EMS LICENSURE COMPACT

SB0256A -1- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

34-LS1391\A

SENATE BILL NO. 256

IN THE LEGISLATURE OF THE STATE OF ALASKA

THIRTY-FOURTH LEGISLATURE - SECOND SESSION

BY SENATOR MYERS

Introduced: 2/23/26
Referred: Labor and Commerce, Finance

A BILL

FOR AN ACT ENTITLED

"An Act relating to the recognition of EMS personnel licensure interstate compact; and 1
providing for an effective date." 2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
* Section 1. AS 18.08.082 is amended by adding a new subsection to read: 4
(d) The department shall implement the recognition of EMS personnel 5
licensure interstate compact under AS 18.08.105. 6
* Sec. 2. AS 18.08 is amended by adding a new section to read: 7
Sec. 18.08.105. Recognition of EMS personnel licensure interstate 8
compact. The recognition of EMS personnel licensure interstate compact as contained 9
in this section is enacted into law and entered into on behalf of the state with all other 10
states and jurisdictions legally joining it in a form substantially as follows: 11
SECTION 1. PURPOSE. 12
In order to protect the public through verification of competency and ensure 13
accountability for patient care related activities all states license emergency medical 14
34-LS1391\A
SB 256 -2- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

services (EMS) personnel, such as emergency medical technicians (EMTs), advanced 1
EMTs and paramedics. This Compact is intended to facilitate the day-to-day 2
movement of EMS personnel across state boundaries in the performance of their EMS 3
duties as assigned by an appropriate authority and authorize state EMS offices to 4
afford immediate legal recognition to EMS personnel licensed in a member state. This 5
Compact recognizes that states have a vested interest in protecting the public's health 6
and safety through their licensing and regulation of EMS personnel and that such state 7
regulation shared among the member states will best protect public health and safety. 8
This Compact is designed to achieve the following purposes and objectives: 9
(1) increase public access to EMS personnel; 10
(2) enhance the states' ability to protect the public's health and safety, 11
especially patient safety; 12
(3) encourage the cooperation of member states in the areas of EMS 13
personnel licensure and regulation; 14
(4) support licensing of military members who are separating from an 15
active-duty tour and their spouses; 16
(5) facilitate the exchange of information between member states 17
regarding EMS personnel licensure, adverse action and significant investigatory 18
information; 19
(6) promote compliance with the laws governing EMS personnel 20
practice in each member state; and 21
(7) invest all member states with the authority to hold EMS personnel 22
accountable through the mutual recognition of member state licenses. 23
SECTION 2. DEFINITIONS. 24
In this Compact: 25
(A) "Advanced Emergency Medical Technician" and "AEMT" mean: an 26
individual licensed with cognitive knowledge and a scope of practice that corresponds 27
to that level in the National EMS Education Standards and National EMS Scope of 28
Practice Model. 29
(B) "Adverse Action" means: any administrative, civil, equitable or criminal 30
action permitted by a state's laws which may be imposed against licensed EMS 31
34-LS1391\A
SB0256A -3- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

personnel by a state EMS authority or state court, including, but not limited to, actions 1
against an individual's license such as revocation, suspension, probation, consent 2
agreement, monitoring or other limitation or encumbrance on the individual's practice, 3
letters of reprimand or admonition, fines, criminal convictions and state court 4
judgments enforcing adverse actions by the state EMS authority. 5
(C) "Alternative program" means: a voluntary, non-disciplinary substance 6
abuse recovery program approved by a state EMS authority. 7
(D) "Certification" means: the successful verification of entry-level cognitive 8
and psychomotor competency using a reliable, validated, and legally defensible 9
examination. 10
(E) "Commission" means: the national administrative body of which all states 11
that have enacted the Compact are members. 12
(F) "Emergency Medical Technician" and "EMT" mean: an individual 13
licensed with cognitive knowledge and a scope of practice that corresponds to that 14
level in the National EMS Education Standards and National EMS Scope of Practice 15
Model. 16
(G) "Home State" means: a member state where an individual is licensed to 17
practice emergency medical services. 18
(H) "License" means: the authorization by a state for an individual to practice 19
as an EMT, AEMT, paramedic, or a level in between EMT and paramedic. 20
(I) "Medical Director" means: a physician licensed in a member state who is 21
accountable for the care delivered by EMS personnel. 22
(J) "Member State" means: a state that has enacted this Compact. 23
(K) "Paramedic" means: an individual licensed with cognitive knowledge and 24
a scope of practice that corresponds to that level in the National EMS Education 25
Standards and National EMS Scope of Practice Model. 26
(L) "Privilege to Practice" means: an individual's authority to deliver 27
emergency medical services in remote states as authorized under this Compact. 28
(M) "Remote State" means: a member state in which an individual is not 29
licensed. 30
(N) "Restricted" means: the outcome of an adverse action that limits a license 31
34-LS1391\A
SB 256 -4- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

or the privilege to practice. 1
(O) "Rule" means: a written statement by the interstate Commission 2
promulgated pursuant to Section 12 of this Compact that is of general applicability; 3
implements, interprets, or prescribes a policy or provision of the Compact; or is an 4
organizational, procedural, or practice requirement of the Commission and has the 5
force and effect of statutory law in a member state and includes the amendment, 6
repeal, or suspension of an existing rule. 7
(P) "Scope of Practice" means: defined parameters of various duties or 8
services that may be provided by an individual with specific credentials. Whether 9
regulated by rule, statute, or court decision, it tends to represent the limits of services 10
an individual may perform. 11
(Q) "Significant Investigatory Information" means: 12
(1) investigative information that a state EMS authority, after a 13
preliminary inquiry that includes notification and an opportunity to respond if required 14
by state law, has reason to believe, if proved true, would result in the imposition of an 15
adverse action on a license or privilege to practice; or 16
(2) investigative information that indicates that the individual 17
represents an immediate threat to public health and safety regardless of whether the 18
individual has been notified and had an opportunity to respond. 19
(R) "State" means: any state, commonwealth, district, or territory of the 20
United States. 21
(S) "State EMS Authority" means: the board, office, or other agency with the 22
legislative mandate to license EMS personnel. 23
SECTION 3. HOME STATE LICENSURE. 24
(A) Any member state in which an individual holds a current license shall be 25
deemed a home state for purposes of this Compact. 26
(B) Any member state may require an individual to obtain and retain a license 27
to be authorized to practice in the member state under circumstances not authorized by 28
the privilege to practice under the terms of this Compact. 29
(C) A home state's license authorizes an individual to practice in a remote 30
state under the privilege to practice only if the home state: 31
34-LS1391\A
SB0256A -5- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

(1) Currently requires the use of the National Registry of Emergency 1
Medical Technicians (NREMT) examination as a condition of issuing initial licenses 2
at the EMT and paramedic levels; 3
(2) Has a mechanism in place for receiving and investigating 4
complaints about individuals; 5
(3) Notifies the Commission, in compliance with the terms herein, of 6
any adverse action or significant investigatory information regarding an individual; 7
(4) No later than five years after activation of the Compact, requires a 8
criminal background check of all applicants for initial licensure, including the use of 9
the results of fingerprint or other biometric data checks compliant with the 10
requirements of the Federal Bureau of Investigation with the exception of federal 11
employees who have suitability determination in accordance with 5 C.F.R. 731.202 12
and submit documentation of such as promulgated in the rules of the Commission; and 13
(5) Complies with the rules of the Commission. 14
SECTION 4. COMPACT PRIVILEGE TO PRACTICE. 15
(A) Member states shall recognize the privilege to practice of an individual 16
licensed in another member state that is in conformance with Section 3. 17
(B) To exercise the privilege to practice under the terms and provisions of this 18
Compact, an individual must: 19
(1) Be at least 18 years of age; 20
(2) Possess a current unrestricted license in a member state as an EMT, 21
AEMT, paramedic, or state recognized and licensed level with a scope of practice and 22
authority between EMT and paramedic; and 23
(3) Practice under the supervision of a medical director. 24
(C) An individual providing patient care in a remote state under the privilege 25
to practice shall function within the scope of practice authorized by the home state 26
unless and until modified by an appropriate authority in the remote state as may be 27
defined in the rules of the commission. 28
(D) Except as provided in Section 4(C), an individual practicing in a remote 29
state will be subject to the remote state's authority and laws. A remote state may, in 30
accordance with due process and that state's laws, restrict, suspend, or revoke an 31
34-LS1391\A
SB 256 -6- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

individual's privilege to practice in the remote state and may take any other necessary 1
actions to protect the health and safety of its citizens. If a remote state takes action it 2
shall promptly notify the home state and the Commission. 3
(E) If an individual's license in any home state is restricted or suspended, the 4
individual shall not be eligible to practice in a remote state under the privilege to 5
practice until the individual's home state license is restored. 6
(F) If an individual's privilege to practice in any remote state is restricted, 7
suspended, or revoked the individual shall not be eligible to practice in any remote 8
state until the individual's privilege to practice is restored. 9
SECTION 5. CONDITIONS OF PRACTICE IN A REMOTE STATE. 10
An individual may practice in a remote state under a privilege to practice only 11
in the performance of the individual's EMS duties as assigned by an appropriate 12
authority, as defined in the rules of the Commission, and under the following 13
circumstances: 14
(1) The individual originates a patient transport in a home state and 15
transports the patient to a remote state; 16
(2) The individual originates in the home state and enters a remote 17
state to pick up a patient and provide care and transport of the patient to the home 18
state; 19
(3) The individual enters a remote state to provide patient care and/or 20
transport within that remote state; 21
(4) The individual enters a remote state to pick up a patient and 22
provide care and transport to a third member state; 23
(5) Other conditions as determined by rules promulgated by the 24
commission. 25
SECTION 6. RELATIONSHIP TO EMERGENCY MANAGEMENT ASSISTANCE 26
COMPACT. 27
Upon a member state's governor's declaration of a state of emergency or 28
disaster that activates the Emergency Management Assistance Compact (EMAC), all 29
relevant terms and provisions of EMAC shall apply and to the extent any terms or 30
provisions of this Compact conflicts with EMAC, the terms of EMAC shall prevail 31
34-LS1391\A
SB0256A -7- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

with respect to any individual practicing in the remote state in response to such 1
declaration. 2
SECTION 7. VETERANS, SERVICE MEMBERS SEPARATING FROM ACTIVE-DUTY 3
MILITARY, AND THEIR SPOUSES. 4
(A) Member states shall consider a veteran, active military service member, 5
and member of the National Guard and Reserves separating from an active-duty tour, 6
and a spouse thereof, who holds a current valid and unrestricted NREMT certification 7
at or above the level of the state license being sought as satisfying the minimum 8
training and examination requirements for such licensure. 9
(B) Member states shall expedite the processing of licensure applications 10
submitted by veterans, active military service members, and members of the National 11
Guard and Reserves separating from an active-duty tour, and their spouses. 12
(C) All individuals functioning with a privilege to practice under this Section 13
remain subject to the Adverse Actions provisions of Section 8. 14
SECTION 8. ADVERSE ACTIONS. 15
(A) A home state shall have exclusive power to impose adverse action against 16
an individual's license issued by the home state. 17
(B) If an individual's license in any home state is restricted or suspended, the 18
individual shall not be eligible to practice in a remote state under the privilege to 19
practice until the individual's home state license is restored. 20
(1) All home state adverse action orders shall include a statement that 21
the individual's Compact privileges are inactive. The order may allow the individual to 22
practice in remote states with prior written authorization from both the home state and 23
remote state's EMS authority. 24
(2) An individual currently subject to adverse action in the home state 25
shall not practice in any remote state without prior written authorization from both the 26
home state and remote state's EMS authority. 27
(C) A member state shall report adverse actions and any occurrences that the 28
individual's Compact privileges are restricted, suspended, or revoked to the 29
Commission in accordance with the rules of the Commission. 30
(D) A remote state may take adverse action on an individual's privilege to 31
34-LS1391\A
SB 256 -8- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

practice within that state. 1
(E) Any member state may take adverse action against an individual's 2
privilege to practice in that state based on the factual findings of another member state, 3
so long as each state follows its own procedures for imposing such adverse action. 4
(F) A home state's EMS authority shall investigate and take appropriate action 5
with respect to reported conduct in a remote state as it would if such conduct had 6
occurred within the home state. In such cases, the home state's law shall control in 7
determining the appropriate adverse action. 8
(G) Nothing in this Compact shall override a member state's decision that 9
participation in an alternative program may be used in lieu of adverse action and that 10
such participation shall remain non-public if required by the member state's laws. 11
Member states must require individuals who enter any alternative programs to agree 12
not to practice in any other member state during the term of the alternative program 13
without prior authorization from such other member state. 14
SECTION 9. ADDITIONAL POWERS INVESTED IN A MEMBER STATE'S EMS 15
AUTHORITY. 16
A member state's EMS authority, in addition to any other powers granted 17
under state law, is authorized under this Compact to: 18
(1) Issue subpoenas for both hearings and investigations that require 19
the attendance and testimony of witnesses and the production of evidence. Subpoenas 20
issued by a member state's EMS authority for the attendance and testimony of 21
witnesses, and/or the production of evidence from another member state, shall be 22
enforced in the remote state by any court of competent jurisdiction, according to that 23
court's practice and procedure in considering subpoenas issued in its own proceedings. 24
The issuing state EMS authority shall pay any witness fees, travel expenses, mileage, 25
and other fees required by the service statutes of the state where the witnesses and/or 26
evidence are located; and 27
(2) Issue cease and desist orders to restrict, suspend, or revoke an 28
individual's privilege to practice in the state. 29
SECTION 10. ESTABLISHMENT OF THE INTERSTATE COMMISSION FOR EMS 30
PERSONNEL PRACTICE. 31
34-LS1391\A
SB0256A -9- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

(A) The Compact states hereby create and establish a joint public agency 1
known as the Interstate Commission for EMS Personnel Practice. 2
(1) The Commission is a body politic and an instrumentality of the 3
Compact states. 4
(2) Venue is proper and judicial proceedings by or against the 5
Commission shall be brought solely and exclusively in a court of competent 6
jurisdiction where the principal office of the Commission is located. The Commission 7
may waive venue and jurisdictional defenses to the extent it adopts or consents to 8
participate in alternative dispute resolution proceedings. 9
(3) Nothing in this Compact shall be construed to be a waiver of 10
sovereign immunity. 11
(B) Membership, Voting, and Meetings. 12
(1) Each member state shall have and be limited to one (1) delegate. 13
The responsible official of the state EMS authority or his designee shall be the 14
delegate to this Compact for each member state. Any delegate may be removed or 15
suspended from office as provided by the law of the state from which the delegate is 16
appointed. Any vacancy occurring in the Commission shall be filled in accordance 17
with the laws of the member state in which the vacancy exists. In the event that more 18
than one board, office, or other agency with the legislative mandate to license EMS 19
personnel at and above the level of EMT exists, the Governor of the state will 20
determine which entity will be responsible for assigning the delegate. 21
(2) Each delegate shall be entitled to one (1) vote with regard to the 22
promulgation of rules and creation of bylaws and shall otherwise have an opportunity 23
to participate in the business and affairs of the Commission. A delegate shall vote in 24
person or by such other means as provided in the bylaws. The bylaws may provide for 25
delegates' participation in meetings by telephone or other means of communication. 26
(3) The Commission shall meet at least once during each calendar 27
year. Additional meetings shall be held as set forth in the bylaws. 28
(4) All meetings shall be open to the public, and public notice of 29
meetings shall be given in the same manner as required under the rulemaking 30
provisions in Section 7. 31
34-LS1391\A
SB 256 -10- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

(5) The Commission may convene in a closed, non-public meeting if 1
the Commission must discuss: 2
(a) Non-compliance of a member state with its obligations 3
under the Compact; 4
(b) The employment, compensation, discipline or other 5
personnel matters, practices or procedures related to specific employees or 6
other matters related to the Commission's internal personnel practices and 7
procedures; 8
(c) Current, threatened, or reasonably anticipated litigation; 9
(d) Negotiation of contracts for the purchase or sale of goods, 10
services, or real estate; 11
(e) Accusing any person of a crime or formally censuring any 12
person; 13
(f) Disclosure of trade secrets or commercial or financial 14
information that is privileged or confidential; 15
(g) Disclosure of information of a personal nature where 16
disclosure would constitute a clearly unwarranted invasion of personal privacy; 17
(h) Disclosure of investigatory records compiled for law 18
enforcement purposes; 19
(i) Disclosure of information related to any investigatory 20
reports prepared by or on behalf of or for use of the Commission or other 21
committee charged with responsibility of investigation or determination of 22
compliance issues pursuant to the Compact; or 23
(j) Matters specifically exempted from disclosure by federal or 24
member state statute. 25
(6) If a meeting, or portion of a meeting, is closed pursuant to this 26
provision, the Commission's legal counsel or designee shall certify that the meeting 27
may be closed and shall reference each relevant exempting provision. The 28
Commission shall keep minutes that fully and clearly describe all matters discussed in 29
a meeting and shall provide a full and accurate summary of actions taken, and the 30
reasons therefore, including a description of the views expressed. All documents 31
34-LS1391\A
SB0256A -11- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

considered in connection with an action shall be identified in such minutes. All 1
minutes and documents of a closed meeting shall remain under seal, subject to release 2
by a majority vote of the Commission or order of a court of competent jurisdiction. 3
(C) The Commission shall, by a majority vote of the delegates, prescribe 4
bylaws and/or rules to govern its conduct as may be necessary or appropriate to carry 5
out the purposes and exercise the powers of the Compact, including but not limited to: 6
(1) Establishing the fiscal year of the Commission; 7
(2) Providing reasonable standards and procedures: 8
(a) for the establishment and meetings of other committees; and 9
(b) governing any general or specific delegation of any 10
authority or function of the Commission; 11
(3) Providing reasonable procedures for calling and conducting 12
meetings of the Commission, ensuring reasonable advance notice of all meetings, and 13
providing an opportunity for attendance of such meetings by interested parties, with 14
enumerated exceptions designed to protect the public's interest, the privacy of 15
individuals, and proprietary information, including trade secrets. The Commission 16
may meet in closed session only after a majority of the membership votes to close a 17
meeting in whole or in part. As soon as practicable, the Commission must make public 18
a copy of the vote to close the meeting revealing the vote of each member with no 19
proxy votes allowed; 20
(4) Establishing the titles, duties and authority, and reasonable 21
procedures for the election of the officers of the Commission; 22
(5) Providing reasonable standards and procedures for the 23
establishment of the personnel policies and programs of the Commission. 24
Notwithstanding any civil service or other similar laws of any member state, the 25
bylaws shall exclusively govern the personnel policies and programs of the 26
Commission; 27
(6) Promulgating a code of ethics to address permissible and prohibited 28
activities of Commission members and employees; 29
(7) Providing a mechanism for winding up the operations of the 30
Commission and the equitable disposition of any surplus funds that may exist after the 31
34-LS1391\A
SB 256 -12- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

termination of the Compact after the payment and/or reserving of all of its debts and 1
obligations; 2
(8) The Commission shall publish its bylaws and file a copy thereof, 3
and a copy of any amendment thereto, with the appropriate agency or officer in each 4
of the member states, if any; 5
(9) The Commission shall maintain its financial records in accordance 6
with the bylaws; 7
(10) The Commission shall meet and take such actions as are 8
consistent with the provisions of this Compact and the bylaws. 9
(D) The Commission shall have the following powers: 10
(1) The authority to promulgate uniform rules to facilitate and 11
coordinate implementation and administration of this Compact. The rules shall have 12
the force and effect of law and shall be binding in all member states; 13
(2) To bring and prosecute legal proceedings or actions in the name of 14
the Commission, provided that the standing of any state EMS authority or other 15
regulatory body responsible for EMS personnel licensure to sue or be sued under 16
applicable law shall not be affected; 17
(3) To purchase and maintain insurance and bonds; 18
(4) To borrow, accept, or contract for services of personnel, including, 19
but not limited to, employees of a member state; 20
(5) To hire employees, elect or appoint officers, fix compensation, 21
define duties, grant such individuals appropriate authority to carry out the purposes of 22
the Compact, and to establish the Commission's personnel policies and programs 23
relating to conflicts of interest, qualifications of personnel, and other related personnel 24
matters; 25
(6) To accept any and all appropriate donations and grants of money, 26
equipment, supplies, materials and services, and to receive, utilize and dispose of the 27
same; provided that at all times the Commission shall strive to avoid any appearance 28
of impropriety and/or conflict of interest; 29
(7) To lease, purchase, accept appropriate gifts or donations of, or 30
otherwise to own, hold, improve or use, any property, real, personal or mixed; 31
34-LS1391\A
SB0256A -13- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

provided that at all times the Commission shall strive to avoid any appearance of 1
impropriety; 2
(8) To sell, convey, mortgage, pledge, lease, exchange, abandon, or 3
otherwise dispose of any property real, personal, or mixed; 4
(9) To establish a budget and make expenditures; 5
(10) To borrow money; 6
(11) To appoint committees, including advisory committees comprised 7
of members, state regulators, state legislators or their representatives, and consumer 8
representatives, and such other interested persons as may be designated in this 9
Compact and the bylaws; 10
(12) To provide and receive information from, and to cooperate with, 11
law enforcement agencies; 12
(13) To adopt and use an official seal; and 13
(14) To perform such other functions as may be necessary or 14
appropriate to achieve the purposes of this Compact consistent with the state 15
regulation of EMS personnel licensure and practice. 16
(E) Financing of the Commission. 17
(1) The Commission shall pay, or provide for the payment of, the 18
reasonable expenses of its establishment, organization, and ongoing activities. 19
(2) The Commission may accept any and all appropriate revenue 20
sources, donations, and grants of money, equipment, supplies, materials, and services. 21
(3) The Commission may levy on and collect an annual assessment 22
from each member state or impose fees on other parties to cover the cost of the 23
operations and activities of the Commission and its staff, which must be in a total 24
amount sufficient to cover its annual budget as approved each year for which revenue 25
is not provided by other sources. The aggregate annual assessment amount shall be 26
allocated based upon a formula to be determined by the Commission, which shall 27
promulgate a rule binding upon all member states. 28
(4) The Commission shall not incur obligations of any kind prior to 29
securing the funds adequate to meet the same; nor shall the Commission pledge the 30
credit of any of the member states, except by and with the authority of the member 31
34-LS1391\A
SB 256 -14- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

state. 1
(5) The Commission shall keep accurate accounts of all receipts and 2
disbursements. The receipts and disbursements of the Commission shall be subject to 3
the audit and accounting procedures established under its bylaws. However, all 4
receipts and disbursements of funds handled by the Commission shall be audited 5
yearly by a certified or licensed public accountant, and the report of the audit shall be 6
included in and become part of the annual report of the Commission. 7
(F) Qualified Immunity, Defense, and Indemnification. 8
(1) The members, officers, executive director, employees and 9
representatives of the Commission shall be immune from suit and liability, either 10
personally or in their official capacity, for any claim for damage to or loss of property 11
or personal injury or other civil liability caused by or arising out of any actual or 12
alleged act, error or omission that occurred, or that the person against whom the claim 13
is made had a reasonable basis for believing occurred within the scope of Commission 14
employment, duties or responsibilities; provided that nothing in this paragraph shall be 15
construed to protect any such person from suit and/or liability for any damage, loss, 16
injury, or liability caused by the intentional or willful or wanton misconduct of that 17
person. 18
(2) The Commission shall defend any member, officer, executive 19
director, employee or representative of the Commission in any civil action seeking to 20
impose liability arising out of any actual or alleged act, error, or omission that 21
occurred within the scope of Commission employment, duties, or responsibilities, or 22
that the person against whom the claim is made had a reasonable basis for believing 23
occurred within the scope of Commission employment, duties, or responsibilities; 24
provided that nothing herein shall be construed to prohibit that person from retaining 25
his or her own counsel; and provided further, that the actual or alleged act, error, or 26
omission did not result from that person's intentional or willful or wanton misconduct. 27
(3) The Commission shall indemnify and hold harmless any member, 28
officer, executive director, employee, or representative of the Commission for the 29
amount of any settlement or judgment obtained against that person arising out of any 30
actual or alleged act, error or omission that occurred within the scope of Commission 31
34-LS1391\A
SB0256A -15- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

employment, duties, or responsibilities, or that such person had a reasonable basis for 1
believing occurred within the scope of Commission employment, duties, or 2
responsibilities, provided that the actual or alleged act, error, or omission did not result 3
from the intentional or willful or wanton misconduct of that person. 4
SECTION 11. COORDINATED DATABASE. 5
(A) The Commission shall provide for the development and maintenance of a 6
coordinated database and reporting system containing licensure, adverse action, and 7
significant investigatory information on all licensed individuals in member states. 8
(B) Notwithstanding any other provision of state law to the contrary, a 9
member state shall submit a uniform data set to the coordinated database on all 10
individuals to whom this Compact is applicable as required by the rules of the 11
Commission, including: 12
(1) Identifying information; 13
(2) Licensure data; 14
(3) Significant investigatory information; 15
(4) Adverse actions against an individual's license; 16
(5) An indicator that an individual's privilege to practice is restricted, 17
suspended or revoked; 18
(6) Non-confidential information related to alternative program 19
participation; 20
(7) Any denial of application for licensure, and the reason(s) for such 21
denial; and 22
(8) Other information that may facilitate the administration of this 23
Compact, as determined by the rules of the Commission. 24
(C) The coordinated database administrator shall promptly notify all member 25
states of any adverse action taken against, or significant investigative information on, 26
any individual in a member state. 27
(D) Member states contributing information to the coordinated database may 28
designate information that may not be shared with the public without the express 29
permission of the contributing state. 30
(E) Any information submitted to the coordinated database that is 31
34-LS1391\A
SB 256 -16- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

subsequently required to be expunged by the laws of the member state contributing the 1
information shall be removed from the coordinated database. 2
SECTION 12. RULEMAKING. 3
(A) The Commission shall exercise its rulemaking powers pursuant to the 4
criteria set forth in this Section and the rules adopted thereunder. Rules and 5
amendments shall become binding as of the date specified in each rule or amendment. 6
(B) If a majority of the legislatures of the member states rejects a rule, by 7
enactment of a statute or resolution in the same manner used to adopt the Compact, 8
then such rule shall have no further force and effect in any member state. 9
(C) Rules or amendments to the rules shall be adopted at a regular or special 10
meeting of the Commission. 11
(D) Prior to promulgation and adoption of a final rule or rules by the 12
Commission, and at least sixty (60) days in advance of the meeting at which the rule 13
will be considered and voted upon, the Commission shall file a Notice of Proposed 14
Rulemaking: 15
(1) On the website of the Commission; and 16
(2) On the website of each member state EMS authority or the 17
publication in which each state would otherwise publish proposed rules. 18
(E) The Notice of Proposed Rulemaking shall include: 19
(1) The proposed time, date, and location of the meeting in which the 20
rule will be considered and voted upon; 21
(2) The text of the proposed rule or amendment and the reason for the 22
proposed rule; 23
(3) A request for comments on the proposed rule from any interested 24
person; and 25
(4) The manner in which interested persons may submit notice to the 26
Commission of their intention to attend the public hearing and any written comments. 27
(F) Prior to adoption of a proposed rule, the Commission shall allow persons 28
to submit written data, facts, opinions, and arguments, which shall be made available 29
to the public. 30
(G) The Commission shall grant an opportunity for a public hearing before it 31
34-LS1391\A
SB0256A -17- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

adopts a rule or amendment if a hearing is requested by: 1
(1) At least twenty-five (25) persons; 2
(2) A governmental subdivision or agency; or 3
(3) An association having at least twenty-five (25) members. 4
(H) If a hearing is held on the proposed rule or amendment, the Commission 5
shall publish the place, time, and date of the scheduled public hearing. 6
(1) All persons wishing to be heard at the hearing shall notify the 7
executive director of the Commission or other designated member in writing of their 8
desire to appear and testify at the hearing not less than five (5) business days before 9
the scheduled date of the hearing. 10
(2) Hearings shall be conducted in a manner providing each person 11
who wishes to comment a fair and reasonable opportunity to comment orally or in 12
writing. 13
(3) No transcript of the hearing is required, unless a written request for 14
a transcript is made, in which case the person requesting the transcript shall bear the 15
cost of producing the transcript. A recording may be made in lieu of a transcript under 16
the same terms and conditions as a transcript. This subsection shall not preclude the 17
Commission from making a transcript or recording of the hearing if it so chooses. 18
(4) Nothing in this section shall be construed as requiring a separate 19
hearing on each rule. Rules may be grouped for the convenience of the Commission 20
at hearings required by this section. 21
(I) Following the scheduled hearing date, or by the close of business on the 22
scheduled hearing date if the hearing was not held, the Commission shall consider all 23
written and oral comments received. 24
(J) The Commission shall, by majority vote of all members, take final action 25
on the proposed rule and shall determine the effective date of the rule, if any, based on 26
the rulemaking record and the full text of the rule. 27
(K) If no written notice of intent to attend the public hearing by interested 28
parties is received, the Commission may proceed with promulgation of the proposed 29
rule without a public hearing. 30
(L) Upon determination that an emergency exists, the Commission may 31
34-LS1391\A
SB 256 -18- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

consider and adopt an emergency rule without prior notice, opportunity for comment, 1
or hearing, provided that the usual rulemaking procedures provided in the Compact 2
and in this section shall be retroactively applied to the rule as soon as reasonably 3
possible, in no event later than ninety (90) days after the effective date of the rule. For 4
the purposes of this provision, an emergency rule is one that must be adopted 5
immediately in order to: 6
(1) Meet an imminent threat to public health, safety, or welfare; 7
(2) Prevent a loss of Commission or member state funds; 8
(3) Meet a deadline for the promulgation of an administrative rule that 9
is established by federal law or rule; or 10
(4) Protect public health and safety. 11
(M) The Commission or an authorized committee of the Commission may 12
direct revisions to a previously adopted rule or amendment for purposes of correcting 13
typographical errors, errors in format, errors in consistency, or grammatical errors. 14
Public notice of any revisions shall be posted on the website of the Commission. The 15
revision shall be subject to challenge by any person for a period of thirty (30) days 16
after posting. The revision may be challenged only on grounds that the revision results 17
in a material change to a rule. A challenge shall be made in writing, and delivered to 18
the chair of the Commission prior to the end of the notice period. If no challenge is 19
made, the revision will take effect without further action. If the revision is challenged, 20
the revision may not take effect without the approval of the Commission. 21
SECTION 13. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. 22
(A) Oversight. 23
(1) The executive, legislative, and judicial branches of state 24
government in each member state shall enforce this Compact and take all actions 25
necessary and appropriate to effectuate the Compact's purposes and intent. The 26
provisions of this Compact and the rules promulgated hereunder shall have standing as 27
statutory law. 28
(2) All courts shall take judicial notice of the Compact and the rules in 29
any judicial or administrative proceeding in a member state pertaining to the subject 30
matter of this Compact which may affect the powers, responsibilities or actions of the 31
34-LS1391\A
SB0256A -19- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

Commission. 1
(3) The Commission shall be entitled to receive service of process in 2
any such proceeding, and shall have standing to intervene in such a proceeding for all 3
purposes. Failure to provide service of process to the Commission shall render a 4
judgment or order void as to the Commission, this Compact, or promulgated rules. 5
(B) Default, Technical Assistance, and Termination. 6
(1) If the Commission determines that a member state has defaulted in 7
the performance of its obligations or responsibilities under this Compact or the 8
promulgated rules, the Commission shall: 9
(a) Provide written notice to the defaulting state and other 10
member states of the nature of the default, the proposed means of curing the 11
default and/or any other action to be taken by the Commission; and 12
(b) Provide remedial training and specific technical assistance 13
regarding the default. 14
(2) If a state in default fails to cure the default, the defaulting state may 15
be terminated from the Compact upon an affirmative vote of a majority of the member 16
states, and all rights, privileges and benefits conferred by this Compact may be 17
terminated on the effective date of termination. A cure of the default does not relieve 18
the offending state of obligations or liabilities incurred during the period of default. 19
(3) Termination of membership in the Compact shall be imposed only 20
after all other means of securing compliance have been exhausted. Notice of intent to 21
suspend or terminate shall be given by the Commission to the governor, the majority 22
and minority leaders of the defaulting state's legislature, and each of the member 23
states. 24
(4) A state that has been terminated is responsible for all assessments, 25
obligations, and liabilities incurred through the effective date of termination, including 26
obligations that extend beyond the effective date of termination. 27
(5) The Commission shall not bear any costs related to a state that is 28
found to be in default or that has been terminated from the Compact, unless agreed 29
upon in writing between the Commission and the defaulting state. 30
(6) The defaulting state may appeal the action of the Commission by 31
34-LS1391\A
SB 256 -20- SB0256A
New Text Underlined [DELETED TEXT BRACKETED]

petitioning the U.S. District Court for the District of Columbia or the federal district 1
where the Commission has its principal offices. The prevailing member shall be 2
awarded all costs of such litigation, including reasonable attorney's fees. 3
(C) Dispute Resolution. 4
(1) Upon request by a member state, the Commission shall attempt to 5
resolve disputes related to the Compact that arise among member states and between 6
member and non-member states. 7
(2) The Commission shall promulgate a rule providing for both 8
mediation and binding dispute resolution for disputes as appropriate. 9
(D) Enforcement. 10
(1) The Commission, in the reasonable exercise of its discretion, shall 11
enforce the provisions and rules of this Compact. 12
(2) By majority vote, the Commission may initiate legal action in the 13
United States District Court for the District of Columbia or the federal district where 14
the Commission has its principal offices against a member state in default to enforce 15
compliance with the provisions of the Compact and its promulgated rules and bylaws. 16
The relief sought may include both injunctive relief and damages. In the event judicial 17
enforcement is necessary, the prevailing member shall be awarded all costs of such 18
litigation, including reasonable attorney's fees. 19
(3) The remedies herein shall not be the exclusive remedies of the 20
Commission. The Commission may pursue any other remedies available under federal 21
or state law. 22
SECTION 14. DATE OF IMPLEMENTATION OF THE INTERSTATE COMMISSION 23
FOR EMS PERSONNEL PRACTICE AND ASSOCIATION RULES, WITHDRAWAL, 24
AND AMENDMENT. 25
(A) The Compact shall come into effect on the date on which the Compact 26
statute is enacted into law in the tenth member state. The provisions, which become 27
effective at that time, shall be limited to the powers granted to the Commission 28
relating to assembly and the promulgation of rules. Thereafter, the Commission shall 29
meet and exercise rulemaking powers necessary to the implementation and 30
administration of the Compact. 31
34-LS1391\A
SB0256A -21- SB 256
New Text Underlined [DELETED TEXT BRACKETED]

(B) Any state that joins the Compact subsequent to the Commission's initial 1
adoption of the rules shall be subject to the rules as they exist on the date on which the 2
Compact becomes law in that state. Any rule that has been previously adopted by the 3
Commission shall have the full force and effect of law on the day the Compact 4
becomes law in that state. 5
(C) Any member state may withdraw from this Compact by enacting a statute 6
repealing the same. 7
(1) A member state's withdrawal shall not take effect until six (6) 8
months after enactment of the repealing statute. 9
(2) Withdrawal shall not affect the continuing requirement of the 10
withdrawing state's EMS authority to comply with the investigative and adverse action 11
reporting requirements of this act prior to the effective date of withdrawal. 12
(D) Nothing contained in this Compact shall be construed to invalidate or 13
prevent any EMS personnel licensure agreement or other cooperative arrangement 14
between a member state and a non-member state that does not conflict with the 15
provisions of this Compact. 16
(E) This Compact may be amended by the member states. No amendment to 17
this Compact shall become effective and binding upon any member state until it is 18
enacted into the laws of all member states. 19
SECTION 15. CONSTRUCTION AND SEVERABILITY. 20
This Compact shall be liberally construed so as to effectuate the purposes 21
thereof. If this Compact shall be held contrary to the constitution of any state member 22
thereto, the Compact shall remain in full force and effect as to the remaining member 23
states. Nothing in this Compact supersedes state law or rules related to licensure of 24
EMS agencies. 25
* Sec. 3. This Act takes effect January 1, 2027. 26