states. 2-7 (b) The general purposes of this compact are to: 2-8 (1) facilitate the states' responsibilities to protect 2-9 the public's health and safety; 2-10 (2) ensure and encourage the cooperation of party 2-11 states in the areas of nurse licensing and regulation; 2-12 (3) facilitate the exchange of information between 2-13 party states in the areas of nurse regulation, investigation, and 2-14 adverse action; 2-15 (4) promote compliance with the laws governing the 2-16 practice of nursing in each jurisdiction; and 2-17 (5) invest all party states with the authority to hold 2-18 a nurse accountable for meeting all state practice laws in the 2-19 state in which the patient is located at the time care is provided 2-20 through the mutual recognition of party state licenses. 2-21 ARTICLE 2. DEFINITIONS. In this compact: 2-22 (a) "Adverse action" means a home or remote state 2-23 action. 2-24 (b) "Alternative program" means a voluntary, 2-25 nondisciplinary monitoring program approved by a nurse licensing 2-26 board. 2-27 (c) "Coordinated licensure information system" means 3-1 an integrated process for collecting, storing, and sharing 3-2 information on nurse licensing and enforcement activities related 3-3 to nurse licensing laws, which is administered by a nonprofit 3-4 organization composed of and controlled by state nurse licensing 3-5 boards. 3-6 (d) "Current significant investigative information" 3-7 means: 3-8 (1) investigative information that a licensing 3-9 board, after a preliminary inquiry that includes notification and 3-10 an opportunity for the nurse to respond if required by state law, 3-11 has reason to believe is not groundless and, if proved true, would 3-12 indicate more than a minor infraction; or 3-13 (2) investigative information that indicates 3-14 that a nurse represents an immediate threat to public health and 3-15 safety regardless of whether the nurse has been notified and had an 3-16 opportunity to respond. 3-17 (e) "Home state" means the party state that is the 3-18 nurse's primary state of residence. 3-19 (f) "Home state action" means any administrative, 3-20 civil, equitable, or criminal action permitted by the home state's 3-21 laws that are imposed on a nurse by the home state's licensing 3-22 board or other authority, including actions against an individual's 3-23 license such as revocation, suspension, probation, or any other 3-24 action that affects a nurse's authorization to practice. 3-25 (g) "Licensing board" means a party state's regulatory 3-26 body responsible for issuing nurse licenses. 3-27 (h) "Multistate licensing privilege" means current, 4-1 official authority from a remote state permitting the practice of 4-2 nursing as a registered nurse, licensed practical nurse, or 4-3 licensed vocational nurse in the party state. All party states have 4-4 the authority, in accordance with existing state due process laws, 4-5 to take actions against the nurse's privilege, including 4-6 revocation, suspension, probation, or any other action that affects 4-7 a nurse's authorization to practice. 4-8 (i) "Nurse" means a registered nurse, licensed 4-9 practical nurse, or licensed vocational nurse as those terms are 4-10 defined by each party state's practice laws. 4-11 (j) "Party state" means any state that has enacted 4-12 this compact. 4-13 (k) "Remote state" means a party state, other than the 4-14 home state, in which: 4-15 (1) a patient is located at the time nursing 4-16 care is provided; or 4-17 (2) in the case of the practice of nursing not 4-18 involving a patient, the recipient of nursing practice is located. 4-19 (l) "Remote state action" means: 4-20 (1) an administrative, civil, equitable, or 4-21 criminal action permitted by a remote state's laws that are imposed 4-22 on a nurse by the remote state's licensing board or other 4-23 authority, including an action against an individual's multistate 4-24 licensing privilege to practice in the remote state; and 4-25 (2) a cease and desist order and other 4-26 injunctive or equitable orders issued by remote states or the 4-27 licensing boards of remote states. 5-1 (m) "State" means a state, territory, possession of 5-2 the United States, the District of Columbia, or the Commonwealth of 5-3 Puerto Rico. 5-4 (n) "State practice laws" means a party state's laws 5-5 and regulations that govern the practice of nursing, define the 5-6 scope of nursing practice, and create the methods and grounds for 5-7 imposing discipline. The term does not include the initial 5-8 qualifications for licensing or requirements necessary to obtain 5-9 and retain a license, except for qualifications or requirements of 5-10 the home state. 5-11 ARTICLE 3. GENERAL PROVISIONS AND JURISDICTION. (a) A 5-12 license to practice registered nursing issued by a home state to a 5-13 resident in that state will be recognized by each party state as 5-14 authorizing a multistate licensing privilege to practice as a 5-15 registered nurse in the party state. A license to practice licensed 5-16 practical nursing or licensed vocational nursing issued by a home 5-17 state to a resident in that state will be recognized by each party 5-18 state as authorizing a multistate licensing privilege to practice 5-19 as a licensed practical nurse or vocational nurse in the party 5-20 state. To obtain or retain a license, an applicant must meet the 5-21 home state's qualifications for a license and license renewal as 5-22 well as all other applicable state laws. 5-23 (b) A party state may, in accordance with state due process 5-24 laws, limit or revoke the multistate licensing privilege of any 5-25 nurse to practice in the party state and may take any other 5-26 necessary actions under the party state's applicable laws to 5-27 protect the health and safety of the party state's citizens. If a 6-1 party state takes this action, the party state shall promptly 6-2 notify the administrator of the coordinated licensure information 6-3 system. The administrator of the coordinated licensure information 6-4 system shall promptly notify the home state of any such actions by 6-5 remote states. 6-6 (c) A nurse practicing in a party state must comply with the 6-7 state practice laws of the state in which the patient is located at 6-8 the time care is provided. The practice of nursing includes 6-9 patient care and all nursing practice defined by the party state's 6-10 practice laws. The practice of nursing will subject a nurse to the 6-11 jurisdiction of the nurse licensing board, the courts, and the laws 6-12 of the party state. 6-13 (d) This compact does not affect additional requirements 6-14 imposed by states for advanced practice registered nursing. 6-15 However, a multistate licensing privilege to practice registered 6-16 nursing granted by a party state shall be recognized by another 6-17 party state as a license to practice registered nursing if the 6-18 state's law requires the license as a precondition for qualifying 6-19 for advanced practice registered nurse authorization. 6-20 (e) Individuals not residing in a party state may apply for 6-21 a nurse license under the laws of a party state. However, the 6-22 license granted to these individuals will not be recognized as 6-23 granting the privilege to practice nursing in any other party state 6-24 unless explicitly agreed to by that party state. 6-25 ARTICLE 4. APPLICATION FOR LICENSE IN A PARTY STATE. (a) 6-26 Once an application for a license is submitted, the licensing board 6-27 in a party state shall ascertain, through the coordinated licensure 7-1 information system, whether: 7-2 (1) the applicant has held or is the holder of a 7-3 license issued by another state; 7-4 (2) a restriction exists on the multistate licensing 7-5 privilege; and 7-6 (3) any other adverse action by any state has been 7-7 taken against the license. 7-8 (b) A nurse in a party state shall hold a license that is 7-9 issued by the home state in only one party state at a time. 7-10 (c) A nurse who intends to change the nurse's primary state 7-11 of residence may apply for a license in the new home state in 7-12 advance of the change. However, a new license will not be issued by 7-13 a party state until a nurse provides satisfactory evidence to the 7-14 new home state's licensing board of a change in the nurse's primary 7-15 state of residence. 7-16 (d) When a nurse changes the nurse's primary state of 7-17 residence by moving from: 7-18 (1) a party state to another party state and obtains a 7-19 license from the new home state, the license from the former home 7-20 state is no longer valid; 7-21 (2) a non-party state to a party state and obtains a 7-22 license from the new home state, the individual state license 7-23 issued by the non-party state is not affected and remains in full 7-24 force if provided by the laws of the non-party state; and 7-25 (3) a party state to a non-party state, the license 7-26 issued by the prior home state converts to a state license valid 7-27 only in the former home state and does not entitle the nurse to the 8-1 multistate licensing privilege to practice in other party states. 8-2 ARTICLE 5. ADVERSE ACTIONS. (a) The licensing board of a 8-3 remote state shall promptly report to the administrator of the 8-4 coordinated licensure information system a remote state action and 8-5 the factual and legal basis for the action, if known. The licensing 8-6 board of a remote state shall promptly report any significant 8-7 current investigative information yet to result in a remote state 8-8 action. The administrator of the coordinated licensure information 8-9 system shall promptly notify the home state of these reports. 8-10 (b) The licensing board of a party state shall have the 8-11 authority to complete a pending investigation of a nurse who 8-12 changes the nurse's primary state of residence during the course of 8-13 the investigation and to take appropriate action. The licensing 8-14 board shall promptly report the conclusions of the investigations 8-15 to the administrator of the coordinated licensure information 8-16 system. The administrator of the coordinated licensure information 8-17 system shall promptly notify the new home state of any action. 8-18 (c) A remote state may take adverse action affecting the 8-19 multistate licensing privilege to practice in that party state. 8-20 However, only the home state has the power to impose adverse action 8-21 against the license issued by the home state. 8-22 (d) For purposes of imposing adverse action, the licensing 8-23 board of the home state shall give the same priority and effect to 8-24 reported conduct received from a remote state as it would to 8-25 conduct occurring in the home state. In so doing, the licensing 8-26 board shall apply its state laws to determine appropriate action. 8-27 (e) The home state may take adverse action based on the 9-1 factual findings of the remote state only if each state follows its 9-2 own procedures for imposing the adverse action. 9-3 (f) This compact does not affect a party state's decision 9-4 that participation in an alternative program may be used instead of 9-5 licensing action and that the participation shall remain non-public 9-6 if required by the party state's laws. Party states must require a 9-7 nurse who enters an alternative program to agree not to practice in 9-8 any other party state during the term of the alternative program 9-9 without prior authorization from the other party state. 9-10 ARTICLE 6. ADDITIONAL AUTHORITIES OF PARTY STATE NURSE 9-11 LICENSING BOARDS. (a) Notwithstanding any other powers, party 9-12 state nurse licensing boards have the authority to: 9-13 (1) if otherwise permitted by state law, recover from 9-14 the affected nurse the costs of investigations and disposition of 9-15 cases resulting from any adverse action taken against the nurse; 9-16 (2) issue subpoenas for hearings and investigations 9-17 that require the attendance and testimony of witnesses and the 9-18 production of evidence; 9-19 (3) issue a cease and desist order to limit or revoke 9-20 a nurse's authority to practice in the state; and 9-21 (4) adopt uniform rules as provided under Article 8(c) 9-22 of this compact. 9-23 (b) A subpoena issued by a nurse licensing board in a party 9-24 state for the attendance and testimony of witnesses or the 9-25 production of evidence from another party state shall be enforced 9-26 in the non-issuing party state by a court of competent jurisdiction 9-27 in accordance with the practice and procedure applicable to 10-1 subpoenas issued in proceedings pending before the court. The 10-2 issuing authority shall pay any witness fees, travel expenses, 10-3 mileage, and other fees required by the service statutes of the 10-4 state in which a witness or evidence is located. 10-5 ARTICLE 7. COORDINATED LICENSURE INFORMATION SYSTEM. (a) 10-6 All party states shall participate in a cooperative effort to 10-7 create a coordinated database of all licensed registered nurses, 10-8 licensed practical nurses, and licensed vocational nurses. This 10-9 system will include information on the licensing and disciplinary 10-10 history of each nurse, as contributed by party states, to assist in 10-11 the coordination of nurse licensing and enforcement efforts. 10-12 (b) Notwithstanding any other provision of law, all party 10-13 states' licensing boards shall promptly report to the coordinated 10-14 licensure information system adverse actions, actions against 10-15 multistate licensing privileges, any current significant 10-16 investigative information yet to result in adverse action, and 10-17 denials of applications and the reasons for the denials. 10-18 (c) Current significant investigative information shall be 10-19 transmitted only to party state licensing boards through the 10-20 coordinated licensure information system. 10-21 (d) Notwithstanding any other provision of law, all party 10-22 states' licensing boards that contribute information to the 10-23 coordinated licensure information system may designate information 10-24 that may not be shared with non-party states or disclosed to other 10-25 entities or individuals without the express permission of the 10-26 contributing state. 10-27 (e) Any personally identifiable information obtained by a 11-1 party state's licensing board from the coordinated licensure 11-2 information system may not be shared with non-party states or 11-3 disclosed to other entities or individuals except to the extent 11-4 permitted by the laws of the party state contributing the 11-5 information. 11-6 (f) Information contributed to the coordinated licensure 11-7 information system that is subsequently required to be expunged by 11-8 the laws of the party state contributing that information shall be 11-9 expunged from the coordinated licensure information system. 11-10 (g) Each compact administrator shall act jointly and in 11-11 consultation with the administrator of the coordinated licensure 11-12 information system to formulate necessary and proper procedures for 11-13 the identification, collection, and exchange of information under 11-14 this compact. 11-15 ARTICLE 8. COMPACT ADMINISTRATION AND EXCHANGE OF 11-16 INFORMATION. (a) The presiding officer of the nurse licensing 11-17 board of a party state or the presiding officer's designee shall be 11-18 the administrator of this compact for the state. 11-19 (b) The compact administrator of each party state shall 11-20 furnish to the compact administrator of each other party state 11-21 information and documents including a uniform data set of 11-22 investigations, identifying information, licensing data, and 11-23 disclosable alternative program participation information to 11-24 facilitate the administration of this compact. 11-25 (c) Compact administrators have the authority to develop 11-26 uniform rules to facilitate and coordinate implementation of this 11-27 compact. The uniform rules shall be adopted by party states under 12-1 Article 6(a)(4) of this compact. 12-2 ARTICLE 9. IMMUNITY. A party state or an officer, employee, 12-3 or agent of a party state's nurse licensing board who acts in 12-4 accordance with the provisions of this compact is not liable for 12-5 any good faith act or omission that occurs while the person is 12-6 performing the person's duties under this compact. Good faith in 12-7 this article does not include wilful misconduct, gross negligence, 12-8 or recklessness. 12-9 ARTICLE 10. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT. (a) 12-10 This compact enters into force and takes effect for a state when 12-11 the state enacts this compact as law. A party state may withdraw 12-12 from the compact by enacting a statute repealing the compact, but a 12-13 withdrawal takes effect six months after the date the withdrawing 12-14 state gives notice of the withdrawal to the executive heads of all 12-15 other party states. 12-16 (b) No withdrawal shall affect the validity or applicability 12-17 by the licensing boards of states remaining party to the compact of 12-18 any report of adverse action occurring prior to the withdrawal. 12-19 (c) This compact does not invalidate or prevent any nurse 12-20 licensing agreement or other cooperative arrangement between a 12-21 party state and a non-party state that is made in accordance with 12-22 the other provisions of this compact. 12-23 (d) This compact may be amended by the party states. An 12-24 amendment to this compact is not effective or binding on the party 12-25 states unless and until all party states enact the amendment into 12-26 the law of each state. 12-27 ARTICLE 11. CONSTRUCTION AND SEVERABILITY. (a) This 13-1 compact shall be liberally construed to effectuate the compact's 13-2 purposes. 13-3 (b) This compact is severable. If a phrase, clause, 13-4 sentence, or provision of this compact is declared to be contrary 13-5 to the constitution of a party state or the United States or the 13-6 applicability of this compact to a government, agency, person, or 13-7 circumstance is held invalid, the validity and applicability of the 13-8 remainder of the compact to a government, agency, person, or 13-9 circumstance is not affected. If this compact is held to be 13-10 contrary to the constitution of a party state, the compact remains 13-11 in full force and effect for the other party states and in full 13-12 force and effect for the party state affected for all severable 13-13 matters. 13-14 (c) If the party states need to settle a dispute under the 13-15 compact the party states may submit the issues in dispute to an 13-16 arbitration panel comprised of: 13-17 (A) an individual appointed by the compact 13-18 administrator in the home state; 13-19 (B) an individual appointed by the compact 13-20 administrator in each remote state involved; and 13-21 (C) an individual mutually agreed upon by the compact 13-22 administrators of each party state involved in the dispute. 13-23 (d) The decision of a majority of the arbitrators shall be 13-24 final and binding. 13-25 Sec. 2. The executive directors of the Board of Nurse 13-26 Examiners and the Board of Vocational Nurse Examiners are the nurse 13-27 licensure compact administrators for this state. The executive 14-1 director of the Board of Nurse Examiners is responsible for 14-2 administering matters relating to registered nurses. The executive 14-3 director of the Board of Vocational Nurse Examiners is responsible 14-4 for administering matters relating to licensed vocational nurses. 14-5 Sec. 3. The Board of Nurse Examiners and the Board of 14-6 Vocational Nurse Examiners may adopt rules necessary to implement 14-7 this article. 14-8 Sec. 4. The terms "nurse," "registered nurse," and 14-9 "vocational nurse" include nurses licensed as registered nurses or 14-10 vocational nurses by a state that is a party to the Nurse Licensure 14-11 Compact. Unless the context indicates otherwise or doing so would 14-12 be inconsistent with the Nurse Licensure Compact, nurses practicing 14-13 in this state under a license issued by a state that is a party to 14-14 the Nurse Licensure Compact have the same rights and obligations as 14-15 imposed by the laws of this state on license holders of the Board 14-16 of Nurse Examiners or the Board of Vocational Nurse Examiners. The 14-17 Board of Nurse Examiners and the Board of Vocational Nurse 14-18 Examiners have the authority to determine whether a right or 14-19 obligation imposed on license holders applies to nurses practicing 14-20 in this state under a license issued by a state that is a party to 14-21 the Nurse Licensure Compact unless that determination is 14-22 inconsistent with the Nurse Licensure Compact. 14-23 Sec. 5. The Board of Nurse Examiners and the Board of 14-24 Vocational Nurse Examiners are the state agencies responsible for 14-25 taking action against registered and vocational nurses practicing 14-26 in this state under a license issued by a state that is a party to 14-27 the Nurse Licensure Compact as authorized by the Nurse Licensure 15-1 Compact. The action shall be taken in accordance with the same 15-2 procedures for taking action against registered and vocational 15-3 nurses licensed by this state. 15-4 Sec. 6. On request and payment of a reasonable fee, the 15-5 Board of Nurse Examiners and the Board of Vocational Nurse 15-6 Examiners shall provide a registered or vocational nurse licensed 15-7 by this state with a copy of information regarding the nurse 15-8 maintained by the Coordinated Licensure Information System under 15-9 Article 7 of the Nurse Licensure Compact. A board is not obligated 15-10 to provide information not available to the board or information 15-11 that is not available to the nurse under the laws of the state 15-12 contributing the information to the Coordinated Licensure 15-13 Information System. 15-14 Sec. 7. Practice-related information provided by the Board 15-15 of Nurse Examiners or the Board of Vocational Nurse Examiners to 15-16 registered or vocational nurses licensed by this state shall be 15-17 made available by the boards on request and at a reasonable cost to 15-18 nurses practicing in this state under a license issued by a state 15-19 that is a party to the Nurse Licensure Compact. 15-20 Sec. 8. The Nurse Licensure Compact expires on December 31, 15-21 2005, unless this section is repealed or the expiration date is 15-22 extended. 15-23 SECTION 2. Section 4, Article 4518, Revised Statutes, is 15-24 amended to read as follows: 15-25 Sec. 4. Any person practicing or offering to practice 15-26 professional nursing in this state for compensation, shall 15-27 hereafter be required to submit evidence to the Board that the 16-1 person is qualified to practice and shall be registered as provided 16-2 by this law unless the person is entitled to practice in this state 16-3 under the Nurse Licensure Compact under Article 4528b, Revised 16-4 Statutes. 16-5 SECTION 3. Section 1, Article 4519a, Revised Statutes, is 16-6 amended to read as follows: 16-7 Sec. 1. (a) An individual enrolled or planning to enroll in 16-8 an educational program that prepares an individual for an initial 16-9 license as a registered nurse who has reason to believe that the 16-10 individual is ineligible for the license may petition the board for 16-11 a declaratory order as to the individual's eligibility. The 16-12 petition must state the basis for the individual's potential 16-13 ineligibility. The board shall have the same powers to investigate 16-14 the petition and the individual's eligibility that it has to 16-15 investigate a person applying for a license. The petitioning 16-16 individual or the board may amend the petition at any time before a 16-17 final determination is made to include additional grounds for 16-18 potential ineligibility. 16-19 (b) If the board finds that a ground for ineligibility does 16-20 not exist, the board, instead of issuing an order, shall notify the 16-21 petitioner in writing listing each ground of potential 16-22 ineligibility and the board's determination. 16-23 (c) If the board proposes to find the petitioner ineligible 16-24 for a license, the petitioner is entitled to a hearing before the 16-25 board in accordance with Subsection (a), Article 4525, Revised 16-26 Statutes, as amended by Section 8, Chapter 840, Acts of the 73rd 16-27 Legislature, 1993. The board's order must set out each basis for 17-1 potential ineligibility and the board's determination as to 17-2 eligibility. 17-3 (d) In the absence of new evidence known to but not 17-4 disclosed by the petitioner or not reasonably available to the 17-5 board at the time the order is issued, the board's ruling on the 17-6 petition determines the individual's eligibility with respect to 17-7 the basis for potential ineligibility set out in the written notice 17-8 or order. 17-9 SECTION 4. Chapter 7, Title 71, Revised Statutes, is amended 17-10 by adding Article 4525.01 to read as follows: 17-11 Art. 4525.01. ADDITIONAL GROUNDS FOR DISCIPLINARY ACTION. 17-12 (a) A person is subject to being refused admission to a licensing 17-13 examination, to denial of a license, or to disciplinary action by 17-14 the board if the person's privilege to practice nursing in another 17-15 jurisdiction is revoked, suspended, denied, or subjected to any 17-16 other disciplinary action. 17-17 (b) A certified copy of the order of denial, suspension, or 17-18 revocation of the privilege or the other action by the jurisdiction 17-19 is conclusive evidence of that action. 17-20 SECTION 5. Section 3, Article 4527a, Revised Statutes, is 17-21 amended to read as follows: 17-22 Sec. 3. (a) No person, unless he or she is licensed under 17-23 this chapter, may practice professional nursing or use in 17-24 connection with his or her name the title "registered nurse," 17-25 "professional nurse," or "graduate nurse," the abbreviation "R.N.," 17-26 or any designation tending to imply that he or she is a licensed 17-27 registered nurse. 18-1 (b) This section does not apply to a person practicing 18-2 professional nursing under the Nurse Licensure Compact under 18-3 Article 4528b, Revised Statutes. 18-4 SECTION 6. Section 2(a), Chapter 118, Acts of the 52nd 18-5 Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas 18-6 Civil Statutes), is amended to read as follows: 18-7 (a) A person may not use the designation Licensed Vocational 18-8 Nurse or the abbreviation L.V.N., unless such person shall hold a 18-9 license issued by the Board pursuant to the provisions of this Act. 18-10 This subsection does not apply to a person practicing vocational 18-11 nursing under the Nurse Licensure Compact under Article 4528b, 18-12 Revised Statutes. 18-13 SECTION 7. Section 10(a), Chapter 118, Acts of the 52nd 18-14 Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas 18-15 Civil Statutes), is amended to read as follows: 18-16 (a) The Board may refuse to admit persons to its 18-17 examinations, may refuse to issue or renew a license, may refuse to 18-18 issue a temporary permit, may issue a warning or reprimand, may 18-19 place on probation a person whose license has been suspended, or 18-20 may suspend or may revoke the license of any practitioner of 18-21 vocational nursing for any of the following reasons: 18-22 (1) violation of this Act or of any rule, regulation, 18-23 or order issued under this Act; 18-24 (2) commission of fraud or deceit in procuring or 18-25 attempting to procure a license to practice vocational nursing; 18-26 (3) conviction of a crime of the grade of felony or a 18-27 crime of a lesser grade which involves moral turpitude; 19-1 (4) use of any nursing license, certificate, diploma, 19-2 or permit or transcript of the license, certificate, diploma, or 19-3 permit, which has been fraudulently purchased, issued, 19-4 counterfeited, or materially altered; 19-5 (5) impersonation of or the acting as a proxy for 19-6 another in any examination required by law to obtain a license to 19-7 practice vocational nursing; 19-8 (6) knowingly aiding or abetting any unlicensed person 19-9 in connection with the unauthorized practice of vocational nursing; 19-10 (7) revocation, suspension, or denial of a license to 19-11 practice vocational or practical nursing in another jurisdiction or 19-12 revocation, suspension, or denial of a license or a privilege to 19-13 practice professional nursing in this state or in another 19-14 jurisdiction; certified copy of the order of denial, suspension, 19-15 or revocation shall be conclusive evidence of that fact; 19-16 (8) intemperate use of alcohol or drugs; 19-17 (9) unprofessional or dishonorable conduct that, in 19-18 the opinion of the Board, is likely to deceive, defraud, or injure 19-19 the public; 19-20 (10) adjudication of mental incompetency; or 19-21 (11) lack of fitness to practice by reason of mental 19-22 or physical health that may result in injury to patients or the 19-23 public. 19-24 SECTION 8. (a) Not later than January 1, 2000, the Board of 19-25 Nurse Examiners and the Board of Vocational Nurse Examiners shall 19-26 participate in a nurse licensure compact evaluation initiative 19-27 designed to evaluate the effectiveness and operability of the Nurse 20-1 Licensure Compact. 20-2 (b) The evaluation initiative shall be conducted by a 20-3 qualified researcher. A component of the evaluation initiative 20-4 shall be a state practice identification system through which 20-5 nurses designate the states in which they practice and that 20-6 provides for updating the information at the time of issuance and 20-7 renewal of licenses. 20-8 (c) The evaluation initiative shall continue at least 20-9 through June 1, 2004, after which a report shall be produced and 20-10 submitted for comment by the Board of Nurse Examiners and the Board 20-11 of Vocational Nurse Examiners. 20-12 (d) The report and the boards' comments shall be submitted 20-13 to the legislature not later than October 1, 2004, in the form of a 20-14 Nurse Licensure Compact evaluation report. 20-15 (e) The boards may accept and spend money made available by 20-16 the federal or state government or by another public or private 20-17 source to fund participation in the evaluation initiative. 20-18 SECTION 9. (a) Except as provided by Subsection (b) of this 20-19 section, this Act takes effect January 1, 2000. 20-20 (b) Article 4528b, Revised Statutes, as added by this Act, 20-21 takes effect January 1, 2000, unless the governor, on the 20-22 recommendation of the Board of Nurse Examiners and the Board of 20-23 Vocational Nurse Examiners, determines a later date would be in the 20-24 best interest of the state. 20-25 SECTION 10. The importance of this legislation and the 20-26 crowded condition of the calendars in both houses create an 20-27 emergency and an imperative public necessity that the 21-1 constitutional rule requiring bills to be read on three several 21-2 days in each house be suspended, and this rule is hereby suspended.