No license is required for practical nursing, but, except as provided 20
in s. 257.03, no person without a license may hold himself or herself out as a licensed 21
practical nurse or licensed attendant, use the title or letters “Trained Practical 22
Nurse" or “T.P.N.", “Licensed Practical Nurse" or “L.P.N.", “
Licensed Attendant" or 23
“L.A.", “Trained Attendant" or “T.A.", or otherwise seek to indicate that he or she is 24
a licensed practical nurse or licensed attendant. No licensed practical nurse or 25
licensed attendant may use the title, or otherwise seek to act as a registered, licensed,
graduate or professional nurse. Anyone violating this subsection shall be subject to 2
the penalties prescribed by s. 441.13. The board shall grant without examination a 3
license as a licensed practical nurse to any person who was on July 1, 1949, a licensed 4
attendant. This subsection does not apply to any person licensed practical nurse
who 5is licensed to practice practical nursing holds a multistate license, as defined in s.
6441.51 (2) (h), issued
by a jurisdiction, other than this state, that has adopted the 7enhanced
nurse licensure compact under s. 441.50 441.51
441.115 (2) (a) of the statutes is amended to read:
(a) In this subsection, “nursing credential" means a license, permit 10
or certificate of registration or certification that is granted to a person by another 11
state or territory or by a foreign country or province and that authorizes or qualifies 12
the person holding the credential to perform acts that are substantially the same as 13
those performed by a person licensed as a registered nurse or licensed practical nurse 14
under this subchapter. In this paragraph, “state or territory" excludes any state or
15territory that has adopted the nurse licensure compact under, except that “nursing
16credential” does not include a multistate license, as defined in s. 441.51 (2) (h), issued
17by a party state, as defined in
441.51 (2) (k)
441.15 (3) (a) (intro.) of the statutes is amended to read:
(a) (intro.) Subject to s. 441.07 (1g), the board shall grant a license 20
to engage in the practice of nurse-midwifery to any person registered nurse who is 21
licensed as a registered nurse
under this subchapter or who holds a multistate
22license, as defined in s. 441.51 (2) (h), issued
in a party state, as defined in s. 441.50 23441.51
(2) (j) (k)
, who does all of the following:
Subchapter II (title) of chapter 441 [precedes 441.50] of the 25
statutes is amended to read:
NURSE LICENSURE COMPACT
441.50 of the statutes is repealed.
441.51 of the statutes is created to read:
6441.51 Enhanced nurse licensure compact. (1) Article I — Findings and
7declaration of purpose.
(a) The party states find all of the following:
1. That the health and safety of the public are affected by the degree of 9
compliance with and the effectiveness of enforcement activities related to state nurse 10
2. That violations of nurse licensure and other laws regulating the practice of 12
nursing may result in injury or harm to the public.
3. That the expanded mobility of nurses and the use of advanced 14
communication technologies as part of our nation's health care delivery system 15
require greater coordination and cooperation among states in the areas of nurse 16
licensure and regulation.
4. That new practice modalities and technology make compliance with 18
individual state nurse licensure laws difficult and complex.
5. That the current system of duplicative licensure for nurses practicing in 20
multiple states is cumbersome and redundant for both nurses and states.
6. That uniformity of nurse licensure requirements throughout the states 22
promotes public safety and public health benefits.
(b) The general purposes of this compact are as follows:
1. To facilitate the states' responsibility to protect the public's health and safety.
2. To ensure and encourage the cooperation of party states in the areas of nurse 2
licensure and regulation.
3. To facilitate the exchange of information between party states in the areas 4
of nurse regulation, investigation, and adverse actions.
4. To promote compliance with the laws governing the practice of nursing in 6
5. To invest all party states with the authority to hold a nurse accountable for 8
meeting all state practice laws in the state in which the patient is located at the time 9
care is rendered through the mutual recognition of party state licenses.
6. To decrease redundancies in the consideration and issuance of nurse 11
7. To provide opportunities for interstate practice by nurses who meet uniform 13
14(2) Article II — Definitions.
As used in this compact:
(a) “Adverse action” means any administrative, civil, equitable, or criminal 16
action permitted by a state's laws which is imposed by a licensing board or other 17
authority against a nurse, including actions against an individual's license or 18
multistate licensure privilege such as revocation, suspension, probation, monitoring 19
of the licensee, limitation on the licensee's practice, or any other encumbrance on 20
licensure affecting a nurse's authorization to practice, including issuance of a cease 21
and desist action.
(b) “Alternative program” means a nondisciplinary monitoring program 23
approved by a licensing board.
(c) “Coordinated licensure information system” means an integrated process 25
for collecting, storing, and sharing information on nurse licensure and enforcement
activities related to nurse licensure laws that is administered by a nonprofit 2
organization composed of and controlled by licensing boards.
(d) “Current significant investigative information” means any of the following:
1. Investigative information that a licensing board, after a preliminary inquiry 5
that includes notification and an opportunity for the nurse to respond, if required by 6
state law, has reason to believe is not groundless and, if proved true, would indicate 7
more than a minor infraction.
2. Investigative information that indicates that the nurse represents an 9
immediate threat to public health and safety regardless of whether the nurse has 10
been notified and had an opportunity to respond.
(e) “Encumbrance” means a revocation or suspension of, or any limitation on, 12
the full and unrestricted practice of nursing imposed by a licensing board.
(f) “Home state” means the party state which is the nurse's primary state of 14
(g) “Licensing board” means a party state's regulatory body responsible for 16
issuing nurse licenses.
(h) “Multistate license” means a license to practice as a registered or a licensed 18
practical/vocational nurse issued by a home state licensing board that authorizes the 19
licensed nurse to practice in all party states under a multistate licensure privilege.
(i) “Multistate licensure privilege” means a legal authorization associated with 21
a multistate license permitting the practice of nursing as either a registered nurse 22
or licensed practical/vocational nurse in a remote state.
(j) “Nurse” means registered nurse or licensed practical/vocational nurse, as 24
those terms are defined by each party state's practice laws.
(k) “Party state” means any state that has adopted this compact.
(L) “Remote state” means a party state, other than the home state.
(m) “Single-state license” means a nurse license issued by a party state that 3
authorizes practice only within the issuing state and does not include a multistate 4
licensure privilege to practice in any other party state.
(n) “State” means a state, territory, or possession of the United States and the 6
District of Columbia.
(o) “State practice laws” means a party state's laws, rules, and regulations that 8
govern the practice of nursing, define the scope of nursing practice, and create the 9
methods and grounds for imposing discipline. “State practice laws” does not include 10
requirements necessary to obtain and retain a license, except for qualifications or 11
requirements of the home state.
12(3) Article III — General provisions and jurisdiction.
(a) A multistate license 13
to practice registered or licensed practical/vocational nursing issued by a home state 14
to a resident in that state will be recognized by each party state as authorizing a 15
nurse to practice as a registered nurse or as a licensed practical/vocational nurse, 16
under a multistate licensure privilege, in each party state.
(b) A state must implement procedures for considering the criminal history 18
records of applicants for initial multistate license or licensure by endorsement. Such 19
procedures shall include the submission of fingerprints or other biometric-based 20
information by applicants for the purpose of obtaining an applicant's criminal 21
history record information from the federal bureau of investigation and the agency 22
responsible for retaining that state's criminal records.
(c) Each party state shall require all of the following for an applicant to obtain 24
or retain a multistate license in the home state:
1. Meets the home state's qualifications for licensure or renewal of licensure, 2
as well as, all other applicable state laws.
2. Satisfies one of the following:
a. Has graduated or is eligible to graduate from a licensing board-approved 5
registered nurse or licensed practical/vocational nurse prelicensure education 6
b. Has graduated from a foreign registered nurse or licensed 8
practical/vocational nurse prelicensure education program that has been approved 9
by the authorized accrediting body in the applicable country and has been verified 10
by an independent credentials review agency to be comparable to a licensing 11
board-approved prelicensure education program.
3. Has, if a graduate of a foreign prelicensure education program not taught 13
in English or if English is not the individual's native language, successfully passed 14
an English proficiency examination that includes the components of reading, 15
speaking, writing, and listening.
4. Has successfully passed an NCLEX-RN or NCLEX-PN Examination or 17
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 20
licensure by endorsement, fingerprints or other biometric data for the purpose of 21
obtaining criminal history record information from the federal bureau of 22
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 24
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 2
disposition, of a misdemeanor offense related to the practice of nursing as 3
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 6
in an alternative program.
11. Has a valid United States social security number.
(d) All party states shall be authorized, in accordance with existing state due 9
process law, to take adverse action against a nurse's multistate licensure privilege 10
such as revocation, suspension, probation or any other action that affects a nurse's 11
authorization to practice under a multistate licensure privilege, including cease and 12
desist actions. If a party state takes such action, it shall promptly notify the 13
administrator of the coordinated licensure information system. The administrator 14
of the coordinated licensure information system shall promptly notify the home state 15
of any such actions by remote states.
(e) A nurse practicing in a party state must comply with the state practice laws 17
of the state in which the client is located at the time service is provided. The practice 18
of nursing is not limited to patient care, but shall include all nursing practice as 19
defined by the state practice laws of the party state in which the client is located. 20
The practice of nursing in a party state under a multistate licensure privilege will 21
subject a nurse to the jurisdiction of the licensing board, the courts, and the laws of 22
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 24
for a party state's single-state license as provided under the laws of each party state. 25
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 2
compact shall affect the requirements established by a party state for the issuance 3
of a single-state license.
(g) Any nurse holding a home state multistate license, on the effective date of 5
this compact, may retain and renew the multistate license issued by the nurse's 6
then-current home state, provided that:
1. A nurse, who changes primary state of residence after this compact's effective 8
date, must meet all applicable requirements under par. (c) to obtain a multistate 9
license from a new home state.
2. A nurse who fails to satisfy the multistate licensure requirements in par. (c) 11
due to a disqualifying event occurring after this compact's effective date shall be 12
ineligible to retain or renew a multistate license, and the nurse's multistate license 13
shall be revoked or deactivated in accordance with applicable rules adopted by the 14
interstate commission of nurse licensure compact administrators (“commission”).
15(4) Article IV — Applications for licensure in a party state.
(a) Upon 16
application for a multistate license, the licensing board in the issuing party state 17
shall ascertain, through the coordinated licensure information system, whether the 18
applicant has ever held, or is the holder of, a license issued by any other state, 19
whether there are any encumbrances on any license or multistate licensure privilege 20
held by the applicant, whether any adverse action has been taken against any license 21
or multistate licensure privilege held by the applicant, and whether the applicant is 22
currently participating in an alternative program.
(b) A nurse may hold a multistate license, issued by the home state, in only one 24
party state at a time.
(c) 1. If a nurse changes primary state of residence by moving between 2 party 2
states, the nurse must apply for licensure in the new home state, and the multistate 3
license issued by the prior home state will be deactivated in accordance with 4
applicable rules adopted by the commission.
2. The nurse may apply for licensure in advance of a change in primary state 6
3. A multistate license shall not be issued by the new home state until the nurse 8
provides satisfactory evidence of a change in primary state of residence to the new 9
home state and satisfies all applicable requirements to obtain a multistate license 10
from the new home state.
(d) If a nurse changes primary state of residence by moving from a party state 12
to a non-party state, the multistate license issued by the prior home state will 13
convert to a single-state license, valid only in the former home state.
14(5) Article V — Additional authorities invested in party state licensing
(a) In addition to the other powers conferred by state law, a licensing board 16
shall have the authority to do any of the following:
1. Take adverse action against a nurse's multistate licensure privilege to 18
practice within that party state, subject to all of the following:
a. Only the home state shall have the power to take adverse action against a 20
nurse's license issued by the home state.
b. For purposes of taking adverse action, the home state licensing board shall 22
give the same priority and effect to reported conduct received from a remote state as 23
it would if such conduct had occurred within the home state. In so doing, the home 24
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 2
authority to practice within that party state.
3. Complete any pending investigations of a nurse who changes primary state 4
of residence during the course of such investigations. The licensing board shall also 5
have the authority to take appropriate action and shall promptly report the 6
conclusions of such investigations to the administrator of the coordinated licensure 7
information system. The administrator of the coordinated licensure information 8
system shall promptly notify the new home state of any such actions.
4. Issue subpoenas for both hearings and investigations that require the 10
attendance and testimony of witnesses, as well as, the production of evidence. 11
Subpoenas issued by a licensing board in a party state for the attendance and 12
testimony of witnesses or the production of evidence from another party state shall 13
be enforced in the latter state by any court of competent jurisdiction, according to the 14
practice and procedure of that court applicable to subpoenas issued in proceedings 15
pending before it. The issuing authority shall pay any witness fees, travel expenses, 16
mileage, and other fees required by the service statutes of the state in which the 17
witnesses or evidence are located.
5. Obtain and submit, for each nurse licensure applicant, fingerprint or other 19
biometric-based information to the federal bureau of investigation for criminal 20
background checks, receive the results of the federal bureau of investigation record 21
search on criminal background checks, and use the results in making licensure 22
6. If otherwise permitted by state law, recover from the affected nurse the costs 24
of investigations and disposition of cases resulting from any adverse action taken 25
against that nurse.
7. Take adverse action based on the factual findings of the remote state, 2
provided that the licensing board follows its own procedures for taking such adverse 3
(b) If adverse action is taken by the home state against a nurse's multistate 5
license, the nurse's multistate licensure privilege to practice in all other party states 6
shall be deactivated until all encumbrances have been removed from the multistate 7
license. All home state disciplinary orders that impose adverse action against a 8
nurse's multistate license shall include a statement that the nurse's multistate 9
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 11
participation in an alternative program may be used in lieu of adverse action. The 12
home state licensing board shall deactivate the multistate licensure privilege under 13
the multistate license of any nurse for the duration of the nurse's participation in an 14
15(6) Article VI — Coordinated licensure information system and exchange of
(a) All party states shall participate in a coordinated licensure 17
information system of all licensed registered nurses and licensed 18
practical/vocational nurses. This system will include information on the licensure 19
and disciplinary history of each nurse, as submitted by party states, to assist in the 20
coordination of nurse licensure and enforcement efforts.
(b) The commission, in consultation with the administrator of the coordinated 22
licensure information system, shall formulate necessary and proper procedures for 23
the identification, collection, and exchange of information under this compact.
(c) All licensing boards shall promptly report to the coordinated licensure 25
information system any adverse action, any current significant investigative
information, denials of applications (with the reasons for such denials), and nurse 2
participation in alternative programs known to the licensing board regardless of 3
whether such participation is deemed nonpublic or confidential under state law.
(d) Current significant investigative information and participation in 5
nonpublic or confidential alternative programs shall be transmitted through the 6
coordinated licensure information system only to party state licensing boards.
(e) Notwithstanding any other provision of law, all party state licensing boards 8
contributing information to the coordinated licensure information system may 9
designate information that may not be shared with nonparty states or disclosed to 10
other entities or individuals without the express permission of the contributing 11
(f) Any personally identifiable information obtained from the coordinated 13
licensure information system by a party state licensing board shall not be shared 14
with nonparty states or disclosed to other entities or individuals except to the extent 15
permitted by the laws of the party state contributing the information.