Vermont nurse practice act delegation
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Title 26 : Professions and Occupations
Chapter 028 : Nursing
- Subchapter 001 : General Provisions
- § 1571. Purpose and effect In order to safeguard the life and health of the people of this State, a person shall not practice or offer to practice registered or practical nursing or as a nursing assistant unless licensed under this chapter. (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1993, No. 201 (Adj. Sess.), § 1; 2015, No. 38, § 7, eff. May 28, 2015.)
- § 1572. Definitions As used in this chapter: (1) “Board” means the Vermont State Board of Nursing. (2) “Registered nursing” means the practice of nursing, which includes: (A) Assessing the health status of individuals and groups. (B) Establishing a nursing diagnosis. (C) Establishing goals to meet identified health care needs. (D) Planning a strategy of medical or health care. (E) Prescribing nursing interventions to implement the strategy of care. (F) Implementing the strategy of care. (G) Delegating nursing interventions that may be performed by others and that do not conflict with this subchapter. (H) Maintaining safe and effective nursing care rendered directly or indirectly. (I) Evaluating responses to interventions. (J) Teaching the theory and practice of nursing. (K) Managing and supervising the practice of nursing. (L) Collaborating with other health professionals in the management of health care. (M) Addressing patient pain. (N) Performance of such additional acts requiring education and training and that are recognized jointly by the medical and nursing professions as proper to be performed by registered nurses. (3) “Licensed practical nursing” means a directed scope of nursing practice that includes: (A) contributing to the assessment of the health status of individuals and groups; (B) participating in the development and modification of the strategy of care; (C) implementing the appropriate aspects of the strategy of care as defined by the Board; (D) maintaining safe and effective nursing care rendered directly or indirectly; (E) participating in the evaluation of responses to interventions: (F) delegating nursing interventions that may be performed by others and that do not conflict with this chapter; and (G) functioning at the direction of a registered nurse, advanced practice registered nurse, licensed physician, or licensed dentist in the performance of activities delegated by that health care professional. (4) “Advanced practice registered nurse” or “APRN” means a licensed registered nurse authorized to practice in this State who, because of specialized education and experience, is licensed and authorized to perform acts of medical diagnosis and to prescribe medical, therapeutic, or corrective measures under administrative rules adopted by the Board. (5) “License” means a current authorization permitting the practice of nursing as a registered nurse, licensed practical nurse, or advanced practice registered nurse, or the practice as a nursing assistant. (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1993, No. 201 (Adj. Sess.), § 1; 2009, No. 25, § 11; 2011, No. 66, § 5, eff. June 1, 2011; 2015, No. 38, § 7, eff. May 28, 2015.)
- § 1573. Vermont State Board of Nursing (a) There is hereby created the Vermont State Board of Nursing consisting of six registered nurses, including at least two licensed as advanced practice registered nurses, two practical nurses, one nursing assistant, and two public members. Board members shall be appointed by the Governor pursuant to 3 V.S.A. §§ 129b and 2004. (b) Appointments of registered and licensed practical nurse members shall be made in a manner designed to be representative of the various types of nursing education programs and nursing services. (c) Each member of the Board shall be a resident of this State. (1) The licensed members shall have the following in their respective categories of licensure: (A) An active license to practice in Vermont. (B) At least five years’ licensed experience. Three of these five years shall have been immediately preceding appointment. (2) The public members shall not be members of any other health-related licensing boards, licensees of any health-occupation boards, or employees of any health agencies or facilities, and shall not derive primary livelihood from the provision of health services at any level of responsibility. (d) [Repealed.] (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1993, No. 201 (Adj. Sess.), § 1; 2005, No. 27, § 45; 2007, No. 163 (Adj. Sess.), § 11; 2011, No. 66, § 5, eff. June 1, 2011; 2015, No. 38, § 7, eff. May 28, 2015; 2017, No. 144 (Adj. Sess.), § 18; 2019, No. 178 (Adj. Sess.), § 7, eff. Oct. 1, 2020.)
- § 1573a. Repealed. 2015, No. 38, § 7, eff. May 28, 2015.
- § 1574. Powers and duties (a) In addition to the powers granted by 3 V.S.A. § 129, the Board shall: (1) Hold annual meetings at which it shall elect a chair, a vice chair, and a secretary from its members; and hold such other meetings as may be deemed necessary to transact its business. (2) Adopt rules necessary to perform its duties under this chapter. (3) Adopt rules setting standards for approval of medication nursing assistant and nursing education programs in Vermont, including all clinical facilities. The Board may require reimbursement for actual and necessary costs incurred for site surveys. (A) After an opportunity for a hearing, the Board may deny or withdraw approval or take lesser action when a program fails to meet the rules requirements. (B) The Board may reinstate a program whose approval has been denied or withdrawn when the Board is satisfied that deficiencies have been remedied and the requirements have been met. (C) Standards for nursing education programs and clinical facilities shall: (i) rely upon the standards of recognized national accrediting bodies without duplicating the function of those bodies; (ii) call for the annual reporting of data, including graduation rates and examination pass rates, appropriate to verify that programs are capable of meeting national standards and sustaining responsible operation in the interests of the public; and (iii) be waivable by the Director of Professional Regulation if the Director finds that a program has exhausted reasonable efforts to comply and that such waiver will not compromise a program’s educational integrity. (4) [Repealed.] (5) Adopt rules setting standards required for licensure as a nursing assistant, practical nurse, registered nurse, or advanced practice registered nurse, and for endorsement of those nurses in special areas of nursing practice that require additional education and experience. (6) Examine, license, and renew the licenses of duly qualified applicants and keep a record of all persons currently licensed as nursing assistants, practical nurses, registered nurses, and advanced practice registered nurses. (7) Adopt rules setting active practice requirements for licensure and renewal. (8) Adopt rules for and approve education programs for the benefit of nurses who are reentering practice following a lapse of five or more years. (9) Investigate complaints of unauthorized practice or unprofessional conduct or incompetency against any person and take proper action under section 1582 or 1584 of this chapter, as the case may be. (10) Adopt rules establishing a program to serve as an alternative to the disciplinary process for nurses and nursing assistants with chemical dependencies or other professional practice issues as designated by the Board. (b) In consultation with the Board, the Director of the Office of Professional Regulation may employ an Executive Director of the Board and contract for such persons as may be necessary to carry out the work of the Board. (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1993, No. 201 (Adj. Sess.), § 1; 2007, No. 29, § 25; 2009, No. 103 (Adj. Sess.), § 10; 2015, No. 38, § 7, eff. May 28, 2015; 2019, No. 30, § 11; 2019, No. 178 (Adj. Sess.), § 7, eff. Oct. 1, 2020.)
- §§ 1575, 1576. Repealed. 2015, No. 38, § 7, eff. May 28, 2015.
- § 1577. Fees Applicants and persons regulated under this chapter shall pay the following fees: (1) Nursing Assistants (A) Application $25.00 (B) Biennial renewal $65.00 (2) Practical Nurses and Registered Nurses (A) Application by exam $75.00 (B) Application by endorsement $175.00 (C) Biennial renewal for Practical Nurses $200.00 (D) Biennial renewal for Registered Nurses $220.00 (3) Advanced Practice Registered Nurses (A) Initial endorsement of advanced practice registered nurses $115.00 (B) Biennial renewal of advanced practice registered nurses $145.00 (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1989, No. 250 (Adj. Sess.), § 44; 1993, No. 201 (Adj. Sess.), § 1; 1995, No. 47, § 23; 1997, No. 59, § 54, eff. June 30, 1997; 2001, No. 143 (Adj. Sess.), § 25, eff. June 27, 2002; 2005, No. 202 (Adj. Sess.), § 13; 2013, No. 191 (Adj. Sess.), § 15; 2015, No. 38, § 7, eff. May 28, 2015; 2019, No. 70, § 17; 2023, No. 77, § 27, eff. June 20, 2023.)
- § 1578. Repealed. 2015, No. 38, § 7, eff. May 28, 2015.
- § 1579. Repealed. 2017, No. 144 (Adj. Sess.), § 18.
- § 1580. Repealed. 1993, No. 201 (Adj. Sess.), §§ 1, 3.
- § 1581. Repealed. 2015, No. 38, § 7, eff. May 28, 2015.
- § 1582. Regulatory authority; unprofessional conduct (a) The Board may deny an application for licensure, renewal, or reinstatement; revoke or suspend any license to practice issued by it; or discipline or in other ways condition the practice of an applicant or licensee upon due notice and opportunity for hearing if the person engages in the following conduct or the conduct set forth in 3 V.S.A. § 129a: (1) making or causing to be made a false, fraudulent, or forged statement or representation in procuring or attempting to procure registration or renew a license; (2) diverting or attempting to divert drugs or equipment or supplies for unauthorized use; (3) engaging in conduct of a character likely to deceive, defraud, or harm the public; (4) willfully failing to file or record, or willfully impeding or obstructing filing or recording, or inducing another person to omit to file or record medical reports; (5) fraudulent or deceitful submission of any information or records to the Board; (6) leaving a nursing assignment without properly advising appropriate personnel; (7) violating confidentiality by inappropriately revealing information or knowledge about a patient or client; (8) knowingly aiding or abetting a health care provider who is not legally practicing within the State in the provision of health care services; (9) permitting one’s name or license to be used by a person, group, or corporation when not actually in charge of or responsible for the treatment given; (10) failing to comply with the patient bill of rights provisions of 18 V.S.A. § 1852 or other statutes governing the profession; (11) sexual misconduct that exploits the provider-patient relationship, including sexual contact with a patient, surrogates, or key third parties; (12) abusing or neglecting a patient or misappropriating patient property; (13) failing to report to the Board any violation of this chapter or of the Board’s rules; or (14) failing to take appropriate action to safeguard a patient from incompetent health care. (b) A person shall not be liable in a civil action for damages resulting from the good faith reporting of information to the Board about incompetent, unprofessional, or unlawful conduct of a licensee. (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1993, No. 201 (Adj. Sess.), § 1; 1997, No. 145 (Adj. Sess.), § 39; 2011, No. 66, § 5, eff. June 1, 2011; 2015, No. 38, § 7, eff. May 28, 2015.)
- § 1583. Exemptions This chapter does not prohibit: (1) Rendering assistance in the case of an emergency or disaster. (2) The practice of nursing that is incidental to their program of study by persons enrolled in approved nursing education programs approved by the Board. (3) The practice of any nurse who is employed by the U.S. government or any bureau, division, or agency thereof, while in the discharge of his or her official duties. (4) The practice of nursing in this State by any currently licensed nurse whose engagement was made outside of this State but required the nurse to accompany and care for the patient while in Vermont. This exception shall not exceed six months. (5) The care of the sick by domestic help of any type, whether employed regularly or because of illness, provided such person is employed primarily in a domestic capacity. (6) The work and duties of attendants in attendant care services programs. (7) The practice of any other occupation or profession licensed under the laws of this State. (8) The providing of care for the sick in accordance with the tenets of any church or religious denomination by its adherents if the individual does not hold himself or herself out to be a registered nurse, licensed practical nurse, or licensed nursing assistant and does not engage in the practice of nursing as defined in this chapter. (9) A person holding an unencumbered license in another U.S. jurisdiction from practicing nursing for no more than 30 days in any calendar year under the supervision of a Vermont licensed registered nurse as part of an educational offering. (10) An advanced practice registered nurse who is duly licensed and in good standing in another state, territory, or jurisdiction of the United States or in Canada from practicing in this State if the APRN is employed as or formally designated as the team APRN by an athletic team visiting Vermont for a specific sporting event and the APRN limits the practice of advanced practice registered nursing in this State to treatment of the members, coaches, and staff of the sports team employing or designating the APRN. (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1989, No. 75, § 2; 1993, No. 201 (Adj. Sess.), § 1; 2009, No. 54, § 88, eff. June 1, 2009; 2011, No. 79 (Adj. Sess.), § 30, eff. April 4, 2012; 2015, No. 38, § 7, eff. May 28, 2015; 2015, No. 94 (Adj. Sess.), § 5, eff. May 10, 2016; 2017, No. 74, § 118.)
- § 1584. Prohibitions; offenses (a) It shall be a violation of this chapter for any person, including any corporation, association, or individual, to: (1) sell or fraudulently obtain or furnish any nursing degree, diploma, certificate of registration, license, or any other related document or record, or to aid or abet therein; (2) practice nursing under cover of any degree, diploma, registration, license, or related document or record illegally or fraudulently obtained or signed or issued unlawfully or under fraudulent representation; (3) practice nursing unless duly registered and currently licensed to do so under the provisions of this chapter; (4) use in connection with a name any words, letters, signs, or figures which imply that a person is a registered or practical nurse or an advanced practice registered nurse when not authorized under this chapter; (5) practice nursing during the time a license issued under this chapter is suspended or revoked; (6) conduct a nursing education program unless the program has been approved by the Board; (7) employ unlicensed persons to practice registered nursing, practical nursing, or as a nursing assistant. (8) [Repealed.] (b) Any person violating this section shall be subject to the penalties provided in 3 V.S.A. § 127. (c) [Repealed.] (Added 1979, No. 192 (Adj. Sess.), § 1; amended 1993, No. 201 (Adj. Sess.), § 1; 2005, No. 148 (Adj. Sess.), § 13; 2007, No. 29, § 27; 2011, No. 66, § 5, eff. June 1, 2011; 2017, No. 144 (Adj. Sess.), § 18.)
- § 1585. Professional corporations; registered or licensed practical nursing A person licensed to practice registered or licensed practical nursing under this chapter may own shares in a professional corporation created under 11 V.S.A. chapter 4 that provides professional services in the medical and nursing professions. (Added 2007, No. 14, § 2, eff. May 2, 2007.)
- Subchapter 002 : Advanced Practice Registered Nurses
- §§ 1591-1601. Repealed. 2015, No. 38, § 8, eff. May 28, 2015.
- § 1611. Advanced practice registered nurse licensure To be eligible for an APRN license, an applicant shall: (1) Have a degree or certificate from a Vermont graduate nursing program approved by the Board or a U.S. graduate program approved by a state or a national accrediting agency that includes a curriculum substantially equivalent to Vermont programs approved by the Board. The educational program shall meet the educational standards set by the national accrediting board and the national certifying board. Programs shall include a supervised clinical component in the role and population focus of the applicant’s certification. The program shall prepare nurses to practice advanced nursing in a role as a nurse practitioner, certified nurse midwife, certified nurse anesthetist, or clinical nurse specialist in psychiatric or mental health nursing and shall include, at a minimum, graduate level courses in: (A) advanced pharmacotherapeutics; (B) advanced patient assessment; and (C) advanced pathophysiology. (2) Hold current advanced nursing certification in a role and population focus granted by a national certifying organization recognized by the Board. (Added 2011, No. 66, § 5, eff. June 1, 2011; amended 2015, No. 38, § 9, eff. May 28, 2015.)
- § 1611a. Fee waiver; pro bono practice (a) An advanced practice registered nurse who holds an unrestricted license in all jurisdictions in which the nurse is currently licensed, who certifies to the Board that he or she will limit his or her practice in Vermont to providing pro bono services at a free or reduced fee clinic, and who meets the requirements for licensure shall be licensed by the Board without payment of the licensing application fee. (b) A license granted under this section shall authorize the licensee to practice advanced practice registered nursing on a voluntary basis in Vermont. (Added 2015, No. 38, § 9, eff. May 28, 2015.)
- § 1612. Repealed. 2017, No. 144 (Adj. Sess.), § 18.
- § 1613. Transition to practice (a)(1) An APRN with fewer than 24 months and 2,400 hours of licensed active advanced nursing practice in an initial role and population focus or fewer than 12 months and 1,600 hours for any additional role and population focus shall have a formal agreement with a collaborating provider as required by Board rule. (2) An APRN shall have and maintain signed and dated copies of all required collaborative provider agreements. (3) An APRN required to practice with a collaborative provider agreement may not engage in solo practice, except with regard to a role and population focus in which the APRN has met the requirements of this subsection. (b) An APRN who satisfies the requirements to engage in solo practice pursuant to subsection (a) of this section shall notify the Board that these requirements have been met. (c) The Board may waive or modify the collaborative provider agreement requirement as necessary to allow an APRN to practice independently during a declared state of emergency. (Added 2011, No. 66, § 5, eff. June 1, 2011; amended 2019, No. 30, § 11; 2019, No. 91 (Adj. Sess.), § 16, eff. March 30, 2020.)
- § 1614. APRN renewal An APRN license renewal application shall include: (1) documentation of completion of the APRN practice requirement; (2) possession of a current certification by a national APRN specialty certifying organization; and (3) a current collaborative provider agreement if required for transition to practice. (Added 2011, No. 66, § 5, eff. June 1, 2011; amended 2017, No. 144 (Adj. Sess.), § 18.)
- § 1615. Advanced practice registered nurses; regulatory authority; unprofessional conduct (a) In addition to the provisions of 3 V.S.A. § 129a and section 1582 of this chapter, the Board may deny an application for licensure, renewal, or reinstatement or may revoke, suspend, or otherwise discipline an advanced practice registered nurse upon due notice and opportunity for hearing if the person engages in the following conduct: (1) Abandonment of a patient in violation of the duty to maintain a provider-patient relationship within the reasonable expectations of continuing care or referral. (2) Solicitation of professional patronage by agents or persons or profiting from the acts of those representing themselves to be agents of the licensed APRN. (3) Division of fees or agreeing to split or divide the fees received for professional services for any person for bringing or referring a patient. (4) Practice beyond those acts and situations that are within the limits of the knowledge and experience of the APRN, and, for an APRN who is practicing under a collaborative agreement, practice beyond those acts and situations that are within both the usual scope of the collaborating provider’s practice and the terms of the collaborative agreement. (5) For an APRN who acts as the collaborating provider for an APRN who is practicing under a collaboration agreement, allowing the mentored APRN to perform a medical act that is outside the usual scope of the mentor’s own practice or that the mentored APRN is not qualified to perform by training or experience or that is not consistent with the requirements of this chapter and the rules of the Board. (6) Providing, prescribing, dispensing, or furnishing medical services or prescription medication or prescription-only devices to a person in response to any communication transmitted or received by computer or other electronic means when the licensee fails to take the following actions to establish and maintain a proper provider-patient relationship: (A) a reasonable effort to verify that the person requesting medication is in fact the patient and is in fact who the person claims to be; (B) establishment of documented diagnosis through the use of accepted medical practices; and (C) maintenance of a current medical record. (7) Prescribing, selling, administering, distributing, ordering, or dispensing any drug legally classified as a controlled substance for his or her own use or for an immediate family member. (8) Signing a blank or undated prescription form. (9) Administering or promoting the sale of medication, devices, appliances, or other patient goods and services in a manner that exploits the patient. (10) Selling, prescribing, giving away, or administering drugs for other than legal and legitimate therapeutic purposes. (11) Agreeing with clinical or bioanalytical laboratories to make payments to such laboratories for individual tests or test series for patients, unless the APRN discloses on the bills to patients or third party payers the name of such laboratory, the amount or amounts to such laboratory for individual tests or test series, and the amount of his or her processing charge or procurement, if any, for each specimen taken. (12) Willful misrepresentation in treatments. (13) Permitting one’s name or license to be used by a person, group, or corporation when not actually in charge of or responsible for the treatment given. (b)(1) For the purposes of subdivision (a)(6) of this section, an electronic, online, or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient. (2) The following would not be in violation of subdivision (a)(6) of this section: (A) initial admission orders for newly hospitalized patients; (B) prescribing for a patient of another provider for whom the prescriber has taken call; (C) prescribing for a patient examined by a licensed APRN, physician assistant, or other practitioner authorized by law and supported by the APRN; (D) continuing medication on a short-term basis for a new patient prior to the patient’s first appointment; or (E) emergency situations where the life or health of the patient is in imminent danger. (Added 2011, No. 66, § 5, eff. June 1, 2011; amended 2015, No. 38, § 9, eff. May 28, 2015; 2017, No. 144 (Adj. Sess.), § 18.)
- § 1615a. APRN subcommittee (a) The Board shall appoint a subcommittee to study and report to the Board on matters relating to advanced practice registered nurse practice. (b) The subcommittee shall be composed of at least five members. (1) The majority shall be advanced practice registered nurses who are licensed and in good standing in this State. (2) At least one member shall be a member of the public, and at least one member shall be a physician designated by the Board of Medical Practice. (c) Members of the subcommittee shall be entitled to compensation and reimbursement of expenses as provided in 32 V.S.A. § 1010. (Added 2015, No. 38, § 9, eff. May 28, 2015.)
- § 1616. Nurse practitioner and nurse midwife signature authority Whenever any provision of Vermont statute or rule or any form provided to any person in this State requires a signature, certification, stamp, verification, affidavit, or other endorsement by a physician, such statute, rule, or form shall be deemed to include a signature, certification, stamp, verification, affidavit, or other endorsement by an advanced practice registered nurse (APRN) licensed pursuant to this chapter and certified as a nurse practitioner or a nurse midwife; provided, however, that nothing in this section shall be construed to expand the scope of practice of APRNs. (Added 2011, No. 122 (Adj. Sess.), § 1.)
- Subchapter 003 : Registered Nurses and Practical Nurses
- § 1621. Registered nurse licensure by examination To be eligible for licensure as a registered nurse by examination, an applicant shall complete: (1) an approved U.S. registered nursing education program meeting requirements set by the Board by rule; and (2) examinations as determined by the Board. (Added 2015, No. 38, § 11, eff. May 28, 2015.)
- Subchapter 004 : Nursing Assistants
- §§ 1621-1624. Repealed. 2015, No. 38, § 10, eff. May 28, 2015.
- § 1622. Registered nurse licensure by endorsement (a) Except as otherwise provided pursuant to subsection (b) of this section, to be eligible for licensure as a registered nurse by endorsement, an applicant shall: (1) hold a current license to practice registered nursing in another U.S. jurisdiction based on education in a nursing program acceptable to the Board; and (2) meet practice requirements set by the Board by rule. (b) Except as otherwise provided by law, the Board shall issue a license to practice as a registered nurse to an applicant who: (1) is a service member or veteran; (2) has received designation by the U.S. Armed Forces as a 66H Nurse or equivalent; (3) has received at least a bachelor’s degree in nursing from a program that is accredited by the Accreditation Commission for Education in Nursing (ACEN) or by the Commission on Collegiate Nursing Education (CCNE) or that is accepted by the U.S. Secretary of Education; and (4) has completed a qualified course in public health nursing or one year of supervised nursing experience. (c) As used in this section: (1) “Service member” means an individual who is an active member of: (A) the U.S. Armed Forces; (B) a reserve component of the U.S. Armed Forces; (C) the U.S. Coast Guard; or (D) the National Guard of any state. (2) “Veteran” means a former service member who received an honorable discharge or a general discharge under honorable conditions from active duty not more than two years prior to submitting an application for licensure. (Added 2015, No. 38, § 11, eff. May 28, 2015; amended 2017, No. 119 (Adj. Sess.), § 4; 2017, No. 144 (Adj. Sess.), § 18.)
- § 1623. Licensure for registered nurses educated outside the United States To be eligible for licensure under this chapter, a registered nurse applicant who was educated outside the United States shall: (1) hold a current registered nurse license from a country outside the United States; (2) complete secondary education; (3) graduate from a registered nursing education program meeting the requirements of rules set by the Board; (4) demonstrate English language proficiency, if the nursing education program was conducted in a language other than English; and (5) complete examinations as determined by the Board. (Added 2015, No. 38, § 11, eff. May 28, 2015.)
- § 1624. Registered nurse license renewal To renew a license, a registered nurse shall meet active practice requirements set by the Board by rule. (Added 2015, No. 38, § 11, eff. May 28, 2015.)
- § 1625. Practical nurse licensure by examination To be eligible for licensure as a practical nurse by examination, an applicant shall: (1) complete an approved U.S. practical nursing education program meeting requirements set by the Board by rule or completion of equivalent study in a program conducted by the U.S. Armed Forces satisfactory to the Director; and (2) complete examinations as determined by the Board. (Added 2015, No. 38, § 11, eff. May 28, 2015; 2019, No. 152 (Adj. Sess.), § 19, eff. April 1, 2021.)
- § 1626. Practical nurse licensure by endorsement To be eligible for licensure as a practical nurse by endorsement, an applicant shall: (1) hold a current license to practice practical nursing in another U.S. jurisdiction based on education in a nursing program acceptable to the Board; and (2) meet practice requirements set by the Board by rule. (Added 2015, No. 38, § 11, eff. May 28, 2015; amended 2017, No. 144 (Adj. Sess.), § 18.)
- § 1627. Licensure for practical nurses educated outside the United States To be eligible for licensure under this chapter, a practical nurse applicant who was educated outside the United States shall: (1) hold a current practical nurse license from a country outside the United States; (2) complete secondary education; (3) graduate from a practical nursing education program meeting the requirements of rules set by the Board; (4) demonstrate English language proficiency if the nursing education program was conducted in a language other than English; and (5) complete examinations as determined by the Board. (Added 2015, No. 38, § 11, eff. May 28, 2015.)
- § 1628. Practical nurse license renewal To renew a license, a practical nurse shall meet active practice requirements set by the Board by rule. (Added 2015, No. 38, § 11, eff. May 28, 2015.)
- § 1629. Fee waiver; pro bono practice (a) A nurse who holds an unrestricted license in all jurisdictions in which the nurse is currently licensed, who certifies to the Board that he or she will limit his or her practice in Vermont to providing pro bono services at a free or reduced fee clinic, and who meets the requirements for licensure shall be licensed by the Board without payment of the licensing application fee. (b) A license granted under this section shall authorize the licensee to practice nursing on a voluntary basis in Vermont. (Added 2015, No. 38, § 11, eff. May 28, 2015.)
- § 1641. Definitions As used in this subchapter: (1) “Medication nursing assistant” means a licensed nursing assistant who: (A) is under the supervision of a nurse holding a currently valid endorsement authorizing the delegation to the nursing assistant of tasks of medication administration performed in a nursing home; (B) has completed a Board-approved medication administration education program and an examination as set forth by rules adopted by the Board; and (C) is endorsed by the Board and authorized to administer medication in a nursing home. (2) “Nursing assistant” means an individual who performs nursing or nursing-related functions under the supervision of a licensed nurse. (3) “Nursing or nursing-related functions” means nursing-related activities as defined by rule, which include basic nursing and restorative duties for which a nursing assistant is prepared by education and supervised practice. (Added 2015, No. 38, § 14, eff. May 28, 2015.)
- § 1642. Nursing assistant licensure by examination The Board may issue a license to practice as a nursing assistant to an applicant who: (1) is no less than 16 years of age; (2) has completed an approved nursing assistant education program; and (3) has successfully completed the competency examination. (Added 2015, No. 38, § 14, eff. May 28, 2015.)
- § 1643. Nursing assistant licensure by endorsement (a) The Board may issue a license to practice as a nursing assistant to an applicant who: (1) is licensed or registered in another U.S. jurisdiction; and (2) has met the practice requirements set by the Board by rule. (b) Except as otherwise provided by law, the Board shall issue a license to practice as a nursing assistant to an applicant who: (1) is a service member or a veteran; (2) has received designation by the U.S. Armed Forces as a 68W Combat Medic Specialist or equivalent; and (3) is certified as a National Registry Emergency Medical Technician. (c) As used in this section: (1) “Service member” means an individual who is an active member of: (A) the U.S. Armed Forces; (B) a reserve component of the U.S. Armed Forces; (C) the U.S. Coast Guard; or (D) the National Guard of any state. (2) “Veteran” means a former service member who received an honorable discharge or a general discharge under honorable conditions from active duty not more than two years prior to submitting an application for licensure. (Added 2015, No. 38, § 14, eff. May 28, 2015; amended 2017, No. 119 (Adj. Sess.), § 5.)
- § 1644. Prohibitions; offenses (a) A person shall not use any letters, words, or insignia in connection with the person’s name that indicate or imply that the person is a nursing assistant unless the person is licensed in accordance with this subchapter. (b) A person shall not practice nursing or nursing-related functions as defined in section 1641 of this subchapter without being licensed by the Board. (c) A person who violates this section shall be subject to the penalties set forth in 3 V.S.A. § 127. (Added 2015, No. 38, § 14, eff. May 28, 2015.)
- § 1645. Renewal (a) To renew a license, a nursing assistant shall meet active practice requirements set by the Board by rule. (b) The Board shall credit as active practice those activities, regardless of title or obligation to hold a license, that reasonably tend to reinforce the training and skills of a licensee. (Added 2015, No. 38, § 14, eff. May 28, 2015; amended 2017, No. 144 (Adj. Sess.), § 18.)
- § 1646. Exemptions (a) Nothing in this subchapter shall be construed to prohibit other licensed or certified professionals from carrying on in the usual manner any of the functions of their professions. (b) This subchapter does not prohibit the performance of nursing or nursing-related functions that are incidental to their program of study by persons enrolled in approved nursing assistant education and competency evaluation programs. (c) Nothing in this subchapter shall be construed to conflict with the administration of medication by nonlicensees pursuant to the residential care home licensing rules adopted by the Department of Disabilities, Aging, and Independent Living. (Added 2015, No. 38, § 14, eff. May 28, 2015.)
- Subchapter 005 : Nurse Licensure Compact
- § 1647. Nurse Licensure Compact; adoption This subchapter is the Vermont adoption of the Nurse Licensure Compact as amended by the National Council of State Boards of Nursing. The form, format, and text of the Compact have been conformed to the conventions of the Vermont Statutes Annotated. It is the intent of the General Assembly that this subchapter be interpreted as substantively the same as the Nurse Licensure Compact that is enacted by other Compact party states. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647a. Findings and declaration of purpose (a) The party states find that: (1) The health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws. (2) Violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public. (3) The expanded mobility of nurses and the use of advanced communication technologies as part of our nation’s health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation. (4) New practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex. (5) The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states. (6) Uniformity of nurse licensure requirements throughout the states promotes public safety and public health benefits. (b) The general purposes of this Compact are to: (1) Facilitate the states’ responsibility to protect the public’s health and safety. (2) Ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation. (3) Facilitate the exchange of information between party states in the areas of nurse regulation, investigation, and adverse actions. (4) Promote compliance with the laws governing the practice of nursing in each jurisdiction. (5) Invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses. (6) Decrease redundancies in the consideration and issuance of nurse licenses. (7) Provide opportunities for interstate practice by nurses who meet uniform licensure requirements. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647b. Definitions As used in this subchapter: (1) “Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state’s laws that is imposed by a licensing board or other authority against a nurse, including actions against an individual’s license or multistate licensure privilege, such as revocation, suspension, probation, monitoring of the licensee, limitation on the licensee’s practice, or any other encumbrance on licensure affecting a nurse’s authorization to practice, including issuance of a cease and desist action. (2) “Alternative program” means a nondisciplinary monitoring program approved by a licensing board. (3) “Commission” means the Interstate Commission of Nurse Licensure Compact Administrators. (4) “Coordinated licensure information system” means an integrated process for collecting, storing, and sharing information on nurse licensure and enforcement activities related to nurse licensure laws that is administered by a nonprofit organization composed of and controlled by licensing boards. (5) “Current significant investigative information” means: (A) investigative information that a licensing board, after a preliminary inquiry that includes notification and an opportunity for the nurse to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction; or (B) investigative information that indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and had an opportunity to respond. (6) “Encumbrance” means a revocation or suspension of, or any limitation on, the full and unrestricted practice of nursing imposed by a licensing board. (7) “Home state” means the party state that is the nurse’s primary state of residence. (8) “Licensing board” means a party state’s regulatory body responsible for issuing nurse licenses. (9) “Multistate license” means a license to practice as a registered nurse (RN) or a licensed practical or vocational nurse (LPN/VN) issued by a home state licensing board that authorizes the licensed nurse to practice in all party states under a multistate licensure privilege. (10) “Multistate licensure privilege” means a legal authorization associated with a multistate license permitting the practice of nursing as either an RN or LPN/VN in a remote state. (11) “Nurse” means RN or LPN/VN, as those terms are defined by each party state’s practice laws. (12) “Party state” means any state that has adopted this Compact. (13) “Remote state” means a party state other than the home state. (14) “Single-state license” means a nurse license issued by a party state that authorizes practice only within the issuing state and does not include a multistate licensure privilege to practice in any other party state. (15) “State” means a state, territory, or possession of the United States and the District of Columbia. (16) “State practice laws” means a party state’s laws, rules, and regulations that govern the practice of nursing, define the scope of nursing practice, and create the methods and grounds for imposing discipline. “State practice laws” do not include requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647c. General provisions and jurisdiction (a) A multistate license to practice registered or licensed practical or vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a nurse to practice as an RN or LPN/VN, under a multistate licensure privilege, in each party state. (b) A state must implement procedures for considering the criminal history records of applicants for initial multistate license or licensure by endorsement. Such procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant’s criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state’s criminal records. (c) Each party state shall require the following for an applicant to obtain or retain a multistate license in the home state: (1) meets the home state’s qualifications for licensure or renewal of licensure as well as all other applicable state laws; (2)(A) has graduated or is eligible to graduate from a licensing board-approved RN or LPN/VN pre-licensure education program; or (B) has graduated from a foreign RN or LPN/VN pre-licensure education program that has been: (i) approved by the authorized accrediting body in the applicable country; and (ii) verified by an independent credentials review agency to be comparable to a licensing board-approved pre-licensure education program; (3) has, if a graduate of a foreign pre-licensure education program not taught in English or if English is not the individual’s native language, successfully passed an English proficiency examination that includes the components of reading, speaking, writing, and listening; (4) has successfully passed an NCLEX-RN or NCLEX-PN Examination or recognized predecessor, as applicable; (5) is eligible for or holds an active, unencumbered license; (6) has submitted, in connection with an application for initial licensure or licensure by endorsement, fingerprints or other biometric data for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state’s criminal records; (7) has not been convicted or found guilty, or has entered into an agreed disposition, of a felony offense under applicable state or federal criminal law; (8) has not been convicted or found guilty, or has entered into an agreed disposition, of a misdemeanor offense related to the practice of nursing as determined on a case-by-case basis; (9) is not currently enrolled in an alternative program; (10) is subject to self-disclosure requirements regarding current participation in an alternative program; and (11) has a valid U.S. Social Security number. (d) All party states shall be authorized, in accordance with existing state due process law, to take adverse action against a nurse’s multistate licensure privilege, such as revocation, suspension, probation, or any other action that affects a nurse’s authorization to practice under a multistate licensure privilege, including cease and desist actions. If a party state takes such action, it shall promptly notify the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states. (e) A nurse practicing in a party state must comply with the state practice laws of the state in which the client is located at the time service is provided. The practice of nursing is not limited to patient care but shall include all nursing practice as defined by the state practice laws of the party state in which the client is located. The practice of nursing in a party state under a multistate licensure privilege will subject a nurse to the jurisdiction of the licensing board, the courts, and the laws of the party state in which the client is located at the time service is provided. (f) Individuals not residing in a party state shall continue to be able to apply for a party state’s single-state license as provided under the laws of each party state. However, the single-state license granted to these individuals will not be recognized as granting the privilege to practice nursing in any other party state. Nothing in this Compact shall affect the requirements established by a party state for the issuance of a single-state license. (g) Any nurse holding a home state multistate license on the effective date of this Compact may retain and renew the multistate license issued by the nurse’s then-current home state, provided that: (1) A nurse who changes primary state of residence after this Compact’s effective date must meet all applicable requirements of subsection (c) of this section to obtain a multistate license from a new home state. (2) A nurse who fails to satisfy the multistate licensure requirements in subsection (c) of this section due to a disqualifying event occurring after this Compact’s effective date shall be ineligible to retain or renew a multistate license, and the nurse’s multistate license shall be revoked or deactivated in accordance with applicable rules adopted by the Interstate Commission of Nurse Licensure Compact Administrators. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647d. Applications for licensure in a party state (a) Upon application for a multistate license, the licensing board in the issuing party state shall ascertain, through the coordinated licensure information system, whether the applicant has ever held, or is the holder of, a license issued by any other state, whether there are any encumbrances on any license or multistate licensure privilege held by the applicant, whether any adverse action has been taken against any license or multistate licensure privilege held by the applicant, and whether the applicant is currently participating in an alternative program. (b) A nurse may hold a multistate license, issued by the home state, in only one party state at a time. (c) If a nurse changes primary state of residence by moving between two party states, the nurse must apply for licensure in the new home state, and the multistate license issued by the prior home state will be deactivated in accordance with applicable rules adopted by the Commission. (1) The nurse may apply for licensure in advance of a change in primary state of residence. (2) A multistate license shall not be issued by the new home state until the nurse provides satisfactory evidence of a change in primary state of residence to the new home state and satisfies all applicable requirements to obtain a multistate license from the new home state. (d) If a nurse changes primary state of residence by moving from a party state to a non-party state, the multistate license issued by the prior home state will convert to a single-state license, valid only in the former home state. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647e. Additional authority invested in party state licensing boards (a) In addition to the other powers conferred by state law, a licensing board shall have the authority to: (1) Take adverse action against a nurse’s multistate licensure privilege to practice within that party state. (A) Only the home state shall have the power to take adverse action against a nurse’s license issued by the home state. (B) For purposes of taking adverse action, the home state licensing board shall give the same priority and effect to reported conduct received from a remote state as it would if such conduct had occurred within the home state. In so doing, the home state shall apply its own state laws to determine appropriate action. (2) Issue cease and desist orders or impose an encumbrance on a nurse’s authority to practice within that party state. (3) Complete any pending investigations of a nurse who changes primary state of residence during the course of such investigations. The licensing board shall also have the authority to take appropriate action and shall promptly report the conclusions of such investigations to the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the new home state of any such actions. (4) Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing board in a party state for the attendance and testimony of witnesses or the production of evidence from another party state shall be enforced in the latter state by any court of competent jurisdiction according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state in which the witnesses or evidence is located. (5) Obtain and submit, for each nurse licensure applicant, fingerprint or other biometric-based information to the Federal Bureau of Investigation for criminal background checks, receive the results of the Federal Bureau of Investigation record search on criminal background checks, and use the results in making licensure decisions. (6) If otherwise permitted by state law, recover from the affected nurse the costs of investigations and disposition of cases resulting from any adverse action taken against that nurse. (7) Take adverse action based on the factual findings of the remote state, provided that the licensing board follows its own procedures for taking such adverse action. (b) If adverse action is taken by the home state against a nurse’s multistate license, the nurse’s multistate licensure privilege to practice in all other party states shall be deactivated until all encumbrances have been removed from the multistate license. All home state disciplinary orders that impose adverse action against a nurse’s multistate license shall include a statement that the nurse’s multistate licensure privilege is deactivated in all party states during the pendency of the order. (c) Nothing in this Compact shall override a party state’s decision that participation in an alternative program may be used in lieu of adverse action. The home state licensing board shall deactivate the multistate licensure privilege under the multistate license of any nurse for the duration of the nurse’s participation in an alternative program. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647f. Coordinated licensure information system (a) All party states shall participate in a coordinated licensure information system of all licensed RNs and LPNs/VNs. This system will include information on the licensure and disciplinary history of each nurse, as submitted by party states, to assist in the coordination of nurse licensure and enforcement efforts. (b) The Commission, in consultation with the administrator of the coordinated licensure information system, shall formulate necessary and proper procedures for the identification, collection, and exchange of information under this Compact. (c) All licensing boards shall promptly report to the coordinated licensure information system any adverse action, current significant investigative information, denials of applications with the reasons for such denials, and nurse participation in alternative programs known to the licensing board regardless of whether such participation is deemed nonpublic or confidential under state law. (d) Current significant investigative information and participation in nonpublic or confidential alternative programs shall be transmitted through the coordinated licensure information system only to party state licensing boards. (e) Notwithstanding any other provision of law, all party state licensing boards contributing information to the coordinated licensure information system may designate information that may not be shared with non-party states or disclosed to other entities or individuals without the express permission of the contributing state. (f) Any personally identifiable information obtained from the coordinated licensure information system by a party state licensing board shall not be shared with non-party states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information. (g) Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing that information shall also be expunged from the coordinated licensure information system. (h) The Compact administrator of each party state shall furnish a uniform data set to the Compact administrator of each other party state, which shall include, at a minimum: (1) identifying information; (2) licensure data; (3) information related to alternative program participation; and (4) other information that may facilitate the administration of this Compact, as determined by Commission rules. (i) The Compact administrator of a party state shall provide all investigative documents and information requested by another party state. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647g. Interstate Commission of Nurse Licensure Compact Administrators; establishment (a) The party states hereby create and establish a joint public entity known as the Interstate Commission of Nurse Licensure Compact Administrators. (1) The Commission is an instrumentality of the party states. (2) Venue is proper, and judicial proceedings by or against the Commission shall be brought solely and exclusively, in a court of competent jurisdiction, where the principal office of the Commission is located. The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. (3) Nothing in this Compact shall be construed to be a waiver of sovereign immunity. (b) Membership, voting, and meetings. (1) Each party state shall have and be limited to one administrator. The head of the state licensing board or designee shall be the administrator of this Compact for each party state. Any administrator may be removed or suspended from office as provided by the law of the state from which the administrator is appointed. Any vacancy occurring in the Commission shall be filled in accordance with the laws of the party state in which the vacancy exists. (2) Each administrator shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission. An administrator shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for an administrator’s participation in meetings by telephone or other means of communication. (3) The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws or rules of the Commission. (4) All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in section 1647h of this chapter. (5) The Commission may convene in a closed, nonpublic meeting if the Commission must discuss: (A) noncompliance of a party state with its obligations under this Compact; (B) the employment, compensation, discipline, or other personnel matters, practices, or procedures related to specific employees or other matters related to the Commission’s internal personnel practices and procedures; (C) current, threatened, or reasonably anticipated litigation; (D) negotiation of contracts for the purchase or sale of goods, services, or real estate; (E) accusing any person of a crime or formally censuring any person; (F) disclosure of trade secrets or commercial or financial information that is privileged or confidential; (G) disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; (H) disclosure of investigatory records compiled for law enforcement purposes; (I) disclosure of information related to any reports prepared by or on behalf of the Commission for the purpose of investigation of compliance with this Compact; or (J) matters specifically exempted from disclosure by federal or state statute. (6) If a meeting, or portion of a meeting, is closed pursuant to this provision, the Commission’s legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision. The Commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefor, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction. (c) The Commission shall, by a majority vote of the administrators, prescribe bylaws or rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of this Compact, including, but not limited to: (1) Establishing the fiscal year of the Commission. (2) Providing reasonable standards and procedures: (A) for the establishment and meetings of other committees; and (B) governing any general or specific delegation of any authority or function of the Commission. (3) Providing reasonable procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all meetings, and providing an opportunity for attendance of such meetings by interested parties, with enumerated exceptions designed to protect the public’s interest, the privacy of individuals, and proprietary information, including trade secrets. The Commission may meet in closed session only after a majority of the administrators vote to close a meeting in whole or in part. As soon as practicable, the Commission must make public a copy of the vote to close the meeting, revealing the vote of each administrator, with no proxy votes allowed. (4) Establishing the titles, duties, and authority and reasonable procedures for the election of the officers of the Commission. (5) Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the Commission. Notwithstanding any civil service or other similar laws of any party state, the bylaws shall exclusively govern the personnel policies and programs of the Commission. (6) Providing a mechanism for winding up the operations of the Commission and the equitable disposition of any surplus funds that may exist after the termination of this Compact after the payment or reserving of all of its debts and obligations. (d) The Commission shall publish its bylaws and rules, and any amendments thereto, in a convenient form on the website of the Commission. (e) The Commission shall maintain its financial records in accordance with the bylaws. (f) The Commission shall meet and take such actions as are consistent with the provisions of this Compact and the bylaws. (g) The Commission shall have the following powers: (1) To promulgate uniform rules to facilitate and coordinate implementation and administration of this Compact. The rules shall have the force and effect of law and shall be binding in all party states. (2) To bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any licensing board to sue or be sued under applicable law shall not be affected. (3) To purchase and maintain insurance and bonds. (4) To borrow, accept, or contract for services of personnel, including, but not limited to, employees of a party state or nonprofit organizations. (5) To cooperate with other organizations that administer state compacts related to the regulation of nursing, including, but not limited to, sharing administrative or staff expenses, office space, or other resources. (6) To hire employees, elect or appoint officers, fix compensation, define duties, and grant such individuals appropriate authority to carry out the purposes of this Compact and to establish the Commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters. (7) To accept any and all appropriate donations, grants, and gifts of money, equipment, supplies, materials, and services and to receive, utilize, and dispose of the same, provided that at all times the Commission shall avoid any appearance of impropriety or conflict of interest. (8) To lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve, or use any property, whether real, personal, or mixed, provided that at all times the Commission shall avoid any appearance of impropriety. (9) To sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, whether real, personal, or mixed. (10) To establish a budget and make expenditures. (11) To borrow money. (12) To appoint committees, including advisory committees composed of administrators, state nursing regulators, state legislators or their representatives, consumer representatives, and other such interested persons. (13) To provide and receive information from, and to cooperate with, law enforcement agencies. (14) To adopt and use an official seal. (15) To perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of nurse licensure and practice. (h) Financing of the Commission. (1) The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities. (2) The Commission may also levy on and collect an annual assessment from each party state to cover the cost of its operations, activities, and staff in its annual budget as approved each year. The aggregate annual assessment amount, if any, shall be allocated based upon a formula to be determined by the Commission, which shall promulgate a rule that is binding upon all party states. (3) The Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same, nor shall the Commission pledge the credit of any of the party states, except by, and with the authority of, such party state. (4) The Commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the Commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the Commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the Commission. (i) Qualified immunity, defense, and indemnification. (1) The administrators, officers, executive director, employees, and representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred, within the scope of Commission employment, duties, or responsibilities, provided that nothing in this subsection shall be construed to protect any such person from suit or liability for any damage, loss, injury, or liability caused by the intentional, willful, or wanton misconduct of that person. (2) The Commission shall defend any administrator, officer, executive director, employee, or representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel, and provided further that the actual or alleged act, error, or omission did not result from that person’s intentional, willful, or wanton misconduct. (3) The Commission shall indemnify and hold harmless any administrator, officer, executive director, employee, or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional, willful, or wanton misconduct of that person. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647h. Rulemaking (a) The Commission shall exercise its rulemaking powers pursuant to the criteria set forth in this section and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment and shall have the same force and effect as provisions of this Compact. (b) Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission. (c) Prior to promulgation and adoption of a final rule or rules by the Commission, and at least 60 days in advance of the meeting at which the rule will be considered and voted upon, the Commission shall file a notice of proposed rulemaking: (1) on the website of the Commission; and (2) on the website of each licensing board or the publication in which each state would otherwise publish proposed rules. (d) The notice of proposed rulemaking shall include: (1) the proposed time, date, and location of the meeting in which the rule will be considered and voted upon; (2) the text of the proposed rule or amendment and the reason for the proposed rule; (3) a request for comments on the proposed rule from any interested person; and (4) the manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments. (e) Prior to adoption of a proposed rule, the Commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public. (f) The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment. (g) The Commission shall publish the place, time, and date of the scheduled public hearing. (1) Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing. All hearings will be recorded, and a copy will be made available upon request. (2) Nothing in this section shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the Commission at hearings required by this section. (h) If no one appears at the public hearing, the Commission may proceed with promulgation of the proposed rule. (i) Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the Commission shall consider all written and oral comments received. (j) The Commission shall, by majority vote of all administrators, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking record and the full text of the rule. (k) Upon determination that an emergency exists, the Commission may consider and adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided that the usual rulemaking procedures provided in this Compact and in this section shall be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to: (1) meet an imminent threat to public health, safety, or welfare; (2) prevent a loss of Commission or party state funds; or (3) meet a deadline for the promulgation of an administrative rule that is required by federal law or rule. (l) The Commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the Commission. The revision shall be subject to challenge by any person for a period of 30 days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing and delivered to the Commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the Commission. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647i. Oversight, dispute resolution, and enforcement (a) Oversight. (1) Each party state shall enforce this Compact and take all actions necessary and appropriate to effectuate this Compact’s purposes and intent. (2) The Commission shall be entitled to receive service of process in any proceeding that may affect the powers, responsibilities, or actions of the Commission and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process in such proceeding to the Commission shall render a judgment or order void as to the Commission, this Compact, or promulgated rules. (b) Default, technical assistance, and termination. (1) If the Commission determines that a party state has defaulted in the performance of its obligations or responsibilities under this Compact or the promulgated rules, the Commission shall: (A) provide written notice to the defaulting state and other party states of the nature of the default, the proposed means of curing the default, or any other action to be taken by the Commission; and (B) provide remedial training and specific technical assistance regarding the default. (2) If a state in default fails to cure the default, the defaulting state’s membership in this Compact may be terminated upon an affirmative vote of a majority of the administrators, and all rights, privileges, and benefits conferred by this Compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default. (3) Termination of membership in this Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the Commission to the governor of the defaulting state and to the executive officer of the defaulting state’s licensing board and each of the party states. (4) A state whose membership in this Compact has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination. (5) The Commission shall not bear any costs related to a state that is found to be in default or whose membership in this Compact has been terminated unless agreed upon in writing between the Commission and the defaulting state. (6) The defaulting state may appeal the action of the Commission by petitioning the U.S. District Court for the District of Columbia or the federal district in which the Commission has its principal offices. The prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. (c) Dispute resolution. (1) Upon request by a party state, the Commission shall attempt to resolve disputes related to the Compact that arise among party states and between party and non-party states. (2) The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes, as appropriate. (3) In the event the Commission cannot resolve disputes among party states arising under this Compact: (A) The party states may submit the issues in dispute to an arbitration panel, which will be composed of individuals appointed by the Compact administrator in each of the affected party states and an individual mutually agreed upon by the Compact administrators of all the party states involved in the dispute. (B) The decision of a majority of the arbitrators shall be final and binding. (d) Enforcement. (1) The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact. (2) By majority vote, the Commission may initiate legal action in the U.S. District Court for the District of Columbia or the federal district in which the Commission has its principal offices against a party state that is in default to enforce compliance with the provisions of this Compact and its promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. (3) The remedies herein shall not be the exclusive remedies of the Commission. The Commission may pursue any other remedies available under federal or state law. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647j. Effective date, withdrawal, and amendment (a) This Compact shall become effective and binding on the earlier of the date of legislative enactment of this Compact into law by not fewer than 26 states or December 31, 2018. All party states to this Compact that also were parties to the prior Nurse Licensure Compact superseded by this Compact (“Prior Compact”) shall be deemed to have withdrawn from the Prior Compact within six months after the effective date of this Compact. (b) Each party state to this Compact shall continue to recognize a nurse’s multistate licensure privilege to practice in that party state issued under the Prior Compact until such party state has withdrawn from the Prior Compact. (c) Any party state may withdraw from this Compact by enacting a statute repealing the same. A party state’s withdrawal shall not take effect until six months after enactment of the repealing statute. (d) A party state’s withdrawal or termination shall not affect the continuing requirement of the withdrawing or terminated state’s licensing board to report adverse actions and significant investigations occurring prior to the effective date of such withdrawal or termination. (e) Nothing contained in this Compact shall be construed to invalidate or prevent any nurse licensure agreement or other cooperative arrangement between a party state and a non-party state that is made in accordance with the other provisions of this Compact. (f) This Compact may be amended by the party states. No amendment to this Compact shall become effective and binding upon the party states unless and until it is enacted into the laws of all party states. (g) Representatives of non-party states to this Compact shall be invited to participate in the activities of the Commission, on a nonvoting basis, prior to the adoption of this Compact by all states. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1647k. Construction and severability This Compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this Compact shall be severable, and if any phrase, clause, sentence, or provision of this Compact is declared to be contrary to the constitution of any party state or of the United States, or if the applicability thereof to any government, agency, person, or circumstance is held invalid, the validity of the remainder of this Compact and the applicability thereof to any government, agency, person, or circumstance shall not be affected thereby. If this Compact shall be held to be contrary to the constitution of any party state, this Compact shall remain in full force and effect as to the remaining party states and in full force and effect as to the party state affected as to all severable matters. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
- § 1648. Administration of the Nurse Licensure Compact (a) The Vermont State Board of Nursing shall have the power to: (1) oversee the administration and enforcement of the Nurse Licensure Compact within the State of Vermont; (2) recover from a nurse practicing under the provisions of the Nurse Licensure Compact the cost of investigation and disposition of a case resulting in adverse action taken against that nurse; and (3) conduct a background check, prior to issuing a multistate license under the provisions of the Nurse Licensure Compact, that includes a fingerprint-based check of State and federal criminal history databases, as authorized by 28 C.F.R. § 20.33. (b) The Executive Director of the Vermont State Board of Nursing or designee shall be the administrator (State Administrator) of the Nurse Licensure Compact for the State of Vermont pursuant to subdivision 1647g(b)(1) of this subchapter. (c) The State Administrator shall promptly, and prior to a vote of the Commission, notify the Commissioner of Finance and Management if the Commission proposes to pledge the credit of the State of Vermont under subdivision 1647g(h)(3) of this subchapter or in any way proposes to impose liability on the State of Vermont for an amount equal to or in excess of $100,000.00. (d) The Vermont State Board of Nursing may: (1) adopt rules necessary to implement and enforce the provisions of this subchapter within the State of Vermont; and (2) take disciplinary action against the practice privilege of a nurse practicing within the State of Vermont under the provisions of the Nurse Licensure Compact, which may include disciplinary action based on disciplinary action taken against the nurse’s license by another party state to the Nurse Licensure Compact. (e) Nothing in this subchapter shall supersede or abridge State labor laws. (Added 2021, No. 64, § 1, eff. Feb. 1, 2022.)
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