103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB2795

 

Introduced 1/17/2024, by Sen. Michael W. Halpin

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in the Act. Provides that the maximum patient assignments may not be exceeded, regardless of the use and application of any patient acuity system. Requires the Department of Public Health to adopt rules governing the implementation and administration of the Act. Provides that all facilities shall adopt written policies and procedures for the training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides requirements for the Act's implementation. Establishes recordkeeping requirements. Provides rights and protections for nurses. Contains a severability provision and other provisions. Amends the Hospital Licensing Act. Provides that a hospital shall not mandate that a registered professional nurse delegate nursing interventions. Makes changes concerning staffing plans. Amends the Nurse Practice Act. Requires the exercise of professional judgment by a direct care registered professional nurse in the performance of his or her scope of practice to be provided in the exclusive interests of the patient. Ratifies and approves the Nurse Licensure Compact, which allows for the issuance of multistate licenses that allow nurses to practice in their home state and other compact states. Provides that the Compact does not supersede existing State labor laws. Provides that the State may not share with or disclose to the Interstate Commission of Nurse Licensure Compact Administrators or any other state any of the contents of a nationwide criminal history records check conducted for the purpose of multistate licensure under the Nurse Licensure Compact.


LRB103 34815 SPS 64670 b

 

 

A BILL FOR

 

SB2795LRB103 34815 SPS 64670 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the Safe
5Patient Limits Act.
 
6    Section 5. Definitions. In this Act:
7    "Couplet" means one postpartum patient and one baby.
8    "Critical trauma patient" means a patient who has an
9injury to an anatomic area that (i) requires life-saving
10interventions or (ii) in conjunction with unstable vital
11signs, poses an immediate threat to life or limb.
12    "Department" means the Department of Public Health.
13    "Direct care registered professional nurse" means a
14registered professional nurse who has accepted a hands-on,
15in-person patient care assignment and whose primary role is to
16provide hands-on, in-person patient care.
17    "Facility" means a hospital licensed under the Hospital
18Licensing Act or organized under the University of Illinois
19Hospital Act, a private or State-owned and State-operated
20general acute care hospital, an LTAC hospital as defined in
21Section 10 of the Long Term Acute Care Hospital Quality
22Improvement Transfer Program Act, an ambulatory surgical
23treatment center as defined in Section 3 of the Ambulatory

 

 

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1Surgical Treatment Center Act, a freestanding emergency center
2licensed under the Emergency Medical Services (EMS) Systems
3Act, a birth center licensed under the Birth Center Licensing
4Act, an acute psychiatric hospital, an acute care specialty
5hospital, or an acute care unit within a health care facility.
6    "Health care emergency" means an emergency that is
7declared by an authorized person within federal, State, or
8local government and is related to circumstances that are
9unpredictable and unavoidable, affect the delivery of medical
10care, and require an immediate or exceptional level of
11emergency or other medical services at the specific facility.
12"Health care emergency" does not include a state of emergency
13that results from a labor dispute in the health care industry
14or consistent understaffing.
15    "Health care workforce" means personnel employed by or
16contracted to work at a facility that have an effect upon the
17delivery of quality care to patients, including, but not
18limited to, registered nurses, licensed practical nurses,
19unlicensed assistive personnel, service, maintenance,
20clerical, professional, and technical workers, and other
21health care workers.
22    "Immediate postpartum patient" means a patient who has
23given birth within the previous 2 hours.
24    "Nursing care" means care that falls within the scope of
25practice described in Section 55-30 or 60-35 of the Nurse
26Practice Act or is otherwise encompassed within recognized

 

 

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1standards of nursing practice.
2    "Rapid response team" means a team of health care
3providers that provide care to patients with early signs of
4deterioration to prevent respiratory or cardiac arrest.
5    "Registered nurse" or "registered professional nurse"
6means a person who is licensed as a registered professional
7nurse under the Nurse Practice Act and practices nursing as
8described in Section 60-35 of the Nurse Practice Act.
9    "Specialty care unit" means a unit that is organized,
10operated, and maintained to provide care for a specific
11medical condition or a specific patient population.
 
12    Section 10. Maximum patient assignments for registered
13nurses.
14    (a) The maximum number of patients assigned to a
15registered nurse in a facility shall not exceed the limits
16provided in this Section. However, nothing shall preclude a
17facility from assigning fewer patients to a registered nurse
18than the limits provided in this Section. The requirements of
19this Section apply at all times during each shift within each
20clinical unit and each patient care area. For the purposes of
21this Act, a patient is assigned to a registered nurse if the
22registered nurse accepts responsibility for the patient's
23nursing care.
24    (b) In all units with critical care or intensive care
25patients, including, but not limited to, coronary care, acute

 

 

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1respiratory care, medical, burn, pediatric, or neonatal
2intensive care patients, the maximum patient assignment of
3critical care patients to a registered nurse is one.
4    (c) In all units with step-down or intermediate intensive
5care patients, the maximum patient assignment of step-down or
6intermediate intensive care patients to a registered nurse is
73.
8    (d) In all units with postanesthesia care patients,
9regardless of the type of anesthesia administered, the maximum
10patient assignment of postanesthesia care patients or patients
11being monitored for the effects of any anesthetizing agent to
12a registered nurse is one.
13    (e) In all units with operating room patients, the maximum
14patient assignment of operating room patients to a registered
15nurse is one, provided that a minimum of one additional person
16serves as a scrub assistant for each patient.
17    (f) In the emergency department:
18        (1) In a unit providing basic emergency services or
19    comprehensive emergency services, the maximum patient
20    assignment at any time to a registered nurse is 3.
21        (2) The maximum assignment of critical care emergency
22    patients to a registered nurse is one. A patient in the
23    emergency department shall be considered a critical care
24    patient when the patient meets the criteria for admission
25    to a critical care service area within the facility.
26        (3) The maximum assignment of critical trauma patients

 

 

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1    in an emergency unit to a registered nurse is one.
2        (4) At least one direct care registered professional
3    nurse shall be assigned to triage patients. The direct
4    care registered professional nurse assigned to triage
5    patients shall be immediately available at all times to
6    triage patients when they arrive in the emergency
7    department. The direct care registered professional nurse
8    assigned to triage patients shall perform triage functions
9    only and may not be assigned the responsibility of the
10    base radio. Triage, radio, or flight registered nurses
11    shall not be counted in the calculation of direct care
12    registered nurse staffing levels.
13    (g) In all units with maternal child care patients the
14maximum patient assignment:
15        (1) to a registered nurse of antepartum patients
16    requiring continuous fetal monitoring is 2;
17        (2) of other antepartum patients who are not in active
18    labor to a registered nurse is 3;
19        (3) of active labor patients to a registered nurse is
20    one;
21        (4) of patients with medical or obstetrical
22    complications during the initiation of epidural anesthesia
23    or during circulation for a caesarean section delivery to
24    a registered nurse is one;
25        (5) during birth is one registered nurse responsible
26    for the patient in labor and, for each newborn, one

 

 

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1    registered nurse whose sole responsibility is that newborn
2    patient;
3        (6) of postpartum patients when the parent has given
4    birth within the previous 2 hours is one registered nurse
5    for each couplet, and in the case of multiple births, one
6    registered nurse for each additional newborn;
7        (7) of couplets to a registered nurse is 2;
8        (8) of patients receiving postpartum or postoperative
9    gynecological care to a registered nurse is 4 when the
10    registered nurse has been assigned only to patients
11    receiving postpartum or postoperative gynecological care;
12        (9) of newborn patients when the patient is unstable,
13    as assessed by a direct care registered professional
14    nurse, to a registered nurse is one; and
15        (10) of newborn patients to a registered nurse is 2
16    when the patients are receiving intermediate care or the
17    nurse has been assigned to a patient care unit that
18    receives newborn patients requiring intermediate care,
19    including, but not limited to, an intermediate care
20    nursery.
21    (h) In all units with pediatric patients, the maximum
22patient assignment of pediatric patients to a registered nurse
23is 3.
24    (i) In all units with psychiatric patients, the maximum
25patient assignment of psychiatric patients to a registered
26nurse is 4.

 

 

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1    (j) In all units with medical and surgical patients, the
2maximum patient assignment of medical or surgical patients to
3a registered nurse is 4.
4    (k) In all units with telemetry patients, the maximum
5patient assignment of telemetry patients to a registered nurse
6is 3.
7    (l) In all units with observational patients, the maximum
8patient assignment of observational patients to a registered
9nurse is 3.
10    (m) In all units with acute rehabilitation patients, the
11maximum patient assignment of acute rehabilitation patients to
12a registered nurse is 4.
13    (n) In all units with conscious sedation patients, the
14maximum patient assignment of conscious sedation patients to a
15registered nurse is one.
16    (o) In any unit not otherwise listed in this Section,
17including all specialty care units not otherwise listed in
18this Section, the maximum patient assignment to a registered
19nurse is 4.
 
20    Section 15. Use of rapid response teams as first
21responders prohibited. A rapid response team's registered
22nurse shall not be given direct care patient assignments while
23assigned as a registered nurse who is responsible for
24responding to a rapid response team request.
 

 

 

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1    Section 20. Implementation by a facility.
2    (a) A facility shall implement the patient limits
3established under Section 10 without diminishing the staffing
4levels of the facility's health care workforce. A facility may
5not lay off licensed practical nurses, licensed psychiatric
6technicians, certified nursing assistants, or other ancillary
7support staff to meet the patient limits under Section 10.
8    (b) Each patient shall be assigned to a direct care
9registered professional nurse who shall directly provide the
10comprehensive patient assessment, development of a plan of
11care, and supervision, implementation, and evaluation of the
12nursing care provided to the patient at least every shift and
13who has the responsibility for the provision of care to a
14particular patient within the registered nurse's scope of
15practice.
16    (c) There shall be no averaging of the number of patients
17and the total number of registered nurses in each clinical
18unit or patient care area in order to meet the patient limits
19under Section 10.
20    (d) Only registered nurses providing direct patient care
21shall be considered when evaluating compliance with the
22patient limits under Section 10. Ancillary staff and
23unlicensed personnel shall not be considered when evaluating
24compliance with the patient limits under Section 10.
25    (e) The hours in which a nurse administrator, nurse
26supervisor, nurse manager, charge nurse, and other licensed

 

 

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1nurse provides patient care shall not be considered when
2evaluating compliance with the patient limits under Section 10
3and with the patient assignment requirement under subsection
4(b) unless the registered nurse:
5        (1) has a current and active direct patient care
6    assignment;
7        (2) provides direct patient care in compliance with
8    this Act;
9        (3) has demonstrated the registered nurse's competence
10    in providing care in the registered nurse's assigned unit
11    to the facility; and
12        (4) has the principal responsibility of providing
13    direct patient care and has no additional job duties
14    during the time period during which the nurse has a
15    patient assignment.
16    (f) The hours in which a nurse administrator, nurse
17supervisor, nurse manager, charge nurse, or other licensed
18nurse provides direct patient care may be considered when
19evaluating compliance with the patient limits under Section 10
20and with the patient assignment requirement under subsection
21(b) only if he or she is providing relief for a direct care
22registered professional nurse during breaks, meals, and other
23routine and expected absences from that unit.
24    (g) At all times during each shift within a facility unit,
25clinical unit, or patient care area of a facility, and with the
26full complement of ancillary support staff, at least 2 direct

 

 

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1care registered nurses shall be physically present in each
2facility unit, clinical unit, or patient care area where a
3patient is present.
4    (h) Identifying a clinical unit or patient care area by a
5name or term other than those listed in this Act does not
6affect a facility's requirement to staff the unit consistent
7with the patient limits identified for the level of intensity
8or type of care described in this Act.
9    (i) A registered nurse providing direct care to a patient
10has the authority to determine if a change in the patient's
11status places the patient in a different category requiring a
12different patient limit under Section 10.
13    (j) A facility shall assign direct care professional
14registered nurses in a patient care unit in accordance with
15Section 10 in order to meet the highest level of intensity and
16type of care provided in the patient care unit. If multiple
17assignments described under Section 10 apply to a patient, the
18facility shall assign a direct care professional registered
19nurse in accordance with the lowest numerical patient
20assignment under that Section.
21    (k) A facility shall provide staffing of direct care
22registered professional nurses above the number of direct care
23registered professional nurses required to comply with the
24patient levels under Section 10, or additional staffing of
25licensed practical nurses, certified nursing assistants, or
26other licensed or unlicensed ancillary support staff, based on

 

 

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1the direct care registered professional nurse's assessment of
2each assigned individual patient, the individual patient's
3nursing care requirements, and the individual patient's
4nursing care plan.
5    (l) A facility shall not employ video monitors, remote
6patient monitoring, or any form of electronic visualization of
7a patient as a substitute for the direct in-person observation
8required for patient assessment by a registered nurse or for
9patient protection. Video monitors or any form of electronic
10visualization of a patient shall not constitute compliance
11with the patient limits under Section 10.
12    (m) A facility must provide relief by a direct care
13registered professional nurse with unit-specific education,
14training, and competence during another direct care registered
15professional nurse's meal periods, breaks, and routine
16absences as part of the facility's obligation to meet the
17patient limits under Section 10 at all times.
 
18    Section 25. Changes in patient census.
19    (a) A facility shall plan for routine fluctuations in its
20patient census, including, but not limited to, admissions,
21discharges, and transfers.
22    (b) If a health care emergency causes a change in the
23number of patients in a clinical care unit or patient care
24area, the facility must be able to demonstrate that immediate
25and diligent efforts were made to maintain required staffing

 

 

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1levels under this Act.
2    (c) A facility shall immediately notify the Department if
3a health care emergency described under subsection (b) causes
4a change in the number of patients in a clinical care unit or
5patient care area and shall report to the Department efforts
6made to maintain staffing levels required under this Act.
 
7    Section 30. Record of staff assignments.
8    (a) A facility shall keep a record of the actual direct
9care registered professional nurse, licensed practical nurse,
10certified nursing assistant, and other ancillary staff
11assignments to individual patients documented on a day-to-day,
12shift-by-shift basis, shall submit copies of its records to
13the Department quarterly, and shall keep copies of its staff
14assignments on file for a period of 7 years.
15    (b) The documentation required under subsection (a) shall
16be submitted to the Department as a mandatory condition of
17licensure. The documentation shall be submitted with a
18certification by the chief nursing officer of the facility
19that the documentation completely and accurately reflects
20registered nurse staffing levels by the facility for each
21shift in each facility unit, clinical unit, and patient care
22area in which patients receive care. The chief nursing officer
23shall execute the certification under penalty of perjury and
24the certification must contain an expressed acknowledgment
25that any false statement constitutes fraud and is subject to

 

 

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1criminal and civil prosecution and penalties.
 
2    Section 35. Implementation by the Department. The
3Department shall adopt rules governing the implementation and
4administration of this Act, including methods for facility
5staff, facility staff's collective bargaining representatives,
6and the public to file complaints regarding violations of this
7Act with the Department. The Department shall conduct periodic
8audits to ensure compliance with this Act.
 
9    Section 40. Nursing staff education, training, and
10orientation.
11    (a) A facility shall adopt written policies that include,
12but are not limited to:
13        (1) procedures for the education, training, and
14    orientation of nursing staff to each clinical area where
15    the nursing staff will work; and
16        (2) criteria for the facility to use in determining
17    whether a registered nurse has demonstrated current
18    competence in providing care in a clinical area.
19    (b) A registered nurse shall not be assigned to a facility
20unit, clinical unit, or patient care area unless the
21registered nurse has first received education, training, and
22orientation in that clinical area that is sufficient to
23provide safe, therapeutic, and competent care to patients in
24that clinical area and has demonstrated competence in

 

 

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1providing care in that clinical area.
2    (c) A registered nurse shall not be assigned to relieve a
3direct care professional registered nurse during breaks,
4meals, and routine absences from a facility unit, clinical
5unit, or patient care area unless that registered nurse has
6first received education, training, and orientation in that
7clinical area that is sufficient to provide safe, therapeutic,
8and competent care to patients in that clinical area and has
9demonstrated competence in providing care in that clinical
10area.
11    (d) A health care facility may not assign any nursing
12personnel from a temporary nursing agency to the facility's
13unit, clinical unit, or patient care area unless the nursing
14personnel have first received education, training, and
15orientation in that clinical area that is sufficient to
16provide safe, therapeutic, and competent care to patients in
17that clinical area and have demonstrated competence in
18providing care in that clinical area.
 
19    Section 45. Enforcement.
20    (a) In addition to any other penalty prescribed by law,
21the Department may impose a civil penalty against a facility
22that violates this Act of up to $25,000 for each violation,
23except that the Department shall impose a civil penalty of at
24least $25,000 for each violation if the Department determines
25that the health care facility has a pattern of violation. A

 

 

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1separate and distinct violation shall be deemed to have been
2committed on each day during which any violation continues
3after receipt of written notice of the violation from the
4Department by the facility.
5    (b) The Department shall post on its website the names of
6facilities against which civil penalties have been imposed
7under this Act, the violation for which the penalty was
8imposed, and additional information as the Department deems
9necessary.
10    (c) A facility's failure to adhere to the patient
11assignment limits under Section 10, any other violation of
12this Act, or any violation of Section 10.10 of the Hospital
13Licensing Act shall be reported by the Department to the
14Attorney General for enforcement, for which the Attorney
15General may bring action in a court of competent jurisdiction
16seeking injunctive relief and civil penalties.
17    (d) It is a defense to an enforcement action under this Act
18if the facility demonstrates that a health care emergency was
19in force at the time of the alleged violation and that the
20facility made immediate and diligent efforts to maintain
21staffing levels required under this Act.
 
22    Section 50. Nurse rights and protections.
23    (a) A registered professional nurse may object to or
24refuse to participate in any activity, practice, assignment,
25or task if:

 

 

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1        (1) in good faith, the registered nurse reasonably
2    believes it to be a violation of the direct care
3    registered professional nurse maximum patient assignments
4    or any other provision established under this Act or a
5    rule adopted by the Department under this Act;
6        (2) the registered nurse, based on the registered
7    nurse's nursing judgment, reasonably believes the
8    registered nurse is not prepared by education, training,
9    or experience to fulfill the assignment without
10    compromising the safety of any patient or jeopardizing the
11    license of the registered nurse; or
12        (3) in the registered nurse's nursing judgment, the
13    activity, policy, practice, assignment or task would be
14    outside the registered nurse's scope of practice or would
15    otherwise compromise the safety of any patient or the
16    registered nurse.
17    (b) A facility shall not retaliate, discriminate, or
18otherwise take adverse action in any manner with respect to
19any aspect of a nurse's employment, including discharge,
20promotion, compensation, or terms, conditions, or privileges
21of employment, based on the nurse's refusal to complete an
22assignment under subsection (a).
23    (c) A facility shall not file a complaint against a
24registered professional nurse with the Board of Nursing based
25on the nurse's refusal to complete an assignment under
26subsection (a).

 

 

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1    (d) A facility shall not retaliate, discriminate, or
2otherwise take adverse action in any manner against any person
3or with respect to any aspect of a nurse's employment,
4including discharge, promotion, compensation, or terms,
5conditions, or privileges of employment, based on that nurse's
6or that person's opposition to any facility policy, practice,
7or action that the nurse in good faith believes violates this
8Act.
9    (e) A facility shall not retaliate, discriminate, or
10otherwise take adverse action against any patient or employee
11of the facility or any other individual on the basis that the
12patient, employee, or individual, in good faith, individually
13or in conjunction with another person or persons, has
14presented a grievance or complaint, initiated or cooperated in
15any investigation or proceeding of any governmental entity,
16regulatory agency, or private accreditation body, made a civil
17claim or demand, or filed an action relating to the care,
18services, or conditions of the facility or of any affiliated
19or related facility.
20    (f) A facility shall not:
21        (1) interfere with, restrain, or deny the exercise of,
22    or attempt to deny the exercise of, a right conferred
23    under this Act; or
24        (2) coerce or intimidate any individual regarding the
25    exercise of, or an attempt to exercise, a right conferred
26    under this Act.
 

 

 

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1    Section 97. Severability. The provisions of this Act are
2severable under Section 1.31 of the Statute on Statutes.
 
3    Section 110. The Hospital Licensing Act is amended by
4changing Section 10.10 as follows:
 
5    (210 ILCS 85/10.10)
6    (Text of Section before amendment by P.A. 103-211)
7    Sec. 10.10. Nurse staffing by patient acuity.
8    (a) Findings. The Legislature finds and declares all of
9the following:
10        (1) The State of Illinois has a substantial interest
11    in promoting quality care and improving the delivery of
12    health care services.
13        (2) Evidence-based studies have shown that the basic
14    principles of staffing in the acute care setting should be
15    based on the complexity of patients' care needs aligned
16    with available nursing skills to promote quality patient
17    care consistent with professional nursing standards.
18        (3) Compliance with this Section promotes an
19    organizational climate that values registered nurses'
20    input in meeting the health care needs of hospital
21    patients.
22    (b) Definitions. As used in this Section:
23    "Acuity model" means an assessment tool selected and

 

 

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1implemented by a hospital, as recommended by a nursing care
2committee, that assesses the complexity of patient care needs
3requiring professional nursing care and skills and aligns
4patient care needs and nursing skills consistent with
5professional nursing standards.
6    "Department" means the Department of Public Health.
7    "Direct patient care" means care provided by a registered
8professional nurse with direct responsibility to oversee or
9carry out medical regimens or nursing care for one or more
10patients.
11    "Nursing care committee" means a hospital-wide committee
12or committees of nurses whose functions, in part or in whole,
13contribute to the development, recommendation, and review of
14the hospital's nurse staffing plan established pursuant to
15subsection (d).
16    "Registered professional nurse" means a person licensed as
17a Registered Nurse under the Nurse Practice Act.
18    "Written staffing plan for nursing care services" means a
19written plan for the assignment of patient care nursing staff
20based on multiple nurse and patient considerations that yield
21minimum staffing levels for inpatient care units and the
22adopted acuity model aligning patient care needs with nursing
23skills required for quality patient care consistent with
24professional nursing standards.
25    (c) Written staffing plan.
26        (1) Every hospital shall implement a written

 

 

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1    hospital-wide staffing plan, prepared by a nursing care
2    committee or committees, that provides for minimum direct
3    care professional registered nurse-to-patient staffing
4    needs for each inpatient care unit, including inpatient
5    emergency departments. If the staffing plan prepared by
6    the nursing care committee is not adopted by the hospital,
7    or if substantial changes are proposed to it, the chief
8    nursing officer shall either: (i) provide a written
9    explanation to the committee of the reasons the plan was
10    not adopted; or (ii) provide a written explanation of any
11    substantial changes made to the proposed plan prior to it
12    being adopted by the hospital. The written hospital-wide
13    staffing plan shall include, but need not be limited to,
14    the following considerations:
15            (A) The complexity of complete care, assessment on
16        patient admission, volume of patient admissions,
17        discharges and transfers, evaluation of the progress
18        of a patient's problems, ongoing physical assessments,
19        planning for a patient's discharge, assessment after a
20        change in patient condition, and assessment of the
21        need for patient referrals.
22            (B) The complexity of clinical professional
23        nursing judgment needed to design and implement a
24        patient's nursing care plan, the need for specialized
25        equipment and technology, the skill mix of other
26        personnel providing or supporting direct patient care,

 

 

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1        and involvement in quality improvement activities,
2        professional preparation, and experience.
3            (C) Patient acuity and the number of patients for
4        whom care is being provided.
5            (D) The ongoing assessments of a unit's patient
6        acuity levels and nursing staff needed shall be
7        routinely made by the unit nurse manager or his or her
8        designee.
9            (E) The identification of additional registered
10        nurses available for direct patient care when
11        patients' unexpected needs exceed the planned workload
12        for direct care staff.
13        (2) In order to provide staffing flexibility to meet
14    patient needs, every hospital shall identify an acuity
15    model for adjusting the staffing plan for each inpatient
16    care unit.
17        (2.5) Each hospital shall implement the staffing plan
18    and assign nursing personnel to each inpatient care unit,
19    including inpatient emergency departments, in accordance
20    with the staffing plan.
21            (A) A registered nurse may report to the nursing
22        care committee any variations where the nurse
23        personnel assignment in an inpatient care unit is not
24        in accordance with the adopted staffing plan and may
25        make a written report to the nursing care committee
26        based on the variations.

 

 

SB2795- 22 -LRB103 34815 SPS 64670 b

1            (B) Shift-to-shift adjustments in staffing levels
2        required by the staffing plan may be made by the
3        appropriate hospital personnel overseeing inpatient
4        care operations. If a registered nurse in an inpatient
5        care unit objects to a shift-to-shift adjustment, the
6        registered nurse may submit a written report to the
7        nursing care committee.
8            (C) The nursing care committee shall develop a
9        process to examine and respond to written reports
10        submitted under subparagraphs (A) and (B) of this
11        paragraph (2.5), including the ability to determine if
12        a specific written report is resolved or should be
13        dismissed.
14        (3) The written staffing plan shall be posted, either
15    by physical or electronic means, in a conspicuous and
16    accessible location for both patients and direct care
17    staff, as required under the Hospital Report Card Act. A
18    copy of the written staffing plan shall be provided to any
19    member of the general public upon request.
20    (d) Nursing care committee.
21        (1) Every hospital shall have a nursing care committee
22    that meets at least 6 times per year. A hospital shall
23    appoint members of a committee whereby at least 55% of the
24    members are registered professional nurses providing
25    direct inpatient care, one of whom shall be selected
26    annually by the direct inpatient care nurses to serve as

 

 

SB2795- 23 -LRB103 34815 SPS 64670 b

1    co-chair of the committee.
2        (2) (Blank).
3        (2.5) A nursing care committee shall prepare and
4    recommend to hospital administration the hospital's
5    written hospital-wide staffing plan. If the staffing plan
6    is not adopted by the hospital, the chief nursing officer
7    shall provide a written statement to the committee prior
8    to a staffing plan being adopted by the hospital that: (A)
9    explains the reasons the committee's proposed staffing
10    plan was not adopted; and (B) describes the changes to the
11    committee's proposed staffing or any alternative to the
12    committee's proposed staffing plan.
13        (3) A nursing care committee's or committees' written
14    staffing plan for the hospital shall be based on the
15    principles from the staffing components set forth in
16    subsection (c). In particular, a committee or committees
17    shall provide input and feedback on the following:
18            (A) Selection, implementation, and evaluation of
19        minimum staffing levels for inpatient care units.
20            (B) Selection, implementation, and evaluation of
21        an acuity model to provide staffing flexibility that
22        aligns changing patient acuity with nursing skills
23        required.
24            (C) Selection, implementation, and evaluation of a
25        written staffing plan incorporating the items
26        described in subdivisions (c)(1) and (c)(2) of this

 

 

SB2795- 24 -LRB103 34815 SPS 64670 b

1        Section.
2            (D) Review the nurse staffing plans for all
3        inpatient areas and current acuity tools and measures
4        in use. The nursing care committee's review shall
5        consider:
6                (i) patient outcomes;
7                (ii) complaints regarding staffing, including
8            complaints about a delay in direct care nursing or
9            an absence of direct care nursing;
10                (iii) the number of hours of nursing care
11            provided through an inpatient hospital unit
12            compared with the number of inpatients served by
13            the hospital unit during a 24-hour period;
14                (iv) the aggregate hours of overtime worked by
15            the nursing staff;
16                (v) the extent to which actual nurse staffing
17            for each hospital inpatient unit differs from the
18            staffing specified by the staffing plan; and
19                (vi) any other matter or change to the
20            staffing plan determined by the committee to
21            ensure that the hospital is staffed to meet the
22            health care needs of patients.
23        (4) A nursing care committee must issue a written
24    report addressing the items described in subparagraphs (A)
25    through (D) of paragraph (3) semi-annually. A written copy
26    of this report shall be made available to direct inpatient

 

 

SB2795- 25 -LRB103 34815 SPS 64670 b

1    care nurses by making available a paper copy of the
2    report, distributing it electronically, or posting it on
3    the hospital's website.
4        (5) A nursing care committee must issue a written
5    report at least annually to the hospital governing board
6    that addresses items including, but not limited to: the
7    items described in paragraph (3); changes made based on
8    committee recommendations and the impact of such changes;
9    and recommendations for future changes related to nurse
10    staffing.
11    (e) Nothing in this Section 10.10 shall be construed to
12limit, alter, or modify any of the terms, conditions, or
13provisions of a collective bargaining agreement entered into
14by the hospital.
15    (f) No hospital may discipline, discharge, or take any
16other adverse employment action against an employee solely
17because the employee expresses a concern or complaint
18regarding an alleged violation of this Section or concerns
19related to nurse staffing.
20    (g) Any employee of a hospital may file a complaint with
21the Department regarding an alleged violation of this Section.
22The Department must forward notification of the alleged
23violation to the hospital in question within 10 business days
24after the complaint is filed. Upon receiving a complaint of a
25violation of this Section, the Department may take any action
26authorized under Section Sections 7 or 9 of this Act.

 

 

SB2795- 26 -LRB103 34815 SPS 64670 b

1(Source: P.A. 102-4, eff. 4-27-21; 102-641, eff. 8-27-21;
2102-813, eff. 5-13-22; revised 9-26-23.)
 
3    (Text of Section after amendment by P.A. 103-211)
4    Sec. 10.10. Nurse staffing by patient acuity.
5    (a) Findings. The Legislature finds and declares all of
6the following:
7        (1) The State of Illinois has a substantial interest
8    in promoting quality care and improving the delivery of
9    health care services.
10        (2) Evidence-based studies have shown that the basic
11    principles of staffing in the acute care setting should be
12    based on the complexity of patients' care needs aligned
13    with available nursing skills to promote quality patient
14    care consistent with professional nursing standards.
15        (3) Compliance with this Section promotes an
16    organizational climate that values registered nurses'
17    input in meeting the health care needs of hospital
18    patients.
19    (b) Definitions. As used in this Section:
20    "Acuity model" means an assessment tool selected and
21implemented by a hospital, as recommended by a nursing care
22committee, that assesses the complexity of patient care needs
23requiring professional nursing care and skills and aligns
24patient care needs and nursing skills consistent with
25professional nursing standards.

 

 

SB2795- 27 -LRB103 34815 SPS 64670 b

1    "Department" means the Department of Public Health.
2    "Direct patient care" means care provided in person by a
3registered professional nurse with direct responsibility to
4oversee or carry out medical regimens or nursing care for one
5or more patients.
6    "Nursing care committee" means a hospital-wide committee
7or committees of nurses whose functions, in part or in whole,
8contribute to the development, recommendation, and review of
9the hospital's nurse staffing plan established pursuant to
10subsection (d).
11    "Registered professional nurse" means a person licensed as
12a Registered Nurse under the Nurse Practice Act.
13    "Written staffing plan for nursing care services" means a
14written plan for the assignment of patient care nursing staff
15based on multiple nurse and patient considerations that
16ensures the facility meets the maximum patient assignment
17limits under Section 10 of the Safe Patient Limits Act and the
18adopted method to adjust the staffing plan for each inpatient
19care unit when additional staff are needed to fulfill the care
20needs of each individual patient as determined by the
21patient's assigned direct care registered professional nurse
22yield minimum staffing levels for inpatient care units and the
23adopted acuity model aligning patient care needs with nursing
24skills required for quality patient care consistent with
25professional nursing standards.
26    (c) Written staffing plan.

 

 

SB2795- 28 -LRB103 34815 SPS 64670 b

1        (1) Every hospital shall implement a written
2    hospital-wide staffing plan, prepared by a nursing care
3    committee or committees, that provides for minimum direct
4    care professional registered nurse-to-patient staffing
5    needs for each inpatient care unit and , including
6    inpatient emergency department departments. If the
7    staffing plan prepared by the nursing care committee is
8    not adopted by the hospital, or if substantial changes are
9    proposed to it, the chief nursing officer shall either:
10    (i) provide a written explanation to the committee of the
11    reasons the plan was not adopted; or (ii) provide a
12    written explanation of any substantial changes made to the
13    proposed plan prior to it being adopted by the hospital.
14    The written hospital-wide staffing plan shall include, but
15    need not be limited to, the following considerations:
16            (A) The complexity of complete care, assessment on
17        patient admission, volume of patient admissions,
18        discharges and transfers, evaluation of the progress
19        of a patient's problems, ongoing physical assessments,
20        planning for a patient's discharge, assessment after a
21        change in patient condition, and assessment of the
22        need for patient referrals.
23            (B) The complexity of clinical professional
24        nursing judgment needed to design and implement a
25        patient's nursing care plan, the need for specialized
26        equipment and technology, the skill mix of other

 

 

SB2795- 29 -LRB103 34815 SPS 64670 b

1        personnel providing or supporting direct patient care,
2        and involvement in quality improvement activities,
3        professional preparation, and experience.
4            (C) Patient acuity and the number of patients for
5        whom care is being provided.
6            (D) The ongoing assessments of a unit's patient
7        acuity levels, as determined by the direct care
8        registered professional nurse responsible for each
9        patient's care, and nursing staff needed shall be
10        routinely made by the unit nurse manager or the unit
11        nurse manager's his or her designee.
12            (E) The identification of additional registered
13        nurses available for direct patient care when
14        patients' unexpected needs exceed the planned workload
15        for direct care staff.
16            (F) Ensuring that patient limits under Section 10
17        of the Safe Patient Limits Act to a registered nurse
18        are not exceeded.
19        (2) In order to provide staffing flexibility to meet
20    patient needs, every hospital shall include in its
21    staffing plan a method to adjust the staffing plan for
22    each inpatient care unit when the maximum patient
23    assignment under Section 10 of the Safe Patient Limits Act
24    should be reduced or additional staff are needed to
25    fulfill the care needs of each individual patient as
26    determined by the patient's assigned direct care

 

 

SB2795- 30 -LRB103 34815 SPS 64670 b

1    registered professional nurse identify an acuity model for
2    adjusting the staffing plan for each inpatient care unit.
3        (2.5) Each hospital shall implement the staffing plan
4    and assign nursing personnel to each inpatient care unit
5    and emergency department , including inpatient emergency
6    departments, in accordance with the staffing plan.
7            (A) A registered nurse may report to the nursing
8        care committee any variations where the nurse
9        personnel assignment in an inpatient care unit is not
10        in accordance with the adopted staffing plan and may
11        make a written report to the nursing care committee
12        based on the variations.
13            (B) Shift-to-shift adjustments in staffing levels
14        required by the staffing plan may be made by the
15        appropriate hospital personnel overseeing inpatient
16        care operations. If a registered nurse in an inpatient
17        care unit objects to a shift-to-shift adjustment, the
18        registered nurse may submit a written report to the
19        nursing care committee.
20            (C) The nursing care committee shall develop a
21        process to examine and respond to written reports
22        submitted under subparagraphs (A) and (B) of this
23        paragraph (2.5), including the ability to determine if
24        a specific written report is resolved or should be
25        dismissed.
26        (3) The written staffing plan shall be posted, either

 

 

SB2795- 31 -LRB103 34815 SPS 64670 b

1    by physical or electronic means, in a conspicuous and
2    accessible location for both patients and direct care
3    staff, as required under the Hospital Report Card Act. A
4    copy of the written staffing plan shall be provided to any
5    member of the general public upon request.
6        (4) The written staffing plan shall be updated on an
7    annual basis and submitted to the Department.
8        (5) Any acuity model, or other method, software, or
9    tool used to create or evaluate a staffing plan adopted by
10    a facility, shall be transparent in all respects,
11    including disclosure of detailed documentation of the
12    methodology used to determine nurse staffing and
13    identifying each factor, assumption, and value used in
14    applying the methodology. This documentation shall be
15    submitted to the Department and made available to facility
16    staff, facility staff's collective bargaining
17    representatives, and the public upon request. The patient
18    limits under Section 10 of the Safe Patient Limits Act
19    shall not be exceeded regardless of the use and
20    application of any acuity model.
21    (d) Nursing care committee.
22        (1) Every hospital shall have a nursing care committee
23    that meets at least 6 times per year. A hospital shall
24    appoint members of a committee whereby at least 55% of the
25    members are registered professional nurses providing
26    direct inpatient care, one of whom shall be selected

 

 

SB2795- 32 -LRB103 34815 SPS 64670 b

1    annually by the direct inpatient care nurses to serve as
2    co-chair of the committee.
3        (2) (Blank).
4        (2.5) A nursing care committee shall prepare and
5    recommend to hospital administration the hospital's
6    written hospital-wide staffing plan. If the staffing plan
7    is not adopted by the hospital, the chief nursing officer
8    shall provide a written statement to the committee prior
9    to a staffing plan being adopted by the hospital that: (A)
10    explains the reasons the committee's proposed staffing
11    plan was not adopted; and (B) describes the changes to the
12    committee's proposed staffing or any alternative to the
13    committee's proposed staffing plan.
14        (3) A nursing care committee's or committees' written
15    staffing plan for the hospital shall be based on the
16    principles from the staffing components set forth in
17    subsection (c). In particular, a committee or committees
18    shall provide input and feedback on the following:
19            (A) Selection, implementation, and evaluation of
20        minimum staffing levels consistent with the maximum
21        patient limits under the Safe Patient Limits Act for
22        inpatient care units.
23            (B) Selection, implementation, and evaluation of a
24        method to increase staffing as needed to meet patient
25        care needs an acuity model to provide staffing
26        flexibility that aligns changing patient acuity with

 

 

SB2795- 33 -LRB103 34815 SPS 64670 b

1        nursing skills required.
2            (C) Selection, implementation, and evaluation of a
3        written staffing plan incorporating the items
4        described in subdivisions (c)(1) and (c)(2) of this
5        Section.
6            (D) Review the nurse staffing plans for all
7        inpatient areas and current acuity tools and measures
8        in use. The nursing care committee's review shall
9        consider:
10                (i) patient outcomes;
11                (ii) complaints regarding staffing, including
12            complaints about a delay in direct care nursing or
13            an absence of direct care nursing;
14                (iii) the number of hours of nursing care
15            provided through an inpatient hospital unit
16            compared with the number of inpatients served by
17            the hospital unit during a 24-hour period;
18                (iv) the aggregate hours of overtime worked by
19            the nursing staff;
20                (v) the extent to which actual nurse staffing
21            for each hospital inpatient unit differs from the
22            staffing specified by the staffing plan; and
23                (vi) any other matter or change to the
24            staffing plan determined by the committee to
25            ensure that the hospital is staffed to meet the
26            health care needs of patients.

 

 

SB2795- 34 -LRB103 34815 SPS 64670 b

1        (4) A nursing care committee must issue a written
2    report addressing the items described in subparagraphs (A)
3    through (D) of paragraph (3) semi-annually. A written copy
4    of this report shall be made available to direct inpatient
5    care nurses by making available a paper copy of the
6    report, distributing it electronically, or posting it on
7    the hospital's website.
8        (5) A nursing care committee must issue a written
9    report at least annually to the hospital governing board
10    that addresses items including, but not limited to: the
11    items described in paragraph (3); changes made based on
12    committee recommendations and the impact of such changes;
13    and recommendations for future changes related to nurse
14    staffing.
15        (6) A nursing care committee must annually notify the
16    hospital nursing staff of the staff's rights under this
17    Section. The annual notice must provide a phone number and
18    an email address for staff to report noncompliance with
19    the nursing staff's rights as described in this Section.
20    The notice must be provided by email or by regular mail in
21    a manner that effectively facilitates receipt of the
22    notice. The Department shall monitor and enforce the
23    requirements of this paragraph (6).
24    (e) Nothing in this Section 10.10 shall be construed to
25limit, alter, or modify any of the terms, conditions, or
26provisions of a collective bargaining agreement entered into

 

 

SB2795- 35 -LRB103 34815 SPS 64670 b

1by the hospital.
2    (f) No hospital may discipline, discharge, or take any
3other adverse employment action against an employee solely
4because the employee expresses a concern or complaint
5regarding an alleged violation of this Section or concerns
6related to nurse staffing.
7    (g) Any employee of a hospital may file a complaint with
8the Department regarding an alleged violation of this Section.
9The Department must forward notification of the alleged
10violation to the hospital in question within 10 business days
11after the complaint is filed. Upon receiving a complaint of a
12violation of this Section, the Department may take any action
13authorized under Section Sections 7 or 9 of this Act.
14    (h) Delegation of nursing interventions by a registered
15professional nurse must be in accordance with the Nurse
16Practice Act.
17    (i) A hospital shall not mandate that a registered
18professional nurse delegate any element of the nursing
19process, including, but not limited to, nursing interventions,
20medication administration, nursing judgment, comprehensive
21patient assessment, development of the plan of care, or
22evaluation of care. A delegation of a nursing intervention by
23a registered professional nurse shall not be delegated again
24to another person.
25    (j) The Department shall establish procedures to ensure
26that the documentation submitted under this Section is

 

 

SB2795- 36 -LRB103 34815 SPS 64670 b

1available for public inspection in its entirety.
2    (k) Nothing in this Section shall be construed to limit,
3alter, or modify the requirements of the Safe Patient Limits
4Act.
5(Source: P.A. 102-4, eff. 4-27-21; 102-641, eff. 8-27-21;
6102-813, eff. 5-13-22; 103-211, eff. 1-1-24; revised 9-26-23.)
 
7    Section 115. The Nurse Practice Act is amended by adding
8Section 50-15.15 and Article 85 as follows:
 
9    (225 ILCS 65/50-15.15 new)
10    Sec. 50-15.15. Nursing judgment.
11    (a) The General Assembly finds that:
12        (1) Performance of the scope of practice of a direct
13    care registered professional nurse requires the exercise
14    of nursing judgment in the exclusive interests of the
15    patient.
16        (2) The exercise of nursing judgment, unencumbered by
17    the commercial or revenue-generation priorities of a
18    hospital, long-term acute care hospital, ambulatory
19    surgical treatment center, or other employing entity of a
20    direct care registered professional nurse is necessary to
21    ensure safe, therapeutic, effective, and competent
22    treatment of patients and is essential to protect the
23    health and safety of the people of Illinois.
24    (b) The exercise of nursing judgment by a direct care

 

 

SB2795- 37 -LRB103 34815 SPS 64670 b

1registered professional nurse in the performance of the scope
2of practice of the registered professional nurse under Section
360-35 or the scope of practice of the advanced practice
4registered nurse under Section 65-30 shall be provided in the
5exclusive interests of the patient and shall not, for any
6purpose, be considered, relied upon, or represented as a job
7function, authority, responsibility, or activity undertaken in
8any respect for the purpose of serving the business,
9commercial, operational, or other institutional interests of
10the employer.
11    (c) A hospital, long-term acute care hospital, ambulatory
12surgical treatment center, or other health care facility shall
13not adopt a policy that:
14        (1) limits a direct care registered professional nurse
15    in performing duties that are part of the nursing process,
16    including, but not limited to, full exercise of nursing
17    judgment in assessing, planning, implementing, and
18    evaluating care;
19        (2) substitutes recommendations, decisions, or outputs
20    of health information technology, algorithms used to
21    achieve a medical or nursing care objective at a facility,
22    systems based on artificial intelligence or machine
23    learning, or clinical practice guidelines for the
24    independent nursing judgment of a direct care registered
25    professional nurse or penalize a direct care registered
26    professional nurse for overriding the technology or

 

 

SB2795- 38 -LRB103 34815 SPS 64670 b

1    guidelines if, in that registered nurse's judgment, and in
2    accordance with that registered nurse's scope of practice,
3    it is in the best interest of the patient to do so; or
4        (3) limits a direct care registered professional nurse
5    in acting as a patient advocate in the exclusive interests
6    of the patient.
 
7    (225 ILCS 65/Art. 85 heading new)
8
ARTICLE 85. NURSE LICENSURE COMPACT

 
9    (225 ILCS 65/85-5 new)
10    Sec. 85-5. Nurse Licensure Compact. The State of Illinois
11ratifies and approves the following Compact:
 
12
ARTICLE I
13
Findings and Declaration of Purpose

 
14    a. The party states find that:
15        1. The health and safety of the public are affected by
16    the degree of compliance with and the effectiveness of
17    enforcement activities related to state nurse licensure
18    laws;
19        2. Violations of nurse licensure and other laws
20    regulating the practice of nursing may result in injury or
21    harm to the public;
22        3. The expanded mobility of nurses and the use of

 

 

SB2795- 39 -LRB103 34815 SPS 64670 b

1    advanced communication technologies as part of our
2    nation's health care delivery system require greater
3    coordination and cooperation among states in the areas of
4    nurse licensure and regulation;
5        4. New practice modalities and technology make
6    compliance with individual state nurse licensure laws
7    difficult and complex;
8        5. The current system of duplicative licensure for
9    nurses practicing in multiple states is cumbersome and
10    redundant for both nurses and states; and
11        6. Uniformity of nurse licensure requirements
12    throughout the states promotes public safety and public
13    health benefits.
14    b. The general purposes of this Compact are to:
15        1. Facilitate the states' responsibility to protect
16    the public's health and safety;
17        2. Ensure and encourage the cooperation of party
18    states in the areas of nurse licensure and regulation;
19        3. Facilitate the exchange of information between
20    party states in the areas of nurse regulation,
21    investigation and adverse actions;
22        4. Promote compliance with the laws governing the
23    practice of nursing in each jurisdiction;
24        5. Invest all party states with the authority to hold
25    a nurse accountable for meeting all state practice laws in
26    the state in which the patient is located at the time care

 

 

SB2795- 40 -LRB103 34815 SPS 64670 b

1    is rendered through the mutual recognition of party state
2    licenses;
3        6. Decrease redundancies in the consideration and
4    issuance of nurse licenses; and
5        7. Provide opportunities for interstate practice by
6    nurses who meet uniform licensure requirements.
 
7
ARTICLE II
8
Definitions

 
9    As used in this Compact:
10        a. "Adverse action" means any administrative, civil,
11    equitable or criminal action permitted by a state's laws
12    which is imposed by a licensing board or other authority
13    against a nurse, including actions against an individual's
14    license or multistate licensure privilege such as
15    revocation, suspension, probation, monitoring of the
16    licensee, limitation on the licensee's practice, or any
17    other encumbrance on licensure affecting a nurse's
18    authorization to practice, including issuance of a cease
19    and desist action.
20        b. "Alternative program" means a non-disciplinary
21    monitoring program approved by a licensing board.
22        c. "Coordinated licensure information system" means an
23    integrated process for collecting, storing and sharing
24    information on nurse licensure and enforcement activities

 

 

SB2795- 41 -LRB103 34815 SPS 64670 b

1    related to nurse licensure laws that is administered by a
2    nonprofit organization composed of and controlled by
3    licensing boards.
4        d. "Current significant investigative information"
5    means:
6            1. Investigative information that a licensing
7        board, after a preliminary inquiry that includes
8        notification and an opportunity for the nurse to
9        respond, if required by state law, has reason to
10        believe is not groundless and, if proved true, would
11        indicate more than a minor infraction; or
12            2. Investigative information that indicates that
13        the nurse represents an immediate threat to public
14        health and safety regardless of whether the nurse has
15        been notified and had an opportunity to respond.
16        e. "Encumbrance" means a revocation or suspension of,
17    or any limitation on, the full and unrestricted practice
18    of nursing imposed by a licensing board.
19        f. "Home state" means the party state which is the
20    nurse's primary state of residence.
21        g. "Licensing board" means a party state's regulatory
22    body responsible for issuing nurse licenses.
23        h. "Multistate license" means a license to practice as
24    a registered or a licensed practical/vocational nurse
25    (LPN/VN) issued by a home state licensing board that
26    authorizes the licensed nurse to practice in all party

 

 

SB2795- 42 -LRB103 34815 SPS 64670 b

1    states under a multistate licensure privilege.
2        i. "Multistate licensure privilege" means a legal
3    authorization associated with a multistate license
4    permitting the practice of nursing as either a registered
5    nurse (RN) or LPN/VN in a remote state.
6        j. "Nurse" means RN or LPN/VN, as those terms are
7    defined by each party state's practice laws.
8        k. "Party state" means any state that has adopted this
9    Compact.
10        l. "Remote state" means a party state, other than the
11    home state.
12        m. "Single-state license" means a nurse license issued
13    by a party state that authorizes practice only within the
14    issuing state and does not include a multistate licensure
15    privilege to practice in any other party state.
16        n. "State" means a state, territory or possession of
17    the United States and the District of Columbia.
18        o. "State practice laws" means a party state's laws,
19    rules and regulations that govern the practice of nursing,
20    define the scope of nursing practice, and create the
21    methods and grounds for imposing discipline. "State
22    practice laws" do not include requirements necessary to
23    obtain and retain a license, except for qualifications or
24    requirements of the home state.
 
25
ARTICLE III

 

 

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1
General Provisions and Jurisdiction

 
2    a. A multistate license to practice registered or licensed
3practical/vocational nursing issued by a home state to a
4resident in that state will be recognized by each party state
5as authorizing a nurse to practice as a registered nurse (RN)
6or as a licensed practical/vocational nurse (LPN/VN), under a
7multistate licensure privilege, in each party state.
8    b. A state must implement procedures for considering the
9criminal history records of applicants for initial multistate
10license or licensure by endorsement. Such procedures shall
11include the submission of fingerprints or other
12biometric-based information by applicants for the purpose of
13obtaining an applicant's criminal history record information
14from the Federal Bureau of Investigation and the agency
15responsible for retaining that state's criminal records.
16    c. Each party state shall require the following for an
17applicant to obtain or retain a multistate license in the home
18state:
19        1. Meets the home state's qualifications for licensure
20    or renewal of licensure, as well as, all other applicable
21    state laws;
22        2. i. Has graduated or is eligible to graduate from a
23    licensing board-approved RN or LPN/VN prelicensure
24    education program; or
25        ii. Has graduated from a foreign RN or LPN/VN

 

 

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1    prelicensure education program that (a) has been approved
2    by the authorized accrediting body in the applicable
3    country and (b) has been verified by an independent
4    credentials review agency to be comparable to a licensing
5    board-approved prelicensure education program;
6        3. Has, if a graduate of a foreign prelicensure
7    education program not taught in English or if English is
8    not the individual's native language, successfully passed
9    an English proficiency examination that includes the
10    components of reading, speaking, writing and listening;
11        4. Has successfully passed an NCLEX-RN® or NCLEX-PN®
12    Examination or recognized predecessor, as applicable;
13        5. Is eligible for or holds an active, unencumbered
14    license;
15        6. Has submitted, in connection with an application
16    for initial licensure or licensure by endorsement,
17    fingerprints or other biometric data for the purpose of
18    obtaining criminal history record information from the
19    Federal Bureau of Investigation and the agency responsible
20    for retaining that state's criminal records;
21        7. Has not been convicted or found guilty, or has
22    entered into an agreed disposition, of a felony offense
23    under applicable state or federal criminal law;
24        8. Has not been convicted or found guilty, or has
25    entered into an agreed disposition, of a misdemeanor
26    offense related to the practice of nursing as determined

 

 

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1    on a case-by-case basis;
2        9. Is not currently enrolled in an alternative
3    program;
4        10. Is subject to self-disclosure requirements
5    regarding current participation in an alternative program;
6    and
7        11. Has a valid United States Social Security number.
8    d. All party states shall be authorized, in accordance
9with existing state due process law, to take adverse action
10against a nurse's multistate licensure privilege such as
11revocation, suspension, probation or any other action that
12affects a nurse's authorization to practice under a multistate
13licensure privilege, including cease and desist actions. If a
14party state takes such action, it shall promptly notify the
15administrator of the coordinated licensure information system.
16The administrator of the coordinated licensure information
17system shall promptly notify the home state of any such
18actions by remote states.
19    e. A nurse practicing in a party state must comply with the
20state practice laws of the state in which the client is located
21at the time service is provided. The practice of nursing is not
22limited to patient care, but shall include all nursing
23practice as defined by the state practice laws of the party
24state in which the client is located. The practice of nursing
25in a party state under a multistate licensure privilege will
26subject a nurse to the jurisdiction of the licensing board,

 

 

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1the courts and the laws of the party state in which the client
2is located at the time service is provided.
3    f. Individuals not residing in a party state shall
4continue to be able to apply for a party state's single-state
5license as provided under the laws of each party state.
6However, the single-state license granted to these individuals
7will not be recognized as granting the privilege to practice
8nursing in any other party state. Nothing in this Compact
9shall affect the requirements established by a party state for
10the issuance of a single-state license.
11    g. Any nurse holding a home state multistate license, on
12the effective date of this Compact, may retain and renew the
13multistate license issued by the nurse's then-current home
14state, provided that:
15        1. A nurse, who changes primary state of residence
16    after this Compact's effective date, must meet all
17    applicable Article III.c. requirements to obtain a
18    multistate license from a new home state.
19        2. A nurse who fails to satisfy the multistate
20    licensure requirements in Article III.c. due to a
21    disqualifying event occurring after this Compact's
22    effective date shall be ineligible to retain or renew a
23    multistate license, and the nurse's multistate license
24    shall be revoked or deactivated in accordance with
25    applicable rules adopted by the Interstate Commission of
26    Nurse Licensure Compact Administrators ("Commission").
 

 

 

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1
ARTICLE IV
2
Applications for Licensure in a Party State

 
3    a. Upon application for a multistate license, the
4licensing board in the issuing party state shall ascertain,
5through the coordinated licensure information system, whether
6the applicant has ever held, or is the holder of, a license
7issued by any other state, whether there are any encumbrances
8on any license or multistate licensure privilege held by the
9applicant, whether any adverse action has been taken against
10any license or multistate licensure privilege held by the
11applicant and whether the applicant is currently participating
12in an alternative program.
13    b. A nurse may hold a multistate license, issued by the
14home state, in only one party state at a time.
15    c. If a nurse changes primary state of residence by moving
16between two party states, the nurse must apply for licensure
17in the new home state, and the multistate license issued by the
18prior home state will be deactivated in accordance with
19applicable rules adopted by the Commission.
20        1. The nurse may apply for licensure in advance of a
21    change in primary state of residence.
22        2. A multistate license shall not be issued by the new
23    home state until the nurse provides satisfactory evidence
24    of a change in primary state of residence to the new home

 

 

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1    state and satisfies all applicable requirements to obtain
2    a multistate license from the new home state.
3    d. If a nurse changes primary state of residence by moving
4from a party state to a non-party state, the multistate
5license issued by the prior home state will convert to a
6single-state license, valid only in the former home state.
 
7
ARTICLE V
8
Additional Authorities Invested in Party State Licensing
9
Boards

 
10    a. In addition to the other powers conferred by state law,
11a licensing board shall have the authority to:
12        1. Take adverse action against a nurse's multistate
13    licensure privilege to practice within that party state.
14            i. Only the home state shall have the power to take
15        adverse action against a nurse's license issued by the
16        home state.
17            ii. For purposes of taking adverse action, the
18        home state licensing board shall give the same
19        priority and effect to reported conduct received from
20        a remote state as it would if such conduct had occurred
21        within the home state. In so doing, the home state
22        shall apply its own state laws to determine
23        appropriate action.
24        2. Issue cease and desist orders or impose an

 

 

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1    encumbrance on a nurse's authority to practice within that
2    party state.
3        3. Complete any pending investigations of a nurse who
4    changes primary state of residence during the course of
5    such investigations. The licensing board shall also have
6    the authority to take appropriate action(s) and shall
7    promptly report the conclusions of such investigations to
8    the administrator of the coordinated licensure information
9    system. The administrator of the coordinated licensure
10    information system shall promptly notify the new home
11    state of any such actions.
12        4. Issue subpoenas for both hearings and
13    investigations that require the attendance and testimony
14    of witnesses, as well as, the production of evidence.
15    Subpoenas issued by a licensing board in a party state for
16    the attendance and testimony of witnesses or the
17    production of evidence from another party state shall be
18    enforced in the latter state by any court of competent
19    jurisdiction, according to the practice and procedure of
20    that court applicable to subpoenas issued in proceedings
21    pending before it. The issuing authority shall pay any
22    witness fees, travel expenses, mileage and other fees
23    required by the service statutes of the state in which the
24    witnesses or evidence are located.
25        5. Obtain and submit, for each nurse licensure
26    applicant, fingerprint or other biometric-based

 

 

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1    information to the Federal Bureau of Investigation for
2    criminal background checks, receive the results of the
3    Federal Bureau of Investigation record search on criminal
4    background checks and use the results in making licensure
5    decisions.
6        6. If otherwise permitted by state law, recover from
7    the affected nurse the costs of investigations and
8    disposition of cases resulting from any adverse action
9    taken against that nurse.
10        7. Take adverse action based on the factual findings
11    of the remote state, provided that the licensing board
12    follows its own procedures for taking such adverse action.
13    b. If adverse action is taken by the home state against a
14nurse's multistate license, the nurse's multistate licensure
15privilege to practice in all other party states shall be
16deactivated until all encumbrances have been removed from the
17multistate license. All home state disciplinary orders that
18impose adverse action against a nurse's multistate license
19shall include a statement that the nurse's multistate
20licensure privilege is deactivated in all party states during
21the pendency of the order.
22    c. Nothing in this Compact shall override a party state's
23decision that participation in an alternative program may be
24used in lieu of adverse action. The home state licensing board
25shall deactivate the multistate licensure privilege under the
26multistate license of any nurse for the duration of the

 

 

SB2795- 51 -LRB103 34815 SPS 64670 b

1nurse's participation in an alternative program.
 
2
ARTICLE VI
3
Coordinated Licensure Information System and Exchange of
4
Information

 
5    a. All party states shall participate in a coordinated
6licensure information system of all licensed registered nurses
7(RNs) and licensed practical/vocational nurses (LPNs/VNs).
8This system will include information on the licensure and
9disciplinary history of each nurse, as submitted by party
10states, to assist in the coordination of nurse licensure and
11enforcement efforts.
12    b. The Commission, in consultation with the administrator
13of the coordinated licensure information system, shall
14formulate necessary and proper procedures for the
15identification, collection and exchange of information under
16this Compact.
17    c. All licensing boards shall promptly report to the
18coordinated licensure information system any adverse action,
19any current significant investigative information, denials of
20applications (with the reasons for such denials) and nurse
21participation in alternative programs known to the licensing
22board regardless of whether such participation is deemed
23nonpublic or confidential under state law.
24    d. Current significant investigative information and

 

 

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1participation in nonpublic or confidential alternative
2programs shall be transmitted through the coordinated
3licensure information system only to party state licensing
4boards.
5    e. Notwithstanding any other provision of law, all party
6state licensing boards contributing information to the
7coordinated licensure information system may designate
8information that may not be shared with non-party states or
9disclosed to other entities or individuals without the express
10permission of the contributing state.
11    f. Any personally identifiable information obtained from
12the coordinated licensure information system by a party state
13licensing board shall not be shared with non-party states or
14disclosed to other entities or individuals except to the
15extent permitted by the laws of the party state contributing
16the information.
17    g. Any information contributed to the coordinated
18licensure information system that is subsequently required to
19be expunged by the laws of the party state contributing that
20information shall also be expunged from the coordinated
21licensure information system.
22    h. The Compact administrator of each party state shall
23furnish a uniform data set to the Compact administrator of
24each other party state, which shall include, at a minimum:
25        1. Identifying information;
26        2. Licensure data;

 

 

SB2795- 53 -LRB103 34815 SPS 64670 b

1        3. Information related to alternative program
2    participation; and
3        4. Other information that may facilitate the
4    administration of this Compact, as determined by
5    Commission rules.
6    i. The Compact administrator of a party state shall
7provide all investigative documents and information requested
8by another party state.
 
9
ARTICLE VII
10
Establishment of the Interstate Commission of Nurse Licensure
11
Compact Administrators

 
12    a. The party states hereby create and establish a joint
13public entity known as the Interstate Commission of Nurse
14Licensure Compact Administrators.
15        1. The Commission is an instrumentality of the party
16    states.
17        2. Venue is proper, and judicial proceedings by or
18    against the Commission shall be brought solely and
19    exclusively, in a court of competent jurisdiction where
20    the principal office of the Commission is located. The
21    Commission may waive venue and jurisdictional defenses to
22    the extent it adopts or consents to participate in
23    alternative dispute resolution proceedings.
24        3. Nothing in this Compact shall be construed to be a

 

 

SB2795- 54 -LRB103 34815 SPS 64670 b

1    waiver of sovereign immunity.
2    b. Membership, Voting and Meetings
3        1. Each party state shall have and be limited to one
4    administrator. The head of the state licensing board or
5    designee shall be the administrator of this Compact for
6    each party state. Any administrator may be removed or
7    suspended from office as provided by the law of the state
8    from which the Administrator is appointed. Any vacancy
9    occurring in the Commission shall be filled in accordance
10    with the laws of the party state in which the vacancy
11    exists.
12        2. Each administrator shall be entitled to one (1)
13    vote with regard to the promulgation of rules and creation
14    of bylaws and shall otherwise have an opportunity to
15    participate in the business and affairs of the Commission.
16    An administrator shall vote in person or by such other
17    means as provided in the bylaws. The bylaws may provide
18    for an administrator's participation in meetings by
19    telephone or other means of communication.
20        3. The Commission shall meet at least once during each
21    calendar year. Additional meetings shall be held as set
22    forth in the bylaws or rules of the commission.
23        4. All meetings shall be open to the public, and
24    public notice of meetings shall be given in the same
25    manner as required under the rulemaking provisions in
26    Article VIII.

 

 

SB2795- 55 -LRB103 34815 SPS 64670 b

1        5. The Commission may convene in a closed, nonpublic
2    meeting if the Commission must discuss:
3            i. Noncompliance of a party state with its
4        obligations under this Compact;
5            ii. The employment, compensation, discipline or
6        other personnel matters, practices or procedures
7        related to specific employees or other matters related
8        to the Commission's internal personnel practices and
9        procedures;
10            iii. Current, threatened or reasonably anticipated
11        litigation;
12            iv. Negotiation of contracts for the purchase or
13        sale of goods, services or real estate;
14            v. Accusing any person of a crime or formally
15        censuring any person;
16            vi. Disclosure of trade secrets or commercial or
17        financial information that is privileged or
18        confidential;
19            vii. Disclosure of information of a personal
20        nature where disclosure would constitute a clearly
21        unwarranted invasion of personal privacy;
22            viii. Disclosure of investigatory records compiled
23        for law enforcement purposes;
24            ix. Disclosure of information related to any
25        reports prepared by or on behalf of the Commission for
26        the purpose of investigation of compliance with this

 

 

SB2795- 56 -LRB103 34815 SPS 64670 b

1        Compact; or
2            x. Matters specifically exempted from disclosure
3        by federal or state statute.
4        6. If a meeting, or portion of a meeting, is closed
5    pursuant to this provision, the Commission's legal counsel
6    or designee shall certify that the meeting may be closed
7    and shall reference each relevant exempting provision. The
8    Commission shall keep minutes that fully and clearly
9    describe all matters discussed in a meeting and shall
10    provide a full and accurate summary of actions taken, and
11    the reasons therefor, including a description of the views
12    expressed. All documents considered in connection with an
13    action shall be identified in such minutes. All minutes
14    and documents of a closed meeting shall remain under seal,
15    subject to release by a majority vote of the Commission or
16    order of a court of competent jurisdiction.
17    c. The Commission shall, by a majority vote of the
18administrators, prescribe bylaws or rules to govern its
19conduct as may be necessary or appropriate to carry out the
20purposes and exercise the powers of this Compact, including
21but not limited to:
22        1. Establishing the fiscal year of the Commission;
23        2. Providing reasonable standards and procedures:
24            i. For the establishment and meetings of other
25        committees; and
26            ii. Governing any general or specific delegation

 

 

SB2795- 57 -LRB103 34815 SPS 64670 b

1        of any authority or function of the Commission;
2        3. Providing reasonable procedures for calling and
3    conducting meetings of the Commission, ensuring reasonable
4    advance notice of all meetings and providing an
5    opportunity for attendance of such meetings by interested
6    parties, with enumerated exceptions designed to protect
7    the public's interest, the privacy of individuals, and
8    proprietary information, including trade secrets. The
9    Commission may meet in closed session only after a
10    majority of the administrators vote to close a meeting in
11    whole or in part. As soon as practicable, the Commission
12    must make public a copy of the vote to close the meeting
13    revealing the vote of each administrator, with no proxy
14    votes allowed;
15        4. Establishing the titles, duties and authority and
16    reasonable procedures for the election of the officers of
17    the Commission;
18        5. Providing reasonable standards and procedures for
19    the establishment of the personnel policies and programs
20    of the Commission. Notwithstanding any civil service or
21    other similar laws of any party state, the bylaws shall
22    exclusively govern the personnel policies and programs of
23    the Commission; and
24        6. Providing a mechanism for winding up the operations
25    of the Commission and the equitable disposition of any
26    surplus funds that may exist after the termination of this

 

 

SB2795- 58 -LRB103 34815 SPS 64670 b

1    Compact after the payment or reserving of all of its debts
2    and obligations;
3    d. The Commission shall publish its bylaws and rules, and
4any amendments thereto, in a convenient form on the website of
5the Commission.
6    e. The Commission shall maintain its financial records in
7accordance with the bylaws.
8    f. The Commission shall meet and take such actions as are
9consistent with the provisions of this Compact and the bylaws.
10    g. The Commission shall have the following powers:
11        1. To promulgate uniform rules to facilitate and
12    coordinate implementation and administration of this
13    Compact. The rules shall have the force and effect of law
14    and shall be binding in all party states;
15        2. To bring and prosecute legal proceedings or actions
16    in the name of the Commission, provided that the standing
17    of any licensing board to sue or be sued under applicable
18    law shall not be affected;
19        3. To purchase and maintain insurance and bonds;
20        4. To borrow, accept or contract for services of
21    personnel, including, but not limited to, employees of a
22    party state or nonprofit organizations;
23        5. To cooperate with other organizations that
24    administer state compacts related to the regulation of
25    nursing, including but not limited to sharing
26    administrative or staff expenses, office space or other

 

 

SB2795- 59 -LRB103 34815 SPS 64670 b

1    resources;
2        6. To hire employees, elect or appoint officers, fix
3    compensation, define duties, grant such individuals
4    appropriate authority to carry out the purposes of this
5    Compact, and to establish the Commission's personnel
6    policies and programs relating to conflicts of interest,
7    qualifications of personnel and other related personnel
8    matters;
9        7. To accept any and all appropriate donations, grants
10    and gifts of money, equipment, supplies, materials and
11    services, and to receive, utilize and dispose of the same;
12    provided that at all times the Commission shall avoid any
13    appearance of impropriety or conflict of interest;
14        8. To lease, purchase, accept appropriate gifts or
15    donations of, or otherwise to own, hold, improve or use,
16    any property, whether real, personal or mixed; provided
17    that at all times the Commission shall avoid any
18    appearance of impropriety;
19        9. To sell, convey, mortgage, pledge, lease, exchange,
20    abandon or otherwise dispose of any property, whether
21    real, personal or mixed;
22        10. To establish a budget and make expenditures;
23        11. To borrow money;
24        12. To appoint committees, including advisory
25    committees comprised of administrators, state nursing
26    regulators, state legislators or their representatives,

 

 

SB2795- 60 -LRB103 34815 SPS 64670 b

1    and consumer representatives, and other such interested
2    persons;
3        13. To provide and receive information from, and to
4    cooperate with, law enforcement agencies;
5        14. To adopt and use an official seal; and
6        15. To perform such other functions as may be
7    necessary or appropriate to achieve the purposes of this
8    Compact consistent with the state regulation of nurse
9    licensure and practice.
10    h. Financing of the Commission
11        1. The Commission shall pay, or provide for the
12    payment of, the reasonable expenses of its establishment,
13    organization and ongoing activities.
14        2. The Commission may also levy on and collect an
15    annual assessment from each party state to cover the cost
16    of its operations, activities and staff in its annual
17    budget as approved each year. The aggregate annual
18    assessment amount, if any, shall be allocated based upon a
19    formula to be determined by the Commission, which shall
20    promulgate a rule that is binding upon all party states.
21        3. The Commission shall not incur obligations of any
22    kind prior to securing the funds adequate to meet the
23    same; nor shall the Commission pledge the credit of any of
24    the party states, except by, and with the authority of,
25    such party state.
26        4. The Commission shall keep accurate accounts of all

 

 

SB2795- 61 -LRB103 34815 SPS 64670 b

1    receipts and disbursements. The receipts and disbursements
2    of the Commission shall be subject to the audit and
3    accounting procedures established under its bylaws.
4    However, all receipts and disbursements of funds handled
5    by the Commission shall be audited yearly by a certified
6    or licensed public accountant, and the report of the audit
7    shall be included in and become part of the annual report
8    of the Commission.
9    i. Qualified Immunity, Defense and Indemnification
10        1. The administrators, officers, executive director,
11    employees and representatives of the Commission shall be
12    immune from suit and liability, either personally or in
13    their official capacity, for any claim for damage to or
14    loss of property or personal injury or other civil
15    liability caused by or arising out of any actual or
16    alleged act, error or omission that occurred, or that the
17    person against whom the claim is made had a reasonable
18    basis for believing occurred, within the scope of
19    Commission employment, duties or responsibilities;
20    provided that nothing in this paragraph shall be construed
21    to protect any such person from suit or liability for any
22    damage, loss, injury or liability caused by the
23    intentional, willful or wanton misconduct of that person.
24        2. The Commission shall defend any administrator,
25    officer, executive director, employee or representative of
26    the Commission in any civil action seeking to impose

 

 

SB2795- 62 -LRB103 34815 SPS 64670 b

1    liability arising out of any actual or alleged act, error
2    or omission that occurred within the scope of Commission
3    employment, duties or responsibilities, or that the person
4    against whom the claim is made had a reasonable basis for
5    believing occurred within the scope of Commission
6    employment, duties or responsibilities; provided that
7    nothing herein shall be construed to prohibit that person
8    from retaining his or her own counsel; and provided
9    further that the actual or alleged act, error or omission
10    did not result from that person's intentional, willful or
11    wanton misconduct.
12        3. The Commission shall indemnify and hold harmless
13    any administrator, officer, executive director, employee
14    or representative of the Commission for the amount of any
15    settlement or judgment obtained against that person
16    arising out of any actual or alleged act, error or
17    omission that occurred within the scope of Commission
18    employment, duties or responsibilities, or that such
19    person had a reasonable basis for believing occurred
20    within the scope of Commission employment, duties or
21    responsibilities, provided that the actual or alleged act,
22    error or omission did not result from the intentional,
23    willful or wanton misconduct of that person.
 
24
ARTICLE VIII
25
Rulemaking

 

 

 

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1    a. The Commission shall exercise its rulemaking powers
2pursuant to the criteria set forth in this Article and the
3rules adopted thereunder. Rules and amendments shall become
4binding as of the date specified in each rule or amendment and
5shall have the same force and effect as provisions of this
6Compact.
7    b. Rules or amendments to the rules shall be adopted at a
8regular or special meeting of the Commission.
9    c. Prior to promulgation and adoption of a final rule or
10rules by the Commission, and at least sixty (60) days in
11advance of the meeting at which the rule will be considered and
12voted upon, the Commission shall file a notice of proposed
13rulemaking:
14        1. On the website of the Commission; and
15        2. On the website of each licensing board or the
16    publication in which each state would otherwise publish
17    proposed rules.
18    d. The notice of proposed rulemaking shall include:
19        1. The proposed time, date and location of the meeting
20    in which the rule will be considered and voted upon;
21        2. The text of the proposed rule or amendment, and the
22    reason for the proposed rule;
23        3. A request for comments on the proposed rule from
24    any interested person; and
25        4. The manner in which interested persons may submit

 

 

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1    notice to the Commission of their intention to attend the
2    public hearing and any written comments.
3    e. Prior to adoption of a proposed rule, the Commission
4shall allow persons to submit written data, facts, opinions
5and arguments, which shall be made available to the public.
6    f. The Commission shall grant an opportunity for a public
7hearing before it adopts a rule or amendment.
8    g. The Commission shall publish the place, time and date
9of the scheduled public hearing.
10        1. Hearings shall be conducted in a manner providing
11    each person who wishes to comment a fair and reasonable
12    opportunity to comment orally or in writing. All hearings
13    will be recorded, and a copy will be made available upon
14    request.
15        2. Nothing in this section shall be construed as
16    requiring a separate hearing on each rule. Rules may be
17    grouped for the convenience of the Commission at hearings
18    required by this section.
19    h. If no one appears at the public hearing, the Commission
20may proceed with promulgation of the proposed rule.
21    i. Following the scheduled hearing date, or by the close
22of business on the scheduled hearing date if the hearing was
23not held, the Commission shall consider all written and oral
24comments received.
25    j. The Commission shall, by majority vote of all
26administrators, take final action on the proposed rule and

 

 

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1shall determine the effective date of the rule, if any, based
2on the rulemaking record and the full text of the rule.
3    k. Upon determination that an emergency exists, the
4Commission may consider and adopt an emergency rule without
5prior notice, opportunity for comment or hearing, provided
6that the usual rulemaking procedures provided in this Compact
7and in this section shall be retroactively applied to the rule
8as soon as reasonably possible, in no event later than ninety
9(90) days after the effective date of the rule. For the
10purposes of this provision, an emergency rule is one that must
11be adopted immediately in order to:
12        1. Meet an imminent threat to public health, safety or
13    welfare;
14        2. Prevent a loss of Commission or party state funds;
15    or
16        3. Meet a deadline for the promulgation of an
17    administrative rule that is required by federal law or
18    rule.
19    l. The Commission may direct revisions to a previously
20adopted rule or amendment for purposes of correcting
21typographical errors, errors in format, errors in consistency
22or grammatical errors. Public notice of any revisions shall be
23posted on the website of the Commission. The revision shall be
24subject to challenge by any person for a period of thirty (30)
25days after posting. The revision may be challenged only on
26grounds that the revision results in a material change to a

 

 

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1rule. A challenge shall be made in writing, and delivered to
2the Commission, prior to the end of the notice period. If no
3challenge is made, the revision will take effect without
4further action. If the revision is challenged, the revision
5may not take effect without the approval of the Commission.
 
6
ARTICLE IX
7
Oversight, Dispute Resolution and Enforcement

 
8    a. Oversight
9        1. Each party state shall enforce this Compact and
10    take all actions necessary and appropriate to effectuate
11    this Compact's purposes and intent.
12        2. The Commission shall be entitled to receive service
13    of process in any proceeding that may affect the powers,
14    responsibilities or actions of the Commission, and shall
15    have standing to intervene in such a proceeding for all
16    purposes. Failure to provide service of process in such
17    proceeding to the Commission shall render a judgment or
18    order void as to the Commission, this Compact or
19    promulgated rules.
20    b. Default, Technical Assistance and Termination
21        1. If the Commission determines that a party state has
22    defaulted in the performance of its obligations or
23    responsibilities under this Compact or the promulgated
24    rules, the Commission shall:

 

 

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1            i. Provide written notice to the defaulting state
2        and other party states of the nature of the default,
3        the proposed means of curing the default or any other
4        action to be taken by the Commission; and
5            ii. Provide remedial training and specific
6        technical assistance regarding the default.
7        2. If a state in default fails to cure the default, the
8    defaulting state's membership in this Compact may be
9    terminated upon an affirmative vote of a majority of the
10    administrators, and all rights, privileges and benefits
11    conferred by this Compact may be terminated on the
12    effective date of termination. A cure of the default does
13    not relieve the offending state of obligations or
14    liabilities incurred during the period of default.
15        3. Termination of membership in this Compact shall be
16    imposed only after all other means of securing compliance
17    have been exhausted. Notice of intent to suspend or
18    terminate shall be given by the Commission to the governor
19    of the defaulting state and to the executive officer of
20    the defaulting state's licensing board and each of the
21    party states.
22        4. A state whose membership in this Compact has been
23    terminated is responsible for all assessments, obligations
24    and liabilities incurred through the effective date of
25    termination, including obligations that extend beyond the
26    effective date of termination.

 

 

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1        5. The Commission shall not bear any costs related to
2    a state that is found to be in default or whose membership
3    in this Compact has been terminated unless agreed upon in
4    writing between the Commission and the defaulting state.
5        6. The defaulting state may appeal the action of the
6    Commission by petitioning the U.S. District Court for the
7    District of Columbia or the federal district in which the
8    Commission has its principal offices. The prevailing party
9    shall be awarded all costs of such litigation, including
10    reasonable attorneys' fees.
11    c. Dispute Resolution
12        1. Upon request by a party state, the Commission shall
13    attempt to resolve disputes related to the Compact that
14    arise among party states and between party and non-party
15    states.
16        2. The Commission shall promulgate a rule providing
17    for both mediation and binding dispute resolution for
18    disputes, as appropriate.
19        3. In the event the Commission cannot resolve disputes
20    among party states arising under this Compact:
21            i. The party states may submit the issues in
22        dispute to an arbitration panel, which will be
23        comprised of individuals appointed by the Compact
24        administrator in each of the affected party states and
25        an individual mutually agreed upon by the Compact
26        administrators of all the party states involved in the

 

 

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1        dispute.
2            ii. The decision of a majority of the arbitrators
3        shall be final and binding.
4    d. Enforcement
5        1. The Commission, in the reasonable exercise of its
6    discretion, shall enforce the provisions and rules of this
7    Compact.
8        2. By majority vote, the Commission may initiate legal
9    action in the U.S. District Court for the District of
10    Columbia or the federal district in which the Commission
11    has its principal offices against a party state that is in
12    default to enforce compliance with the provisions of this
13    Compact and its promulgated rules and bylaws. The relief
14    sought may include both injunctive relief and damages. In
15    the event judicial enforcement is necessary, the
16    prevailing party shall be awarded all costs of such
17    litigation, including reasonable attorneys' fees.
18        3. The remedies herein shall not be the exclusive
19    remedies of the Commission. The Commission may pursue any
20    other remedies available under federal or state law.
 
21
ARTICLE X
22
Effective Date, Withdrawal and Amendment

 
23    a. This Compact shall become effective and binding on the
24earlier of the date of legislative enactment of this Compact

 

 

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1into law by no less than twenty-six (26) states or December 31,
22018. All party states to this Compact, that also were parties
3to the prior Nurse Licensure Compact, superseded by this
4Compact, ("Prior Compact"), shall be deemed to have withdrawn
5from said Prior Compact within six (6) months after the
6effective date of this Compact.
7    b. Each party state to this Compact shall continue to
8recognize a nurse's multistate licensure privilege to practice
9in that party state issued under the Prior Compact until such
10party state has withdrawn from the Prior Compact.
11    c. Any party state may withdraw from this Compact by
12enacting a statute repealing the same. A party state's
13withdrawal shall not take effect until six (6) months after
14enactment of the repealing statute.
15    d. A party state's withdrawal or termination shall not
16affect the continuing requirement of the withdrawing or
17terminated state's licensing board to report adverse actions
18and significant investigations occurring prior to the
19effective date of such withdrawal or termination.
20    e. Nothing contained in this Compact shall be construed to
21invalidate or prevent any nurse licensure agreement or other
22cooperative arrangement between a party state and a non-party
23state that is made in accordance with the other provisions of
24this Compact.
25    f. This Compact may be amended by the party states. No
26amendment to this Compact shall become effective and binding

 

 

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1upon the party states unless and until it is enacted into the
2laws of all party states.
3    g. Representatives of non-party states to this Compact
4shall be invited to participate in the activities of the
5Commission, on a nonvoting basis, prior to the adoption of
6this Compact by all states.
 
7
ARTICLE XI
8
Construction and Severability

 
9This Compact shall be liberally construed so as to effectuate
10the purposes thereof. The provisions of this Compact shall be
11severable, and if any phrase, clause, sentence or provision of
12this Compact is declared to be contrary to the constitution of
13any party state or of the United States, or if the
14applicability thereof to any government, agency, person or
15circumstance is held invalid, the validity of the remainder of
16this Compact and the applicability thereof to any government,
17agency, person or circumstance shall not be affected thereby.
18If this Compact shall be held to be contrary to the
19constitution of any party state, this Compact shall remain in
20full force and effect as to the remaining party states and in
21full force and effect as to the party state affected as to all
22severable matters.
 
23    (225 ILCS 65/85-10 new)

 

 

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1    Sec. 85-10. State labor laws. The Nurse Licensure Compact
2does not supersede existing State labor laws.
 
3    (225 ILCS 65/85-15 new)
4    Sec. 85-15. Criminal history record checks. The State may
5not share with or disclose to the Interstate Commission of
6Nurse Licensure Compact Administrators or any other state any
7of the contents of a nationwide criminal history records check
8conducted for the purpose of multistate licensure under the
9Nurse Licensure Compact.
 
10    Section 995. No acceleration or delay. Where this Act
11makes changes in a statute that is represented in this Act by
12text that is not yet or no longer in effect (for example, a
13Section represented by multiple versions), the use of that
14text does not accelerate or delay the taking effect of (i) the
15changes made by this Act or (ii) provisions derived from any
16other Public Act.

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    New Act
4    210 ILCS 85/10.10
5    225 ILCS 65/50-15.15 new
6    225 ILCS 65/Art. 85
7    heading new
8    225 ILCS 65/85-5 new
9    225 ILCS 65/85-10 new
10    225 ILCS 65/85-15 new