HEALTHCARE COMPACTS; RURAL HEALTH PROGRAM

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CS FOR SENATE BILL NO. 281(HSS)

IN THE LEGISLATURE OF THE STATE OF ALASKA

THIRTY-FOURTH LEGISLATURE - SECOND SESSION

BY THE SENATE HEALTH AND SOCIAL SERVICES COMMITTEE

Offered: 5/1/26
Referred: Labor and Commerce

Sponsor(s): SENATE HEALTH AND SOCIAL SERVICES COMMITTEE
A BILL

FOR AN ACT ENTITLED

"An Act relating to the rural health transformation program; relating to the practice of 1
genetic counseling; relating to the licensure of genetic counselors; establishing the 2
Genetic Counseling Advisory Council; relating to the duties of the State Medical Board; 3
relating to telehealth; relating to physicians, osteopaths, podiatrists, and physician 4
assistants; relating to the interstate medical licensure compact; relating to the PA 5
licensure compact; relating to psychologists; relating to the psychology 6
interjurisdictional compact; relating to the practice of respiratory care; relating to the 7
duties of the Department of Commerce, Community, and Economic Development; 8
relating to medical malpractice liability of health care providers; relating to immunity 9
from civil liability for a health care provider providing free health care services; relating 10
to national criminal history record checks; relating to respiratory care practitioners 11
providing documentation and treatment plans for public school students with asthma or 12
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anaphylaxis; relating to emergency medical technicians, advanced emergency medical 1
technicians, and mobile intensive care paramedics; relating to the recognition of EMS 2
personnel licensure interstate compact; prohibiting unfair discrimination under group 3
health insurance against certain providers; establishing the Rural Health 4
Transformation Program Advisory Council; and providing for an effective date." 5
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 6
* Section 1. AS 08.01.010 is amended by adding a new paragraph to read: 7
(42) regulation of respiratory care practitioners under AS 08.90. 8
* Sec. 2. AS 08.02.110(a) is amended to read: 9
(a) An acupuncturist licensed under AS 08.06, an audiologist or speech-10
language pathologist licensed under AS 08.11, a behavior analyst licensed under 11
AS 08.15, a person licensed in the state as a chiropractor under AS 08.20, a 12
professional or associate counselor licensed under AS 08.29, a dentist under AS 08.36, 13
a dietitian or nutritionist licensed under AS 08.38, a genetic counselor licensed 14
under AS 08.53, a massage therapist licensed under AS 08.61, a marital and family 15
therapist licensed under AS 08.63, a medical practitioner or osteopath under AS 08.64, 16
a direct-entry midwife certified under AS 08.65, a registered or advanced practice 17
registered nurse under AS 08.68, an optometrist under AS 08.72, a licensed 18
pharmacist under AS 08.80, a physical therapist or occupational therapist licensed 19
under AS 08.84, a psychologist under AS 08.86, or a clinical social worker licensed 20
under AS 08.95, shall use as professional identification appropriate letters or a title 21
after that person's name that represents the person's specific field of practice. The 22
letters or title shall appear on all signs, stationery, or other advertising in which the 23
person offers or displays personal professional services to the public. In addition, a 24
person engaged in the practice of medicine or osteopathy as defined in AS 08.64.380, 25
or a person engaged in any manner in the healing arts who diagnoses, treats, tests, or 26
counsels other persons in relation to human health or disease and uses the letters 27
"M.D." or the title "doctor" or "physician" or another title that tends to show that the 28
person is willing or qualified to diagnose, treat, test, or counsel another person, shall 29
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clarify the letters or title by adding the appropriate specialist designation, if any, such 1
as "dermatologist," "radiologist," "audiologist," "naturopath," or the like. 2
* Sec. 3. AS 08.02.110(a), as amended by sec. 2 of this Act, is amended to read: 3
(a) An acupuncturist licensed under AS 08.06, an audiologist or speech-4
language pathologist licensed under AS 08.11, a behavior analyst licensed under 5
AS 08.15, a person licensed in the state as a chiropractor under AS 08.20, a 6
professional or associate counselor licensed under AS 08.29, a dentist under AS 08.36, 7
a dietitian or nutritionist licensed under AS 08.38, a genetic counselor licensed under 8
AS 08.53, a massage therapist licensed under AS 08.61, a marital and family therapist 9
licensed under AS 08.63, a medical practitioner or osteopath under AS 08.64, a direct-10
entry midwife certified under AS 08.65, a registered or advanced practice registered 11
nurse under AS 08.68, an optometrist under AS 08.72, a licensed pharmacist under 12
AS 08.80, a physical therapist or occupational therapist licensed under AS 08.84, a 13
psychologist under AS 08.86, a respiratory care practitioner licensed under 14
AS 08.90, or a clinical social worker licensed under AS 08.95, shall use as 15
professional identification appropriate letters or a title after that person's name that 16
represents the person's specific field of practice. The letters or title shall appear on all 17
signs, stationery, or other advertising in which the person offers or displays personal 18
professional services to the public. In addition, a person engaged in the practice of 19
medicine or osteopathy as defined in AS 08.64.380, or a person engaged in any 20
manner in the healing arts who diagnoses, treats, tests, or counsels other persons in 21
relation to human health or disease and uses the letters "M.D." or the title "doctor" or 22
"physician" or another title that tends to show that the person is willing or qualified to 23
diagnose, treat, test, or counsel another person, shall clarify the letters or title by 24
adding the appropriate specialist designation, if any, such as "dermatologist," 25
"radiologist," "audiologist," "naturopath," or the like. 26
* Sec. 4. AS 08.02.130(j)(1) is amended to read: 27
(1) "health care provider" means 28
(A) an audiologist or speech-language pathologist licensed 29
under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 30
licensed under AS 08.20; a professional or associate counselor licensed under 31
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AS 08.29; a dental hygienist licensed under AS 08.32; a dentist licensed under 1
AS 08.36; a dietitian or nutritionist licensed under AS 08.38; a naturopath 2
licensed under AS 08.45; a genetic counselor licensed under AS 08.53; a 3
marital and family therapist licensed under AS 08.63; a physician licensed 4
under AS 08.64; a podiatrist, osteopath, or physician assistant licensed under 5
AS 08.64; a direct-entry midwife certified under AS 08.65; a nurse licensed 6
under AS 08.68; a dispensing optician licensed under AS 08.71; an optometrist 7
licensed under AS 08.72; a pharmacist licensed under AS 08.80; a physical 8
therapist or occupational therapist licensed under AS 08.84; a psychologist or 9
psychological associate licensed under AS 08.86; or a social worker licensed 10
under AS 08.95; 11
(B) a physician licensed in another state; or 12
(C) a member of a multidisciplinary care team who is licensed 13
in another state; 14
* Sec. 5. AS 08.02.130(j)(1), as amended by sec. 4 of this Act, is amended to read: 15
(1) "health care provider" means 16
(A) an audiologist or speech-language pathologist licensed 17
under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 18
licensed under AS 08.20; a professional or associate counselor licensed under 19
AS 08.29; a dental hygienist licensed under AS 08.32; a dentist licensed under 20
AS 08.36; a dietitian or nutritionist licensed under AS 08.38; a naturopath 21
licensed under AS 08.45; a genetic counselor licensed under AS 08.53; a 22
marital and family therapist licensed under AS 08.63; a physician licensed 23
under AS 08.64; a podiatrist, osteopath, or physician assistant licensed under 24
AS 08.64; a direct-entry midwife certified under AS 08.65; a nurse licensed 25
under AS 08.68; a dispensing optician licensed under AS 08.71; an optometrist 26
licensed under AS 08.72; a pharmacist licensed under AS 08.80; a physical 27
therapist or occupational therapist licensed under AS 08.84; a psychologist or 28
psychological associate licensed under AS 08.86; a respiratory care 29
practitioner licensed under AS 08.90 and authorized under 30
AS 08.90.060(a)(4)(H); or a social worker licensed under AS 08.95; 31
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(B) a physician licensed in another state; or 1
(C) a member of a multidisciplinary care team who is licensed 2
in another state; 3
* Sec. 6. AS 08.02.130(j)(4) is amended to read: 4
(4) "member of a multidisciplinary care team" means an audiologist, 5
speech-language pathologist, behavior analyst, professional counselor, dietitian, 6
genetic counselor, nutritionist, naturopath, marital and family therapist, podiatrist, 7
osteopath, physician assistant, nurse, pharmacist, physical therapist, occupational 8
therapist, psychologist or psychological associate, advanced nurse practitioner, or 9
social worker who is a member of a team coordinated by a physician licensed in 10
another state who meets the requirements of (b)(3) of this section; 11
* Sec. 7. AS 08 is amended by adding a new chapter to read: 12
Chapter 53. Genetic Counselors. 13
Article 1. Licensing of Genetic Counselors. 14
Sec. 08.53.100. License required; title. (a) Except as provided in 15
AS 08.53.150 and 08.53.210, a person may not practice, offer or attempt to practice, or 16
advertise or announce as being prepared or qualified to practice as a genetic counselor 17
without a license. 18
(b) Unless licensed under this chapter or excepted from licensure under 19
AS 08.53.210(a), a person may not use or publicly display a title in connection with 20
the person's name, including "genetic counselor," "licensed genetic counselor," "gene 21
counselor," "genetic consultant," "genetic associate," or a similar title or associated 22
letters, abbreviations, or insignia indicating that the person holds a genetic counseling 23
license. 24
Sec. 08.53.110. Qualifications for license. (a) The board shall issue a license 25
to practice genetic counseling to an applicant who 26
(1) pays the required fees and applies on a form prescribed by the 27
board; and 28
(2) provides evidence satisfactory to the board that the applicant 29
(A) has successfully completed a certification program in 30
genetic counseling or medical genetics that, at the time of graduation, is 31
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accredited by a nationally recognized certifying organization for genetic 1
counseling or medical genetics and approved by the board in regulation; 2
(B) has passed a certified genetic counselor examination 3
provided by a nationally recognized certifying organization for genetic 4
counseling or medical genetics approved by the board in regulation; 5
(C) unless the license was later reinstated, has not had a license 6
to practice genetic counseling revoked, suspended, or, while under 7
investigation, has not voluntarily surrendered a license, in this state or another; 8
(D) is not the subject of an unresolved or adverse decision 9
based on a complaint, investigation, review procedure, or other disciplinary 10
proceeding undertaken by a state, territorial, local, or federal genetic 11
counseling licensing jurisdiction or law enforcement agency that relates to 12
criminal or fraudulent activity, genetic counseling malpractice, or negligent 13
genetic counseling and that adversely reflects on the applicant's ability or 14
competence to practice as a genetic counselor or on the safety or well-being of 15
a patient or client; and 16
(E) meets other qualifications for a license to practice genetic 17
counseling established by the board by regulation. 18
(b) The board shall issue a license to practice genetic counseling to an 19
applicant who does not qualify for licensure under (a)(2)(A) or (a)(2)(B) of this 20
section if the applicant 21
(1) meets the qualifications prescribed in (a)(1) and (a)(2)(C) - (E) of 22
this section; 23
(2) submits a letter of recommendation from three individuals who 24
have worked with the applicant in an employment setting within the previous 10 years 25
and can attest to the applicant's competency in providing genetic counseling services; 26
at least one letter of recommendation must be from a genetic counselor who qualifies 27
for licensure under (a) of this section, and at least one letter of recommendation must 28
be from either a certified clinical geneticist or a certified medical geneticist; in this 29
paragraph, "certified clinical geneticist" or "certified medical geneticist" means a 30
medical doctor certified by a nationally recognized certifying organization for genetic 31
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counseling or medical genetics approved by the board in regulation, to be competent 1
in diagnosing, managing, and counseling patients, clients, and families about genetic 2
conditions; 3
(3) provides evidence satisfactory to the board that the applicant 4
(A) has worked as a genetic counselor for at least 10 years 5
before the effective date of this Act; 6
(B) has a master's degree or higher in genetics or related field 7
of study as determined by the board in regulation; 8
(C) has earned continuing education units in genetic counseling 9
within the last five years from a program by a nationally recognized certifying 10
organization for genetic counseling or medical genetics approved by the board 11
in regulation; and 12
(D) has never failed a certified genetic counselor examination 13
provided by a nationally recognized certifying organization for genetic 14
counseling or medical genetics. 15
Sec. 08.53.120. Temporary license. The board shall issue a temporary license 16
to practice genetic counseling for up to one year to an applicant who meets the 17
requirements of AS 08.53.110(a)(1), (a)(2)(A), and (a)(2)(C) - (E), and has met the 18
requirement to take the examination required under AS 08.53.110(a)(2)(B), but has 19
either not taken the examination or has not received examination results. A genetic 20
counselor working under a temporary license shall work under the general supervision 21
of a licensed genetic counselor or a licensed physician. A genetic counselor working 22
under a temporary license who fails the examination may renew the temporary license 23
for up to one year by submitting an application to the board that has been signed by 24
the licensed genetic counselor or physician supervising the applicant. A temporary 25
license terminates 30 days after the holder of the temporary license fails to pass the 26
examination. 27
Sec. 08.53.130. Licensure by credentials. The board may issue a license to 28
practice genetic counseling to an applicant who pays the required fees and provides 29
satisfactory evidence to the board that the applicant holds an equivalent valid license 30
issued by another state, territory, or jurisdiction of the United States. 31
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Sec. 08.53.140. Renewal of license; continuing education. (a) The board 1
shall renew the license of a licensee who applies for renewal on a form provided by 2
the board, pays the required fee, provides evidence of continued competency in 3
accordance with regulations adopted by the board, and provides evidence satisfactory 4
to the board that the licensee meets the requirements of either (b) or (c) of this section. 5
(b) A licensee shall provide with an application to renew the license evidence 6
satisfactory to the board demonstrating the licensee has completed, within two years 7
immediately preceding the application, 50 continuing education units provided by a 8
nationally recognized certifying organization for genetic counseling or medical 9
genetics that is approved by the board in regulation. 10
(c) A licensee may submit a written request to the board to waive or reduce 11
the continuing education requirements under (b) of this section or grant an extension 12
of time in which the continuing education requirements must be completed. The board 13
may grant the request if the licensee was unable to complete the continuing education 14
requirements because 15
(1) of an illness of the licensee or of a family member for whom the 16
licensee provides care; 17
(2) the licensee experienced another demonstrated hardship that 18
substantially interfered with the licensee's ability to complete the continuing education 19
requirements; or 20
(3) approved continuing education units were not reasonably available 21
to the licensee. 22
Sec. 08.53.150. Genetic counseling intern. (a) A person enrolled as a student 23
in a certification program in genetic counseling or medical genetics that is accredited 24
by a nationally recognized certifying organization for genetic counseling or medical 25
genetics and approved by the board in regulation may perform genetic counseling 26
services using the title of genetic counseling intern if the services 27
(1) performed are an integral part of the student's course of study; and 28
(2) are performed under the direct supervision of a licensed genetic 29
counselor who is assigned to supervise the student. 30
(b) In this section, "direct supervision" means supervision that is on-site or 31
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available by visual or real-time electronic means through which a supervising licensed 1
genetic counselor guides the genetic counseling intern while the genetic counseling 2
intern performs a clinical activity; "direct supervision" may include demonstration, 3
coaching, and observation to the extent that the demonstration, coaching, or 4
observation otherwise meets the requirements of this subsection. 5
Article 2. Regulation of Genetic Counselors. 6
Sec. 08.53.160. Scope of practice of genetic counselors. A licensed genetic 7
counselor may 8
(1) obtain and evaluate individual, family, and medical histories to 9
determine genetic risk for medical conditions and diseases in a patient or client or a 10
patient's or client's family members, including future potential children of the patient 11
or client; 12
(2) discuss the features, natural history, means of diagnosis, genetic 13
and environmental factors, and management of risk for genetic or medical conditions 14
or diseases with a patient or client; 15
(3) identify, order, and coordinate genetic laboratory tests and other 16
diagnostic studies as appropriate for the genetic assessment of a patient or client; 17
(4) integrate genetic laboratory test results and other diagnostic studies 18
with a patient's or client's personal and family medical history to assess and 19
communicate risk factors for genetic or medical conditions and diseases; 20
(5) explain the results and clinical implications of genetic laboratory 21
tests and other diagnostic studies to a patient or client; 22
(6) evaluate a patient's or client's or the patient's or client's family's 23
responses to, risk of, or risk of the recurrence of a medical condition or disease, and 24
provide related counseling and anticipatory guidance centered on the patient or client; 25
(7) use and provide referrals for community and online resources for 26
medical, educational, financial, and psychosocial support and advocacy to patients, 27
clients, families, and health care professionals; and 28
(8) provide written clinical documentation of medical, genetic, and 29
counseling information to patients, clients, families, and health care professionals. 30
Sec. 08.53.170. Disciplinary sanctions. (a) In addition to the board's powers 31
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under AS 08.01.075, the board may revoke or suspend the license of a genetic 1
counselor, or may reprimand, censure, or discipline a licensee, if, after a hearing, the 2
board finds that the licensee 3
(1) used or knowingly cooperated in deceit, fraud, or intentional 4
misrepresentation to obtain a license; 5
(2) engaged in unprofessional conduct in the course of providing 6
professional services; 7
(3) violated the code of ethics adopted by the board; 8
(4) violated any provision of this chapter, a regulation adopted under 9
this chapter, or an order issued by the board; or 10
(5) has been convicted of a felony or a crime that involves moral 11
turpitude. 12
(b) The board may reinstate a revoked license if the licensee applies for 13
reinstatement of the revoked license at least one year after the revocation and, after a 14
hearing, the board finds that the licensee is able to practice the profession with skill 15
and safety. 16
Article 3. Genetic Counseling Advisory Council. 17
Sec. 08.53.180. Genetic Counseling Advisory Council. (a) The board shall 18
establish the Genetic Counseling Advisory Council for the purpose of advising the 19
board on matters relating to administering this chapter. 20
(b) The council consists of at least three and not more than five members 21
appointed by the board. A majority membership of the council must be licensed 22
genetic counselors. The council must include at least one licensed physician. If the 23
council has five members, the council may include one public member. A public 24
member of the council may not 25
(1) be engaged in the occupation that the board regulates; 26
(2) be associated by legal contract with a member of the occupation 27
that the board regulates except as a consumer of the services provided by a practitioner 28
of the occupation; or 29
(3) have a direct financial interest in the occupation that the board 30
regulates. 31
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(c) The council shall meet at least annually or as necessary to conduct 1
business. The council may meet at the call of the chair, by the written request of a 2
majority of the council members, or at the request of the board. 3
(d) At the first meeting of the council, and annually thereafter, the council 4
shall elect from its membership a chair, vice chair, and secretary. An officer shall 5
serve until a successor is elected. 6
(e) A majority of the members of the council constitute a quorum. 7
(f) Members of the council serve staggered terms of three years. A council 8
member may not be appointed for more than three consecutive full terms. If a vacancy 9
occurs, the board shall appoint a qualified person to fill the unexpired portion of the 10
term. The board may remove a council member if the council member 11
(1) during the term of service, no longer meets the qualifications 12
required for appointment to the council; 13
(2) fails to attend council meetings for a period of one year; 14
(3) is found by the board to be in violation of a provision of this 15
chapter. 16
(g) Members of the council are entitled to per diem and travel expenses 17
authorized for boards and commissions under AS 39.20.180. 18
Article 4. General Provisions. 19
Sec. 08.53.200. Application of Administrative Procedure Act. AS 44.62 20
(Administrative Procedure Act) applies to any action taken by the board under this 21
chapter. 22
Sec. 08.53.210. Exceptions to application of chapter. (a) This chapter does 23
not apply to a genetic counselor who is 24
(1) in the miliary service in the discharge of official duties; 25
(2) in the employ of the United States Public Health Service, United 26
States Department of Veterans Affairs, United States Indian Health Service, or another 27
agency of the federal government, in the discharge of official duties; 28
(3) licensed in another state or jurisdiction who is teaching or 29
demonstrating clinical techniques at a meeting, seminar, or limited course of 30
instruction sponsored by a genetic counseling society or association or by an 31
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accredited genetic counseling or medical genetics educational institution; 1
(4) employed in the state by an Indian health program, as that term is 2
defined in 25 U.S.C. 1603, while providing genetic counseling services to a person the 3
Indian health program is entitled to serve under 25 U.S.C. 5301 - 5332 (Indian Self-4
Determination and Education Assistance Act), as amended, and 25 U.S.C. 1601 et seq. 5
(Indian Health Care Improvement Act), as amended. 6
(b) A health care provider licensed in the state who is not a licensed genetic 7
counselor may provide genetic information, education, and support consistent with the 8
scope of the health care provider's practice, education, and training. 9
(c) A person excepted from this chapter under (a) of this section is held to the 10
same standard of care as a person covered by this chapter. 11
Sec. 08.53.220. Penalty. A person who violates a provision of this chapter or a 12
regulation adopted under this chapter for which a penalty is not otherwise provided is 13
guilty of a class B misdemeanor. 14
Sec. 08.53.230. Regulation of genetic counselors; powers of the board. (a) 15
In consultation with the Genetic Counseling Advisory Council established under 16
AS 08.53.180, the board shall adopt regulations necessary to carry out the purposes of 17
AS 08.53 regarding the licensure of genetic counselors and regulation of services a 18
genetic counselor may perform. The regulations must include the adoption of a code 19
of ethics for genetic counselors based on nationally recognized ethical standards for 20
genetic counselors. 21
(b) The board shall have the power to administer oaths, subpoena witnesses, 22
and compel the production of documents pertinent to carrying out duties imposed by 23
this chapter. 24
Sec. 08.53.300. Definitions. In this chapter, 25
(1) "board" means the State Medical Board; 26
(2) "licensed genetic counselor" means a genetic counselor licensed 27
under this chapter. 28
* Sec. 8. AS 08.64.101(a) is amended to read: 29
(a) The board shall 30
(1) except as provided in regulations adopted by the board under (b) of 31
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this section, examine and issue licenses to applicants; 1
(2) develop written guidelines to ensure that licensing requirements are 2
not unreasonably burdensome and the issuance of licenses is not unreasonably 3
withheld or delayed; 4
(3) after a hearing, impose disciplinary sanctions on persons who 5
violate this chapter, AS 08.53, or the regulations or orders of the board; 6
(4) adopt regulations ensuring that renewal of licenses is contingent on 7
proof of continued competency on the part of the licensee; 8
(5) under regulations adopted by the board, contract with private 9
professional organizations to establish an impaired medical professionals program to 10
identify, confront, evaluate, and treat persons licensed under this chapter who abuse 11
alcohol, other drugs, or other substances or are mentally ill or cognitively impaired; 12
(6) adopt regulations that establish guidelines for a physician or 13
physician assistant who is rendering a diagnosis, providing treatment, or prescribing, 14
dispensing, or administering a prescription drug to a person without conducting a 15
physical examination under AS 08.64.364; the guidelines must include a nationally 16
recognized model policy for standards of care of a patient who is at a different location 17
than the physician or physician assistant; 18
(7) require that a licensee who has a federal Drug Enforcement 19
Administration registration number register with the controlled substance prescription 20
database under AS 17.30.200(n); and 21
(8) implement the Interstate Medical Licensure Compact under 22
AS 08.64.253 and the PA Licensure Compact under AS 08.64.254. 23
* Sec. 9. AS 08.64.103(a) is amended to read: 24
(a) After consulting with the board, the department shall employ two persons 25
who are not members of the board; one shall be assigned as the investigator for the 26
board; the other shall be assigned as the executive secretary for the board. The 27
investigator shall 28
(1) conduct investigations into alleged violations of this chapter, 29
alleged violations of AS 08.53, and into alleged violations of regulations and orders 30
of the board; 31
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(2) at the request of the board, conduct investigations based on 1
complaints filed with the department or with the board; [AND] 2
(3) be directly responsible and accountable to the board, except that 3
only the department has authority to terminate the investigator's employment and the 4
department shall provide day-to-day [DAY TO DAY] and administrative supervision 5
of the investigator; and 6
(4) in consultation with the Genetic Counseling Advisory Council, 7
ensure that applicants for a license or renewal meet the applicable requirements 8
under AS 08.53 and established by the board. 9
* Sec. 10. AS 08.64.130(a) is amended to read: 10
(a) The board shall preserve a record of its proceedings, which must contain 11
the name, age, residence, and duration of residence of each applicant for a license 12
under this chapter, the time spent by the applicant in medical study, the place of 13
medical study, and the year and school from which degrees were granted. The record 14
must also show whether the applicant was granted a license or rejected. 15
* Sec. 11. AS 08.64.190 is amended by adding a new subsection to read: 16
(b) An applicant applying for an expedited license as a physician or osteopath 17
under AS 08.64.253 or a license as a physician assistant under AS 08.64.107 shall 18
submit, along with the application, the applicant's fingerprints and the fees required by 19
the Department of Public Safety under AS 12.62.160 for criminal justice information 20
and a national criminal history record check. The board shall forward the fingerprints 21
and fees to the Department of Public Safety to obtain a report of criminal justice 22
information under AS 12.62 and a national criminal history record check under 23
AS 12.62.400. Criminal justice information and criminal history record information 24
obtained under this subsection may only be used by the board for the purpose of 25
determining an applicant's qualifications and fitness for a license, expedited license, or 26
compact privilege under this chapter. 27
* Sec. 12. AS 08.64.200(a) is amended to read: 28
(a) Except for foreign medical graduates as specified in AS 08.64.225, each 29
physician applicant shall 30
(1) submit a certificate of graduation from a legally chartered medical 31
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school accredited by the Association of American Medical Colleges and the Council 1
on Medical Education of the American Medical Association; 2
(2) submit a certificate from a recognized hospital or hospitals 3
certifying that the applicant has satisfactorily performed the duties of resident 4
physician or intern for a period of 5
(A) one year if the applicant graduated from medical school 6
before January 1, 1995, as evidenced by a certificate of completion of the first 7
year of postgraduate training from the facility where the applicant completed 8
the first year of internship or residency; and 9
(B) two years if the applicant graduated from medical school 10
on or after January 1, 1995, as evidenced by a certificate of completion of the 11
first year of postgraduate training from the facility where the applicant 12
completed the first year of internship or residency and a certificate of 13
successful completion of one additional year of postgraduate training at a 14
recognized hospital; 15
(3) submit a list of negotiated settlements or judgments in claims or 16
civil actions alleging medical malpractice against the applicant, including an 17
explanation of the basis for each claim or action; 18
(4) not have a license to practice medicine in another state, country, 19
province, or territory that is currently suspended or revoked for disciplinary reasons; 20
[AND] 21
(5) receive education in pain management and opioid use and 22
addiction, unless the applicant has demonstrated to the satisfaction of the board that 23
the applicant does not currently hold a valid federal Drug Enforcement Administration 24
registration number; an applicant may include past professional experience or 25
professional education as proof of professional competence; and 26
(6) submit the applicant's fingerprints and the fees required by the 27
Department of Public Safety under AS 12.62.160 for criminal justice information 28
and a national criminal history record check; the board shall forward the 29
fingerprints and fees to the Department of Public Safety for a report of criminal 30
justice information under AS 12.62 and a national criminal history record check 31
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under AS 12.62.400. 1
* Sec. 13. AS 08.64.205 is amended to read: 2
Sec. 08.64.205. Qualifications for osteopath applicants. Each osteopath 3
applicant shall meet the qualifications prescribed in AS 08.64.200(a)(3) - (6) 4
[AS 08.64.200(a)(3) - (5)] and shall 5
(1) submit a certificate of graduation from the legally chartered school 6
of osteopathy approved by the board; 7
(2) submit a certificate from a hospital approved by the American 8
Medical Association or the American Osteopathic Association that certifies that the 9
osteopath has satisfactorily completed and performed the duties of intern or resident 10
physician for 11
(A) one year if the applicant graduated from a school of 12
osteopathy before January 1, 1995, as evidenced by a certificate of completion 13
of the first year of postgraduate training from the facility where the applicant 14
completed the first year of internship or residency; or 15
(B) two years if the applicant graduated from a school of 16
osteopathy on or after January 1, 1995, as evidenced by a certificate of 17
completion of the first year of postgraduate training from the facility where the 18
applicant completed the first year of internship or residency and a certificate of 19
successful completion of one additional year of postgraduate training at a 20
recognized hospital; 21
(3) take the examination required by AS 08.64.210 or be certified to 22
practice by the National Board of Examiners for Osteopathic Physicians and Surgeons 23
or by the National Board of Osteopathic Medical Examiners; 24
(4) receive education in pain management and opioid use and 25
addiction, unless the applicant has demonstrated to the satisfaction of the board that 26
the applicant does not currently hold a valid federal Drug Enforcement Administration 27
registration number; an applicant may include past professional experience or 28
professional education as proof of professional competence. 29
* Sec. 14. AS 08.64.209(a) is amended to read: 30
(a) Each applicant who desires to practice podiatry shall meet the 31
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qualifications prescribed in AS 08.64.200(a)(3) - (6) [AS 08.64.200(a)(3) - (5)] and 1
shall 2
(1) submit a certificate of graduation from a legally chartered school of 3
podiatry approved by the board; 4
(2) take the examination required by AS 08.64.210; the board shall call 5
to its aid a podiatrist of known ability who is licensed to practice podiatry to assist in 6
the examination and licensure of applicants for a license to practice podiatry; 7
(3) receive education in pain management and opioid use and 8
addiction, unless the applicant has demonstrated to the satisfaction of the board that 9
the applicant does not currently hold a valid federal Drug Enforcement Administration 10
registration number; an applicant may include past professional experience or 11
professional education as proof of professional competence; 12
(4) meet other qualifications of experience or education that the board 13
may require. 14
* Sec. 15. AS 08.64.225(a) is amended to read: 15
(a) Applicants who are graduates of medical colleges not accredited by the 16
Association of American Medical Colleges and the Council on Medical Education of 17
the American Medical Association shall 18
(1) meet the requirements of AS 08.64.200(a)(3) - (6) 19
[AS 08.64.200(a)(3) - (5)] and 08.64.255; 20
(2) have successfully completed 21
(A) three years of postgraduate training as evidenced by a 22
certificate of completion of the first year of postgraduate training from the 23
facility where the applicant completed the first year of internship or residency 24
and a certificate of successful completion of two additional years of 25
postgraduate training at a recognized hospital; or 26
(B) other requirements establishing proof of competency and 27
professional qualifications as the board considers necessary to ensure the 28
continued protection of the public adopted at the discretion of the board by 29
regulation, including education in pain management and opioid use and 30
addiction, unless the applicant has demonstrated to the satisfaction of the board 31
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that the applicant does not currently hold a valid federal Drug Enforcement 1
Administration registration number; an applicant may include past professional 2
experience or professional education as proof of professional competence; and 3
(3) have passed examinations as specified by the board in regulations. 4
* Sec. 16. AS 08.64 is amended by adding new sections to read: 5
Sec. 08.64.253. Interstate Medical Licensure Compact. The Interstate 6
Medical Licensure Compact as contained in this section is enacted into law and 7
entered into on behalf of the state with all other states and jurisdictions legally joining 8
it in a form substantially as follows: 9
SECTION 1. PURPOSE. 10
In order to strengthen access to health care, and in recognition of the advances 11
in the delivery of health care, the member states of the Interstate Medical Licensure 12
Compact have allied in common purpose to develop a comprehensive process that 13
complements the existing licensing and regulatory authority of state medical boards, 14
provides a streamlined process that allows physicians to become licensed in multiple 15
states, thereby enhancing the portability of a medical license and ensuring the safety of 16
patients. The Compact creates another pathway for licensure and does not otherwise 17
change a state's existing Medical Practice Act. The Compact also adopts the prevailing 18
standard for licensure and affirms that the practice of medicine occurs where the 19
patient is located at the time of the physician-patient encounter, and therefore, requires 20
the physician to be under the jurisdiction of the state medical board where the patient 21
is located. State medical boards that participate in the Compact retain the jurisdiction 22
to impose an adverse action against a license to practice medicine in that state issued 23
to a physician through the procedures in the Compact. 24
SECTION 2. DEFINITIONS. 25
In this compact, 26
(a) "Bylaws" means those bylaws established by the Interstate Commission 27
pursuant to Section 11. 28
(b) "Commissioner" means the voting representative appointed by each 29
member board pursuant to Section 11. 30
(c) "Conviction" means a finding by a court that an individual is guilty of a 31
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criminal offense through adjudication, or entry of a plea of guilt or no contest to the 1
charge by the offender. Evidence of an entry of a conviction of a criminal offense by 2
the court shall be considered final for purposes of disciplinary action by a member 3
board. 4
(d) "Expedited License" means a full and unrestricted medical license granted 5
by a member state to an eligible physician through the process set forth in the 6
Compact. 7
(e) "Interstate Commission" means the interstate commission created pursuant 8
to Section 11. 9
(f) "License" means authorization by a member state for a physician to engage 10
in the practice of medicine, which would be unlawful without authorization. 11
(g) "Medical Practice Act" means laws and regulations governing the practice 12
of allopathic and osteopathic medicine within a member state. 13
(h) "Member Board" means a state agency in a member state that acts in the 14
sovereign interests of the state by protecting the public through licensure, regulation, 15
and education of physicians as directed by the state government. 16
(i) "Member State" means a state that has enacted the Compact. 17
(j) "Physician" means any person who 18
(1) is a graduate of a medical school accredited by the Liaison 19
Committee on Medical Education, the Commission on Osteopathic College 20
Accreditation, or a medical school listed in the International Medical Education 21
Directory or its equivalent; 22
(2) passed each component of the United States Medical Licensing 23
Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing 24
Examination (COMLEX-USA) within three attempts, or any of its predecessor 25
examinations accepted by a state medical board as an equivalent examination for 26
licensure purposes; 27
(3) successfully completed graduate medical education approved by 28
the Accreditation Council for Graduate Medical Education or the American 29
Osteopathic Association; 30
(4) holds specialty certification or a time-unlimited specialty certificate 31
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recognized by the American Board of Medical Specialties or the American 1
Osteopathic Association's Bureau of Osteopathic Specialists; 2
(5) possesses a full and unrestricted license to engage in the practice of 3
medicine issued by a member board; 4
(6) has never been convicted, received adjudication, deferred 5
adjudication, community supervision, or deferred disposition for any offense by a 6
court of appropriate jurisdiction; 7
(7) has never held a license authorizing the practice of medicine 8
subjected to discipline by a licensing agency in any state, federal, or foreign 9
jurisdiction, excluding any action related to non-payment of fees related to a license; 10
(8) has never had a controlled substance license or permit suspended or 11
revoked by a state or the United States Drug Enforcement Administration; and 12
(9) is not under active investigation by a licensing agency or law 13
enforcement authority in any state, federal, or foreign jurisdiction. 14
(k) "Practice of Medicine" means that clinical prevention, diagnosis, or 15
treatment of human disease, injury, or condition requiring a physician to obtain and 16
maintain a license in compliance with the Medical Practice Act of a member state. 17
(l) "Offense" means a felony, gross misdemeanor, or crime of moral turpitude. 18
(m) "Rule" means a written statement by the Interstate Commission 19
promulgated pursuant to Section 12 of the Compact that is of general applicability, 20
implements, interprets, or prescribes a policy or provision of the Compact, or an 21
organizational, procedural, or practice requirement of the Interstate Commission, and 22
has the force and effect of statutory law in a member state, and includes the 23
amendment, repeal, or suspension of an existing rule. 24
(n) "State" means any state, commonwealth, district, or territory of the United 25
States. 26
(o) "State of Principal License" means a member state where a physician holds 27
a license to practice medicine and which has been designated as such by the physician 28
for purposes of registration and participation in the Compact. 29
SECTION 3. ELIGIBILITY. 30
(a) A physician must meet the eligibility requirements as defined in Section 31
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2(j) to receive an expedited license under the terms and provisions of the Compact. 1
(b) A physician who does not meet the requirements of Section 2(j) may 2
obtain a license to practice medicine in a member state if the individual complies with 3
all laws and requirements, other than the Compact, relating to the issuance of a license 4
to practice medicine in that state. 5
SECTION 4. DESIGNATION OF STATE OF PRINCIPAL LICENSE. 6
(a) A physician shall designate a member state as the state of principal license 7
for purposes of registration for expedited licensure through the Compact if the 8
physician possesses a full and unrestricted license to practice medicine in that state, 9
and the state is 10
(1) The state of principal residence for the physician; 11
(2) The state where at least 25 percent of the practice of medicine 12
occurs; 13
(3) The location of the physician's employer; or 14
(4) If no state qualifies under subsection (1), subsection (2), or 15
subsection (3), the state designated as state of residence for purpose of federal income 16
tax. 17
(b) A physician may redesignate a member state as state of principal license at 18
any time, as long as the state meets the requirements of subsection (a). 19
(c) The Interstate Commission is authorized to develop rules to facilitate 20
redesignation of another member state as the state of principal license. 21
SECTION 5. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE. 22
(a) A physician seeking licensure through the Compact shall file an 23
application for an expedited license with the member board of the state selected by the 24
physician as the state of principal license. 25
(b) Upon receipt of an application for an expedited license, the member board 26
within the state selected as the state of principal license shall evaluate whether the 27
physician is eligible for expedited licensure and issue a letter of qualification, 28
verifying or denying the physician's eligibility, to the Interstate Commission. 29
(1) Static qualifications, which include verification of medical 30
education, graduate medical education, results of any medical or licensing 31
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examination, and other qualifications as determined by the Interstate Commission 1
through rule, shall not be subject to additional primary source verification where 2
already primary source verified by the state of principal license. 3
(2) The member board within the state selected as the state of principal 4
license shall, in the course of verifying eligibility, perform a criminal background 5
check of an applicant, including the use of the results of fingerprint or other biometric 6
data checks compliant with the requirements of the Federal Bureau of Investigation, 7
with the exception of federal employees who have suitability determination in 8
accordance with 5 C.F.R. 731.202. 9
(3) Appeal on the determination of eligibility shall be made to the 10
member state where the application was filed and shall be subject to the law of that 11
state. 12
(c) Upon verification in subsection (b), physicians eligible for an expedited 13
license shall complete the registration process established by the Interstate 14
Commission to receive a license in a member state selected pursuant to subsection (a), 15
including the payment of any applicable fees. 16
(d) After receiving verification of eligibility under subsection (b) and any fees 17
under subsection (c), a member board shall issue an expedited license to the physician. 18
This license shall authorize the physician to practice medicine in the issuing state 19
consistent with the Medical Practice Act and all applicable laws and regulations of the 20
issuing member board and member state. 21
(e) An expedited license shall be valid for a period consistent with the 22
licensure period in the member state and in the same manner as required for other 23
physicians holding a full and unrestricted license within the member state. 24
(f) An expedited license obtained through the Compact shall be terminated if a 25
physician fails to maintain a license in the state of principal licensure for a non-26
disciplinary reason, without redesignation of a new state of principal licensure. 27
(g) The Interstate Commission is authorized to develop rules regarding the 28
application process, including payment of any applicable fees, and the issuance of an 29
expedited license. 30
SECTION 6. FEES FOR EXPEDITED LICENSURE. 31
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(a) A member state issuing an expedited license authorizing the practice of 1
medicine in that state may impose a fee for a license issued or renewed through the 2
Compact. 3
(b) The Interstate Commission is authorized to develop rules regarding fees 4
for expedited licenses. 5
SECTION 7. RENEWAL AND CONTINUED PARTICIPATION. 6
(a) A physician seeking to renew an expedited license granted in a member 7
state shall complete a renewal process with the Interstate Commission if the physician 8
(1) Maintains a full and unrestricted license in a state of principal 9
license; 10
(2) Has not been convicted, received adjudication, deferred 11
adjudication, community supervision, or deferred disposition for any offense by a 12
court of appropriate jurisdiction; 13
(3) Has not had a license authorizing the practice of medicine subject 14
to discipline by a licensing agency in any state, federal, or foreign jurisdiction, 15
excluding any action related to non-payment of fees related to a license; and 16
(4) Has not had a controlled substance license or permit suspended or 17
revoked by a state or the United States Drug Enforcement Administration. 18
(b) Physicians shall comply with all continuing professional development or 19
continuing medical education requirements for renewal of a license issued by a 20
member state. 21
(c) The Interstate Commission shall collect any renewal fees charged for the 22
renewal of a license and distribute the fees to the applicable member board. 23
(d) Upon receipt of any renewal fees collected in subsection (c), a member 24
board shall renew the physician's license. 25
(e) Physician information collected by the Interstate Commission during the 26
renewal process will be distributed to all member boards. 27
(f) The Interstate Commission is authorized to develop rules to address 28
renewal of licenses obtained through the Compact. 29
SECTION 8. COORDINATED INFORMATION SYSTEM. 30
(a) The Interstate Commission shall establish a database of all physicians 31
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licensed, or who have applied for licensure, under Section 5. 1
(b) Notwithstanding any other provision of law, member boards shall report to 2
the Interstate Commission any public action or complaints against a licensed physician 3
who has applied or received an expedited license through the Compact. 4
(c) Member boards shall report disciplinary or investigatory information 5
determined as necessary and proper by rule of the Interstate Commission. 6
(d) Member boards may report any non-public complaint, disciplinary, or 7
investigatory information not required by subsection (c) to the Interstate Commission. 8
(e) Member boards shall share complaint or disciplinary information about a 9
physician upon request of another member board. 10
(f) All information provided to the Interstate Commission or distributed by 11
member boards shall be confidential, filed under seal, and used only for investigatory 12
or disciplinary matters. 13
(g) The Interstate Commission is authorized to develop rules for mandated or 14
discretionary sharing of information by member boards. 15
SECTION 9. JOINT INVESTIGATIONS. 16
(a) Licensure and disciplinary records of physicians are deemed investigative. 17
(b) In addition to the authority granted to a member board by its respective 18
Medical Practice Act or other applicable state law, a member board may participate 19
with other member boards in joint investigations of physicians licensed by the member 20
boards. 21
(c) A subpoena issued by a member state shall be enforceable in other member 22
states. 23
(d) Member boards may share any investigative, litigation, or compliance 24
materials in furtherance of any joint or individual investigation initiate under the 25
Compact. 26
(e) Any member state may investigate actual or alleged violations of the 27
statutes authorizing the practice of medicine in any other member state in which a 28
physician holds a license to practice medicine. 29
SECTION 10. DISCIPLINARY ACTIONS. 30
(a) Any disciplinary action taken by any member board against a physician 31
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licensed through the Compact shall be deemed unprofessional conduct which may be 1
subject to discipline by other member boards, in addition to any violation of the 2
Medical Practice Act or regulations in that state. 3
(b) If a license granted to a physician by the member board in the state of 4
principal license is revoked, surrendered or relinquished in lieu of discipline, or 5
suspended, then all licenses issued to the physician by member boards shall 6
automatically be placed, without further action necessary by any member board, on 7
the same status. If the member board in the state of principal license subsequently 8
reinstates the physician's license, a license issued to the physician by any other 9
member board shall remain encumbered until that respective member board takes 10
action to reinstate the license in a manner consistent with the Medical Practice Act of 11
that state. 12
(c) If disciplinary action is taken against a physician by a member board not in 13
the state of principal license, any other member board may deem the action conclusive 14
as to matter of law and fact decided, and 15
(1) Impose the same or lesser sanctions against the physician so long 16
as such sanctions are consistent with the Medical Practice Act of that state; or 17
(2) Pursue separate disciplinary action against the physician under its 18
respective Medical Practice Act, regardless of the action taken in other member states. 19
(d) If a license granted to a physician by a member board is revoked, 20
surrendered or relinquished in lieu of discipline, or suspended, then any licenses 21
issued to the physician by any other member boards shall be suspended, automatically 22
and immediately without further action necessary by the other member boards, for 23
ninety (90) days upon entry of the order by the disciplining board, to permit the 24
member boards to investigate the basis for the action under the Medical Practice Act 25
of that state. A member board may terminate the automatic suspension of the license it 26
issued prior to the completion of the ninety (90) day suspension period in a manner 27
consistent with the Medical Practice Act of that state. 28
SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION. 29
(a) The member states hereby create the "Interstate Medical Licensure 30
Compact Commission." 31
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(b) The purpose of the Interstate Commission is the administration of the 1
Interstate Medical Licensure Compact, which is a discretionary state function. 2
(c) The Interstate Commission shall be a body corporate and joint agency of 3
the member states and shall have all the responsibilities, powers, and duties set forth in 4
the Compact, and such additional powers as may be conferred upon it by a subsequent 5
concurrent action of the respective legislatures of the member states in accordance 6
with the terms of the Compact. 7
(d) The Interstate Commission shall consist of two voting representatives 8
appointed by each member state who shall serve as Commissioners. In states where 9
allopathic and osteopathic physicians are regulated by separate member boards, or if 10
the licensing and disciplinary authority is split between separate member boards, or if 11
the licensing and disciplinary authority is split between multiple member boards 12
within a member state, the member state shall appoint one representative from each 13
member board. A Commissioner shall be 14
(1) An allopathic or osteopathic physician appointed to a member 15
board; 16
(2) An executive director, executive secretary, or similar executive of a 17
member board; or 18
(3) A member of the public appointed to a member board. 19
(e) The Interstate Commission shall meet at least once each calendar year. A 20
portion of this meeting shall be a business meeting to address such matters as may 21
properly come before the Commission, including the election of officers. The 22
chairperson may call additional meetings and shall call for a meeting upon the request 23
of a majority of the member states. 24
(f) The bylaws may provide for meetings of the Interstate Commission to be 25
conducted by telecommunication or electronic communication. 26
(g) Each Commissioner participating at a meeting of the Interstate 27
Commission is entitled to one vote. A majority of Commissioners shall constitute a 28
quorum for the transaction of business, unless a larger quorum is required by the 29
bylaws of the Interstate Commission. A Commissioner shall not delegate a vote to 30
another Commissioner. In the absence of its Commissioner, a member state may 31
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delegate voting authority for a specified meeting to another person from that state who 1
shall meet the requirements of subsection (d). 2
(h) The Interstate Commission shall provide public notice of all meetings and 3
all meetings shall be open to the public. The Interstate Commission may close a 4
meeting, in full or in portion, where it determines by a two-thirds vote of the 5
Commissioners present that an open meeting would be likely to 6
(1) Relate solely to the internal personnel practice and procedures of 7
the Interstate Commission; 8
(2) Discuss matters specifically exempted from disclosure by federal 9
statute; 10
(3) Discuss trade secrets, commercial, or financial information that is 11
privileged or confidential; 12
(4) Involve accusing a person of a crime, or formally censuring a 13
person; 14
(5) Discuss information of a personal nature where disclosure would 15
constitute a clearly unwarranted invasion of personal privacy; 16
(6) Discuss investigative records compiled for law enforcement 17
purposes; or 18
(7) Specifically relate to the participation in a civil action or other legal 19
proceeding. 20
(i) The Interstate Commission shall keep minutes which shall fully describe all 21
matters discussed in a meeting and shall provide a full and accurate summary of 22
actions taken, including record of any roll call votes. 23
(j) The Interstate Commission shall make its information and official records, 24
to the extent not otherwise designated in the Compact or by its rules, available to the 25
public for inspection. 26
(k) The Interstate Commission shall establish an executive committee, which 27
shall include officers, members, and others as determined by the bylaws. The 28
executive committee shall have the power to act on behalf of the Interstate 29
Commission, with the exception of rulemaking, during periods when the Interstate 30
Commission is not in session. When acting on behalf of the Interstate Commission, 31
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the executive committee shall oversee the administration of the Compact including 1
enforcement and compliance with the provisions of the Compact, its bylaws and rules, 2
and other such duties as necessary. 3
(l) The Interstate Commission shall establish other committees for governance 4
and administration of the Compact. 5
SECTION 12. POWERS AND DUTIES OF THE INTERSTATE COMMISSION. 6
(a) Oversee and maintain the administration of the Compact; 7
(b) Promulgate rules which shall be binding to the extent and in the manner 8
provided for in the Compact; 9
(c) Issue, upon the request of a member state or member board, advisory 10
opinions concerning the meaning or interpretation of the Compact, its bylaws, rules, 11
and actions; 12
(d) Enforce compliance with Compact provisions, the rules promulgated by 13
the Interstate Commission, and the bylaws, using all necessary and proper means, 14
including but not limited to the use of judicial process; 15
(e) Establish and appoint committees including, but not limited to, an 16
executive committee as required by Section 11, which shall have the power to act on 17
behalf of the Interstate Commission in carrying out its powers and duties; 18
(f) Pay, or provide for the payment of the expenses related to the 19
establishment, organization, and ongoing activities of the Interstate Commission; 20
(g) Establish and maintain one or more offices; 21
(h) Borrow, accept, hire, or contract for services of personnel; 22
(i) Purchase and maintain insurance and bonds; 23
(j) Employ an executive director who shall have such powers to employ, select 24
or appoint employees, agents, or consultants, and to determine their qualifications, 25
define their duties, and fix their compensation; 26
(k) Establish personnel policies and programs relating to conflicts of interest, 27
rates of compensation, and qualifications of personnel; 28
(l) Accept donations and grants of money, equipment, supplies, materials, and 29
services and to receive, utilize, and dispose of it in a manner consistent with the 30
conflict of interest policies established by the Interstate Commission; 31
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(m) Lease, purchase, accept contributions or donations of, or otherwise to 1
own, hold, improve or use, any property, real, personal, or mixed; 2
(n) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise 3
dispose of any property, real, personal, or mixed; 4
(o) Establish a budget and make expenditures; 5
(p) Adopt a seal and bylaws governing the management and operation of the 6
Interstate Commission; 7
(q) Report annually to the legislatures and governors of the member states 8
concerning the activities of the Interstate Commission during the preceding year. Such 9
reports shall also include reports of financial audits and any recommendations that 10
may have been adopted by the Interstate Commission; 11
(r) Coordinate education, training, and public awareness regarding the 12
Compact, its implementation, and its operation; 13
(s) Maintain records in accordance with the bylaws; 14
(t) Seek and obtain trademarks, copyrights, and patents; and 15
(u) Perform such functions as may be necessary or appropriate to achieve the 16
purpose of the Compact. 17
SECTION 13. FINANCE POWERS. 18
(a) The Interstate Commission may levy on and collect an annual assessment 19
from each member state to cover the cost of the operations and activities of the 20
Interstate Commission and its staff. The total assessment must be sufficient to cover 21
the annual budget approved each year for which revenue is not provided by other 22
sources. The aggregate annual assessment amount shall be allocated upon a formula to 23
be determined by the Interstate Commission, which shall promulgate a rule binding 24
upon all member states. 25
(b) The Interstate Commission shall not incur obligations of any kind prior to 26
securing the funds adequate to meet the same. 27
(c) The Interstate Commission shall not pledge the credit of any of the 28
member states, except by, and with the authority of, the member state. 29
(d) The Interstate Commission shall be subject to a yearly financial audit 30
conducted by a certified or licensed accountant and the report of the audit shall be 31
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included in the annual report of the Interstate Commission. 1
SECTION 14. ORGANIZATION AND OPERATION OF THE INTERSTATE 2
COMMISSION. 3
(a) The Interstate Commission shall, by a majority of Commissioners present 4
and voting, adopt bylaws to govern its conduct as may be necessary or appropriate to 5
carry out the purposes of the Compact within twelve (12) months of the first Interstate 6
Commission meeting. 7
(b) The Interstate Commission shall elect or appoint annually from among its 8
Commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall 9
have such authority and duties as may be specified in the bylaws. The chairperson, or 10
in the chairperson's absence or disability, the vice-chairperson, shall preside at all 11
meetings of the Interstate Commission. 12
(c) Officers selected in subsection (b) shall serve without remuneration for the 13
Interstate Commission. 14
(d) The officers and employees of the Interstate Commission shall be immune 15
from suit and liability, either personally or in their official capacity, for a claim for 16
damage to or loss of property or personal injury or other civil liability caused or 17
arising out of, or relating to, an actual or alleged act, error, or omission that occurred, 18
or that such person had a reasonable basis for believing occurred, within the scope of 19
Interstate Commission employment, duties, or responsibilities; provided that such 20
person shall not be protected from suit or liability for damage, loss, injury, or liability 21
caused by the intentional or willful and wanton misconduct of such person. 22
(e) The liability of the executive director and employees of the Interstate 23
Commission or representatives of the Interstate Commission, acting within the scope 24
of such person's employment or duties for acts, errors, or omissions occurring within 25
such person's state, may not exceed the limits of liability set forth under the 26
constitution and laws of that state for state officials, employees, and agents. The 27
Interstate Commission is considered to be an instrumentality of the states for the 28
purpose of any such action. Nothing in this subsection shall be construed to protect 29
such person from suit or liability for damage, loss, injury, or liability caused by the 30
intentional or willful and wanton misconduct of such person. 31
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(f) The Interstate Commission shall defend the executive director, its 1
employees, and subject to the approval of the attorney general or other appropriate 2
legal counsel of the member state represented by an Interstate Commission 3
representative, shall defend such Interstate Commission representative in any civil 4
action seeking to impose liability arising out of an actual or alleged act, error or 5
omission that occurred within the scope of Interstate Commission employment, duties 6
or responsibilities, or that the defendant had a reasonable basis for believing occurred 7
within the scope of Interstate Commission employment, duties, or responsibilities, 8
provided that the actual or alleged act, error, or omission did not result from 9
intentional or willful and wanton misconduct on the part of such person. 10
(g) To the extent not covered by the state involved, member state, or the 11
Interstate Commission, the representatives or employees of the Interstate Commission 12
shall be held harmless in the amount of a settlement or judgement, including attorney's 13
fees and costs, obtained against such persons arising out of an actual or alleged act, 14
error, or omission that occurred within the scope of the Interstate Commission 15
employment, duties, or responsibilities, or that such persons had a reasonable basis for 16
believing occurred within the scope of Interstate Commission employment, duties, or 17
responsibilities, provided that the actual or alleged act, error, or omission did not result 18
from intentional or willful and wanton misconduct on the part of such person. 19
SECTION 15. RULEMAKING FUNCTIONS OF THE INTERSTATE 20
COMMISSION. 21
(a) The Interstate Commission shall promulgate reasonable rules in order to 22
effectively and efficiently achieve the purpose of the Compact. Notwithstanding the 23
foregoing, in the event the Interstate Commission exercises its rulemaking authority in 24
a manner that is beyond the scope of the purposes of the Compact, or the powers 25
granted hereunder, then such an action by the Interstate Commission shall be invalid 26
and have no force or effect. 27
(b) Rules deemed appropriate for the operations of the Interstate Commission 28
shall be made pursuant to a rulemaking process that substantially conforms to the 29
"Model State Administrative Procedure Act" of 2010, and subsequent amendments 30
thereto. 31
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(c) Not later than thirty (30) days after a rule is promulgated, any person may 1
file a petition for judicial review of the rule in the United States District Court for the 2
District of Columbia or the federal district where the Interstate Commission has its 3
principal offices, provided that the filing of such a petition shall not stay or otherwise 4
prevent the rule from becoming effective unless the court finds that the petitioner has a 5
substantial likelihood of success. The court shall give deference to the actions of the 6
Interstate Commission consistent with applicable law and shall not find the rule to be 7
unlawful if the rule represents a reasonable exercise of the authority granted to the 8
Interstate Commission. 9
SECTION 16. OVERSIGHT OF INTERSTATE COMPACT. 10
(a) The executive, legislative, and judicial branches of state government in 11
each member state shall enforce the Compact and shall take all actions necessary and 12
appropriate to effectuate the Compact's purposes and intent. The provisions of the 13
Compact and the rules promulgated hereunder shall have standing as statutory law but 14
shall not override existing state authority to regulate the practice of medicine. 15
(b) All courts shall take judicial notice of the Compact and the rules in any 16
judicial or administrative proceeding in a member state pertaining to the subject matter 17
of the Compact which may affect the powers, responsibilities or actions of the 18
Interstate Commission. 19
(c) The Interstate Commission shall be entitled to receive all services of 20
process in any such proceeding, and shall have standing to intervene in the proceeding 21
for all purposes. Failure to provide service of process to the Interstate Commission 22
shall render a judgment or order void as to the Interstate Commission, the Compact, or 23
promulgated rules. 24
SECTION 17. ENFORCEMENT OF INTERSTATE COMPACT. 25
(a) The Interstate Commission, in the reasonable exercise of its discretion, 26
shall enforce the provisions and rules of the Compact. 27
(b) The Interstate Commission may, by majority vote of the Commissioners, 28
initiate legal action in the United States Court for the District of Columbia, or, at the 29
discretion of the Interstate Commission, in the federal district where the Interstate 30
Commission has its principal offices, to enforce compliance with the provisions of the 31
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Compact, and its promulgated rules and bylaws, against a member state in default. The 1
relief sought may including both injunctive relief and damages. In the event judicial 2
enforcement is necessary, the prevailing party shall be awarded all costs of such 3
litigation including reasonable attorney's fees. 4
(c) The remedies herein shall not be the exclusive remedies of the Interstate 5
Commission. The Interstate Commission may avail itself of any other remedies 6
available under state law or regulation of a profession. 7
SECTION 18. DEFAULT PROCEDURES. 8
(a) The grounds for default include, but are not limited to, failure of a member 9
state to perform such obligations or responsibilities imposed upon it by the Compact, 10
or the rules and bylaws of the Interstate Commission promulgated under the Compact. 11
(b) If the Interstate Commission determines that a member state has defaulted 12
in the performance of its obligations or responsibilities under the Compact, or the 13
bylaws or promulgated rules, the Interstate Commission shall 14
(1) provide written notice to the defaulting state and other member 15
states, of the nature of the default, the means of curing the default, and any action 16
taken by the Interstate Commission; the Interstate Commission shall specify the 17
conditions by which the defaulting state must cure its default; and 18
(2) provide remedial training and specific technical assistance 19
regarding the default. 20
(c) If the defaulting state fails to cure the default, the defaulting state shall be 21
terminated from the Compact upon an affirmative vote of a majority of the 22
Commissioners and all rights, privileges, and benefits conferred by the Compact shall 23
terminate on the effective date of termination. A cure of the default does not relieve 24
the offending state of obligations or liabilities incurred during the period of the 25
default. 26
(d) Termination of membership in the Compact shall be imposed only after all 27
other means of securing compliance have been exhausted. Notice of intent to terminate 28
shall be given by the Interstate Commission to the governor, the majority and minority 29
leaders of the defaulting state's legislature, and each of the member states. 30
(e) The Interstate Commission shall establish rules and procedures to address 31
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licenses and physicians that are materially impacted by the termination of a member 1
state, or the withdrawal of a member state. 2
(f) The member state which has been terminated is responsible for all due, 3
obligations, and liabilities incurred through the effective date of termination including 4
obligations, the performance of which extends beyond the effective date of 5
termination. 6
(g) The Interstate Commission shall not bear any costs relating to any state 7
that has been found to be in default or which has been terminated from the Compact, 8
unless otherwise mutually agreed upon in writing between the Interstate Commission 9
and the defaulting state. 10
(h) The defaulting state may appeal the action of the Interstate Commission by 11
petitioning the United States District Court for the District of Columbia or the federal 12
district where the Interstate Commission has its principal offices. The prevailing party 13
shall be awarded all costs of such litigation including reasonable attorney's fees. 14
SECTION 19. DISPUTE RESOLUTION. 15
(a) The Interstate Commission shall attempt, upon the request of a member 16
state, to resolve disputes which are subject to the Compact and which may arise 17
among member states or member boards. 18
(b) The Interstate Commission shall promulgate rules providing for both 19
mediation and binding dispute resolution as appropriate. 20
SECTION 20. MEMBER STATES, EFFECTIVE DATE, AND AMENDMENT. 21
(a) Any state is eligible to become a member of the Compact. 22
(b) The Compact shall become effective and binding upon legislative 23
enactment of the Compact into law by no less than seven (7) states. Thereafter, it shall 24
become effective and binding on a state upon enactment of the Compact into law by 25
that state. 26
(c) The governors of non-member states, or their designees, shall be invited to 27
participate in the activities of the Interstate Commission on a non-voting basis prior to 28
adoption of the Compact by all states. 29
(d) The Interstate Commission may propose amendments to the Compact for 30
enactment by the member states. No amendment shall become effective and binding 31
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upon the Interstate Commission and the member states unless and until it is enacted 1
into law by unanimous consent of the member states. 2
SECTION 21. WITHDRAWAL. 3
(a) Once effective, the Compact shall continue in force and remain binding 4
upon each and every member state; provided that a member state may withdraw from 5
the Compact by specifically repealing the statute which enacted the Compact into law. 6
(b) Withdrawal from the Compact shall be by the enactment of a statute 7
repealing the same, but shall not take effect until one (1) year after the effective date 8
of such statute and until written notice of the withdrawal has been given by the 9
withdrawing state to the governor of each other member state. 10
(c) The withdrawing state shall immediately notify the chairperson of the 11
Interstate Commission in writing upon the introduction of legislation repealing the 12
Compact in the withdrawing state. 13
(d) The Interstate Commission shall notify the other member states of the 14
withdrawing state's intent to withdraw within sixty (60) days of its receipt of notice 15
provided under subsection (c). 16
(e) The withdrawing state is responsible for all dues, obligations and liabilities 17
incurred through the effective date of withdrawal, including obligations, the 18
performance of which extend beyond the effective date of withdrawal. 19
(f) Reinstatement following withdrawal of a member state shall occur upon 20
the withdrawing date reenacting the Compact or upon such later date as determined by 21
the Interstate Commission. 22
(g) The Interstate Commission is authorized to develop rules to address the 23
impact of the withdrawal of a member state on licenses granted in other member states 24
to physicians who designated the withdrawing member state as the state of principal 25
license. 26
SECTION 22. DISSOLUTION. 27
(a) The Compact shall dissolve effective upon the date of the withdrawal or 28
default of the member state which reduces the membership of the Compact to one (1) 29
member state. 30
(b) Upon the dissolution of the Compact, the Compact becomes null and void 31
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and shall be of no further force or effect, and the business and affairs of the Interstate 1
Commission shall be concluded, and surplus funds shall be distributed in accordance 2
with the bylaws. 3
SECTION 23. SEVERABILITY AND CONSTRUCTION. 4
(a) The provisions of the Compact shall be severable, and if any phrase, 5
clause, sentence, or provision is deemed unenforceable, the remaining provisions of 6
the Compact shall be enforceable. 7
(b) The provisions of the Compact shall be liberally construed to effectuate its 8
purposes. 9
(c) Nothing in the Compact shall be construed to prohibit the applicability of 10
other interstate compacts to which the member states are members. 11
SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS. 12
(a) Nothing herein prevents the enforcement of any other law of a member 13
state that is not inconsistent with the Compact. 14
(b) All laws in a member state in conflict with the Compact are superseded to 15
the extent of the conflict. 16
(c) All lawful actions of the Interstate Commission, including all rules and 17
bylaws promulgated by the Commission, are binding upon the member states. 18
(d) All agreements between the Interstate Commission and the member states 19
are binding in accordance with their terms. 20
(e) In the event any provision of the Compact exceeds the constitutional limits 21
imposed on the legislature of any member state, such provision shall be ineffective to 22
the extent of the conflict with the constitutional provision in question in that member 23
state. 24
Sec. 08.64.254. PA Licensure Compact. The PA licensure compact as 25
contained in this section is enacted into law and entered into on behalf of the state with 26
all other states and jurisdictions legally joining it in a form substantially as follows: 27
SECTION 1. PURPOSE. 28
In order to strengthen access to Medical Services, and in recognition of the 29
advances in the delivery of Medical Services, the Participating States of the PA 30
Licensure Compact have allied in common purpose to develop a comprehensive 31
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process that complements the existing authority of State Licensing Boards to license 1
and discipline PAs and seeks to enhance the portability of a License to practice as a 2
PA while safeguarding the safety of patients. This Compact allows Medical Services 3
to be provided by PAs, via the mutual recognition of the Licensee's Qualifying 4
License by other Compact Participating States. This Compact also adopts the 5
prevailing standard for PA licensure and affirms that the practice and delivery of 6
Medical Services by the PA occurs where the patient is located at the time of the 7
patient encounter, and therefore requires the PA to be under the jurisdiction of the 8
State Licensing Board where the patient is located. State Licensing Boards that 9
participate in this Compact retain the jurisdiction to impose Adverse Action against a 10
Compact Privilege in that State issued to a PA through the procedures of this 11
Compact. The PA Licensure Compact will alleviate burdens for military families by 12
allowing active duty military personnel and their spouses to obtain a Compact 13
Privilege based on having an unrestricted License in good standing from a 14
Participating State. 15
SECTION 2. DEFINITIONS. 16
In this Compact: 17
(A) "Adverse Action" means any administrative, civil, equitable, or criminal 18
action permitted by a State's laws which is imposed by a Licensing Board or other 19
authority against a PA License or License application or Compact Privilege such as 20
License denial, censure, revocation, suspension, probation, monitoring of the 21
Licensee, or restriction on the Licensee's practice. 22
(B) "Compact Privilege" means the authorization granted by a Remote State to 23
allow a Licensee from another Participating State to practice as a PA to provide 24
Medical Services and other licensed activity to a patient located in the Remote State 25
under the Remote State's laws and regulations. 26
(C) "Conviction" means a finding by a court that an individual is guilty of a 27
felony or misdemeanor offense through adjudication or entry of a plea of guilty or no 28
contest to the charge by the offender. 29
(D) "Criminal Background Check" means the submission of fingerprints or 30
other biometric-based information for a License applicant for the purpose of obtaining 31
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that applicant's criminal history record information, as defined in 28 C.F.R. 20.3(d), 1
from the State's criminal history record repository as defined in 28 C.F.R. 20.3(f). 2
(E) "Data System" means the repository of information about Licensees, 3
including but not limited to License status and Adverse Actions, which is created and 4
administered under the terms of this Compact. 5
(F) "Executive Committee" means a group of directors and ex-officio 6
individuals elected or appointed pursuant to Section 7(F)(2). 7
(G) "Impaired Practitioner" means a PA whose practice is adversely affected 8
by health-related condition(s) that impact their ability to practice. 9
(H) "Investigative Information" means information, records, or documents 10
received or generated by a Licensing Board pursuant to an investigation. 11
(I) "Jurisprudence Requirement" means the assessment of an individual's 12
knowledge of the laws and Rules governing the practice of a PA in a State. 13
(J) "License" means current authorization by a State, other than authorization 14
pursuant to a Compact Privilege, for a PA to provide Medical Services, which would 15
be unlawful without current authorization. 16
(K) "Licensee" means an individual who holds a License from a State to 17
provide Medical Services as a PA. 18
(L) "Licensing Board" means any State entity authorized to license and 19
otherwise regulate PAs. 20
(M) "Medical Services" means health care services provided for the diagnosis, 21
prevention, treatment, cure or relief of a health condition, injury, or disease, as defined 22
by a State's laws and regulations. 23
(N) "Model Compact" means the model for the PA Licensure Compact on file 24
with The Council of State Governments or other entity as designated by the 25
Commission. 26
(O) "Participating State" means a State that has enacted this Compact. 27
(P) "PA" means an individual who is licensed as a physician assistant in a 28
State. For purposes of this Compact, any other title or status adopted by a State to 29
replace the term "physician assistant" shall be deemed synonymous with "physician 30
assistant" and shall confer the same rights and responsibilities to the Licensee under 31
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the provisions of this Compact at the time of its enactment. 1
(Q) "PA Licensure Compact Commission," "Compact Commission," or 2
"Commission" mean the national administrative body created pursuant to Section 7(A) 3
of this Compact. 4
(R) "Qualifying License" means an unrestricted License issued by a 5
Participating State to provide Medical Services as a PA. 6
(S) "Remote State" means a Participating State where a Licensee who is not 7
licensed as a PA is exercising or seeking to exercise the Compact Privilege. 8
(T) "Rule" means a regulation promulgated by an entity that has the force and 9
effect of law. 10
(U) "Significant Investigative Information" means Investigative Information 11
that a Licensing Board, after an inquiry or investigation that includes notification and 12
an opportunity for the PA to respond if required by State law, has reason to believe is 13
not groundless and, if proven true, would indicate more than a minor infraction. 14
(V) "State" means any state, commonwealth, district, or territory of the United 15
States. 16
SECTION 3. STATE PARTICIPATION IN THIS COMPACT. 17
(A) To participate in this Compact, a Participating State shall: 18
(1) License PAs. 19
(2) Participate in the Compact Commission's Data System. 20
(3) Have a mechanism in place for receiving and investigating 21
complaints against Licensees and License applicants. 22
(4) Notify the Commission, in compliance with the terms of this 23
Compact and Commission Rules, of any Adverse Action against a Licensee or License 24
applicant and the existence of Significant Investigative Information regarding a 25
Licensee or License applicant. 26
(5) Fully implement a Criminal Background Check requirement, 27
within a time frame established by Commission Rule, by its Licensing Board receiving 28
the results of a Criminal Background Check and reporting to the Commission whether 29
the License applicant has been granted a License. 30
(6) Comply with the Rules of the Compact Commission. 31
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(7) Utilize passage of a recognized national exam such as the NCCPA 1
PANCE as a requirement for PA licensure. 2
(8) Grant the Compact Privilege to a holder of a Qualifying License in 3
a Participating State. 4
(B) Nothing in this Compact prohibits a Participating State from charging a 5
fee for granting the Compact Privilege. 6
SECTION 4. COMPACT PRIVILEGE. 7
(A) To exercise the Compact Privilege, a Licensee must: 8
(1) Have graduated from a PA program accredited by the Accreditation 9
Review Commission on Education for the Physician Assistant, Inc. or other programs 10
authorized by Commission Rule. 11
(2) Hold current NCCPA certification. 12
(3) Have no felony or misdemeanor Conviction. 13
(4) Have never had a controlled substance license, permit, or 14
registration suspended or revoked by a State or by the United States Drug 15
Enforcement Administration. 16
(5) Have a unique identifier as determined by Commission Rule. 17
(6) Hold a Qualifying License. 18
(7) Have had no revocation of a License or limitation or restriction on 19
any License currently held due to an adverse action. 20
(8) If a Licensee has had a limitation or restriction on a License or 21
Compact Privilege due to an Adverse Action, two years must have elapsed from the 22
date on which the License or Compact Privilege is no longer limited or restricted due 23
to the Adverse Action. 24
(9) If a Compact Privilege has been revoked or is limited or restricted 25
in a Participating State for conduct that would not be a basis for disciplinary action in 26
a Participating State in which the Licensee is practicing or applying to practice under 27
a Compact Privilege, that Participating State shall have the discretion not to 28
consider such action as an Adverse Action requiring the denial or removal of a 29
Compact Privilege in that State. 30
(10) Notify the Compact Commission that the Licensee is seeking the 31
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Compact Privilege in a Remote State. 1
(11) Meet any Jurisprudence Requirement of a Remote State in which 2
the Licensee is seeking to practice under the Compact Privilege and pay any fees 3
applicable to satisfying the Jurisprudence Requirement. 4
(12) Report to the Commission any Adverse Action taken by a non-5
participating State within thirty (30) days after the action is taken. 6
(B) The Compact Privilege is valid until the expiration or revocation of the 7
Qualifying License unless terminated pursuant to an Adverse Action. The Licensee 8
must also comply with all of the requirements of (A) of this Section above to maintain 9
the Compact Privilege in a Remote State. If the Participating State takes Adverse 10
Action against a Qualifying License, the Licensee shall lose the Compact Privilege in 11
any Remote State in which the Licensee has a Compact Privilege until all of the 12
following occur: 13
(1) The License is no longer limited or restricted; and 14
(2) Two (2) years have elapsed from the date on which the License is 15
no longer limited or restricted due to the Adverse Action. 16
(C) Once a restricted or limited License satisfies the requirements of (B)(1) 17
and (2) of this Section, the Licensee must meet the requirements of (A) of this Section 18
to obtain a Compact Privilege in any Remote State. 19
(D) For each Remote State in which a PA seeks authority to prescribe 20
controlled substances, the PA shall satisfy all requirements imposed by such State in 21
granting or renewing such authority. 22
SECTION 5. DESIGNATION OF THE STATE FROM WHICH LICENSEE IS 23
APPLYING FOR A COMPACT PRIVILEGE. 24
(A) Upon a Licensee's application for a Compact Privilege, the Licensee shall 25
identify to the Commission the Participating State from which the Licensee is 26
applying, in accordance with applicable Rules adopted by the Commission, and 27
subject to the following requirements: 28
(1) When applying for a Compact Privilege, the Licensee shall provide 29
the Commission with the address of the Licensee's primary residence and thereafter 30
shall immediately report to the Commission any change in the address of the 31
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Licensee's primary residence. 1
(2) When applying for a Compact Privilege, the Licensee is required to 2
consent to accept service of process by mail at the Licensee's primary residence on file 3
with the Commission with respect to any action brought against the Licensee by the 4
Commission or a Participating State, including a subpoena, with respect to any action 5
brought or investigation conducted by the Commission or a Participating State. 6
SECTION 6. ADVERSE ACTIONS. 7
(A) A Participating State in which a Licensee is licensed shall have exclusive 8
power to impose Adverse Action against the Qualifying License issued by that 9
Participating State. 10
(B) In addition to the other powers conferred by State law, a Remote State 11
shall have the authority, in accordance with existing State due process law, to do all of 12
the following: 13
(1) Take Adverse Action against a PA's Compact Privilege within that 14
State to remove a Licensee's Compact Privilege or take other action necessary under 15
applicable law to protect the health and safety of its citizens. 16
(2) Issue subpoenas for both hearings and investigations that require 17
the attendance and testimony of witnesses as well as the production of evidence. 18
Subpoenas issued by a Licensing Board in a Participating State for the attendance and 19
testimony of witnesses or the production of evidence from another Participating State 20
shall be enforced in the latter State by any court of competent jurisdiction, according 21
to the practice and procedure of that court applicable to subpoenas issued in 22
proceedings pending before it. The issuing authority shall pay any witness fees, travel 23
expenses, mileage and other fees required by the service statutes of the State in which 24
the witnesses or evidence are located. 25
(3) Notwithstanding (2) of this subsection, subpoenas may not be 26
issued by a Participating State to gather evidence of conduct in another State that is 27
lawful in that other State for the purpose of taking Adverse Action against a Licensee's 28
Compact Privilege or application for a Compact Privilege in that Participating State. 29
(4) Nothing in this Compact authorizes a Participating State to impose 30
discipline against a PA's Compact Privilege or to deny an application for a Compact 31
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Privilege in that Participating State for the individual's otherwise lawful practice in 1
another State. 2
(C) For purposes of taking Adverse Action, the Participating State which 3
issued the Qualifying License shall give the same priority and effect to reported 4
conduct received from any other Participating State as it would if the conduct had 5
occurred within the Participating State which issued the Qualifying License. In so 6
doing, that Participating State shall apply its own State laws to determine appropriate 7
action. 8
(D) A Participating State, if otherwise permitted by State law, may recover 9
from the affected PA the costs of investigations and disposition of cases resulting from 10
any Adverse Action taken against that PA. 11
(E) A Participating State may take Adverse Action based on the factual 12
findings of a Remote State, provided that the Participating State follows its own 13
procedures for taking the Adverse Action. 14
(F) Joint Investigations. 15
(1) In addition to the authority granted to a Participating State by its 16
respective State PA laws and regulations or other applicable State law, any 17
Participating State may participate with other Participating States in joint 18
investigations of Licensees. 19
(2) Participating States shall share any investigative, litigation, or 20
compliance materials in furtherance of any joint or individual investigation initiated 21
under this Compact. 22
(G) If an Adverse Action is taken against a PA's Qualifying License, the PA's 23
Compact Privilege in all Remote States shall be deactivated until two (2) years have 24
elapsed after all restrictions have been removed from the State License. All 25
disciplinary orders by the Participating State which issued the Qualifying License that 26
impose Adverse Action against a PA's License shall include a Statement that the PA's 27
Compact Privilege is deactivated in all Participating States during the pendency of the 28
order. 29
(H) If any Participating State takes Adverse Action, it promptly shall notify 30
the administrator of the Data System. 31
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SECTION 7. ESTABLISHMENT OF THE PA LICENSURE COMPACT 1
COMMISSION. 2
(A) The Participating States hereby create and establish a joint government 3
agency and national administrative body known as the PA Licensure Compact 4
Commission. The Commission is an instrumentality of the Compact States acting 5
jointly and not an instrumentality of any one State. The Commission shall come into 6
existence on or after the effective date of the Compact as set forth in Section 11(A). 7
(B) Membership, Voting, and Meetings. 8
(1) Each Participating State shall have and be limited to one (1) 9
delegate selected by that Participating State's Licensing Board or, if the State has more 10
than one Licensing Board, selected collectively by the Participating State's Licensing 11
Boards. 12
(2) The delegate shall be either: 13
(a) A current PA, physician or public member of a Licensing 14
Board or PA Council/Committee; or 15
(b) An administrator of a Licensing Board. 16
(3) Any delegate may be removed or suspended from office as 17
provided by the laws of the State from which the delegate is appointed. 18
(4) The Participating State Licensing Board shall fill any vacancy 19
occurring in the Commission within sixty (60) days. 20
(5) Each delegate shall be entitled to one (1) vote on all matters voted 21
on by the Commission and shall otherwise have an opportunity to participate in the 22
business and affairs of the Commission. A delegate shall vote in person or by such 23
other means as provided in the bylaws. The bylaws may provide for delegates' 24
participation in meetings by telecommunications, video conference, or other means of 25
communication. 26
(6) The Commission shall meet at least once during each calendar 27
year. Additional meetings shall be held as set forth in this Compact and the bylaws. 28
(7) The Commission shall establish by Rule a term of office for 29
delegates. 30
(C) The Commission shall have the following powers and duties: 31
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(1) Establish a code of ethics for the Commission; 1
(2) Establish the fiscal year of the Commission; 2
(3) Establish fees; 3
(4) Establish bylaws; 4
(5) Maintain its financial records in accordance with the bylaws; 5
(6) Meet and take such actions as are consistent with the provisions of 6
this Compact and the bylaws; 7
(7) Promulgate Rules to facilitate and coordinate implementation and 8
administration of this Compact. The Rules shall have the force and effect of law and 9
shall be binding in all Participating States; 10
(8) Bring and prosecute legal proceedings or actions in the name of the 11
Commission, provided that the standing of any State Licensing Board to sue or be 12
sued under applicable law shall not be affected; 13
(9) Purchase and maintain insurance and bonds; 14
(10) Borrow, accept, or contract for services of personnel, including, 15
but not limited to, employees of a Participating State; 16
(11) Hire employees and engage contractors, elect or appoint officers, 17
fix compensation, define duties, grant such individuals appropriate authority to carry 18
out the purposes of this Compact, and establish the Commission's personnel policies 19
and programs relating to conflicts of interest, qualifications of personnel, and other 20
related personnel matters; 21
(12) Accept any and all appropriate donations and grants of money, 22
equipment, supplies, materials and services, and receive, utilize and dispose of the 23
same; provided that at all times the Commission shall avoid any appearance of 24
impropriety or conflict of interest; 25
(13) Lease, purchase, accept appropriate gifts or donations of, or 26
otherwise own, hold, improve or use, any property, real, personal or mixed; provided 27
that at all times the Commission shall avoid any appearance of impropriety; 28
(14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or 29
otherwise dispose of any property real, personal, or mixed; 30
(15) Establish a budget and make expenditures; 31
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(16) Borrow money; 1
(17) Appoint committees, including standing committees composed of 2
members, State regulators, State legislators or their representatives, and consumer 3
representatives, and such other interested persons as may be designated in this 4
Compact and the bylaws; 5
(18) Provide and receive information from, and cooperate with, law 6
enforcement agencies; 7
(19) Elect a Chair, Vice Chair, Secretary and Treasurer and such other 8
officers of the Commission as provided in the Commission's bylaws; 9
(20) Reserve for itself, in addition to those reserved exclusively to the 10
Commission under the Compact, powers that the Executive Committee may not 11
exercise; 12
(21) Approve or disapprove a State's participation in the Compact 13
based upon its determination as to whether the State's Compact legislation departs in a 14
material manner from the Model Compact language; 15
(22) Prepare and provide to the Participating States an annual report; 16
and 17
(23) Perform such other functions as may be necessary or appropriate 18
to achieve the purposes of this Compact consistent with the State regulation of PA 19
licensure and practice. 20
(D) Meetings of the Commission. 21
(1) All meetings of the Commission that are not closed pursuant to this 22
subsection shall be open to the public. Notice of public meetings shall be posted on the 23
Commission's website at least thirty (30) days prior to the public meeting. 24
(2) Notwithstanding (D)(1) of this Section, the Commission may 25
convene a public meeting by providing at least twenty-four (24) hours prior notice on 26
the Commission's website, and any other means as provided in the Commission's 27
Rules, for any of the reasons it may dispense with notice of proposed rulemaking 28
under Section 9(L). 29
(3) The Commission may convene in a closed, non-public meeting or 30
non-public part of a public meeting to receive legal advice or to discuss: 31
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(a) Non-compliance of a Participating State with its obligations 1
under this Compact; 2
(b) The employment, compensation, discipline or other matters, 3
practices or procedures related to specific employees or other matters related to 4
the Commission's internal personnel practices and procedures; 5
(c) Current, threatened, or reasonably anticipated litigation; 6
(d) Negotiation of contracts for the purchase, lease, or sale of 7
goods, services, or real estate; 8
(e) Accusing any person of a crime or formally censuring any 9
person; 10
(f) Disclosure of trade secrets or commercial or financial 11
information that is privileged or confidential; 12
(g) Disclosure of information of a personal nature where 13
disclosure would constitute a clearly unwarranted invasion of personal privacy; 14
(h) Disclosure of investigative records compiled for law 15
enforcement purposes; 16
(i) Disclosure of information related to any investigative 17
reports prepared by or on behalf of or for use of the Commission or other 18
committee charged with responsibility of investigation or determination of 19
compliance issues pursuant to this Compact; 20
(j) Legal advice; or 21
(k) Matters specifically exempted from disclosure by federal or 22
Participating States' statutes. 23
(4) If a meeting, or portion of a meeting, is closed pursuant to this 24
provision, the chair of the meeting or the chair's designee shall certify that the meeting 25
or portion of the meeting may be closed and shall reference each relevant exempting 26
provision. 27
(5) The Commission shall keep minutes that fully and clearly describe 28
all matters discussed in a meeting and shall provide a full and accurate summary of 29
actions taken, including a description of the views expressed. All documents 30
considered in connection with an action shall be identified in such minutes. All 31
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minutes and documents of a closed meeting shall remain under seal, subject to release 1
by a majority vote of the Commission or order of a court of competent jurisdiction. 2
(E) Financing of the Commission. 3
(1) The Commission shall pay, or provide for the payment of, the 4
reasonable expenses of its establishment, organization, and ongoing activities. 5
(2) The Commission may accept any and all appropriate revenue 6
sources, donations, and grants of money, equipment, supplies, materials, and services. 7
(3) The Commission may levy on and collect an annual assessment 8
from each Participating State and may impose Compact Privilege fees on Licensees of 9
Participating States to whom a Compact Privilege is granted to cover the cost of the 10
operations and activities of the Commission and its staff, which must be in a total 11
amount sufficient to cover its annual budget as approved by the Commission each year 12
for which revenue is not provided by other sources. The aggregate annual assessment 13
amount levied on Participating States shall be allocated based upon a formula to be 14
determined by Commission Rule. 15
(a) A Compact Privilege expires when the Licensee's 16
Qualifying License in the Participating State from which the Licensee applied 17
for the Compact Privilege expires. 18
(b) If the Licensee terminates the Qualifying License through 19
which the Licensee applied for the Compact Privilege before its scheduled 20
expiration, and the Licensee has a Qualifying License in another Participating 21
State, the Licensee shall inform the Commission that it is changing to that 22
Participating State the Participating State through which it applies for a 23
Compact Privilege and pay to the Commission any Compact Privilege fee 24
required by Commission Rule. 25
(4) The Commission shall not incur obligations of any kind prior to 26
securing the funds adequate to meet the same; nor shall the Commission pledge the 27
credit of any of the Participating States, except by and with the authority of the 28
Participating State. 29
(5) The Commission shall keep accurate accounts of all receipts and 30
disbursements. The receipts and disbursements of the Commission shall be subject to 31
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the financial review and accounting procedures established under its bylaws. All 1
receipts and disbursements of funds handled by the Commission shall be subject to an 2
annual financial review by a certified or licensed public accountant, and the report of 3
the financial review shall be included in and become part of the annual report of the 4
Commission. 5
(F) The Executive Committee. 6
(1) The Executive Committee shall have the power to act on behalf of 7
the Commission according to the terms of this Compact and Commission Rules. 8
(2) The Executive Committee shall be composed of nine (9) members: 9
(a) Seven voting members who are elected by the Commission 10
from the current membership of the Commission; 11
(b) One ex-officio, nonvoting member from a recognized 12
national PA professional association; and 13
(c) One ex-officio, nonvoting member from a recognized 14
national PA certification organization. 15
(3) The ex-officio members will be selected by their respective 16
organizations. 17
(4) The Commission may remove any member of the Executive 18
Committee as provided in its bylaws. 19
(5) The Executive Committee shall meet at least annually. 20
(6) The Executive Committee shall have the following duties and 21
responsibilities: 22
(a) Recommend to the Commission changes to the 23
Commission's Rules or bylaws, changes to this Compact legislation, fees to be 24
paid by Compact Participating States such as annual dues, and any 25
Commission Compact fee charged to Licensees for the Compact Privilege; 26
(b) Ensure Compact administration services are appropriately 27
provided, contractual or otherwise; 28
(c) Prepare and recommend the budget; 29
(d) Maintain financial records on behalf of the Commission; 30
(e) Monitor Compact compliance of Participating States and 31
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provide compliance reports to the Commission; 1
(f) Establish additional committees as necessary; 2
(g) Exercise the powers and duties of the Commission during 3
the interim between Commission meetings, except for issuing proposed 4
rulemaking or adopting Commission Rules or bylaws, or exercising any other 5
powers and duties exclusively reserved to the Commission by the 6
Commission's Rules; and 7
(h) Perform other duties as provided in the Commission's Rules 8
or bylaws. 9
(7) All meetings of the Executive Committee at which it votes or plans 10
to vote on matters in exercising the powers and duties of the Commission shall be 11
open to the public and public notice of such meetings shall be given as public 12
meetings of the Commission are given. 13
(8) The Executive Committee may convene in a closed, non-public 14
meeting for the same reasons that the Commission may convene in a non-public 15
meeting as set forth in Section 7(D)(3) and shall announce the closed meeting as the 16
Commission is required to under Section 7(D)(4) and keep minutes of the closed 17
meeting as the Commission is required to under Section 7(D)(5). 18
(G) Qualified Immunity, Defense, and Indemnification. 19
(1) The members, officers, executive director, employees and 20
representatives of the Commission shall be immune from suit and liability, both 21
personally and in their official capacity, for any claim for damage to or loss of 22
property or personal injury or other civil liability caused by or arising out of any actual 23
or alleged act, error, or omission that occurred, or that the person against whom the 24
claim is made had a reasonable basis for believing occurred within the scope of 25
Commission employment, duties or responsibilities; provided that nothing in this 26
paragraph shall be construed to protect any such person from suit or liability for any 27
damage, loss, injury, or liability caused by the intentional or willful or wanton 28
misconduct of that person. The procurement of insurance of any type by the 29
Commission shall not in any way compromise or limit the immunity granted 30
hereunder. 31
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(2) The Commission shall defend any member, officer, executive 1
director, employee, and representative of the Commission in any civil action seeking 2
to impose liability arising out of any actual or alleged act, error, or omission that 3
occurred within the scope of Commission employment, duties, or responsibilities, or 4
as determined by the Commission that the person against whom the claim is made had 5
a reasonable basis for believing occurred within the scope of Commission 6
employment, duties, or responsibilities; provided that nothing herein shall be 7
construed to prohibit that person from retaining their own counsel at their own 8
expense; and provided further, that the actual or alleged act, error, or omission did not 9
result from that person's intentional or willful or wanton misconduct. 10
(3) The Commission shall indemnify and hold harmless any member, 11
officer, executive director, employee, and representative of the Commission for the 12
amount of any settlement or judgment obtained against that person arising out of any 13
actual or alleged act, error, or omission that occurred within the scope of Commission 14
employment, duties, or responsibilities, or that such person had a reasonable basis for 15
believing occurred within the scope of Commission employment, duties, or 16
responsibilities, provided that the actual or alleged act, error, or omission did not result 17
from the intentional or willful or wanton misconduct of that person. 18
(4) Venue is proper and judicial proceedings by or against the 19
Commission shall be brought solely and exclusively in a court of competent 20
jurisdiction where the principal office of the Commission is located. The Commission 21
may waive venue and jurisdictional defenses in any proceedings as authorized by 22
Commission Rules. 23
(5) Nothing herein shall be construed as a limitation on the liability of 24
any Licensee for professional malpractice or misconduct, which shall be governed 25
solely by any other applicable State laws. 26
(6) Nothing herein shall be construed to designate the venue or 27
jurisdiction to bring actions for alleged acts of malpractice, professional misconduct, 28
negligence, or other such civil action pertaining to the practice of a PA. All such 29
matters shall be determined exclusively by State law other than this Compact. 30
(7) Nothing in this Compact shall be interpreted to waive or otherwise 31
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abrogate a Participating State's state action immunity or state action affirmative 1
defense with respect to antitrust claims under the Sherman Act, Clayton Act, or any 2
other State or federal antitrust or anticompetitive law or regulation. 3
(8) Nothing in this Compact shall be construed to be a waiver of 4
sovereign immunity by the Participating States or by the Commission. 5
SECTION 8. DATA SYSTEM. 6
(A) The Commission shall provide for the development, maintenance, 7
operation, and utilization of a coordinated data and reporting system containing 8
licensure, Adverse Action, and the reporting of the existence of Significant 9
Investigative Information on all licensed PAs and applicants denied a License in 10
Participating States. 11
(B) Notwithstanding any other State law to the contrary, a Participating State 12
shall submit a uniform data set to the Data System on all PAs to whom this Compact 13
is applicable (utilizing a unique identifier) as required by the Rules of the 14
Commission, including: 15
(1) Identifying information; 16
(2) Licensure data; 17
(3) Adverse Actions against a License or Compact Privilege; 18
(4) Any denial of application for licensure, and the reason(s) for such 19
denial (excluding the reporting of any Criminal history record information where 20
prohibited by law); 21
(5) The existence of Significant Investigative Information; and 22
(6) Other information that may facilitate the administration of this 23
Compact, as determined by the Rules of the Commission. 24
(C) Significant Investigative Information pertaining to a Licensee in any 25
Participating State shall only be available to other Participating States. 26
(D) The Commission shall promptly notify all Participating States of any 27
Adverse Action taken against a Licensee or an individual applying for a License that 28
has been reported to it. This Adverse Action information shall be available to any 29
other Participating State. 30
(E) Participating States contributing information to the Data System may, in 31
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accordance with State or federal law, designate information that may not be shared 1
with the public without the express permission of the contributing State. 2
Notwithstanding any such designation, such information shall be reported to the 3
Commission through the Data System. 4
(F) Any information submitted to the Data System that is subsequently 5
expunged pursuant to federal law or the laws of the Participating State contributing the 6
information shall be removed from the Data System upon reporting of such by the 7
Participating State to the Commission. 8
(G) The records and information provided to a Participating State pursuant to 9
this Compact or through the Data System, when certified by the Commission or an 10
agent thereof, shall constitute the authenticated business records of the Commission, 11
and shall be entitled to any associated hearsay exception in any relevant judicial, 12
quasi-judicial or administrative proceedings in a Participating State. 13
SECTION 9. RULEMAKING. 14
(A) The Commission shall exercise its Rulemaking powers pursuant to the 15
criteria set forth in this Section and the Rules adopted thereunder. Commission Rules 16
shall become binding as of the date specified by the Commission for each Rule. 17
(B) The Commission shall promulgate reasonable Rules in order to effectively 18
and efficiently implement and administer this Compact and achieve its purposes. A 19
Commission Rule shall be invalid and have no force or effect only if a court of 20
competent jurisdiction holds that the Rule is invalid because the Commission 21
exercised its rulemaking authority in a manner that is beyond the scope of the 22
purposes of this Compact, or the powers granted hereunder, or based upon another 23
applicable standard of review. 24
(C) The Rules of the Commission shall have the force of law in each 25
Participating State, provided however that where the Rules of the Commission conflict 26
with the laws of the Participating State that establish the medical services a PA may 27
perform in the Participating State, as held by a court of competent jurisdiction, the 28
Rules of the Commission shall be ineffective in that State to the extent of the conflict. 29
(D) If a majority of the legislatures of the Participating States rejects a 30
Commission Rule, by enactment of a statute or resolution in the same manner used to 31
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adopt this Compact within four (4) years of the date of adoption of the Rule, then such 1
Rule shall have no further force and effect in any Participating State or to any State 2
applying to participate in the Compact. 3
(E) Commission Rules shall be adopted at a regular or special meeting of the 4
Commission. 5
(F) Prior to promulgation and adoption of a final Rule or Rules by the 6
Commission, and at least thirty (30) days in advance of the meeting at which the Rule 7
will be considered and voted upon, the Commission shall file a Notice of Proposed 8
Rulemaking: 9
(1) On the website of the Commission or other publicly accessible 10
platform; and 11
(2) To persons who have requested notice of the Commission's notices 12
of proposed rulemaking; and 13
(3) In such other way(s) as the Commission may by Rule specify. 14
(G) The Notice of Proposed Rulemaking shall include: 15
(1) The time, date, and location of the public hearing on the proposed 16
Rule and the proposed time, date and location of the meeting in which the proposed 17
Rule will be considered and voted upon; 18
(2) The text of the proposed Rule and the reason for the proposed 19
Rule; 20
(3) A request for comments on the proposed Rule from any interested 21
person and the date by which written comments must be received; and 22
(4) The manner in which interested persons may submit notice to the 23
Commission of their intention to attend the public hearing or provide any written 24
comments. 25
(H) Prior to adoption of a proposed Rule, the Commission shall allow persons 26
to submit written data, facts, opinions, and arguments, which shall be made available 27
to the public. 28
(I) If the hearing is to be held via electronic means, the Commission shall 29
publish the mechanism for access to the electronic hearing. 30
(1) All persons wishing to be heard at the hearing shall as directed in 31
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the Notice of Proposed Rulemaking, not less than five (5) business days before the 1
scheduled date of the hearing, notify the Commission of their desire to appear and 2
testify at the hearing. 3
(2) Hearings shall be conducted in a manner providing each person 4
who wishes to comment a fair and reasonable opportunity to comment orally or in 5
writing. 6
(3) All hearings shall be recorded. A copy of the recording and the 7
written comments, data, facts, opinions, and arguments received in response to the 8
proposed rulemaking shall be made available to a person upon request. 9
(4) Nothing in this section shall be construed as requiring a separate 10
hearing on each proposed Rule. Proposed Rules may be grouped for the convenience 11
of the Commission at hearings required by this section. 12
(J) Following the public hearing the Commission shall consider all written and 13
oral comments timely received. 14
(K) The Commission shall, by majority vote of all delegates, take final action 15
on the proposed Rule and shall determine the effective date of the Rule, if adopted, 16
based on the Rulemaking record and the full text of the Rule. 17
(1) If adopted, the Rule shall be posted on the Commission's website. 18
(2) The Commission may adopt changes to the proposed Rule 19
provided the changes do not enlarge the original purpose of the proposed Rule. 20
(3) The Commission shall provide on its website an explanation of the 21
reasons for substantive changes made to the proposed Rule as well as reasons for 22
substantive changes not made that were recommended by commenters. 23
(4) The Commission shall determine a reasonable effective date for the 24
Rule. Except for an emergency as provided in (L) of this Section, the effective date of 25
the Rule shall be no sooner than thirty (30) days after the Commission issued the 26
notice that it adopted the Rule. 27
(L) Upon determination that an emergency exists, the Commission may 28
consider and adopt an emergency Rule with twenty-four (24) hours prior notice, 29
without the opportunity for comment, or hearing, provided that the usual rulemaking 30
procedures provided in this Compact and in this section shall be retroactively applied 31
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to the Rule as soon as reasonably possible, in no event later than ninety (90) days after 1
the effective date of the Rule. For the purposes of this provision, an emergency Rule is 2
one that must be adopted immediately by the Commission in order to: 3
(1) Meet an imminent threat to public health, safety, or welfare; 4
(2) Prevent a loss of Commission or Participating State funds; 5
(3) Meet a deadline for the promulgation of a Commission Rule that is 6
established by federal law or Rule; or 7
(4) Protect public health and safety. 8
(M) The Commission or an authorized committee of the Commission may 9
direct revisions to a previously adopted Commission Rule for purposes of correcting 10
typographical errors, errors in format, errors in consistency, or grammatical errors. 11
Public notice of any revisions shall be posted on the website of the Commission. The 12
revision shall be subject to challenge by any person for a period of thirty (30) days 13
after posting. The revision may be challenged only on grounds that the revision results 14
in a material change to a Rule. A challenge shall be made as set forth in the notice of 15
revisions and delivered to the Commission prior to the end of the notice period. If no 16
challenge is made, the revision will take effect without further action. If the revision is 17
challenged, the revision may not take effect without the approval of the Commission. 18
(N) No Participating State's rulemaking requirements shall apply under this 19
Compact. 20
SECTION 10. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. 21
(A) Oversight. 22
(1) The executive and judicial branches of State government in each 23
Participating State shall enforce this Compact and take all actions necessary and 24
appropriate to implement the Compact. 25
(2) Venue is proper and judicial proceedings by or against the 26
Commission shall be brought solely and exclusively in a court of competent 27
jurisdiction where the principal office of the Commission is located. The Commission 28
may waive venue and jurisdictional defenses to the extent it adopts or consents to 29
participate in alternative dispute resolution proceedings. Nothing herein shall affect or 30
limit the selection or propriety of venue in any action against a Licensee for 31
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professional malpractice, misconduct or any such similar matter. 1
(3) The Commission shall be entitled to receive service of process in 2
any proceeding regarding the enforcement or interpretation of the Compact or the 3
Commission's Rules and shall have standing to intervene in such a proceeding for all 4
purposes. Failure to provide the Commission with service of process shall render a 5
judgment or order in such proceeding void as to the Commission, this Compact, or 6
Commission Rules. 7
(B) Default, Technical Assistance, and Termination. 8
(1) If the Commission determines that a Participating State has 9
defaulted in the performance of its obligations or responsibilities under this Compact 10
or the Commission Rules, the Commission shall provide written notice to the 11
defaulting State and other Participating States. The notice shall describe the default, 12
the proposed means of curing the default and any other action that the Commission 13
may take and shall offer remedial training and specific technical assistance regarding 14
the default. 15
(2) If a State in default fails to cure the default, the defaulting State 16
may be terminated from this Compact upon an affirmative vote of a majority of the 17
delegates of the Participating States, and all rights, privileges and benefits conferred 18
by this Compact upon such State may be terminated on the effective date of 19
termination. A cure of the default does not relieve the offending State of obligations or 20
liabilities incurred during the period of default. 21
(3) Termination of participation in this Compact shall be imposed only 22
after all other means of securing compliance have been exhausted. Notice of intent to 23
suspend or terminate shall be given by the Commission to the governor, the majority 24
and minority leaders of the defaulting State's legislature, and to the Licensing Board(s) 25
of each of the Participating States. 26
(4) A State that has been terminated is responsible for all assessments, 27
obligations, and liabilities incurred through the effective date of termination, including 28
obligations that extend beyond the effective date of termination. 29
(5) The Commission shall not bear any costs related to a State that is 30
found to be in default or that has been terminated from this Compact, unless agreed 31
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upon in writing between the Commission and the defaulting State. 1
(6) The defaulting State may appeal its termination from the Compact 2
by the Commission by petitioning the U.S. District Court for the District of Columbia 3
or the federal district where the Commission has its principal offices. The prevailing 4
member shall be awarded all costs of such litigation, including reasonable attorney's 5
fees. 6
(7) Upon the termination of a State's participation in the Compact, the 7
State shall immediately provide notice to all Licensees within that State of such 8
termination: 9
(a) Licensees who have been granted a Compact Privilege in 10
that State shall retain the Compact Privilege for one hundred eighty (180) days 11
following the effective date of such termination. 12
(b) Licensees who are licensed in that State who have been 13
granted a Compact Privilege in a Participating State shall retain the Compact 14
Privilege for one hundred eighty (180) days unless the Licensee also has a 15
Qualifying License in a Participating State or obtains a Qualifying License in a 16
Participating State before the one hundred eighty (180)-day period ends, in 17
which case the Compact Privilege shall continue. 18
(C) Dispute Resolution. 19
(1) Upon request by a Participating State, the Commission shall 20
attempt to resolve disputes related to this Compact that arise among Participating 21
States and between participating and non-Participating States. 22
(2) The Commission shall promulgate a Rule providing for both 23
mediation and binding dispute resolution for disputes as appropriate. 24
(D) Enforcement. 25
(1) The Commission, in the reasonable exercise of its discretion, shall 26
enforce the provisions of this Compact and Rules of the Commission. 27
(2) If compliance is not secured after all means to secure compliance 28
have been exhausted, by majority vote, the Commission may initiate legal action in the 29
United States District Court for the District of Columbia or the federal district where 30
the Commission has its principal offices, against a Participating State in default to 31
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enforce compliance with the provisions of this Compact and the Commission's 1
promulgated Rules and bylaws. The relief sought may include both injunctive relief 2
and damages. In the event judicial enforcement is necessary, the prevailing party shall 3
be awarded all costs of such litigation, including reasonable attorney's fees. 4
(3) The remedies herein shall not be the exclusive remedies of the 5
Commission. The Commission may pursue any other remedies available under federal 6
or State law. 7
(E) Legal Action Against the Commission. 8
(1) A Participating State may initiate legal action against the 9
Commission in the U.S. District Court for the District of Columbia or the federal 10
district where the Commission has its principal offices to enforce compliance with the 11
provisions of the Compact and its Rules. The relief sought may include both injunctive 12
relief and damages. In the event judicial enforcement is necessary, the prevailing party 13
shall be awarded all costs of such litigation, including reasonable attorney's fees. 14
(2) No person other than a Participating State shall enforce this 15
Compact against the Commission. 16
SECTION 11. DATE OF IMPLEMENTATION OF THE PA LICENSURE 17
COMPACT COMMISSION. 18
(A) This Compact shall come into effect on the date on which this Compact 19
statute is enacted into law in the seventh Participating State. 20
(1) On or after the effective date of the Compact, the Commission shall 21
convene and review the enactment of each of the States that enacted the Compact prior 22
to the Commission convening ("Charter Participating States") to determine if the 23
statute enacted by each such Charter Participating State is materially different than the 24
Model Compact. 25
(a) A Charter Participating State whose enactment is found to 26
be materially different from the Model Compact shall be entitled to the default 27
process set forth in Section 10(B). 28
(b) If any Participating State later withdraws from the Compact 29
or its participation is terminated, the Commission shall remain in existence and 30
the Compact shall remain in effect even if the number of Participating States 31
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should be less than seven. Participating States enacting the Compact 1
subsequent to the Commission convening shall be subject to the process set 2
forth in Section 7(C)(21) to determine if their enactments are materially 3
different from the Model Compact and whether they qualify for participation in 4
the Compact. 5
(2) Participating States enacting the Compact subsequent to the seven 6
initial Charter Participating States shall be subject to the process set forth in Section 7
7(C)(21) to determine if their enactments are materially different from the Model 8
Compact and whether they qualify for participation in the Compact. 9
(3) All actions taken for the benefit of the Commission or in 10
furtherance of the purposes of the administration of the Compact prior to the effective 11
date of the Compact or the Commission coming into existence shall be considered to 12
be actions of the Commission unless specifically repudiated by the Commission. 13
(B) Any State that joins this Compact shall be subject to the Commission's 14
Rules and bylaws as they exist on the date on which this Compact becomes law in that 15
State. Any Rule that has been previously adopted by the Commission shall have the 16
full force and effect of law on the day this Compact becomes law in that State. 17
(C) Any Participating State may withdraw from this Compact by enacting a 18
statute repealing the same. 19
(1) A Participating State's withdrawal shall not take effect until one 20
hundred eighty (180) days after enactment of the repealing statute. During this one 21
hundred eighty (180) day-period, all Compact Privileges that were in effect in the 22
withdrawing State and were granted to Licensees licensed in the withdrawing State 23
shall remain in effect. If any Licensee licensed in the withdrawing State is also 24
licensed in another Participating State or obtains a license in another Participating 25
State within the one hundred eighty (180) days, the Licensee's Compact Privileges in 26
other Participating States shall not be affected by the passage of the one hundred 27
eighty (180) days. 28
(2) Withdrawal shall not affect the continuing requirement of the State 29
Licensing Board(s) of the withdrawing State to comply with the investigative, and 30
Adverse Action reporting requirements of this Compact prior to the effective date of 31
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withdrawal. 1
(3) Upon the enactment of a statute withdrawing a State from this 2
Compact, the State shall immediately provide notice of such withdrawal to all 3
Licensees within that State. Such withdrawing State shall continue to recognize all 4
licenses granted pursuant to this Compact for a minimum of one hundred eighty (180) 5
days after the date of such notice of withdrawal. 6
(D) Nothing contained in this Compact shall be construed to invalidate or 7
prevent any PA licensure agreement or other cooperative arrangement between 8
Participating States and between a Participating State and non-Participating State that 9
does not conflict with the provisions of this Compact. 10
(E) This Compact may be amended by the Participating States. No amendment 11
to this Compact shall become effective and binding upon any Participating State until 12
it is enacted materially in the same manner into the laws of all Participating States as 13
determined by the Commission. 14
SECTION 12. CONSTRUCTION AND SEVERABILITY. 15
(A) This Compact and the Commission's rulemaking authority shall be 16
liberally construed so as to effectuate the purposes, and the implementation and 17
administration of the Compact. Provisions of the Compact expressly authorizing or 18
requiring the promulgation of Rules shall not be construed to limit the Commission's 19
rulemaking authority solely for those purposes. 20
(B) The provisions of this Compact shall be severable and if any phrase, 21
clause, sentence or provision of this Compact is held by a court of competent 22
jurisdiction to be contrary to the constitution of any Participating State, a State seeking 23
participation in the Compact, or of the United States, or the applicability thereof to any 24
government, agency, person or circumstance is held to be unconstitutional by a court 25
of competent jurisdiction, the validity of the remainder of this Compact and the 26
applicability thereof to any other government, agency, person or circumstance shall 27
not be affected thereby. 28
(C) Notwithstanding (B) of this section or this section, the Commission may 29
deny a State's participation in the Compact or, in accordance with the requirements of 30
Section 10(B), terminate a Participating State's participation in the Compact, if it 31
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determines that a constitutional requirement of a Participating State is, or would be 1
with respect to a State seeking to participate in the Compact, a material departure from 2
the Compact. Otherwise, if this Compact shall be held to be contrary to the 3
constitution of any Participating State, the Compact shall remain in full force and 4
effect as to the remaining Participating States and in full force and effect as to the 5
Participating State affected as to all severable matters. 6
SECTION 13. BINDING EFFECT OF COMPACT. 7
(A) Nothing herein prevents the enforcement of any other law of a 8
Participating State that is not inconsistent with this Compact. 9
(B) Any laws in a Participating State in conflict with this Compact are 10
superseded to the extent of the conflict. 11
(C) All agreements between the Commission and the Participating States are 12
binding in accordance with their terms. 13
* Sec. 17. AS 08.64.315 is amended to read: 14
Sec. 08.64.315. Fees. The department shall set fees under AS 08.01.065 for 15
each of the following: 16
(1) application; 17
(2) license by examination; 18
(3) license by endorsement or waiver of examination; 19
(4) temporary permit; 20
(5) locum tenens permit; 21
(6) license renewal, active; 22
(7) license renewal, inactive; 23
(8) license by reexamination; 24
(9) expedited license issued or renewed through the Interstate 25
Medical Licensure Compact under AS 08.64.253; 26
(10) compact privilege. 27
* Sec. 18. AS 08.86.070 is amended to read: 28
Sec. 08.86.070. Duties of the board. The board shall 29
(1) establish objective examination requirements for persons who 30
apply for a license to practice psychology in the state; 31
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(2) examine, or cause to be examined, eligible license applicants; 1
(3) approve the issuance of licenses to qualified applicants; 2
(4) adopt regulations establishing standards for the practice of 3
psychology; 4
(5) impose disciplinary sanctions as authorized by this chapter; 5
(6) adopt regulations requiring proof of continued competency for 6
license renewal; 7
(7) review, when requested by the department, the quality and 8
availability of psychological services in the state; 9
(8) compile information for submission to the department on the 10
practice of psychology by psychologists and psychological associates in the state; 11
(9) implement the Psychology Interjurisdictional Compact under 12
AS 08.86.225. 13
* Sec. 19. AS 08.86.130(a) is amended to read: 14
(a) The board shall issue a psychologist license to a person who 15
(1) holds an earned doctorate degree, from an academic institution 16
whose program of graduate study for a doctorate degree in psychology meets the 17
criteria established by the board by regulation, in 18
(A) clinical psychology; 19
(B) counseling psychology; or 20
(C) education in a field of specialization considered equivalent 21
by the board; 22
(2) has not engaged in dishonorable conduct related to the practice of 23
counseling or psychometry; 24
(3) has one year of post doctoral supervised experience approved by 25
the board; [AND] 26
(4) takes and passes the objective examination developed or approved 27
by the board; and 28
(5) has been fingerprinted and has provided the fees required by 29
the Department of Public Safety under AS 12.62.160 for criminal justice 30
information and a national criminal history record check; the fingerprints and 31
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fees shall be forwarded to the Department of Public Safety to obtain a report of 1
criminal justice information under AS 12.62 and a national criminal history 2
record check under AS 12.62.400; criminal justice information and criminal 3
history record information obtained under this paragraph may only be used by 4
the board for the purpose of determining an applicant's qualifications and fitness 5
for a license or authority to practice under this chapter. 6
* Sec. 20. AS 08.86.140(a) is amended to read: 7
(a) The department shall set fees under AS 08.01.065 for the following: 8
(1) application; 9
(2) examination; 10
(3) credential review; 11
(4) initial license; 12
(5) license renewal; 13
(6) authority to practice under AS 08.86.225. 14
* Sec. 21. AS 08.86.150 is amended to read: 15
Sec. 08.86.150. License by credentials. A person who is licensed or certified 16
as a psychologist by a licensing authority other than the state is entitled to be licensed 17
in the state without examination if the person applies on the proper application form, 18
submits proof of continued competence as required by regulation of the board, 19
submits the person's fingerprints and fees as required under (b) of this section, 20
pays the credential review fee, and the person 21
(1) holds a doctoral degree with primary emphasis on psychology that 22
satisfies the requirements of AS 08.86.130 and the examination and qualification 23
requirements for the person's out-of-state license or certificate were essentially similar 24
to or higher than the examination and qualification requirements for licensure under 25
this chapter; 26
(2) is a diplomate in good standing of the American Board of 27
Professional Psychology; or 28
(3) is certified or registered with a credentialing organization in 29
psychology approved by the board in regulation and with requirements essentially 30
similar to or higher than the requirements for licensure under this chapter. 31
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* Sec. 22. AS 08.86.150 is amended by adding a new subsection to read: 1
(b) An applicant for a license by credentials shall submit to the board 2
the applicant's fingerprints and the fees required by the Department of Public Safety 3
under AS 12.62.160 for criminal justice information and a national criminal history 4
record check. The board shall forward the fingerprints and fees to the Department of 5
Public Safety to obtain a report of criminal justice information under AS 12.62 and a 6
national criminal history record check under AS 12.62.400. Criminal justice 7
information and criminal history record information obtained under this subsection 8
may only be used by the board for the purpose of determining an applicant's 9
qualifications and fitness for a license or authority to practice under this chapter. 10
* Sec. 23. AS 08.86 is amended by adding a new section to read: 11
Article 5A. Psychology Interjurisdictional Compact. 12
Sec. 08.86.225. Compact enacted. The Psychology Interjurisdictional 13
Compact as contained in this section is enacted into law and entered into on behalf of 14
the state with all other states and jurisdictions legally joining it in a form substantially 15
as follows: 16
ARTICLE I. PURPOSE. 17
Whereas, states license psychologists, in order to protect the public through 18
verification of education, training and experience and ensure accountability for 19
professional practice; and 20
Whereas, this Compact is intended to regulate the day to day practice of 21
telepsychology (i.e. the provision of psychological services using telecommunication 22
technologies) by psychologists across state boundaries in the performance of their 23
psychological practice as assigned by an appropriate authority; and 24
Whereas, this Compact is intended to regulate the temporary in-person, face-25
to-face practice of psychology by psychologists across state boundaries for 30 days 26
within a calendar year in the performance of their psychological practice as assigned 27
by an appropriate authority; 28
Whereas, this Compact is intended to authorize State Psychology Regulatory 29
Authorities to afford legal recognition, in a manner consistent with the terms of the 30
Compact, to psychologists licensed in another state; 31
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Whereas, this Compact recognizes that states have a vested interest in 1
protecting the public's health and safety through their licensing and regulation of 2
psychologists and that such state regulation will best protect public health and safety; 3
Whereas, this Compact does not apply when a psychologist is licensed in both 4
the home and Receiving States; and 5
Whereas, this Compact does not apply to permanent in-person, face-to-face 6
practice, it does allow for authorization of temporary psychological practice. 7
Consistent with these principles, this Compact is designed to achieve the 8
following purposes and objectives: 9
(1) Increase public access to professional psychological services by 10
allowing for telepsychological practice across state lines as well as temporary in-11
person, face-to-face services in a state which the psychologist is not licensed to 12
practice psychology; 13
(2) Enhance the states' ability to protect the public's health and safety, 14
especially client/patient safety; 15
(3) Encourage the cooperation of Compact States in the areas of 16
psychology licensure and regulation; 17
(4) Facilitate the exchange of information between Compact States 18
regarding psychologist licensure, adverse actions and disciplinary history; 19
(5) Promote compliance with the laws governing psychological 20
practice in each Compact State; and 21
(6) Invest all Compact States with the authority to hold licensed 22
psychologists accountable through the mutual recognition of Compact State licenses. 23
ARTICLE II. DEFINITIONS. 24
As used in this Compact, unless the context clearly requires a different construction, 25
(A) "Adverse Action" means: any action taken by a State Psychology 26
Regulatory Authority which finds a violation of a statute or regulation that is identified 27
by the State Psychology Regulatory Authority as discipline and is a matter of public 28
record; 29
(B) "Association of State and Provincial Psychology Boards" means: 30
the recognized membership organization composed of State and Provincial 31
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Psychology Regulatory Authorities responsible for the licensure and registration of 1
psychologists throughout the United States and Canada; 2
(C) "Authority to Practice Interjurisdictional Telepsychology" means: 3
a licensed psychologist's authority to practice telepsychology, within the limits 4
authorized under this Compact, in another Compact State; 5
(D) "Bylaws" means: those Bylaws established by the Psychology 6
Interjurisdictional Compact Commission pursuant to Article X for its governance, or 7
for directing and controlling its actions and conduct; 8
(E) "Client/Patient" means: the recipient of psychological services, 9
whether psychological services are delivered in the context of healthcare, corporate, 10
supervision, and/or consulting services; 11
(F) "Commissioner" means: the voting representative appointed by 12
each State Psychology Regulatory Authority pursuant to Article X; 13
(G) "Compact State" means: a state, the District of Columbia, or 14
United States territory that has enacted this Compact legislation and which has not 15
withdrawn pursuant to Article XIII(C) or been terminated pursuant to Article XII(B); 16
(H) "Coordinated Licensure Information System" and "Coordinated 17
Database" mean: an integrated process for collecting, storing, and sharing information 18
on psychologists' licensure and enforcement activities related to psychology licensure 19
laws, which is administered by the recognized membership organization composed of 20
state and provincial psychology regulatory authorities; 21
(I) "Confidentiality" means: the principle that data or information is 22
not made available or disclosed to unauthorized persons and/or processes; 23
(J) "Day" means: any part of a day in which psychological work is 24
performed; 25
(K) "Distant State" means: the Compact State where a psychologist is 26
physically present (not through the use of telecommunications technologies), to 27
provide temporary in-person, face-to-face psychological services; 28
(L) "E.Passport" means: a certificate issued by the Association of State 29
and Provincial Psychology Boards that promotes the standardization in the criteria of 30
interjurisdictional telepsychology practice and facilitates the process for licensed 31
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psychologists to provide telepsychological services across state lines; 1
(M) "Executive Board" means: a group of directors elected or 2
appointed to act on behalf of, and within the powers granted to them by, the 3
Commission; 4
(N) "Home State" means: a Compact State where a psychologist is 5
licensed to practice psychology; if the psychologist is licensed in more than one 6
Compact State and is practicing under the Authorization to Practice Interjurisdictional 7
Telepsychology, the Home State is the Compact State where the psychologist is 8
physically present when the telepsychological services are delivered, or if the 9
psychologist is licensed in more than one Compact State and is practicing under the 10
Temporary Authorization to Practice, the Home State is any Compact State where the 11
psychologist is licensed; 12
(O) "Identity History Summary" means: a summary of information 13
retained by the Federal Bureau of Investigation, or other designee with similar 14
authority, in connection with arrests and, in some instances, federal employment, 15
naturalization, or military service; 16
(P) "In-person, Face-to-Face" means: interactions in which the 17
psychologist and the client/patient are in the same physical space and which does not 18
include interactions that may occur through the use of telecommunication 19
technologies; 20
(Q) "Interjurisdictional Practice Certificate" and "IPC" mean: a 21
certificate issued by the Association of State and Provincial Psychology Boards that 22
grants temporary authority to practice based on notification to the State Psychology 23
Regulatory Authority of intention to practice temporarily, and verification of one's 24
qualifications for such practice; 25
(R) "License" means: authorization by a State Psychology Regulatory 26
Authority to engage in the independent practice of psychology, which would be 27
unlawful without the authorization; 28
(S) "Non-Compact State" means: any state which is not at the time a 29
Compact State; 30
(T) "Psychologist" means: an individual licensed for the independent 31
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practice of psychology; 1
(U) "Psychology Interjurisdictional Compact Commission" and 2
"Commission" mean: the national administration of which all Compact States are 3
members; 4
(V) "Receiving State" means: a Compact State where the client/patient 5
is physically located when the telepsychological services are delivered; 6
(W) "Rule" means: a written statement by the Psychology 7
Interjurisdictional Compact Commission promulgated pursuant to Article XI of the 8
Compact that is of general applicability, implements, interprets, or prescribes a policy 9
or provision of the Compact, or an organizational, procedural, or practice requirement 10
of the Commission and has the force and effect of statutory law in a Compact State, 11
and includes the amendment, repeal or suspension of an existing Rule; 12
(X) "Significant Investigatory Information" means: 13
(1) investigative information that a State Psychology 14
Regulatory Authority, after a preliminary inquiry that includes notification and 15
an opportunity to respond if required by state law, has reason to believe, if 16
proven true, would indicate more than a violation of state statute or ethics code 17
that would be considered more substantial than a minor infraction; or 18
(2) investigative information that indicates that the 19
psychologist represents an immediate threat to public health and safety 20
regardless of whether the psychologist has been notified and/or had an 21
opportunity to respond; 22
(Y) "State" means: a state, commonwealth, territory, or possession of 23
the United States, or the District of Columbia; 24
(Z) "State Psychology Regulatory Authority" means: the board, office 25
or other agency with the legislative mandate to license and regulate the practice of 26
psychology; 27
(AA) "Telepsychology" means: the provision of psychological services 28
using telecommunication technologies; 29
(BB) "Temporary Authorization to Practice" means: a licensed 30
psychologist's authority to conduct temporary in-person, face-to-face practice, within 31
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the limits authorized under this Compact, in another Compact State; 1
(CC) "Temporary In-Person, Face-to-Face Practice" means: where a 2
psychologist is physically present (not through the use of telecommunications 3
technologies), in the Distant State to provide for the practice of psychology for 30 4
days within a calendar year and based on notification to the Distant State. 5
ARTICLE III. HOME STATE LICENSURE. 6
(A) The Home State shall be a Compact State where a psychologist is licensed 7
to practice psychology. 8
(B) A psychologist may hold one or more Compact State licenses at a time. If 9
the psychologist is licensed in more than one Compact State, the Home State is the 10
Compact State where the psychologist is physically present when the services are 11
delivered as authorized by the Authority to Practice Interjurisdictional Telepsychology 12
under the terms of this Compact. 13
(C) Any Compact State may require a psychologist not previously licensed in 14
a Compact State to obtain and retain a license to be authorized to practice in the 15
Compact State under circumstances not authorized by the Authority to Practice 16
Interjurisdictional Telepsychology under the terms of this Compact. 17
(D) Any Compact State may require a psychologist to obtain and retain a 18
license to be authorized to practice in a Compact State under circumstances not 19
authorized by Temporary Authorization to Practice under the terms of this Compact. 20
(E) A Home State's license authorizes a psychologist to practice in a 21
Receiving State under the Authority to Practice Interjurisdictional Telepsychology 22
only if the Compact State: 23
(1) Currently requires the psychologist to hold an active E.Passport; 24
(2) Has a mechanism in place for receiving and investigating 25
complaints about licensed individuals; 26
(3) Notifies the Commission, in compliance with the terms herein, of 27
any adverse action or significant investigatory information regarding a licensed 28
individual; 29
(4) Requires an Identity History Summary of all applicants at initial 30
licensure, including the use of the results of fingerprints or other biometric data checks 31
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compliant with the requirements of the Federal Bureau of Investigation, or other 1
designee with similar authority, no later than ten years after activation of the Compact; 2
and 3
(5) Complies with the Bylaws and Rules of the Commission. 4
(F) A Home State's license grants Temporary Authorization to Practice to a 5
psychologist in a Distant State only if the Compact State: 6
(1) Currently requires the psychologist to hold an active IPC; 7
(2) Has a mechanism in place for receiving and investigating 8
complaints about licensed individuals; 9
(3) Notifies the Commission, in compliance with the terms herein, of 10
any adverse action or significant investigatory information regarding a licensed 11
individual; 12
(4) Requires an Identity History Summary of all applicants at initial 13
licensure, including the use of the results of fingerprints or other biometric data checks 14
compliant with the requirements of the Federal Bureau of Investigation, or other 15
designee with similar authority, no later than ten years after activation of the Compact; 16
and 17
(5) Complies with the Bylaws and Rules of the Commission. 18
ARTICLE IV. COMPACT PRIVILEGE TO PRACTICE TELEPSYCHOLOGY. 19
(A) Compact States shall recognize the right of a psychologist, licensed in a 20
Compact State in conformance with Article III, to practice telepsychology in other 21
Compact States (Receiving States) in which the psychologist is not licensed, under the 22
Authority to Practice Interjurisdictional Telepsychology as provided in the Compact. 23
(B) To exercise the Authority to Practice Interjurisdictional Telepsychology 24
under the terms and provisions of this Compact, a psychologist licensed to practice in 25
a Compact State must: 26
(1) Hold a graduate degree in psychology from an institute of higher 27
education that was, at the time the degree was awarded: 28
(a) Regionally accredited by an accrediting body recognized by 29
the United States Department of Education to grant graduate degrees, or 30
authorized by Provincial Statute or Royal Charter to grant doctoral degrees; or 31
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(b) A foreign college or university deemed to be equivalent to 1
(B)(1)(a) of this Article by a foreign credential evaluation service that is a 2
member of the National Association of Credential Evaluation Services or by a 3
recognized foreign credential evaluation service; and 4
(2) Hold a graduate degree in psychology that meets the following 5
criteria: 6
(a) The program, wherever it may be administratively housed, 7
must be clearly identified and labeled as a psychology program. Such a 8
program must specify in pertinent institutional catalogues and brochures its 9
intent to educate and train professional psychologists; 10
(b) The psychology program must stand as a recognizable, 11
coherent, organizational entity within the institution; 12
(c) There must be a clear authority and primary responsibility 13
for the core and specialty areas whether or not the program cuts across 14
administrative lines; 15
(d) The program must consist of an integrated, organized 16
sequence of study; 17
(e) There must be an identifiable psychology faculty sufficient 18
in size and breadth to carry out its responsibilities; 19
(f) The designated director of the program must be a 20
psychologist and a member of the core faculty; 21
(g) The program must have an identifiable body of students 22
who are matriculated in that program for a degree; 23
(h) The program must include supervised practicum, internship, 24
or field training appropriate to the practice of psychology; 25
(i) The curriculum shall encompass a minimum of three 26
academic years of full-time graduate study for doctoral degree and a minimum 27
of one academic year of full-time graduate study for master's degree; 28
(j) The program includes an acceptable residency as defined by 29
the Rules of the Commission. 30
(3) Possess a current, full and unrestricted license to practice 31
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psychology in a Home State which is a Compact State; 1
(4) Have no history of adverse action that violate the Rules of the 2
Commission; 3
(5) Have no criminal record history reported on an Identity History 4
Summary that violates the Rules of the Commission; 5
(6) Possess a current, active E.Passport; 6
(7) Provide attestations in regard to areas of intended practice, 7
conformity with standards of practice, competence in telepsychology technology; 8
criminal background; and knowledge and adherence to legal requirements in the Home 9
and Receiving States, and provide a release of information to allow for primary source 10
verification in a manner specified by the Commission; and 11
(8) Meet other criteria as defined by the Rules of the Commission. 12
(C) The Home State maintains authority over the license of any psychologist 13
practicing in a Receiving State under the Authority to Practice Interjurisdictional 14
Telepsychology. 15
(D) A psychologist practicing in a Receiving State under the Authority to 16
Practice Interjurisdictional Telepsychology will be subject to the Receiving State's 17
scope of practice. A Receiving State may, in accordance with that state's due process 18
law, limit or revoke a psychologist's Authority to Practice Interjurisdictional 19
Telepsychology in the Receiving State and may take any other necessary actions under 20
the Receiving State's applicable law to protect the health and safety of the Receiving 21
State's citizens. If a Receiving State takes action, the state shall promptly notify the 22
Home State and the Commission. 23
(E) If a psychologist's license in any Home State, another Compact State, or 24
any Authority to Practice Interjurisdictional Telepsychology in any Receiving State, is 25
restricted, suspended or otherwise limited, the E.Passport shall be revoked and 26
therefore the psychologist shall not be eligible to practice telepsychology in a 27
Compact State under the Authority to Practice Interjurisdictional Telepsychology. 28
ARTICLE V. COMPACT TEMPORARY AUTHORIZATION TO PRACTICE. 29
(A) Compact States shall also recognize the right of a psychologist, licensed in 30
a Compact State in conformance with Article III, to practice temporarily in other 31
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Compact States (Distant States) in which the psychologist is not licensed, as provided 1
in the Compact. 2
(B) To exercise the Temporary Authorization to Practice under the terms and 3
provisions of this Compact, a psychologist licensed to practice in a Compact State 4
must: 5
(1) Hold a graduate degree in psychology from an institute of higher 6
education that was, at the time the degree was awarded: 7
(a) Regionally accredited by an accrediting body recognized by 8
the United States Department of Education to grant graduate degrees, or 9
authorized by Provincial Statute or Royal Charter to grant doctoral degrees; or 10
(b) A foreign college or university deemed to be equivalent to 11
(B)(1)(a) of this Article by a foreign credential evaluation service that is a 12
member of the National Association of Credential Evaluation Services or by a 13
recognized foreign credential evaluation service; and 14
(2) Hold a graduate degree in psychology that meets the following 15
criteria: 16
(a) The program, wherever it may be administratively housed, 17
must be clearly identified and labeled as a psychology program. Such a 18
program must specify in pertinent institutional catalogues and brochures its 19
intent to educate and train professional psychologists; 20
(b) The psychology program must stand as a recognizable, 21
coherent, organizational entity within the institution; 22
(c) There must be a clear authority and primary responsibility 23
for the core and specialty areas whether or not the program cuts across 24
administrative lines; 25
(d) The program must consist of an integrated, organized 26
sequence of study; 27
(e) There must be an identifiable psychology faculty sufficient 28
in size and breadth to carry out its responsibilities; 29
(f) The designated director of the program must be a 30
psychologist and a member of the core faculty; 31
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(g) The program must have an identifiable body of students 1
who are matriculated in that program for a degree; 2
(h) The program must include supervised practicum, internship, 3
or field training appropriate to the practice of psychology; 4
(i) The curriculum shall encompass a minimum of three 5
academic years of full-time graduate study for doctoral degrees and a 6
minimum of one academic year of full-time graduate study for master's degree; 7
(j) The program includes an acceptable residency as defined by 8
the Rules of the Commission. 9
(3) Possess a current, full and unrestricted license to practice 10
psychology in a Home State which is a Compact State; 11
(4) No history of adverse action that violate the Rules of the 12
Commission; 13
(5) No criminal record history that violates the Rules of the 14
Commission; 15
(6) Possess a current, active IPC; 16
(7) Provide attestations in regard to areas of intended practice and 17
work experience and provide a release of information to allow for primary source 18
verification in a manner specified by the Commission; and 19
(8) Meet other criteria as defined by the Rules of the Commission. 20
(C) A psychologist practicing in a Distant State under the Temporary 21
Authorization to Practice shall practice within the scope of practice authorized by the 22
Distant State. 23
(D) A psychologist practicing in a Distant State under the Temporary 24
Authorization to Practice will be subject to the Distant State's authority and law. A 25
Distant State may, in accordance with that state's due process law, limit or revoke a 26
psychologist's Temporary Authorization to Practice in the Distant State and may take 27
any other necessary actions under the Distant State's applicable law to protect the 28
health and safety of the Distant State's citizens. If a Distant State takes action, the state 29
shall promptly notify the Home State and the Commission. 30
(E) If a psychologist's license in any Home State, another Compact State, or 31
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any Temporary Authorization to Practice in any Distant State, is restricted, suspended 1
or otherwise limited, the IPC shall be revoked and therefore the psychologist shall not 2
be eligible to practice in a Compact State under the Temporary Authorization to 3
Practice. 4
ARTICLE VI. CONDITIONS OF TELEPSYCHOLOGY PRACTICE IN A RECEIVING 5
STATE. 6
(A) A psychologist may practice in a Receiving State under the Authority to 7
Practice Interjurisdictional Telepsychology only in the performance of the scope of 8
practice for psychology as assigned by an appropriate State Psychology Regulatory 9
Authority, as defined in the Rules of the Commission, and under the following 10
circumstances: 11
(1) The psychologist initiates a client/patient contact in a Home State 12
via telecommunications technologies with a client/patient in a Receiving State; 13
(2) Other conditions regarding telepsychology as determined by Rules 14
promulgated by the Commission. 15
ARTICLE VII. ADVERSE ACTIONS. 16
(A) A Home State shall have the power to impose adverse action against a 17
psychologist's license issued by the Home State. A Distant State shall have the power 18
to take adverse action on a psychologist's Temporary Authorization to Practice within 19
that Distant State. 20
(B) A Receiving State may take adverse action on a psychologist's Authority 21
to Practice Interjurisdictional Telepsychology within that Receiving State. A Home 22
State may take adverse action against a psychologist based on an adverse action taken 23
by a Distant State regarding temporary in-person, face-to-face practice. 24
(C) If a Home State takes adverse action against a psychologist's license, that 25
psychologist's Authority to Practice Interjurisdictional Telepsychology is terminated 26
and the E.Passport is revoked. Furthermore, that psychologist's Temporary 27
Authorization to Practice is terminated and the IPC is revoked. 28
(1) All Home State disciplinary orders which impose adverse action 29
shall be reported to the Commission in accordance with the Rules promulgated by the 30
Commission. A Compact State shall report adverse actions in accordance with the 31
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Rules of the Commission. 1
(2) In the event discipline is reported on a psychologist, the 2
psychologist will not be eligible for telepsychology or temporary in-person, face-to-3
face practice in accordance with the Rules of the Commission. 4
(3) Other actions may be imposed as determined by the Rules 5
promulgated by the Commission. 6
(D) A Home State's psychology regulatory authority shall investigate and take 7
appropriate action with respect to reported inappropriate conduct engaged in by a 8
licensee which occurred in a Receiving State as it would if such conduct had occurred 9
by a licensee within the Home State. In such cases, the Home State's law shall control 10
in determining any adverse action against a psychologist's license. 11
(E) A Distant State's psychology regulatory authority shall investigate and 12
take appropriate action with respect to reported inappropriate conduct engaged in by a 13
psychologist practicing under temporary authorization practice which occurred in that 14
Distant State as it would if such conduct had occurred by a licensee within the Home 15
State. In such cases, Distant State's law shall control in determining any adverse action 16
against a psychologist's Temporary Authorization to Practice. 17
(F) Nothing in this Compact shall override a Compact State's decision that a 18
psychologist's participation in an alternative program may be used in lieu of adverse 19
action and that such participation shall remain non-public if required by the Compact 20
State's law. Compact States must require psychologists who enter any alternative 21
programs to not provide telepsychology services under the Authority to Practice 22
Interjurisdictional Telepsychology or provide temporary psychological services under 23
the Temporary Authorization to Practice in any other Compact State during the term 24
of the alternative program. 25
(G) No other judicial or administrative remedies shall be available to a 26
psychologist in the event a Compact State imposes an adverse action pursuant to (C) 27
of this Article. 28
ARTICLE VIII. ADDITIONAL AUTHORITIES INVESTED IN A COMPACT STATE'S 29
PSYCHOLOGY REGULATORY AUTHORITY. 30
(A) In addition to any other powers granted under state law, a Compact State's 31
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psychology regulatory authority shall have the authority under this Compact to: 1
(1) Issue subpoenas, for both hearings and investigations, which 2
require the attendance and testimony of witnesses and the production of evidence. 3
Subpoenas issued by a Compact State's psychology regulatory authority for the 4
attendance and testimony of witnesses, and/or the production of evidence from another 5
Compact State shall be enforced in the latter state by any court of competent 6
jurisdiction, according to that court's practice and procedure in considering subpoenas 7
issued in its own proceedings. The issuing State Psychology Regulatory Authority 8
shall pay any witness fees, travel expenses, mileage and other fees required by the 9
service statutes of the state where the witnesses and/or evidence are located; and 10
(2) Issue cease and desist and/or injunctive relief orders to revoke a 11
psychologist's Authority to Practice Interjurisdictional Telepsychology and/or 12
Temporary Authorization to Practice. 13
(3) During the course of any investigation, a psychologist may not 14
change his/her Home State licensure. A Home State Psychology Regulatory Authority 15
is authorized to complete any pending investigations of a psychologist and to take any 16
actions appropriate under its law. The Home State Psychology Regulatory Authority 17
shall promptly report the conclusions of such investigations to the Commission. Once 18
an investigation has been completed, and pending the outcome of said investigation, 19
the psychologist may change his/her Home State licensure. The Commission shall 20
promptly notify the new Home State of any such decisions as provided in the Rules of 21
the Commission. All information provided to the Commission or distributed by 22
Compact States pursuant to the psychologist shall be confidential, filed under seal and 23
used for investigatory or disciplinary matters. The Commission may create additional 24
Rules for mandated or discretionary sharing of information by Compact States. 25
ARTICLE IX. COORDINATED LICENSURE INFORMATION SYSTEM. 26
(A) The Commission shall provide for the development and maintenance of a 27
coordinated licensure information system (coordinated database) and reporting system 28
containing licensure and disciplinary action information on all licensees to whom this 29
Compact is applicable in all Compact States as defined by the Rules of the 30
Commission. 31
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(B) Notwithstanding any other provision of state law to the contrary, a 1
Compact State shall submit a uniform data set to the coordinated database on all 2
licensees as required by the Rules of the Commission, including: 3
(1) Identifying information; 4
(2) Licensure data; 5
(3) Significant investigatory information; 6
(4) Adverse actions against a psychologist's license; 7
(5) An indicator that a psychologist's Authority to Practice 8
Interjurisdictional Telepsychology and/or Temporary Authorization to Practice is 9
revoked; 10
(6) Non-confidential information related to alternative program 11
participation information; 12
(7) Any denial of application for licensure, and the reasons for such 13
denial; and 14
(8) Other information which may facilitate the administration of this 15
Compact, as determined by the Rules of the Commission. 16
(C) The coordinated database administrator shall promptly notify all Compact 17
States of any adverse action taken against, or significant investigative information on, 18
any licensee in a Compact State. 19
(D) Compact States reporting information to the coordinated database may 20
designate information that may not be shared with the public without the express 21
permission of the Compact State reporting the information. 22
(E) Any information submitted to the coordinated database that is 23
subsequently required to be expunged by the law of the Compact State reporting the 24
information shall be removed from the coordinated database. 25
ARTICLE X. ESTABLISHMENT OF THE PSYCHOLOGY 26
INTERJURISDICTIONAL COMPACT COMMISSION. 27
(A) The Compact States hereby create and establish a joint public agency 28
known as the Psychology Interjurisdictional Compact Commission. 29
(1) The Commission is a body politic and an instrumentality of the 30
Compact States. 31
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(2) Venue is proper and judicial proceedings by or against the 1
Commission shall be brought solely and exclusively in a court of competent 2
jurisdiction where the principal office of the Commission is located. The Commission 3
may waive venue and jurisdictional defenses to the extent it adopts or consents to 4
participate in alternative dispute resolution proceedings. 5
(3) Nothing in this Compact shall be construed to be a waiver of 6
sovereign immunity. 7
(B) Membership, Voting, and Meetings. 8
(1) The Commission shall consist of one voting representative 9
appointed by each Compact State who shall serve as that state's commissioner. The 10
State Psychology Regulatory Authority shall appoint its delegate. This delegate shall 11
be empowered to act on behalf of the Compact State. This delegate shall be limited to: 12
(a) Executive director, executive secretary or similar executive; 13
(b) Current member of the State Psychology Regulatory 14
Authority of a Compact State; or 15
(c) Designee empowered with the appropriate delegate 16
authority to act on behalf of the Compact State. 17
(2) Any commissioner may be removed or suspended from office as 18
provided by the law of the state from which the commissioner is appointed. Any 19
vacancy occurring in the commission shall be filled in accordance with the laws of the 20
Compact State in which the vacancy exists. 21
(3) Each commissioner shall be entitled to one (1) vote with regard to 22
the promulgation of Rules and creation of Bylaws and shall otherwise have an 23
opportunity to participate in the business and affairs of the Commission. A 24
commissioner shall vote in person or by such other means as provided in the Bylaws. 25
The Bylaws may provide for commissioners' participation in meetings by telephone or 26
other means of communication. 27
(4) The Commission shall meet at least once during each calendar 28
year. Additional meetings shall be held as set forth in the Bylaws. 29
(5) All meetings shall be open to the public, and public notice of 30
meetings shall be given in the same manner as required under the rulemaking 31
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provisions in Article XI. 1
(6) The Commission may convene in a closed, non-public meeting if 2
the Commission must discuss: 3
(a) Non-compliance of a Compact State with its obligations 4
under the Compact; 5
(b) The employment, compensation, discipline or other 6
personnel matters, practices or procedures related to specific employees or 7
other matters related to the Commission's internal personnel practices and 8
procedures; 9
(c) Current, threatened, or reasonably anticipated litigation 10
against the Commission; 11
(d) Negotiation of contracts for the purchase or sale of goods, 12
services or real estate; 13
(e) Accusation against any person of a crime or formally 14
censuring any person; 15
(f) Disclosure of trade secrets or commercial or financial 16
information which is privileged or confidential; 17
(g) Disclosure of information of a personal nature where 18
disclosure would constitute a clearly unwarranted invasion of personal privacy; 19
(h) Disclosure of investigatory records compiled for law 20
enforcement purposes; 21
(i) Disclosure of information related to any investigatory 22
reports prepared by or on behalf of or for use of the Commission or other 23
committee charged with responsibility for investigation or determination of 24
compliance issues pursuant to the Compact; or 25
(j) Matters specifically exempted from disclosure by federal 26
and state statute. 27
(7) If a meeting, or portion of a meeting, is closed pursuant to this 28
provision, the Commission's legal counsel or designee shall certify that the meeting 29
may be closed and shall reference each relevant exempting provision. The 30
Commission shall keep minutes which fully and clearly describe all matters discussed 31
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in a meeting and shall provide a full and accurate summary of actions taken, of any 1
person participating in the meeting, and the reasons therefore, including a description 2
of the views expressed. All documents considered in connection with an action shall 3
be identified in such minutes. All minutes and documents of a closed meeting shall 4
remain under seal, subject to release only by a majority vote of the Commission or 5
order of a court of competent jurisdiction. 6
(C) The Commission shall, by a majority vote of the commissioners, prescribe 7
Bylaws and/or Rules to govern its conduct as may be necessary or appropriate to carry 8
out the purposes and exercise the powers of the Compact, including but not limited to: 9
(1) Establishing the fiscal year of the Commission; 10
(2) Providing reasonable standards and procedures: 11
(a) for the establishment and meetings of other committees; and 12
(b) governing any general or specific delegation of any 13
authority or function of the Commission; 14
(3) Providing reasonable procedures for calling and conducting 15
meetings of the Commission, ensuring reasonable advance notice of all meetings and 16
providing an opportunity for attendance of such meetings by interested parties, with 17
enumerated exceptions designed to protect the public's interest, the privacy of 18
individuals of such proceedings, and proprietary information, including trade secrets. 19
The Commission may meet in closed session only after a majority of the 20
commissioners vote to close a meeting to the public in whole or in part. As soon as 21
practicable, the Commission must make public a copy of the vote to close the meeting 22
revealing the vote of each commissioner with no proxy votes allowed; 23
(4) Establishing the titles, duties and authority and reasonable 24
procedures for the election of the officers of the Commission; 25
(5) Providing reasonable standards and procedures for the 26
establishment of the personnel policies and programs of the Commission. 27
Notwithstanding any civil service or other similar law of any Compact State, the 28
Bylaws shall exclusively govern the personnel policies and programs of the 29
Commission; 30
(6) Promulgating a Code of Ethics to address permissible and 31
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prohibited activities of Commission members and employees; 1
(7) Providing a mechanism for concluding the operations of the 2
Commission and the equitable disposition of any surplus funds that may exist after the 3
termination of the Compact after the payment and/or reserving of all of its debts and 4
obligations; 5
(8) The Commission shall publish its Bylaws in a convenient form and 6
file a copy thereof and a copy of any amendment thereto, with the appropriate agency 7
or officer in each of the Compact States; 8
(9) The Commission shall maintain its financial records in accordance 9
with the Bylaws; and 10
(10) The Commission shall meet and take such actions as are 11
consistent with the provisions of this Compact and the Bylaws. 12
(D) The Commission shall have the following powers: 13
(1) The authority to promulgate uniform Rules to facilitate and 14
coordinate implementation and administration of this Compact. The Rules shall have 15
the force and effect of law and shall be binding in all Compact States; 16
(2) To bring and prosecute legal proceedings or actions in the name of 17
the Commission, provided that the standing of any State Psychology Regulatory 18
Authority or other regulatory body responsible for psychology licensure to sue or be 19
sued under applicable law shall not be affected; 20
(3) To purchase and maintain insurance and bonds; 21
(4) To borrow, accept or contract for services of personnel, including, 22
but not limited to, employees of a Compact State; 23
(5) To hire employees, elect or appoint officers, fix compensation, 24
define duties, grant such individuals appropriate authority to carry out the purposes of 25
the Compact, and to establish the Commission's personnel policies and programs 26
relating to conflicts of interest, qualifications of personnel, and other related personnel 27
matters; 28
(6) To accept any and all appropriate donations and grants of money, 29
equipment, supplies, materials and services, and to receive, utilize and dispose of the 30
same; provided that at all times the Commission shall strive to avoid any appearance 31
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of impropriety and/or conflict of interest; 1
(7) To lease, purchase, accept appropriate gifts or donations of, or 2
otherwise to own, hold, improve or use, any property, real, personal or mixed; 3
provided that at all times the Commission shall strive to avoid any appearance of 4
impropriety; 5
(8) To sell, convey, mortgage, pledge, lease, exchange, abandon or 6
otherwise dispose of any property real, personal or mixed; 7
(9) To establish a budget and make expenditures; 8
(10) To borrow money; 9
(11) To appoint committees, including advisory committees comprised 10
of members, state regulators, state legislators or their representatives, and consumer 11
representatives, and such other interested persons as may be designated in this 12
Compact and the Bylaws; 13
(12) To provide and receive information from, and to cooperate with, 14
law enforcement agencies; 15
(13) To adopt and use an official seal; and 16
(14) To perform such other functions as may be necessary or 17
appropriate to achieve the purposes of this Compact consistent with the state 18
regulation of psychology licensure, temporary in-person, face-to-face practice and 19
telepsychology practice. 20
(E) The Executive Board. 21
The elected officers shall serve as the Executive Board, which shall 22
have the power to act on behalf of the Commission according to the terms of this 23
Compact. 24
(1) The Executive Board shall be comprised of six members: 25
(a) Five voting members who are elected from the current 26
membership of the Commission by the Commission; 27
(b) One ex-officio, nonvoting member from the recognized 28
membership organization composed of state and provincial psychology 29
regulatory authorities. 30
(2) The ex-officio member must have served as staff or member on a 31
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State Psychology Regulatory Authority and will be selected by its respective 1
organization. 2
(3) The Commission may remove any member of the Executive Board 3
as provided in Bylaws. 4
(4) The Executive Board shall meet at least annually. 5
(5) The Executive Board shall have the following duties and 6
responsibilities: 7
(a) Recommend to the entire Commission changes to the Rules 8
or Bylaws, changes to this Compact legislation, fees paid by Compact States 9
such as annual dues, and any other applicable fees; 10
(b) Ensure Compact administration services are appropriately 11
provided, contractual or otherwise; 12
(c) Prepare and recommend the budget; 13
(d) Maintain financial records on behalf of the Commission; 14
(e) Monitor Compact compliance of member states and provide 15
compliance reports to the Commission; 16
(f) Establish additional committees as necessary; and 17
(g) Other duties as provided in Rules or Bylaws. 18
(F) Financing of the Commission. 19
(1) The Commission shall pay, or provide for the payment of the 20
reasonable expenses of its establishment, organization and ongoing activities. 21
(2) The Commission may accept any and all appropriate revenue 22
sources, donations and grants of money, equipment, supplies, materials and services. 23
(3) The Commission may levy on and collect an annual assessment 24
from each Compact State or impose fees on other parties to cover the cost of the 25
operations and activities of the Commission and its staff which must be in a total 26
amount sufficient to cover its annual budget as approved each year for which revenue 27
is not provided by other sources. The aggregate annual assessment amount shall be 28
allocated based upon a formula to be determined by the Commission which shall 29
promulgate a Rule binding upon all Compact States. 30
(4) The Commission shall not incur obligations of any kind prior to 31
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securing the funds adequate to meet the same; nor shall the Commission pledge the 1
credit of any of the Compact States, except by and with the authority of the Compact 2
State. 3
(5) The Commission shall keep accurate accounts of all receipts and 4
disbursements. The receipts and disbursements of the Commission shall be subject to 5
the audit and accounting procedures established under its Bylaws. However, all 6
receipts and disbursements of funds handled by the Commission shall be audited 7
yearly by a certified or licensed public accountant and the report of the audit shall be 8
included in and become part of the annual report of the Commission. 9
(G) Qualified Immunity, Defense, and Indemnification. 10
(1) The members, officers, Executive Director, employees and 11
representatives of the Commission shall be immune from suit and liability, either 12
personally or in their official capacity, for any claim for damage to or loss of property 13
or personal injury or other civil liability caused by or arising out of any actual or 14
alleged act, error or omission that occurred, or that the person against whom the claim 15
is made had a reasonable basis for believing occurred within the scope of Commission 16
employment, duties or responsibilities; provided that nothing in this paragraph shall be 17
construed to protect any such person from suit and/or liability for any damage, loss, 18
injury or liability caused by the intentional or willful or wanton misconduct of that 19
person. 20
(2) The Commission shall defend any member, officer, Executive 21
Director, employee or representative of the Commission in any civil action seeking to 22
impose liability arising out of any actual or alleged act, error or omission that occurred 23
within the scope of Commission employment, duties or responsibilities, or that the 24
person against whom the claim is made had a reasonable basis for believing occurred 25
within the scope of Commission employment, duties or responsibilities; provided that 26
nothing herein shall be construed to prohibit that person from retaining his or her own 27
counsel; and provided further, that the actual or alleged act, error or omission did not 28
result from that person's intentional or willful or wanton misconduct. 29
(3) The Commission shall indemnify and hold harmless any member, 30
officer, Executive Director, employee or representative of the Commission for the 31
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amount of any settlement or judgment obtained against that person arising out of any 1
actual or alleged act, error or omission that occurred within the scope of Commission 2
employment, duties or responsibilities, or that such person had a reasonable basis for 3
believing occurred within the scope of Commission employment, duties or 4
responsibilities, provided that the actual or alleged act, error or omission did not result 5
from the intentional or willful or wanton misconduct of that person. 6
ARTICLE XI. RULEMAKING. 7
(A) The Commission shall exercise its rulemaking powers pursuant to the 8
criteria set forth in this Article and the Rules adopted thereunder. Rules and 9
amendments shall become binding as of the date specified in each Rule or amendment. 10
(B) If a majority of the legislatures of the Compact States rejects a Rule, by 11
enactment of a statute or resolution in the same manner used to adopt the Compact, 12
then such Rule shall have no further force and effect in any Compact State. 13
(C) Rules or amendments to the Rules shall be adopted at a regular or special 14
meeting of the Commission. 15
(D) Prior to promulgation and adoption of a final Rule or Rules by the 16
Commission, and at least sixty (60) days in advance of the meeting at which the Rule 17
will be considered and voted upon, the Commission shall file a notice of proposed 18
rulemaking: 19
(1) On the website of the Commission; and 20
(2) On the website of each Compact States' psychology regulatory 21
authority or the publication in which each state would otherwise publish proposed 22
Rules. 23
(E) The notice of proposed rulemaking shall include: 24
(1) The proposed time, date, and location of the meeting in which the 25
Rule will be considered and voted upon; 26
(2) The text of the proposed Rule or amendment and the reason for the 27
proposed Rule; 28
(3) A request for comments on the proposed Rule from any interested 29
person; and 30
(4) The manner in which interested persons may submit notice to the 31
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Commission of their intention to attend the public hearing and any written comments. 1
(F) Prior to adoption of a proposed Rule, the Commission shall allow persons 2
to submit written data, facts, opinions and arguments, which shall be made available to 3
the public. 4
(G) The Commission shall grant an opportunity for a public hearing before it 5
adopts a Rule or amendment if a hearing is requested by: 6
(1) At least twenty-five (25) persons who submit comments 7
independently of each other; 8
(2) A governmental subdivision or agency; or 9
(3) A duly appointed person in an association that has at least twenty-10
five (25) members. 11
(H) If a hearing is held on the proposed Rule or amendment, the Commission 12
shall publish the place, time, and date of the scheduled public hearing. 13
(1) All persons wishing to be heard at the hearing shall notify the 14
Executive Director of the Commission or other designated member in writing of their 15
desire to appear and testify at the hearing not less than five (5) business days before 16
the scheduled date of the hearing. 17
(2) Hearings shall be conducted in a manner providing each person 18
who wishes to comment a fair and reasonable opportunity to comment orally or in 19
writing. 20
(3) No transcript of the hearing is required, unless a written request for 21
a transcript is made, in which case the person requesting the transcript shall bear the 22
cost of producing the transcript. A recording may be made in lieu of a transcript under 23
the same terms and conditions as a transcript. This subsection shall not preclude the 24
Commission from making a transcript or recording of the hearing if it so chooses. 25
(4) Nothing in this section shall be construed as requiring a separate 26
hearing on each Rule. Rules may be grouped for the convenience of the Commission 27
at hearings required by this section. 28
(I) Following the scheduled hearing date, or by the close of business on the 29
scheduled hearing date if the hearing was not held, the Commission shall consider all 30
written and oral comments received. 31
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(J) The Commission shall, by majority vote of all members, take final action 1
on the proposed Rule and shall determine the effective date of the Rule, if any, based 2
on the rulemaking record and the full text of the Rule. 3
(K) If no written notice of intent to attend the public hearing by interested 4
parties is received, the Commission may proceed with promulgation of the proposed 5
Rule without a public hearing. 6
(L) Upon determination that an emergency exists, the Commission may 7
consider and adopt an emergency Rule without prior notice, opportunity for comment, 8
or hearing, provided that the usual rulemaking procedures provided in the Compact 9
and in this section shall be retroactively applied to the Rule as soon as reasonably 10
possible, in no event later than ninety (90) days after the effective date of the Rule. For 11
the purposes of this provision, an emergency Rule is one that must be adopted 12
immediately in order to: 13
(1) Meet an imminent threat to public health, safety, or welfare; 14
(2) Prevent a loss of Commission or Compact State funds; 15
(3) Meet a deadline for the promulgation of an administrative rule that 16
is established by federal law or rule; or 17
(4) Protect public health and safety. 18
(M) The Commission or an authorized committee of the Commission may 19
direct revisions to a previously adopted Rule or amendment for purposes of correcting 20
typographical errors, errors in format, errors in consistency, or grammatical errors. 21
Public notice of any revisions shall be posted on the website of the Commission. The 22
revision shall be subject to challenge by any person for a period of thirty (30) days 23
after posting. The revision may be challenged only on grounds that the revision results 24
in a material change to a Rule. A challenge shall be made in writing, and delivered to 25
the chair of the Commission prior to the end of the notice period. If no challenge is 26
made, the revision will take effect without further action. If the revision is challenged, 27
the revision may not take effect without the approval of the Commission. 28
ARTICLE XII. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. 29
(A) Oversight 30
(1) The executive, legislative and judicial branches of state 31
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government in each Compact State shall enforce this Compact and take all actions 1
necessary and appropriate to effectuate the Compact's purposes and intent. The 2
provisions of this Compact and the Rules promulgated hereunder shall have standing 3
as statutory law. 4
(2) All courts shall take judicial notice of the Compact and the Rules in 5
any judicial or administrative proceeding in a Compact State pertaining to the subject 6
matter of this Compact which may affect the powers, responsibilities or actions of the 7
Commission. 8
(3) The Commission shall be entitled to receive service of process in 9
any such proceeding, and shall have standing to intervene in such a proceeding for all 10
purposes. Failure to provide service of process to the Commission shall render a 11
judgment or order void as to the Commission, this Compact or promulgated Rules. 12
(B) Default, Technical Assistance, and Termination 13
(1) If the Commission determines that a Compact State has defaulted 14
in the performance of its obligations or responsibilities under this Compact or the 15
promulgated Rules, the Commission shall: 16
(a) Provide written notice to the defaulting state and other 17
Compact States of the nature of the default, the proposed means of remedying 18
the default and/or any other action to be taken by the Commission; and 19
(b) Provide remedial training and specific technical assistance 20
regarding the default. 21
(2) If a state in default fails to remedy the default, the defaulting state 22
may be terminated from the Compact upon an affirmative vote of a majority of the 23
Compact States, and all rights, privileges and benefits conferred by this Compact shall 24
be terminated on the effective date of termination. A remedy of the default does not 25
relieve the offending state of obligations or liabilities incurred during the period of 26
default. 27
(3) Termination of membership in the Compact shall be imposed only 28
after all other means of securing compliance have been exhausted. Notice of intent to 29
suspend or terminate shall be submitted by the Commission to the governor, the 30
majority and minority leaders of the defaulting state's legislature, and each of the 31
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Compact States. 1
(4) A Compact State which has been terminated is responsible for all 2
assessments, obligations and liabilities incurred through the effective date of 3
termination, including obligations which extend beyond the effective date of 4
termination. 5
(5) The Commission shall not bear any costs incurred by the state 6
which is found to be in default or which has been terminated from the Compact, unless 7
agreed upon in writing between the Commission and the defaulting state. 8
(6) The defaulting state may appeal the action of the Commission by 9
petitioning the United States District Court for the State of Georgia or the federal 10
district where the Compact has its principal offices. The prevailing member shall be 11
awarded all costs of such litigation, including reasonable attorney's fees. 12
(C) Dispute Resolution 13
(1) Upon request by a Compact State, the Commission shall attempt to 14
resolve disputes related to the Compact which arise among Compact States and 15
between Compact and Non-Compact States. 16
(2) The Commission shall promulgate a Rule providing for both 17
mediation and binding dispute resolution for disputes that arise before the 18
Commission. 19
(D) Enforcement 20
(1) The Commission, in the reasonable exercise of its discretion, shall 21
enforce the provisions and Rules of this Compact. 22
(2) By majority vote, the Commission may initiate legal action in the 23
United States District Court for the State of Georgia or the federal district where the 24
Compact has its principal offices against a Compact State in default to enforce 25
compliance with the provisions of the Compact and its promulgated Rules and 26
Bylaws. The relief sought may include both injunctive relief and damages. In the event 27
judicial enforcement is necessary, the prevailing member shall be awarded all costs of 28
such litigation, including reasonable attorney's fees. 29
(3) The remedies herein shall not be the exclusive remedies of the 30
Commission. The Commission may pursue any other remedies available under federal 31
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or state law. 1
ARTICLE XIII. DATE OF IMPLEMENTATION OF THE PSYCHOLOGY 2
INTERJURISDICTIONAL COMPACT COMMISSION AND ASSOCIATED 3
RULES, WITHDRAWAL, AND AMENDMENTS. 4
(A) The Compact shall come into effect on the date on which the Compact is 5
enacted into law in the seventh Compact State. The provisions which become effective 6
at that time shall be limited to the powers granted to the Commission relating to 7
assembly and the promulgation of Rules. Thereafter, the Commission shall meet and 8
exercise rulemaking powers necessary to the implementation and administration of the 9
Compact. 10
(B) Any state which joins the Compact subsequent to the Commission's initial 11
adoption of the Rules shall be subject to the Rules as they exist on the date on which 12
the Compact becomes law in that state. Any Rule which has been previously adopted 13
by the Commission shall have the full force and effect of law on the day the Compact 14
becomes law in that state. 15
(C) Any Compact State may withdraw from this Compact by enacting a 16
statute repealing the same. 17
(1) A Compact State's withdrawal shall not take effect until six (6) 18
months after enactment of the repealing statute. 19
(2) Withdrawal shall not affect the continuing requirement of the 20
withdrawing state's psychology regulatory authority to comply with the investigative 21
and adverse action reporting requirements of this act prior to the effective date of 22
withdrawal. 23
(D) Nothing contained in this Compact shall be construed to invalidate or 24
prevent any psychology licensure agreement or other cooperative arrangement 25
between a Compact State and a Non-Compact State which does not conflict with the 26
provisions of this Compact. 27
(E) This Compact may be amended by the Compact States. No amendment to 28
this Compact shall become effective and binding upon any Compact State until it is 29
enacted into the law of all Compact States. 30
ARTICLE XIV. CONSTRUCTION AND SEVERABILITY. 31
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This Compact shall be liberally construed so as to effectuate the purposes 1
thereof. If this Compact shall be held contrary to the constitution of any state member 2
thereto, the Compact shall remain in full force and effect as to the remaining Compact 3
States. 4
* Sec. 24. AS 08 is amended by adding a new chapter to read: 5
Chapter 90. Respiratory Care Practitioners. 6
Sec. 08.90.010. License required. Unless licensed under this chapter, a person 7
may not 8
(1) practice respiratory care; or 9
(2) represent that the person is a respiratory care practitioner, including 10
using the titles "licensed respiratory care practitioner" or "R.C.P." or any other words, 11
abbreviations, signs, or symbols indicating that the person is a licensee. 12
Sec. 08.90.020. Licensure. (a) The department shall issue a license to practice 13
respiratory care to an applicant who submits to the department written evidence, 14
verified by oath, that the applicant has 15
(1) obtained a high school diploma or its equivalent; 16
(2) successfully completed an accredited respiratory care educational 17
program; 18
(3) passed an examination for a registered respiratory therapist 19
credential that is administered by a nationally recognized organization for respiratory 20
therapists and approved by the department in regulation; 21
(4) paid the required fees; and 22
(5) met all other requirements established by the department in 23
regulation. 24
(b) The department shall issue a license to practice respiratory care to an 25
applicant who submits to the department, before the date that is one year after the 26
effective date of this Act, the required fees and written evidence, verified by oath, that 27
the applicant was employed in the state to practice respiratory care under the direction 28
of a physician on or before the effective date of this Act. An applicant issued a license 29
under this subsection may renew the license without meeting the initial licensure 30
requirements provided under (a)(2) and (3) of this section, but is otherwise subject to 31
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this chapter. 1
Sec. 08.90.030. Licensure by credentials. The department shall issue a license 2
by credentials to practice respiratory care to an applicant who submits to the 3
department written evidence, verified by oath, that the applicant 4
(1) is currently licensed to practice respiratory care in another state, a 5
territory of the United States, or a foreign country with requirements for licensure that 6
the department determines are substantially equivalent to those required under this 7
chapter; 8
(2) has current valid credentials as a registered respiratory therapist 9
conferred by a nationally recognized organization for respiratory therapists that is 10
approved by the department in regulation; 11
(3) paid the required fees; and 12
(4) met all other requirements established by the department in 13
regulation. 14
Sec. 08.90.040. Evidence of licensure in other jurisdictions. An applicant for 15
a license under AS 08.90.020 or 08.90.030 must submit evidence to the department of 16
all licenses granted to the applicant to practice respiratory care in another state, a 17
territory of the United States, or a foreign country and whether that license is in good 18
standing. 19
Sec. 08.90.050. License renewal. The department may renew a license issued 20
under this chapter only if the licensee submits proof to the department that the licensee 21
completed 20 credit hours of continuing respiratory care education during the previous 22
licensing period. 23
Sec. 08.90.060. Scope of practice of respiratory care; qualified medical 24
directors. (a) A licensee may, under the supervision of a qualified medical director 25
and as authorized either under a medically approved protocol or under a written or oral 26
order from an authorized provider, perform the management, rehabilitation, diagnostic 27
evaluation, and care of a patient with a deficiency or abnormality of the 28
cardiopulmonary system and associated aspects of other system functions, including 29
(1) providing pulmonary care services that are safe, aseptic, and 30
preventive or restorative to the patient; 31
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(2) administering to the patient pharmacological, diagnostic, and 1
therapeutic agents related to respiratory care procedures that are necessary to 2
implement a treatment, disease prevention, pulmonary rehabilitative, or diagnostic 3
regimen prescribed by an authorized provider; 4
(3) making observations of the patient and monitoring the patient's 5
signs, symptoms, behavior, and physical responses to respiratory therapy treatment to 6
determine whether the patient exhibits any abnormal characteristics and, based on 7
those determinations, refer the patient, implement respiratory therapy protocols, or 8
change the patient's treatment regimen; 9
(4) employing on the patient the diagnostic or therapeutic use of 10
(A) medical gases, excluding general anesthesia; 11
(B) aerosols; 12
(C) humidification; 13
(D) pharmacological agents related to respiratory care 14
procedures; 15
(E) mechanical or physiological ventilatory support; 16
(F) bronchopulmonary hygiene procedures; 17
(G) oxygen therapy; 18
(H) telehealth as permitted under AS 08.02.130; 19
(I) cardiopulmonary disease management; and 20
(J) instruction on tobacco cessation; 21
(5) diagnostic or therapeutic techniques that may be medically 22
essential to maintaining the patient's good respiratory health, including 23
(A) maintaining natural airways; 24
(B) inserting, without cutting tissue, and maintaining artificial 25
airways; 26
(C) collecting blood and other body fluids, including specimens 27
from the respiratory tract; 28
(D) collecting inspired and expired gas samples; 29
(E) analyzing blood samples and respiratory secretions; 30
(F) measuring ventilatory volumes, pressures, and flows; 31
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(G) measuring hemodynamic and other physiological 1
parameters of the cardiopulmonary system; 2
(H) performing cardiopulmonary resuscitation; and 3
(I) implementing and maintaining environmental control 4
systems and hyperbaric therapy; 5
(6) transcribing the written or oral orders of an authorized provider 6
regarding the patient; 7
(7) providing instruction and education to the patient on the proper 8
methods of providing self-care and preventing cardiopulmonary disease and other 9
conditions requiring the use of respiratory care equipment and techniques; 10
(8) participating in air and ground transport of the patient; 11
(9) inserting and maintaining invasive lines for the patient; 12
(10) managing and maintaining an extracorporeal membrane 13
oxygenation unit for the patient; 14
(11) determining which medically approved respiratory care protocols 15
should be followed for the patient, in the absence of an authorized provider, during an 16
emergency; 17
(12) establishing procedures for administering treatment and testing of 18
the patient ordered by an authorized provider to aid diagnosis, patient health 19
monitoring, or medical research; and 20
(13) providing inhalation and respiratory therapy to the patient. 21
(b) A licensee may practice respiratory care in a clinic, hospital, skilled 22
nursing facility, or private dwelling. A licensee may practice respiratory care in 23
another location if the department determines that the location is appropriate or 24
necessary, the location is authorized by a physician in a written or oral order, and the 25
practices performed at the location are performed under the supervision of a qualified 26
medical director. 27
(c) A licensee may perform advanced techniques not ordinarily in the scope of 28
practice of respiratory care if the licensee has received formal training to perform 29
those techniques from a respiratory care educational program that 30
(1) is accredited, supervised, and structured; 31
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(2) evaluated the competence of the licensee through a standardized 1
testing mechanism; and 2
(3) included clinical, didactic, and laboratory activities. 3
(d) A qualified medical director supervising a licensee under (a) of this section 4
shall be readily accessible to the licensee and is responsible for the quality, safety, and 5
appropriateness of the respiratory care services provided by the licensee. 6
(e) In this section, 7
(1) "authorized provider" means a physician or physician assistant 8
licensed under AS 08.64 or advanced practice registered nurse licensed under 9
AS 08.68 acting within the scope of the license; 10
(2) "home health agency" means a public agency or private 11
organization, or a subdivision of a public agency or private organization, that 12
primarily engages in providing skilled nursing services in combination with 13
respiratory therapy, physical therapy, occupational therapy, speech therapy, or services 14
provided by a home health aide to an individual in the individual's home, an assisted 15
living home, or another residential setting; 16
(3) "public agency" means an agency operated by the state or a local 17
government; 18
(4) "qualified medical director" means a physician who 19
(A) is licensed to practice medicine in the state and is legally 20
authorized to direct an inpatient or outpatient health care organization, home 21
health agency, assisted living home, or the health care division or department 22
of a hospital, medical clinic, or other medical health maintenance facility; and 23
(B) has substantial professional training or experience in the 24
management of acute and chronic respiratory disorders; 25
(5) "subdivision" means a component of a multi-function facility or 26
home health agency, such as the home health care division of a hospital or the division 27
of a public agency, that independently meets the requirements for licensure as a home 28
health agency. 29
Sec. 08.90.070. Disciplinary sanctions. (a) The department may revoke, 30
suspend, or refuse to issue a license to a person if the department finds that the person 31
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(1) secured or attempted to secure a license to practice respiratory care 1
through fraud, deceit, or intentional misrepresentation; 2
(2) is unfit or incompetent to practice respiratory care; 3
(3) uses drugs or alcohol in a manner that affects the person's ability to 4
practice respiratory care competently and safely; 5
(4) engaged in dishonest or unethical conduct in connection with the 6
delivery of respiratory care services to patients; 7
(5) used or attempted to use as valid a license to practice respiratory 8
care that was illegally or fraudulently obtained; 9
(6) practiced respiratory care after the revocation, suspension, or 10
expiration of the person's license; 11
(7) failed to meet the standards of practice for respiratory care, 12
including 13
(A) wilfully and repeatedly ordering and performing laboratory 14
tests or studies that were unnecessary and clinically unjustifiable; or 15
(B) administrating treatment that was unnecessary and 16
clinically unjustifiable; 17
(8) violated, or aided or abetted another person in violating, this 18
chapter; 19
(9) has been convicted of 20
(A) a felony that materially affects the ability to safely practice 21
respiratory care; or 22
(B) insurance fraud; 23
(10) failed to disclose that a license to practice respiratory care in 24
another state, a territory of the United States, or a foreign country is not in good 25
standing. 26
(b) When determining whether to refuse to issue a license to an applicant or 27
impose a disciplinary sanction on a licensee under (a)(3) of this section, the 28
department shall consider whether an applicant or licensee is participating in a 29
substance abuse program. 30
Sec. 08.90.080. Exceptions. (a) This chapter does not apply to 31
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(1) a person licensed in this state under a statute outside this chapter 1
who performs respiratory care within the scope of practice for which the person's 2
license was issued; 3
(2) a student enrolled in an accredited respiratory care educational 4
program who is 5
(A) practicing respiratory care as an integral part of the 6
program; or 7
(B) practicing respiratory care, within limits established by the 8
department, as an employee of a health care provider while a licensee or 9
physician is available to communicate with, consult with, and assist the 10
student; 11
(3) a person who is not a licensee and practices respiratory care as self-12
care or care for a member of the person's family; 13
(4) a person practicing respiratory care in an emergency; 14
(5) a person practicing respiratory care within the scope of the person's 15
duties while 16
(A) in the armed forces of the United States; or 17
(B) working in a federal facility; 18
(6) a person employed in a diagnostic laboratory, physician's office, 19
clinic, or outpatient treatment facility that is administering treatment or performing 20
diagnostic procedures in that location under the direction of a physician; and 21
(7) a person employed by a durable or home medical equipment 22
company who delivers, calibrates, or maintains respiratory care equipment and does 23
not assess or evaluate patients. 24
(b) A student practicing respiratory care shall use the title 25
(1) "student respiratory care practitioner" or "student R.C.P." if 26
practicing under (a)(2)(A) of this section; and 27
(2) "student respiratory care practitioner," "trainee respiratory care 28
practitioner," "student R.C.P.," or "trainee R.C.P." if practicing under (a)(2)(B) of this 29
section. 30
Sec. 08.90.090. Criminal penalty. A person who violates or aids a person in a 31
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violation of this chapter is guilty of a class B misdemeanor. 1
Sec. 08.90.100. Regulations. The department may adopt regulations to carry 2
out the purposes of this chapter. 3
Sec. 08.90.990. Definitions. In this chapter, 4
(1) "accredited respiratory care educational program" means a 5
respiratory care educational program that is 6
(A) accredited by a national health education accrediting body 7
in collaboration with a national respiratory care accrediting body; and 8
(B) approved by the department; 9
(2) "department" means the Department of Commerce, Community, 10
and Economic Development; 11
(3) "licensee" means a person licensed to practice respiratory care 12
under this chapter; 13
(4) "physician" means a person licensed as a physician under 14
AS 08.64. 15
* Sec. 25. AS 09.55.560(2) is amended to read: 16
(2) "health care provider" means an acupuncturist licensed under 17
AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 18
chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a 19
dentist licensed under AS 08.36; a genetic counselor licensed under AS 08.53; a 20
nurse licensed under AS 08.68; a dispensing optician licensed under AS 08.71; a 21
naturopath licensed under AS 08.45; an optometrist licensed under AS 08.72; a 22
pharmacist licensed under AS 08.80; a physical therapist or occupational therapist 23
licensed under AS 08.84; a physician or physician assistant licensed under AS 08.64; a 24
podiatrist; a psychologist and a psychological associate licensed under AS 08.86; a 25
hospital as defined in AS 47.32.900, including a governmentally owned or operated 26
hospital; an employee of a health care provider acting within the course and scope of 27
employment; an ambulatory surgical facility and other organizations whose primary 28
purpose is the delivery of health care, including a health maintenance organization, 29
individual practice association, integrated delivery system, preferred provider 30
organization or arrangement, and a physical hospital organization; 31
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* Sec. 26. AS 09.55.560(2), as amended by sec. 25 of this Act, is amended to read: 1
(2) "health care provider" means an acupuncturist licensed under 2
AS 08.06; an audiologist or speech-language pathologist licensed under AS 08.11; a 3
chiropractor licensed under AS 08.20; a dental hygienist licensed under AS 08.32; a 4
dentist licensed under AS 08.36; a genetic counselor licensed under AS 08.53; a nurse 5
licensed under AS 08.68; a dispensing optician licensed under AS 08.71; a naturopath 6
licensed under AS 08.45; an optometrist licensed under AS 08.72; a pharmacist 7
licensed under AS 08.80; a respiratory care practitioner licensed under AS 08.90; 8
a physical therapist or occupational therapist licensed under AS 08.84; a physician or 9
physician assistant licensed under AS 08.64; a podiatrist; a psychologist and a 10
psychological associate licensed under AS 08.86; a hospital as defined in 11
AS 47.32.900, including a governmentally owned or operated hospital; an employee 12
of a health care provider acting within the course and scope of employment; an 13
ambulatory surgical facility and other organizations whose primary purpose is the 14
delivery of health care, including a health maintenance organization, individual 15
practice association, integrated delivery system, preferred provider organization or 16
arrangement, and a physical hospital organization; 17
* Sec. 27. AS 09.65.300(c)(1) is amended to read: 18
(1) "health care provider" means a physician, physician assistant, 19
dentist, dental hygienist, osteopath, optometrist, chiropractor, registered nurse, 20
practical nurse, advanced practice registered nurse, naturopath, physical therapist, 21
occupational therapist, marital and family therapist, psychologist, psychological 22
associate, behavior analyst, assistant behavior analyst, licensed clinical social worker, 23
athletic trainer, certified direct-entry midwife, genetic counselor, licensed 24
professional counselor, or licensed associate counselor; 25
* Sec. 28. AS 09.65.300(c)(1), as amended by sec. 27 of this Act, is amended to read: 26
(1) "health care provider" means a physician, physician assistant, 27
dentist, dental hygienist, osteopath, optometrist, chiropractor, registered nurse, 28
practical nurse, advanced practice registered nurse, naturopath, respiratory care 29
practitioner, physical therapist, occupational therapist, marital and family therapist, 30
psychologist, psychological associate, behavior analyst, assistant behavior analyst, 31
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licensed clinical social worker, athletic trainer, certified direct-entry midwife, genetic 1
counselor, licensed professional counselor, or licensed associate counselor; 2
* Sec. 29. AS 12.62.400(a) is amended by adding new paragraphs to read: 3
(26) licensure as a physician, osteopath, podiatrist, or physician 4
assistant under AS 08.64, including an expedited license as a physician or osteopath 5
under AS 08.64.253 or compact privilege to practice as a physician assistant under 6
AS 08.64.254; 7
(27) licensure as a psychologist under AS 08.86, including an authority 8
to practice under AS 08.86.225; 9
(28) certification or licensure as an emergency medical technician or 10
mobile intensive care paramedic under AS 18.08 or as an advanced emergency 11
medical technician under regulations adopted under AS 18.08, including a privilege to 12
practice under AS 18.08.105. 13
* Sec. 30. AS 14.30.141(e) is amended to read: 14
(e) In this section, "health care provider" means a licensed physician, 15
advanced practice registered nurse, respiratory care practitioner, physician assistant, 16
village health aide, or pharmacist operating within the scope of the health care 17
provider's authority. 18
* Sec. 31. AS 18.08.082 is amended by adding new subsections to read: 19
(d) An applicant for a license or certificate as an emergency medical 20
technician or mobile intensive care paramedic under this section or as an advanced 21
emergency medical technician under regulations adopted under this chapter shall 22
submit to the department the applicant's fingerprints and the fees required by the 23
Department of Public Safety under AS 12.62.160 for criminal justice information and 24
a national criminal history record check. The department shall forward the fingerprints 25
and fees to the Department of Public Safety to obtain a report of criminal justice 26
information under AS 12.62 and a national criminal history record check under 27
AS 12.62.400. Criminal justice information and criminal history record information 28
obtained under this subsection may only be used by the department for the purpose of 29
determining an applicant's qualifications and fitness for a license or privilege to 30
practice under this chapter. 31
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(e) The department shall implement the recognition of EMS personnel 1
licensure interstate compact under AS 18.08.105. 2
* Sec. 32. AS 18.08 is amended by adding a new section to read: 3
Sec. 18.08.105. Recognition of EMS personnel licensure interstate 4
compact. The recognition of EMS personnel licensure interstate compact as contained 5
in this section is enacted into law and entered into on behalf of the state with all other 6
states and jurisdictions legally joining it in a form substantially as follows: 7
SECTION 1. PURPOSE. 8
In order to protect the public through verification of competency and ensure 9
accountability for patient care related activities all states license emergency medical 10
services (EMS) personnel, such as emergency medical technicians (EMTs), advanced 11
EMTs and paramedics. This Compact is intended to facilitate the day-to-day 12
movement of EMS personnel across state boundaries in the performance of their EMS 13
duties as assigned by an appropriate authority and authorize state EMS offices to 14
afford immediate legal recognition to EMS personnel licensed in a member state. This 15
Compact recognizes that states have a vested interest in protecting the public's health 16
and safety through their licensing and regulation of EMS personnel and that such state 17
regulation shared among the member states will best protect public health and safety. 18
This Compact is designed to achieve the following purposes and objectives: 19
(1) increase public access to EMS personnel; 20
(2) enhance the states' ability to protect the public's health and safety, 21
especially patient safety; 22
(3) encourage the cooperation of member states in the areas of EMS 23
personnel licensure and regulation; 24
(4) support licensing of military members who are separating from an 25
active-duty tour and their spouses; 26
(5) facilitate the exchange of information between member states 27
regarding EMS personnel licensure, adverse action and significant investigatory 28
information; 29
(6) promote compliance with the laws governing EMS personnel 30
practice in each member state; and 31
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(7) invest all member states with the authority to hold EMS personnel 1
accountable through the mutual recognition of member state licenses. 2
SECTION 2. DEFINITIONS. 3
In this Compact: 4
(A) "Advanced Emergency Medical Technician" and "AEMT" mean: an 5
individual licensed with cognitive knowledge and a scope of practice that corresponds 6
to that level in the National EMS Education Standards and National EMS Scope of 7
Practice Model. 8
(B) "Adverse Action" means: any administrative, civil, equitable or criminal 9
action permitted by a state's laws which may be imposed against licensed EMS 10
personnel by a state EMS authority or state court, including, but not limited to, actions 11
against an individual's license such as revocation, suspension, probation, consent 12
agreement, monitoring or other limitation or encumbrance on the individual's practice, 13
letters of reprimand or admonition, fines, criminal convictions and state court 14
judgments enforcing adverse actions by the state EMS authority. 15
(C) "Alternative program" means: a voluntary, non-disciplinary substance 16
abuse recovery program approved by a state EMS authority. 17
(D) "Certification" means: the successful verification of entry-level cognitive 18
and psychomotor competency using a reliable, validated, and legally defensible 19
examination. 20
(E) "Commission" means: the national administrative body of which all states 21
that have enacted the Compact are members. 22
(F) "Emergency Medical Technician" and "EMT" mean: an individual 23
licensed with cognitive knowledge and a scope of practice that corresponds to that 24
level in the National EMS Education Standards and National EMS Scope of Practice 25
Model. 26
(G) "Home State" means: a member state where an individual is licensed to 27
practice emergency medical services. 28
(H) "License" means: the authorization by a state for an individual to practice 29
as an EMT, AEMT, paramedic, or a level in between EMT and paramedic. 30
(I) "Medical Director" means: a physician licensed in a member state who is 31
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accountable for the care delivered by EMS personnel. 1
(J) "Member State" means: a state that has enacted this Compact. 2
(K) "Paramedic" means: an individual licensed with cognitive knowledge and 3
a scope of practice that corresponds to that level in the National EMS Education 4
Standards and National EMS Scope of Practice Model. 5
(L) "Privilege to Practice" means: an individual's authority to deliver 6
emergency medical services in remote states as authorized under this Compact. 7
(M) "Remote State" means: a member state in which an individual is not 8
licensed. 9
(N) "Restricted" means: the outcome of an adverse action that limits a license 10
or the privilege to practice. 11
(O) "Rule" means: a written statement by the interstate Commission 12
promulgated pursuant to Section 12 of this Compact that is of general applicability; 13
implements, interprets, or prescribes a policy or provision of the Compact; or is an 14
organizational, procedural, or practice requirement of the Commission and has the 15
force and effect of statutory law in a member state and includes the amendment, 16
repeal, or suspension of an existing rule. 17
(P) "Scope of Practice" means: defined parameters of various duties or 18
services that may be provided by an individual with specific credentials. Whether 19
regulated by rule, statute, or court decision, it tends to represent the limits of services 20
an individual may perform. 21
(Q) "Significant Investigatory Information" means: 22
(1) investigative information that a state EMS authority, after a 23
preliminary inquiry that includes notification and an opportunity to respond if required 24
by state law, has reason to believe, if proved true, would result in the imposition of an 25
adverse action on a license or privilege to practice; or 26
(2) investigative information that indicates that the individual 27
represents an immediate threat to public health and safety regardless of whether the 28
individual has been notified and had an opportunity to respond. 29
(R) "State" means: any state, commonwealth, district, or territory of the 30
United States. 31
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(S) "State EMS Authority" means: the board, office, or other agency with the 1
legislative mandate to license EMS personnel. 2
SECTION 3. HOME STATE LICENSURE. 3
(A) Any member state in which an individual holds a current license shall be 4
deemed a home state for purposes of this Compact. 5
(B) Any member state may require an individual to obtain and retain a license 6
to be authorized to practice in the member state under circumstances not authorized by 7
the privilege to practice under the terms of this Compact. 8
(C) A home state's license authorizes an individual to practice in a remote 9
state under the privilege to practice only if the home state: 10
(1) Currently requires the use of the National Registry of Emergency 11
Medical Technicians (NREMT) examination as a condition of issuing initial licenses 12
at the EMT and paramedic levels; 13
(2) Has a mechanism in place for receiving and investigating 14
complaints about individuals; 15
(3) Notifies the Commission, in compliance with the terms herein, of 16
any adverse action or significant investigatory information regarding an individual; 17
(4) No later than five years after activation of the Compact, requires a 18
criminal background check of all applicants for initial licensure, including the use of 19
the results of fingerprint or other biometric data checks compliant with the 20
requirements of the Federal Bureau of Investigation with the exception of federal 21
employees who have suitability determination in accordance with 5 C.F.R. 731.202 22
and submit documentation of such as promulgated in the rules of the Commission; and 23
(5) Complies with the rules of the Commission. 24
SECTION 4. COMPACT PRIVILEGE TO PRACTICE. 25
(A) Member states shall recognize the privilege to practice of an individual 26
licensed in another member state that is in conformance with Section 3. 27
(B) To exercise the privilege to practice under the terms and provisions of this 28
Compact, an individual must: 29
(1) Be at least 18 years of age; 30
(2) Possess a current unrestricted license in a member state as an EMT, 31
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AEMT, paramedic, or state recognized and licensed level with a scope of practice and 1
authority between EMT and paramedic; and 2
(3) Practice under the supervision of a medical director. 3
(C) An individual providing patient care in a remote state under the privilege 4
to practice shall function within the scope of practice authorized by the home state 5
unless and until modified by an appropriate authority in the remote state as may be 6
defined in the rules of the commission. 7
(D) Except as provided in Section 4(C), an individual practicing in a remote 8
state will be subject to the remote state's authority and laws. A remote state may, in 9
accordance with due process and that state's laws, restrict, suspend, or revoke an 10
individual's privilege to practice in the remote state and may take any other necessary 11
actions to protect the health and safety of its citizens. If a remote state takes action it 12
shall promptly notify the home state and the Commission. 13
(E) If an individual's license in any home state is restricted or suspended, the 14
individual shall not be eligible to practice in a remote state under the privilege to 15
practice until the individual's home state license is restored. 16
(F) If an individual's privilege to practice in any remote state is restricted, 17
suspended, or revoked the individual shall not be eligible to practice in any remote 18
state until the individual's privilege to practice is restored. 19
SECTION 5. CONDITIONS OF PRACTICE IN A REMOTE STATE. 20
An individual may practice in a remote state under a privilege to practice only 21
in the performance of the individual's EMS duties as assigned by an appropriate 22
authority, as defined in the rules of the Commission, and under the following 23
circumstances: 24
(1) The individual originates a patient transport in a home state and 25
transports the patient to a remote state; 26
(2) The individual originates in the home state and enters a remote 27
state to pick up a patient and provide care and transport of the patient to the home 28
state; 29
(3) The individual enters a remote state to provide patient care and/or 30
transport within that remote state; 31
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(4) The individual enters a remote state to pick up a patient and 1
provide care and transport to a third member state; 2
(5) Other conditions as determined by rules promulgated by the 3
commission. 4
SECTION 6. RELATIONSHIP TO EMERGENCY MANAGEMENT ASSISTANCE 5
COMPACT. 6
Upon a member state's governor's declaration of a state of emergency or 7
disaster that activates the Emergency Management Assistance Compact (EMAC), all 8
relevant terms and provisions of EMAC shall apply and to the extent any terms or 9
provisions of this Compact conflicts with EMAC, the terms of EMAC shall prevail 10
with respect to any individual practicing in the remote state in response to such 11
declaration. 12
SECTION 7. VETERANS, SERVICE MEMBERS SEPARATING FROM ACTIVE-DUTY 13
MILITARY, AND THEIR SPOUSES. 14
(A) Member states shall consider a veteran, active military service member, 15
and member of the National Guard and Reserves separating from an active-duty tour, 16
and a spouse thereof, who holds a current valid and unrestricted NREMT certification 17
at or above the level of the state license being sought as satisfying the minimum 18
training and examination requirements for such licensure. 19
(B) Member states shall expedite the processing of licensure applications 20
submitted by veterans, active military service members, and members of the National 21
Guard and Reserves separating from an active-duty tour, and their spouses. 22
(C) All individuals functioning with a privilege to practice under this Section 23
remain subject to the Adverse Actions provisions of Section 8. 24
SECTION 8. ADVERSE ACTIONS. 25
(A) A home state shall have exclusive power to impose adverse action against 26
an individual's license issued by the home state. 27
(B) If an individual's license in any home state is restricted or suspended, the 28
individual shall not be eligible to practice in a remote state under the privilege to 29
practice until the individual's home state license is restored. 30
(1) All home state adverse action orders shall include a statement that 31
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the individual's Compact privileges are inactive. The order may allow the individual to 1
practice in remote states with prior written authorization from both the home state and 2
remote state's EMS authority. 3
(2) An individual currently subject to adverse action in the home state 4
shall not practice in any remote state without prior written authorization from both the 5
home state and remote state's EMS authority. 6
(C) A member state shall report adverse actions and any occurrences that the 7
individual's Compact privileges are restricted, suspended, or revoked to the 8
Commission in accordance with the rules of the Commission. 9
(D) A remote state may take adverse action on an individual's privilege to 10
practice within that state. 11
(E) Any member state may take adverse action against an individual's 12
privilege to practice in that state based on the factual findings of another member state, 13
so long as each state follows its own procedures for imposing such adverse action. 14
(F) A home state's EMS authority shall investigate and take appropriate action 15
with respect to reported conduct in a remote state as it would if such conduct had 16
occurred within the home state. In such cases, the home state's law shall control in 17
determining the appropriate adverse action. 18
(G) Nothing in this Compact shall override a member state's decision that 19
participation in an alternative program may be used in lieu of adverse action and that 20
such participation shall remain non-public if required by the member state's laws. 21
Member states must require individuals who enter any alternative programs to agree 22
not to practice in any other member state during the term of the alternative program 23
without prior authorization from such other member state. 24
SECTION 9. ADDITIONAL POWERS INVESTED IN A MEMBER STATE'S EMS 25
AUTHORITY. 26
A member state's EMS authority, in addition to any other powers granted 27
under state law, is authorized under this Compact to: 28
(1) Issue subpoenas for both hearings and investigations that require 29
the attendance and testimony of witnesses and the production of evidence. Subpoenas 30
issued by a member state's EMS authority for the attendance and testimony of 31
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witnesses, and/or the production of evidence from another member state, shall be 1
enforced in the remote state by any court of competent jurisdiction, according to that 2
court's practice and procedure in considering subpoenas issued in its own proceedings. 3
The issuing state EMS authority shall pay any witness fees, travel expenses, mileage, 4
and other fees required by the service statutes of the state where the witnesses and/or 5
evidence are located; and 6
(2) Issue cease and desist orders to restrict, suspend, or revoke an 7
individual's privilege to practice in the state. 8
SECTION 10. ESTABLISHMENT OF THE INTERSTATE COMMISSION FOR EMS 9
PERSONNEL PRACTICE. 10
(A) The Compact states hereby create and establish a joint public agency 11
known as the Interstate Commission for EMS Personnel Practice. 12
(1) The Commission is a body politic and an instrumentality of the 13
Compact states. 14
(2) Venue is proper and judicial proceedings by or against the 15
Commission shall be brought solely and exclusively in a court of competent 16
jurisdiction where the principal office of the Commission is located. The Commission 17
may waive venue and jurisdictional defenses to the extent it adopts or consents to 18
participate in alternative dispute resolution proceedings. 19
(3) Nothing in this Compact shall be construed to be a waiver of 20
sovereign immunity. 21
(B) Membership, Voting, and Meetings. 22
(1) Each member state shall have and be limited to one (1) delegate. 23
The responsible official of the state EMS authority or his designee shall be the 24
delegate to this Compact for each member state. Any delegate may be removed or 25
suspended from office as provided by the law of the state from which the delegate is 26
appointed. Any vacancy occurring in the Commission shall be filled in accordance 27
with the laws of the member state in which the vacancy exists. In the event that more 28
than one board, office, or other agency with the legislative mandate to license EMS 29
personnel at and above the level of EMT exists, the Governor of the state will 30
determine which entity will be responsible for assigning the delegate. 31
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(2) Each delegate shall be entitled to one (1) vote with regard to the 1
promulgation of rules and creation of bylaws and shall otherwise have an opportunity 2
to participate in the business and affairs of the Commission. A delegate shall vote in 3
person or by such other means as provided in the bylaws. The bylaws may provide for 4
delegates' participation in meetings by telephone or other means of communication. 5
(3) The Commission shall meet at least once during each calendar 6
year. Additional meetings shall be held as set forth in the bylaws. 7
(4) All meetings shall be open to the public, and public notice of 8
meetings shall be given in the same manner as required under the rulemaking 9
provisions in Section 7. 10
(5) The Commission may convene in a closed, non-public meeting if 11
the Commission must discuss: 12
(a) Non-compliance of a member state with its obligations 13
under the Compact; 14
(b) The employment, compensation, discipline or other 15
personnel matters, practices or procedures related to specific employees or 16
other matters related to the Commission's internal personnel practices and 17
procedures; 18
(c) Current, threatened, or reasonably anticipated litigation; 19
(d) Negotiation of contracts for the purchase or sale of goods, 20
services, or real estate; 21
(e) Accusing any person of a crime or formally censuring any 22
person; 23
(f) Disclosure of trade secrets or commercial or financial 24
information that is privileged or confidential; 25
(g) Disclosure of information of a personal nature where 26
disclosure would constitute a clearly unwarranted invasion of personal privacy; 27
(h) Disclosure of investigatory records compiled for law 28
enforcement purposes; 29
(i) Disclosure of information related to any investigatory 30
reports prepared by or on behalf of or for use of the Commission or other 31
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committee charged with responsibility of investigation or determination of 1
compliance issues pursuant to the Compact; or 2
(j) Matters specifically exempted from disclosure by federal or 3
member state statute. 4
(6) If a meeting, or portion of a meeting, is closed pursuant to this 5
provision, the Commission's legal counsel or designee shall certify that the meeting 6
may be closed and shall reference each relevant exempting provision. The 7
Commission shall keep minutes that fully and clearly describe all matters discussed in 8
a meeting and shall provide a full and accurate summary of actions taken, and the 9
reasons therefore, including a description of the views expressed. All documents 10
considered in connection with an action shall be identified in such minutes. All 11
minutes and documents of a closed meeting shall remain under seal, subject to release 12
by a majority vote of the Commission or order of a court of competent jurisdiction. 13
(C) The Commission shall, by a majority vote of the delegates, prescribe 14
bylaws and/or rules to govern its conduct as may be necessary or appropriate to carry 15
out the purposes and exercise the powers of the Compact, including but not limited to: 16
(1) Establishing the fiscal year of the Commission; 17
(2) Providing reasonable standards and procedures: 18
(a) for the establishment and meetings of other committees; and 19
(b) governing any general or specific delegation of any 20
authority or function of the Commission; 21
(3) Providing reasonable procedures for calling and conducting 22
meetings of the Commission, ensuring reasonable advance notice of all meetings, and 23
providing an opportunity for attendance of such meetings by interested parties, with 24
enumerated exceptions designed to protect the public's interest, the privacy of 25
individuals, and proprietary information, including trade secrets. The Commission 26
may meet in closed session only after a majority of the membership votes to close a 27
meeting in whole or in part. As soon as practicable, the Commission must make public 28
a copy of the vote to close the meeting revealing the vote of each member with no 29
proxy votes allowed; 30
(4) Establishing the titles, duties and authority, and reasonable 31
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procedures for the election of the officers of the Commission; 1
(5) Providing reasonable standards and procedures for the 2
establishment of the personnel policies and programs of the Commission. 3
Notwithstanding any civil service or other similar laws of any member state, the 4
bylaws shall exclusively govern the personnel policies and programs of the 5
Commission; 6
(6) Promulgating a code of ethics to address permissible and prohibited 7
activities of Commission members and employees; 8
(7) Providing a mechanism for winding up the operations of the 9
Commission and the equitable disposition of any surplus funds that may exist after the 10
termination of the Compact after the payment and/or reserving of all of its debts and 11
obligations; 12
(8) The Commission shall publish its bylaws and file a copy thereof, 13
and a copy of any amendment thereto, with the appropriate agency or officer in each 14
of the member states, if any; 15
(9) The Commission shall maintain its financial records in accordance 16
with the bylaws; 17
(10) The Commission shall meet and take such actions as are 18
consistent with the provisions of this Compact and the bylaws. 19
(D) The Commission shall have the following powers: 20
(1) The authority to promulgate uniform rules to facilitate and 21
coordinate implementation and administration of this Compact. The rules shall have 22
the force and effect of law and shall be binding in all member states; 23
(2) To bring and prosecute legal proceedings or actions in the name of 24
the Commission, provided that the standing of any state EMS authority or other 25
regulatory body responsible for EMS personnel licensure to sue or be sued under 26
applicable law shall not be affected; 27
(3) To purchase and maintain insurance and bonds; 28
(4) To borrow, accept, or contract for services of personnel, including, 29
but not limited to, employees of a member state; 30
(5) To hire employees, elect or appoint officers, fix compensation, 31
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define duties, grant such individuals appropriate authority to carry out the purposes of 1
the Compact, and to establish the Commission's personnel policies and programs 2
relating to conflicts of interest, qualifications of personnel, and other related personnel 3
matters; 4
(6) To accept any and all appropriate donations and grants of money, 5
equipment, supplies, materials and services, and to receive, utilize and dispose of the 6
same; provided that at all times the Commission shall strive to avoid any appearance 7
of impropriety and/or conflict of interest; 8
(7) To lease, purchase, accept appropriate gifts or donations of, or 9
otherwise to own, hold, improve or use, any property, real, personal or mixed; 10
provided that at all times the Commission shall strive to avoid any appearance of 11
impropriety; 12
(8) To sell, convey, mortgage, pledge, lease, exchange, abandon, or 13
otherwise dispose of any property real, personal, or mixed; 14
(9) To establish a budget and make expenditures; 15
(10) To borrow money; 16
(11) To appoint committees, including advisory committees comprised 17
of members, state regulators, state legislators or their representatives, and consumer 18
representatives, and such other interested persons as may be designated in this 19
Compact and the bylaws; 20
(12) To provide and receive information from, and to cooperate with, 21
law enforcement agencies; 22
(13) To adopt and use an official seal; and 23
(14) To perform such other functions as may be necessary or 24
appropriate to achieve the purposes of this Compact consistent with the state 25
regulation of EMS personnel licensure and practice. 26
(E) Financing of the Commission. 27
(1) The Commission shall pay, or provide for the payment of, the 28
reasonable expenses of its establishment, organization, and ongoing activities. 29
(2) The Commission may accept any and all appropriate revenue 30
sources, donations, and grants of money, equipment, supplies, materials, and services. 31
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(3) The Commission may levy on and collect an annual assessment 1
from each member state or impose fees on other parties to cover the cost of the 2
operations and activities of the Commission and its staff, which must be in a total 3
amount sufficient to cover its annual budget as approved each year for which revenue 4
is not provided by other sources. The aggregate annual assessment amount shall be 5
allocated based upon a formula to be determined by the Commission, which shall 6
promulgate a rule binding upon all member states. 7
(4) The Commission shall not incur obligations of any kind prior to 8
securing the funds adequate to meet the same; nor shall the Commission pledge the 9
credit of any of the member states, except by and with the authority of the member 10
state. 11
(5) The Commission shall keep accurate accounts of all receipts and 12
disbursements. The receipts and disbursements of the Commission shall be subject to 13
the audit and accounting procedures established under its bylaws. However, all 14
receipts and disbursements of funds handled by the Commission shall be audited 15
yearly by a certified or licensed public accountant, and the report of the audit shall be 16
included in and become part of the annual report of the Commission. 17
(F) Qualified Immunity, Defense, and Indemnification. 18
(1) The members, officers, executive director, employees and 19
representatives of the Commission shall be immune from suit and liability, either 20
personally or in their official capacity, for any claim for damage to or loss of property 21
or personal injury or other civil liability caused by or arising out of any actual or 22
alleged act, error or omission that occurred, or that the person against whom the claim 23
is made had a reasonable basis for believing occurred within the scope of Commission 24
employment, duties or responsibilities; provided that nothing in this paragraph shall be 25
construed to protect any such person from suit and/or liability for any damage, loss, 26
injury, or liability caused by the intentional or willful or wanton misconduct of that 27
person. 28
(2) The Commission shall defend any member, officer, executive 29
director, employee or representative of the Commission in any civil action seeking to 30
impose liability arising out of any actual or alleged act, error, or omission that 31
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occurred within the scope of Commission employment, duties, or responsibilities, or 1
that the person against whom the claim is made had a reasonable basis for believing 2
occurred within the scope of Commission employment, duties, or responsibilities; 3
provided that nothing herein shall be construed to prohibit that person from retaining 4
his or her own counsel; and provided further, that the actual or alleged act, error, or 5
omission did not result from that person's intentional or willful or wanton misconduct. 6
(3) The Commission shall indemnify and hold harmless any member, 7
officer, executive director, employee, or representative of the Commission for the 8
amount of any settlement or judgment obtained against that person arising out of any 9
actual or alleged act, error or omission that occurred within the scope of Commission 10
employment, duties, or responsibilities, or that such person had a reasonable basis for 11
believing occurred within the scope of Commission employment, duties, or 12
responsibilities, provided that the actual or alleged act, error, or omission did not result 13
from the intentional or willful or wanton misconduct of that person. 14
SECTION 11. COORDINATED DATABASE. 15
(A) The Commission shall provide for the development and maintenance of a 16
coordinated database and reporting system containing licensure, adverse action, and 17
significant investigatory information on all licensed individuals in member states. 18
(B) Notwithstanding any other provision of state law to the contrary, a 19
member state shall submit a uniform data set to the coordinated database on all 20
individuals to whom this Compact is applicable as required by the rules of the 21
Commission, including: 22
(1) Identifying information; 23
(2) Licensure data; 24
(3) Significant investigatory information; 25
(4) Adverse actions against an individual's license; 26
(5) An indicator that an individual's privilege to practice is restricted, 27
suspended or revoked; 28
(6) Non-confidential information related to alternative program 29
participation; 30
(7) Any denial of application for licensure, and the reason(s) for such 31
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denial; and 1
(8) Other information that may facilitate the administration of this 2
Compact, as determined by the rules of the Commission. 3
(C) The coordinated database administrator shall promptly notify all member 4
states of any adverse action taken against, or significant investigative information on, 5
any individual in a member state. 6
(D) Member states contributing information to the coordinated database may 7
designate information that may not be shared with the public without the express 8
permission of the contributing state. 9
(E) Any information submitted to the coordinated database that is 10
subsequently required to be expunged by the laws of the member state contributing the 11
information shall be removed from the coordinated database. 12
SECTION 12. RULEMAKING. 13
(A) The Commission shall exercise its rulemaking powers pursuant to the 14
criteria set forth in this Section and the rules adopted thereunder. Rules and 15
amendments shall become binding as of the date specified in each rule or amendment. 16
(B) If a majority of the legislatures of the member states rejects a rule, by 17
enactment of a statute or resolution in the same manner used to adopt the Compact, 18
then such rule shall have no further force and effect in any member state. 19
(C) Rules or amendments to the rules shall be adopted at a regular or special 20
meeting of the Commission. 21
(D) Prior to promulgation and adoption of a final rule or rules by the 22
Commission, and at least sixty (60) days in advance of the meeting at which the rule 23
will be considered and voted upon, the Commission shall file a Notice of Proposed 24
Rulemaking: 25
(1) On the website of the Commission; and 26
(2) On the website of each member state EMS authority or the 27
publication in which each state would otherwise publish proposed rules. 28
(E) The Notice of Proposed Rulemaking shall include: 29
(1) The proposed time, date, and location of the meeting in which the 30
rule will be considered and voted upon; 31
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(2) The text of the proposed rule or amendment and the reason for the 1
proposed rule; 2
(3) A request for comments on the proposed rule from any interested 3
person; and 4
(4) The manner in which interested persons may submit notice to the 5
Commission of their intention to attend the public hearing and any written comments. 6
(F) Prior to adoption of a proposed rule, the Commission shall allow persons 7
to submit written data, facts, opinions, and arguments, which shall be made available 8
to the public. 9
(G) The Commission shall grant an opportunity for a public hearing before it 10
adopts a rule or amendment if a hearing is requested by: 11
(1) At least twenty-five (25) persons; 12
(2) A governmental subdivision or agency; or 13
(3) An association having at least twenty-five (25) members. 14
(H) If a hearing is held on the proposed rule or amendment, the Commission 15
shall publish the place, time, and date of the scheduled public hearing. 16
(1) All persons wishing to be heard at the hearing shall notify the 17
executive director of the Commission or other designated member in writing of their 18
desire to appear and testify at the hearing not less than five (5) business days before 19
the scheduled date of the hearing. 20
(2) Hearings shall be conducted in a manner providing each person 21
who wishes to comment a fair and reasonable opportunity to comment orally or in 22
writing. 23
(3) No transcript of the hearing is required, unless a written request for 24
a transcript is made, in which case the person requesting the transcript shall bear the 25
cost of producing the transcript. A recording may be made in lieu of a transcript under 26
the same terms and conditions as a transcript. This subsection shall not preclude the 27
Commission from making a transcript or recording of the hearing if it so chooses. 28
(4) Nothing in this section shall be construed as requiring a separate 29
hearing on each rule. Rules may be grouped for the convenience of the Commission at 30
hearings required by this section. 31
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(I) Following the scheduled hearing date, or by the close of business on the 1
scheduled hearing date if the hearing was not held, the Commission shall consider all 2
written and oral comments received. 3
(J) The Commission shall, by majority vote of all members, take final action 4
on the proposed rule and shall determine the effective date of the rule, if any, based on 5
the rulemaking record and the full text of the rule. 6
(K) If no written notice of intent to attend the public hearing by interested 7
parties is received, the Commission may proceed with promulgation of the proposed 8
rule without a public hearing. 9
(L) Upon determination that an emergency exists, the Commission may 10
consider and adopt an emergency rule without prior notice, opportunity for comment, 11
or hearing, provided that the usual rulemaking procedures provided in the Compact 12
and in this section shall be retroactively applied to the rule as soon as reasonably 13
possible, in no event later than ninety (90) days after the effective date of the rule. For 14
the purposes of this provision, an emergency rule is one that must be adopted 15
immediately in order to: 16
(1) Meet an imminent threat to public health, safety, or welfare; 17
(2) Prevent a loss of Commission or member state funds; 18
(3) Meet a deadline for the promulgation of an administrative rule that 19
is established by federal law or rule; or 20
(4) Protect public health and safety. 21
(M) The Commission or an authorized committee of the Commission may 22
direct revisions to a previously adopted rule or amendment for purposes of correcting 23
typographical errors, errors in format, errors in consistency, or grammatical errors. 24
Public notice of any revisions shall be posted on the website of the Commission. The 25
revision shall be subject to challenge by any person for a period of thirty (30) days 26
after posting. The revision may be challenged only on grounds that the revision results 27
in a material change to a rule. A challenge shall be made in writing, and delivered to 28
the chair of the Commission prior to the end of the notice period. If no challenge is 29
made, the revision will take effect without further action. If the revision is challenged, 30
the revision may not take effect without the approval of the Commission. 31
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SECTION 13. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. 1
(A) Oversight. 2
(1) The executive, legislative, and judicial branches of state 3
government in each member state shall enforce this Compact and take all actions 4
necessary and appropriate to effectuate the Compact's purposes and intent. The 5
provisions of this Compact and the rules promulgated hereunder shall have standing as 6
statutory law. 7
(2) All courts shall take judicial notice of the Compact and the rules in 8
any judicial or administrative proceeding in a member state pertaining to the subject 9
matter of this Compact which may affect the powers, responsibilities or actions of the 10
Commission. 11
(3) The Commission shall be entitled to receive service of process in 12
any such proceeding, and shall have standing to intervene in such a proceeding for all 13
purposes. Failure to provide service of process to the Commission shall render a 14
judgment or order void as to the Commission, this Compact, or promulgated rules. 15
(B) Default, Technical Assistance, and Termination. 16
(1) If the Commission determines that a member state has defaulted in 17
the performance of its obligations or responsibilities under this Compact or the 18
promulgated rules, the Commission shall: 19
(a) Provide written notice to the defaulting state and other 20
member states of the nature of the default, the proposed means of curing the 21
default and/or any other action to be taken by the Commission; and 22
(b) Provide remedial training and specific technical assistance 23
regarding the default. 24
(2) If a state in default fails to cure the default, the defaulting state may 25
be terminated from the Compact upon an affirmative vote of a majority of the member 26
states, and all rights, privileges and benefits conferred by this Compact may be 27
terminated on the effective date of termination. A cure of the default does not relieve 28
the offending state of obligations or liabilities incurred during the period of default. 29
(3) Termination of membership in the Compact shall be imposed only 30
after all other means of securing compliance have been exhausted. Notice of intent to 31
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suspend or terminate shall be given by the Commission to the governor, the majority 1
and minority leaders of the defaulting state's legislature, and each of the member 2
states. 3
(4) A state that has been terminated is responsible for all assessments, 4
obligations, and liabilities incurred through the effective date of termination, including 5
obligations that extend beyond the effective date of termination. 6
(5) The Commission shall not bear any costs related to a state that is 7
found to be in default or that has been terminated from the Compact, unless agreed 8
upon in writing between the Commission and the defaulting state. 9
(6) The defaulting state may appeal the action of the Commission by 10
petitioning the U.S. District Court for the District of Columbia or the federal district 11
where the Commission has its principal offices. The prevailing member shall be 12
awarded all costs of such litigation, including reasonable attorney's fees. 13
(C) Dispute Resolution. 14
(1) Upon request by a member state, the Commission shall attempt to 15
resolve disputes related to the Compact that arise among member states and between 16
member and non-member states. 17
(2) The Commission shall promulgate a rule providing for both 18
mediation and binding dispute resolution for disputes as appropriate. 19
(D) Enforcement. 20
(1) The Commission, in the reasonable exercise of its discretion, shall 21
enforce the provisions and rules of this Compact. 22
(2) By majority vote, the Commission may initiate legal action in the 23
United States District Court for the District of Columbia or the federal district where 24
the Commission has its principal offices against a member state in default to enforce 25
compliance with the provisions of the Compact and its promulgated rules and bylaws. 26
The relief sought may include both injunctive relief and damages. In the event judicial 27
enforcement is necessary, the prevailing member shall be awarded all costs of such 28
litigation, including reasonable attorney's fees. 29
(3) The remedies herein shall not be the exclusive remedies of the 30
Commission. The Commission may pursue any other remedies available under federal 31
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or state law. 1
SECTION 14. DATE OF IMPLEMENTATION OF THE INTERSTATE COMMISSION 2
FOR EMS PERSONNEL PRACTICE AND ASSOCIATED RULES, WITHDRAWAL, 3
AND AMENDMENT. 4
(A) The Compact shall come into effect on the date on which the Compact 5
statute is enacted into law in the tenth member state. The provisions, which become 6
effective at that time, shall be limited to the powers granted to the Commission 7
relating to assembly and the promulgation of rules. Thereafter, the Commission shall 8
meet and exercise rulemaking powers necessary to the implementation and 9
administration of the Compact. 10
(B) Any state that joins the Compact subsequent to the Commission's initial 11
adoption of the rules shall be subject to the rules as they exist on the date on which the 12
Compact becomes law in that state. Any rule that has been previously adopted by the 13
Commission shall have the full force and effect of law on the day the Compact 14
becomes law in that state. 15
(C) Any member state may withdraw from this Compact by enacting a statute 16
repealing the same. 17
(1) A member state's withdrawal shall not take effect until six (6) 18
months after enactment of the repealing statute. 19
(2) Withdrawal shall not affect the continuing requirement of the 20
withdrawing state's EMS authority to comply with the investigative and adverse action 21
reporting requirements of this act prior to the effective date of withdrawal. 22
(D) Nothing contained in this Compact shall be construed to invalidate or 23
prevent any EMS personnel licensure agreement or other cooperative arrangement 24
between a member state and a non-member state that does not conflict with the 25
provisions of this Compact. 26
(E) This Compact may be amended by the member states. No amendment to 27
this Compact shall become effective and binding upon any member state until it is 28
enacted into the laws of all member states. 29
SECTION 15. CONSTRUCTION AND SEVERABILITY. 30
This Compact shall be liberally construed so as to effectuate the purposes 31
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thereof. If this Compact shall be held contrary to the constitution of any state member 1
thereto, the Compact shall remain in full force and effect as to the remaining member 2
states. Nothing in this Compact supersedes state law or rules related to licensure of 3
EMS agencies. 4
* Sec. 33. AS 21.36.090(d) is amended to read: 5
(d) Except to the extent necessary to comply with AS 21.42.365 and 6
AS 21.56, a person may not practice or permit unfair discrimination against a person 7
who provides a service covered under a group health insurance policy that extends 8
coverage on an expense incurred basis, or under a group service or indemnity type 9
contract issued by a health maintenance organization or a nonprofit corporation, if the 10
service is within the scope of the provider's occupational license. In this subsection, 11
"provider" means a state licensed physician, physician assistant, dentist, osteopath, 12
optometrist, chiropractor, advanced practice registered nurse, pharmacist, naturopath, 13
physical therapist, occupational therapist, marital and family therapist, psychologist, 14
psychological associate, licensed clinical social worker, licensed professional 15
counselor, licensed associate counselor, certified direct-entry midwife, genetic 16
counselor, or dental hygienist holding an advanced practice permit. 17
* Sec. 34. AS 21.36.090(d), as amended by sec. 33 of this Act, is amended to read: 18
(d) Except to the extent necessary to comply with AS 21.42.365 and 19
AS 21.56, a person may not practice or permit unfair discrimination against a person 20
who provides a service covered under a group health insurance policy that extends 21
coverage on an expense incurred basis, or under a group service or indemnity type 22
contract issued by a health maintenance organization or a nonprofit corporation, if the 23
service is within the scope of the provider's occupational license. In this subsection, 24
"provider" means a state licensed physician, physician assistant, dentist, osteopath, 25
optometrist, chiropractor, advanced practice registered nurse, pharmacist, naturopath, 26
respiratory care practitioner, physical therapist, occupational therapist, marital and 27
family therapist, psychologist, psychological associate, licensed clinical social worker, 28
licensed professional counselor, licensed associate counselor, certified direct-entry 29
midwife, genetic counselor, or dental hygienist holding an advanced practice permit. 30
* Sec. 35. AS 44.29 is amended by adding new sections to read: 31
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Article 5A. Rural Health Transformation Program. 1
Sec. 44.29.410. Rural Health Transformation Program Advisory Council. 2
(a) The Rural Health Transformation Program Advisory Council is established in the 3
department. 4
(b) The council consists of eight members as follows: 5
(1) the deputy commissioner of health, or the deputy commissioner of 6
health's designee, who shall serve as the chair and is a nonvoting member; 7
(2) one member who represents a tribal health organization or 8
consortium, appointed by the governor; in this paragraph, "tribal health 9
organization" means an organization recognized by the United States Indian 10
Health Service to provide health-related services; 11
(3) one member who represents a federally qualified health center or 12
professional organization for federally qualified health centers, appointed by the 13
governor; in this paragraph, "federally qualified health center" has the meaning given 14
in 42 U.S.C. 1396d(l)(2)(B); 15
(4) one member who represents a hospital or professional organization 16
for hospitals, appointed by the governor; 17
(5) one member who represents a local government, appointed by the 18
governor; 19
(6) one member who represents the Alaska Mental Health Trust 20
Authority, appointed by the governor; 21
(7) one member of the house of representatives, appointed by the 22
speaker of the house; and 23
(8) one member of the senate, appointed by the president of the senate. 24
(c) In addition to the qualifications required under (b)(2) - (6) of this section, 25
the governor shall appoint members under (b)(2) - (6) of this section 26
(1) based on interest in public affairs, good judgment, knowledge, and 27
ability in the field of action of the council; 28
(2) with a view to providing diversity of interest and points of view in 29
the membership; 30
(3) without consideration of political affiliation; and 31
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(4) so that the members appointed under (b)(2) - (6) of this section 1
collectively represent each judicial district. 2
(d) A member of the council serves at the pleasure of the appointing authority 3
of the member. 4
(e) Members of the council are not entitled to compensation or per diem and 5
travel expenses authorized under AS 39.20.180. 6
(f) The council shall meet in person, telephonically, or by electronic means at 7
least biannually. 8
(g) The council shall advise the department on the state's participation in the 9
rural health transformation program. 10
(h) The council may adopt bylaws for the operation of the council. 11
Sec. 44.29.420. Department duties. (a) The department shall 12
(1) establish specific criteria for scoring grant applications; 13
(2) publish on the department's Internet website 14
(A) the state's application for the rural health transformation 15
program, changes to the application, and the state's approved application; 16
(B) the criteria established under (1) of this subsection; 17
(C) annual updates on the grant applications the state receives, 18
the application scores, the grants awarded, how the awarded grants are being 19
used by grantees, and the progress of each grantee in achieving the goals 20
identified in the grantee's application; and 21
(D) annual updates on all state projects funded with money 22
received by the state under the rural health transformation program; and 23
(3) by the first day of each regular session of the legislature, deliver 24
copies of the reports the department submitted to the federal government in the 25
previous year under the rural health transformation program to the senate secretary 26
and the chief clerk of the house of representatives and notify the legislature that the 27
reports are available. 28
(b) The department may use funds received by the state under the rural health 29
transformation program to award grants. The department shall award grants in a 30
manner that addresses the initiatives identified in the state's approved application. 31
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Sec. 44.29.450. Definitions. In AS 44.29.410 - 44.29.450, 1
(1) "approved application" means an application to participate in the 2
rural health transformation program that has been approved by the federal 3
government; 4
(2) "council" means the Rural Health Transformation Program 5
Advisory Council; 6
(3) "department" means the Department of Health; 7
(4) "rural health transformation program" means the program 8
authorized under 42 U.S.C. 1397ee(h). 9
* Sec. 36. AS 44.29.410, 44.29.420, and 44.29.450 are repealed December 31, 2031. 10
* Sec. 37. The uncodified law of the State of Alaska is amended by adding a new section to 11
read: 12
TRANSITION: CURRENT GENETIC COUNSELORS. Notwithstanding the 13
licensing requirement of AS 08.53.100, enacted by sec. 7 of this Act, a person who, on the 14
day before the effective date of sec. 7 of this Act, is engaged in the practice of genetic 15
counseling, may continue to practice genetic counseling without a license issued under 16
AS 08.53 by the State Medical Board until July 1, 2027. 17
* Sec. 38. The uncodified law of the State of Alaska is amended by adding a new section to 18
read: 19
TRANSITION: INITIAL MEMBERS OF THE GENETIC COUNSELING 20
ADVISORY COUNCIL. (a) The State Medical Board shall appoint the initial members of the 21
Genetic Counseling Advisory Council established in AS 08.53.180, enacted by sec. 7 of this 22
Act, during the first meeting of the board following the effective date of sec. 7 of this Act. 23
(b) Notwithstanding AS 08.53.180(b), enacted by sec. 7 of this Act, a person who is 24
engaged in the practice of genetic counseling on the day before the effective date of sec. 7 of 25
this Act may be appointed by the State Medical Board as an initial member of the Genetic 26
Counseling Advisory Council without a license issued under AS 08.53 by the State Medical 27
Board. A person appointed under this subsection may only continue to serve on the Genetic 28
Counseling Advisory Council after July 1, 2027, if the person obtains a license issued under 29
AS 08.53 by the State Medical Board on or before July 1, 2027. 30
* Sec. 39. The uncodified law of the State of Alaska is amended by adding a new section to 31
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read: 1
TRANSITION: QUALIFICATIONS TO PRACTICE RESPIRATORY CARE. 2
Notwithstanding the licensing requirements of AS 08.90.010 and 08.90.020, enacted by sec. 3
24 of this Act, a person who, on the day before the effective date of sec. 24 of this Act, is 4
engaged in the practice of respiratory care and is qualified to perform acts within the scope of 5
practice of respiratory care, may continue to perform those acts without a license issued under 6
AS 08.90 by the Department of Commerce, Community, and Economic Development for a 7
period not to exceed one year after the effective date of sec. 24 of this Act. 8
* Sec. 40. Sections 1, 3, 5, 24, 26, 28, 30, 34, and 39 of this Act take effect January 1, 2027. 9