North Carolina Board of Nursing

PROPOSED RULE CHANGES

21 NCAC 36. 0702 Issuance of a License by a Compact Party State

Reason for Proposed Rule: To bring the licensure compact rules in compliance with the Nurse Licensure Compact Administration Rules for the Nurse Licensure Compact, consistent with Article 9G of Chapter 90.

Public Hearing: A public hearing will be held Friday, July 26, 2013 at 8:30 am at the NC Board of Nursing office located at 4516 Lake Boone Trail, Raleigh, NC 27607.

Instructions for oral and written comments: Persons may submit objections to this rule by contacting Angela H. Ellis, APA Coordinator, NC Board of Nursing, PO Box 2129, Raleigh, NC 27602-2129; Fax: 919-781-9461; email: angela@ncbon.com.

Approved Proposed Rule Revisions:

21 NCAC 36. 0702 is proposed to be amended as follows:

21 NCAC 36 .0702 ISSUANCE OF A LICENSE BY A COMPACT PARTY STATE

For the purpose of the Compact:

(1) A nurse applying for a license in a home state shall produce evidence of the nurse’s primary state of residence. Such evidence shall include a declaration signed by the licensee attesting to the licensee's primary state of residence. Further evidence that may be requested includes, but is not limited to:
(a) Driver's license with a home address;
(b) Voter registration card displaying a home address;
(c) Federal income tax return declaring the primary state of residence;
(d) Military Form No. 2058 – state of legal residence certificate; or
(e) W2 from US Government or any bureau, division or agency thereof indicating the declared state of residence.
(2) A nurse changing primary state of residence, from one party state to another party state, may continue to practice under the former home state license and multistate licensure privilege during the processing of the nurse's licensure application in the new home state for a period not to exceed ~~30 days.~~ 90 days.
(3) The licensure application in the new home state of a nurse under pending investigation by the former home state shall be held in abeyance. The ~~30-day~~ 90-day period in Item (2) of this Rule shall be stayed until resolution of the pending investigation.
(4) The former home state license shall no longer be valid upon the issuance of a new home state license.
(5) If a decision denying licensure is made by the new home state, the new home state shall notify the former home state within 10 business days and the former home state may take action in accordance with that state's laws and rules.
(6) ~~As of July 1, 2005, no~~ No individual shall be issued a multistate licensure privilege unless the applicant provides evidence of successful completion of the licensing examination developed by the National Council of State Boards of Nursing, Inc.
(7) A nurse on a visa from another country applying for licensure in a party state may declare either the country of origin or the party state as the primary state of residence. If the foreign country is declared the primary state of residence, a single state license will be issued by the party state.
(8) A license issued by a party state is valid for practice in all other party states unless clearly designated as valid only in the state which issued the license.

History Note: Authority G.S. 90-171.82(6); 90-171.83(a)(b); 90-171.85(b); 90-171.87(4);

Eff. July 1, 2000;

Amended Eff. November 1, 2013; July 1, 2012; July 1, 2005.

21 NCAC 36. 0804 Process for Approval to Practice

Reason for Proposed Rule: 21 NCAC 36 .0804(b) addresses the NP refresher course requirement, but does not include the language in .0808 making the refresher course a prerequisite for approval to practice; however, since the refresher course is addressed in this rule, it would be appropriate to include the proposed addition in this rule as well.

Public Hearing: A public hearing will be held Friday, July 26, 2013 at 8:30 am at the NC Board of Nursing office located at 4516 Lake Boone Trail, Raleigh, NC 27607.

Approved Proposed Rule Revisions:

21 NCAC 36. 0804 is proposed to be amended as follows:

21 NCAC 36 .0804 PROCESS FOR APPROVAL TO PRACTICE

(a) Prior to the performance of any medical acts, a nurse practitioner shall:
(1) meet registration requirements as specified in 21 NCAC 36 .0803;
(2) submit an application for approval to practice;
(3) submit any additional information necessary to evaluate the application as requested; and
(4) have a collaborative practice agreement with a primary supervising physician.
(b) A nurse practitioner seeking approval to practice who has not practiced as a nurse practitioner in more than two years shall complete a nurse practitioner refresher course approved by the Board of Nursing in accordance with Paragraphs (o) and (p) of 21 NCAC 36 .0220 and consisting of common conditions and their management directly related to the nurse practitioner's area of education and certification. A nurse practitioner refresher course participant may be granted an approval to practice that is limited to clinical activities required by the refresher course.
(c) The nurse practitioner shall not practice until notification of approval to practice is received from the Board of Nursing after both Boards have approved the application.
(d) The nurse practitioner's approval to practice is terminated when the nurse practitioner discontinues working within the approved nurse practitioner collaborative practice agreement, or experiences an interruption in her or his registered nurse licensure status, and the nurse practitioner shall so notify the Board of Nursing in writing. The Boards shall extend the nurse practitioner's approval to practice in cases of emergency such as injury, sudden illness or death of the primary supervising physician.
(e) Applications for approval to practice in North Carolina shall be submitted to the Board of Nursing and then approved by both Boards as follows:
(1) the Board of Nursing shall verify compliance with Rule .0803 and Paragraph (a) of this Rule; and
(2) the Medical Board shall verify that the designated primary supervising physician holds a valid license to practice medicine in North Carolina and compliance with Paragraph (a) of this Rule.
(f) Applications for approval of changes in practice arrangements for a nurse practitioner currently approved to practice in North Carolina shall be submitted by the applicant as follows:
(1) addition or change of primary supervising physician shall be submitted to the Board of Nursing and processed pursuant to protocols developed by both Boards; and
(2) request for change(s) in the scope of practice shall be submitted to the Joint Subcommittee.
(g) A registered nurse who was previously approved to practice as a nurse practitioner in this state who reapplies for approval to practice shall:
(1) meet the nurse practitioner approval requirements as stipulated in Rule .0808(c) of this Section; and
(2) complete the appropriate application.
(h) Volunteer Approval to Practice. The North Carolina Board of Nursing shall grant approval to practice in a volunteer capacity to a nurse practitioner who has met the qualifications to practice as a nurse practitioner in North Carolina.
(i) The nurse practitioner shall pay the appropriate fee as outlined in Rule .0813 of this Section.
(j) A Nurse Practitioner approved under this Section shall keep proof of current licensure, registration and approval available for inspection at each practice site upon request by agents of either Board.

History Note: Authority G.S. 90-18(13), (14); 90-18.2; 90-171.20(7); 90-171.23(b);

Recodified from 21 NCAC 36.0227(c) Eff. August 1, 2004;

Amended Eff. November 1, 2013; January 1, 2013; December 1, 2009; November 1, 2008; January 1, 2007; August 1, 2004.

21 NCAC 36. 0808 Inactive Status

Reason for Proposed Rule: 21 NCAC 36.0808(d) requires an NP who has been out of active practice for greater than 2 years to complete an NP refresher course in order to be eligible to apply for approval to practice. Feedback from NPs completing the refresher course indicates that it is becoming increasingly difficult for them to find clinical preceptorships in order to complete the course. They are unable to acquire individual liability coverage and institutions will not allow them to perform clinical activities without an approval to practice. In addition, text deleted to coincide with text in 21 NCAC 36. 0804(d)

Public Hearing: A public hearing will be held Friday, July 26, 2013 at 8:30 am at the NC Board of Nursing office located at 4516 Lake Boone Trail, Raleigh, NC 27607.

Approved Proposed Rule Revisions:

21 NCAC 36. 0808 Inactive Status is proposed to be amended as follows:

21 NCAC 36 .0808 INACTIVE STATUS

(a) Any nurse practitioner who wishes to place her or his approval to practice on an inactive status shall notify the Board of Nursing in writing.
(b) A nurse practitioner with an inactive approval to practice status shall not practice as a nurse practitioner.
(c) A nurse practitioner with an inactive approval to practice status who reapplies for approval to practice shall meet the qualifications for approval to practice in Rules .0803(a)(1), .0804(a) and (b), .0807, and .0810 of this Section and receive notification from the Board of Nursing of approval prior to beginning practice after the application is approved by both Boards.
(d) A nurse practitioner who has not practiced as a nurse practitioner in more than two years shall complete a nurse practitioner refresher course approved by the Board of Nursing in accordance with Paragraphs (o) and (p) of 21 NCAC 36 .0220 and consisting of common conditions and management of these conditions directly related to the nurse practitioner's area of education and ~~certification~~ certification. ~~in order to be eligible to apply for approval to practice.~~ A nurse practitioner refresher course participant may be granted an approval to practice that is limited to clinical activities required by the refresher course.

History Note: Authority G.S. 90-18(13); 90-18.2; 90-171.36; 90-171.83;

Recodified from 21 NCAC 36 .0227(g) Eff. August 1, 2004;

Amended Eff. November 1, 2013; January 1, 2013; December 1, 2009; December 1, 2006; August 1, 2004.