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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to health and human services; 2
providing a short title; amending s. 395.1055, F.S.; 3
removing obsolete provisions; amending s. 401.411, 4
F.S.; authorizing the Department of Health to deny, 5
suspend, or revoke a license, certificate, or permit 6
or reprimand, fine, or take adverse action against an 7
emergency medical technician or paramedic under 8
certain circumstances; amending s. 401.25, F.S.; 9
providing exemption from licensure for emergency 10
medical technicians or paramedics under certain 11
circumstances; requiring the Department of Health to 12
appoint a state delegate for the Interstate Compact 13
Commission for EMS Personnel Practice; creating s. 14
401.466, F.S.; enacting the Emergency Medical Services 15
Personnel Licensure Interstate Compact; providing 16
purpose; providing definitions; providing requirements 17
for home state licensure and practice of EMS 18
personnel; requiring compact states meet certain 19
criteria to participate in the compact; authorizing 20
EMS personnel to practice in other member states under 21
certain circumstances; providing that authority over 22
EMS personnel licenses remains with the home state; 23
providing guidelines and requirements for EMS 24
personnel to practice in a remote state; providing 25
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
that certain terms and provisions of the Emergency 26
Management Assistance Compact apply in specified 27
circumstances; requiring member states to take 28
specified actions related to veterans, active duty 29
servicemembers, and their spouses; providing 30
requirements for adverse actions against EMS 31
personnel; providing requirements and limitations on 32
EMS personnel who have an adverse action; requiring 33
member states report adverse actions and specified 34
occurrences to the Interstate Commission for EMS 35
Personnel Practice; providing additional powers 36
invested in a member state's EMS authority; 37
establishing the Interstate Commission for EMS 38
Personnel Practice; providing for the jurisdiction and 39
venue for court proceedings; providing membership, 40
duties, and powers of the commission; authorizing the 41
commission to adopt rules; providing immunity to 42
specified individuals; providing requirements relating 43
to delegates; requiring compact states to participate 44
in a coordinated data and reporting system; providing 45
for the development of a database, reporting 46
procedures, and the exchange of certain information 47
between compact states; providing rulemaking 48
procedures; providing for state enforcement of the 49
compact; providing for the termination of compact 50
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
membership; providing procedures for the resolution of 51
certain disputes; providing for the implementation of 52
the compact; providing requirements to withdraw from 53
the compact; providing compact amendment procedures; 54
providing construction and severability; amending s. 55
409.814, F.S.; revising eligibility requirements for 56
the Florida Kidcare program; amending s. 409.818, 57
F.S.; revising administrative duties of the agency; 58
amending s. 409.902, F.S.; revising eligibility 59
requirements for certain medical assistance payments; 60
amending s. 409.90201, F.S.; revising recipient 61
information required for Medicaid eligibility; 62
amending s. 409.904, F.S.; revising the time period in 63
which the agency will retroactively make payments to 64
Medicaid-covered services for certain persons; 65
amending s. 409.905, F.S.; prohibiting the agency from 66
making a payment to a prohibited entity; creating s. 67
414.321, F.S.; providing eligibility requirements for 68
food assistance; creating s. 414.332, F.S.; requiring 69
the Department of Children and Families develop and 70
implement a food assistance payment accuracy 71
improvement plan; providing requirements for the plan; 72
requiring the department to submit the plan to the 73
Governor and the Legislature by a specified date; 74
requiring the department, by a specified date, to 75
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
submit certain quarterly progress reports to the 76
Governor and the Legislature; providing for future 77
repeal; amending s. 414.455, F.S.; revising 78
requirements for participation in an employment and 79
training program to receive food assistance from the 80
Supplemental Nutrition Assistance Program; requiring 81
the Department of Children and Families to apply for 82
and comply with certain work requirements in 83
accordance with federal law for food assistance; 84
amending s. 456.0575, F.S.; requiring a health care 85
practitioner to provide a patient with a certain 86
notification in writing upon referring the patient to 87
certain providers; authorizing a practitioner to 88
confirm network status; requiring disciplinary action 89
against a health care practitioner under certain 90
conditions; amending s. 456.073, F.S.; revising the 91
significant investigation information the Department 92
of Health is required to report relating to certain 93
physician assistants, emergency medical technicians or 94
paramedics, and clinical social workers; amending s. 95
456.076, F.S.; requiring the terms of the monitoring 96
contracts for certain physician assistants, emergency 97
medical technicians or paramedics, and clinical social 98
workers to include withdrawal from all practice under 99
certain circumstances; creating s. 456.66, F.S.; 100
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
enacting the Physician Assistant Licensure Compact; 101
providing purpose; providing definitions; providing 102
requirements for compact states to participate in the 103
compact; providing criteria that a physician assistant 104
must satisfy to practice under the compact; 105
maintaining that authority over a physician 106
assistant's license remains with the home state but 107
authorizing remote states to define the scope of and 108
act on a physician assistant's authority to practice 109
in the compact state under the compact; prohibiting a 110
physician assistant from practicing under the compact 111
if his or her authority to do so has been acted on by 112
any compact state; requiring compact states to report 113
to the Physician Assistant Licensure Compact 114
Commission adverse actions taken against a physician 115
assistant; establishing the Physician Assistant 116
Licensure Compact Commission; providing jurisdiction 117
and venue for court proceedings; providing membership, 118
duties, and powers; authorizing the commission to 119
adopt rules; providing immunity to specified 120
individuals; requiring compact states to participate 121
in a coordinated data and reporting system; providing 122
for the development of a data system, reporting 123
procedures, and exchange of certain information 124
between compact states; providing rulemaking 125
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
procedures; providing for state enforcement of the 126
compact; providing for the termination of compact 127
membership; providing procedures for the resolution of 128
certain disputes; providing compact amendment 129
procedures; authorizing nonparty states to participate 130
in commission activities before adoption of the 131
compact; providing construction and severability; 132
amending s. 458.307, F.S.; requiring the Board of 133
Medicine and the Board of Osteopathic Medicine to 134
jointly appoint an individual to serve as the state's 135
delegate on the Physician Assistant Licensure Compact 136
Commission; amending ss. 458.347 and 459.022, F.S.; 137
revising the number of physician assistants a 138
physician may supervise; authorizing the Board of 139
Medicine and the Board of Osteopathic Medicine to take 140
adverse action against a physician assistant's 141
privilege to practice under the Physician Assistant 142
Licensure Compact and to deny, suspend, or revoke the 143
licensure of a physician assistant who violates the 144
compact; providing an exemption from licensure for 145
certain physician assistants; amending s. 464.0123, 146
F.S.; revising practice requirements for an autonomous 147
advanced practice registered nurse; authorizing an 148
autonomous advanced practice registered nurse to 149
perform certain acts; amending s. 466.017, F.S.; 150
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
authorizing a dental hygienist to prescribe, 151
administer, and dispense certain agents and administer 152
local anesthesia under certain circumstances; amending 153
s. 466.024, F.S.; revising the remediable and 154
delegable duties of a dentist; creating s. 491.022, 155
F.S.; creating the Social Work Licensure Interstate 156
Compact; providing purposes, objectives, and 157
definitions; specifying requirements for state 158
participation in the compact and duties of member 159
states; specifying that the compact does not affect an 160
individual's ability to apply for, and a member 161
state's ability to grant, a single state license 162
pursuant to the laws of that state; providing for 163
recognition of compact privilege in member states; 164
specifying criteria a licensee must meet for compact 165
privilege; providing for the expiration and renewal of 166
compact privilege; specifying that a licensee with 167
compact privilege in a remote state must adhere to the 168
laws and rules of that state; authorizing member 169
states to act on a licensee's compact privilege under 170
certain circumstances; specifying the consequences and 171
parameters of practice for a licensee whose compact 172
privilege has been acted upon or whose home state 173
license is encumbered; specifying that a licensee may 174
hold a home state license in only one member state at 175
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
a time; specifying requirements and procedures for 176
changing a home state license designation; authorizing 177
active duty military personnel or their spouses to 178
keep their home state designation during active duty; 179
authorizing member states to take adverse actions 180
against licensees and issue subpoenas for hearings and 181
investigations under certain circumstances; providing 182
requirements and procedures for such adverse action; 183
authorizing member states to engage in joint 184
investigations under certain circumstances; providing 185
that a licensee's compact privilege must be 186
deactivated in all member states for the duration of 187
an encumbrance imposed by the licensee's home state; 188
providing for notice to the data system and the 189
licensee's home state of any adverse action taken 190
against a licensee; establishing the Social Work 191
Licensure Compact Commission; providing for 192
jurisdiction and venue for court proceedings; 193
providing for membership and powers of the commission; 194
specifying powers and duties of the commission's 195
executive committee; authorizing the commission to 196
convene in closed, nonpublic meetings under certain 197
circumstances; providing for the financing of the 198
commission; providing specified individuals immunity 199
from civil liability under certain circumstances; 200
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
providing exceptions; requiring the commission to 201
defend the specified individuals in civil actions 202
under certain circumstances; requiring the commission 203
to indemnify and hold harmless specified individuals 204
for any settlement or judgment obtained in such 205
actions under certain circumstances; providing for the 206
development of the data system, reporting procedures, 207
and the exchange of specified information between 208
member states; requiring the commission to notify 209
member states of any adverse action taken against a 210
licensee or applicant for licensure; authorizing 211
member states to designate as confidential information 212
provided to the data system; requiring the commission 213
to remove information from the data system under 214
certain circumstances; providing rulemaking procedures 215
for the commission; providing for member state 216
enforcement of the compact; authorizing the commission 217
to receive notice of process, and have standing to 218
intervene, in certain proceedings; rendering certain 219
judgments and orders void as to the commission, the 220
compact, or commission rules under certain 221
circumstances; providing for defaults and termination 222
of compact membership; providing procedures for the 223
resolution of certain disputes; providing for 224
commission enforcement of the compact; providing for 225
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
remedies; providing for implementation of, withdrawal 226
from, and amendment to the compact; specifying that 227
licensees practicing in a remote state under the 228
compact must adhere to the laws and rules of that 229
state; specifying that the compact, commission rules, 230
and commission actions are binding on member states; 231
providing construction; providing for severability; 232
amending s. 491.004, F.S.; requiring the Board of 233
Clinical Social Work, Marriage and Family Therapy, and 234
Mental Health Counseling to appoint an individual to 235
serve as the state's delegate on the commission; 236
amending ss. 491.005 and 491.006, F.S.; exempting 237
certain persons from licensure requirements; amending 238
s. 491.009, F.S.; authorizing certain disciplinary 239
action under the compact for specified prohibited 240
acts; amending s. 627.6471, F.S.; requiring certain 241
health insurers to apply payments for services 242
provided by nonpreferred providers toward insureds' 243
deductibles and out-of-pocket maximums if specified 244
conditions are met; amending s. 768.28, F.S.; 245
designating state delegates of the Physician Assistant 246
Licensure Compact Commission and the Interstate 247
Commission for EMS Personnel Practice and other 248
members or employees of the commissions as state 249
agents for the purpose of applying sovereign immunity 250
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
and waivers of sovereign immunity; requiring the 251
commissions to pay certain judgments or claims; 252
authorizing the commissions to maintain insurance 253
coverage to pay such judgments or claims; designating 254
the state's delegate and other members or employees of 255
the Social Work Licensure Compact Commission as state 256
agents for the purpose of applying waivers of 257
sovereign immunity; requiring the commission to pay 258
certain claims or judgments; authorizing the 259
commission to maintain insurance coverage to pay such 260
claims or judgments; providing effective dates. 261
262
Be It Enacted by the Legislature of the State of Florida: 263
264
Section 1. This act may be cited as the "Big Beautiful 265
Healthcare Frontier Act." 266
Section 2. Subsections (12) through (19) of section 267
395.1055, Florida Statutes, are renumbered as subsections (11) 268
through (18), respectively, and subsection (11) and paragraph 269
(a) of present subsection (14) of that section are amended to 270
read: 271
395.1055 Rules and enforcement.— 272
(11) The Secretary of Health Care Administration shall 273
consult the pediatric cardiac technical advisory panel for an 274
advisory recommendation on any certificate of need applications 275
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
to establish pediatric cardiac surgical centers. 276
(13)(a)(14)(a) The Secretary of Health Care Administration 277
may request announced or unannounced site visits to any existing 278
pediatric cardiac surgical center or facility seeking licensure 279
as a pediatric cardiac surgical center through the certificate 280
of need process, to ensure compliance with this section and 281
rules adopted hereunder. 282
Section 3. Subsection (1) of section 401.411, Florida 283
Statutes, is amended, and subsection (9) is added to that 284
section, to read: 285
401.411 Disciplinary action; penalties.— 286
(1) The department may deny, suspend, or revoke a license, 287
certificate, or permit or may reprimand or fine any licensee, 288
certificateholder, or other person operating under this part or 289
s. 401.466, for any of the following grounds: 290
(a) The violation of any rule of the department or any 291
provision of this part. 292
(b) Being found guilty of, or pleading nolo contendere to, 293
regardless of adjudication in any jurisdiction, a crime that 294
relates to practice as an emergency medical technician or 295
paramedic, or to practice in any other occupation, when 296
operating under this part. 297
(c) Addiction to alcohol or any controlled substance. 298
(d) Engaging in or attempting to engage in the possession, 299
except in legitimate duties under the supervision of a licensed 300
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
physician, or the sale or distribution of any controlled 301
substance as set forth in chapter 893. 302
(e) The conviction in any court in any state or in any 303
federal court of a felony, unless the person's civil rights have 304
been restored. 305
(f) Knowingly making false or fraudulent claims; 306
procuring, attempting to procure, or renewing a certificate, 307
license, or permit by fakery, fraudulent action, or 308
misrepresentation. 309
(g) Unprofessional conduct, including, but not limited to, 310
any departure from or failure to conform to the minimal 311
prevailing standards of acceptable practice under this part, 312
including undertaking activities that the emergency medical 313
technician, paramedic, health care professional, or other 314
professional is not qualified by training or experience to 315
perform. 316
(h) Sexual misconduct with a patient, including inducing 317
or attempting to induce the patient to engage, or engaging or 318
attempting to engage the patient, in sexual activity. 319
(i) The failure to give to the department, or its 320
authorized representative, true information upon request 321
regarding an alleged or confirmed violation of this part or rule 322
of the department. 323
(j) Fraudulent or misleading advertising or advertising in 324
an unauthorized category. 325
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(k) Practicing as an emergency medical technician, 326
paramedic, health care professional, or other professional 327
operating under this part without reasonable skill and without 328
regard for the safety of the public by reason of illness, 329
drunkenness, or the use of drugs, narcotics, or chemicals or any 330
other substance or as a result of any mental or physical 331
condition. 332
(l) The failure to report to the department any person 333
known to be in violation of this part. However, a professional 334
known to be operating under this part without reasonable skill 335
and without regard for the safety of the public by reason of 336
illness, drunkenness, or the use of drugs, narcotics, chemicals, 337
or any other type of material, or as a result of a mental or 338
physical condition, may be reported to a consultant operating an 339
impaired practitioner program as described in s. 456.076 rather 340
than to the department. 341
(9) The department may take adverse action against an 342
emergency medical technician's or paramedic's privilege to 343
practice under the Emergency Medical Services Personnel 344
Licensure Interstate Compact pursuant to s. 401.466 and may 345
impose any of the penalties in s. 456.072(2) if the emergency 346
medical technician or paramedic commits an act specified in 347
subsection (1) or s. 456.072(1). 348
Section 4. Subsections (9) and (10) are added to section 349
401.25, Florida Statutes, to read: 350
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
401.25 Licensure as a basic life support or an advanced 351
life support service.— 352
(9) A person licensed as an emergency medical technician 353
or paramedic in another state who is practicing under the 354
Emergency Medical Services Personnel Licensure Interstate 355
Compact pursuant to s. 401.466, and only within the scope 356
provided therein, is exempt from the licensure requirements of 357
this section, as applicable. 358
(10) The department shall appoint a person to serve as the 359
state's delegate on the Interstate Compact Commission for EMS 360
Personnel Practice, as required under 401.466. 361
Section 5. Section 401.466, Florida Statutes, is created 362
to read: 363
401.466 Emergency Medical Services Personnel Licensure 364
Interstate Compact.—The Emergency Medical Services Personnel 365
Licensure Interstate Compact is enacted into law and entered 366
into by this state with all other jurisdictions legally joining 367
therein in the form substantially as follows: 368
369
ARTICLE I 370
PURPOSE 371
372
The purpose of this compact is to protect the public 373
through verification of competency and ensure accountability for 374
patient care-related activities of all states' licensed 375
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
emergency medical services (EMS) personnel, such as emergency 376
medical technicians (EMTs), advanced EMTs, and paramedics. This 377
compact is intended to facilitate the day-to-day movement of EMS 378
personnel across state boundaries in the performance of their 379
EMS duties as assigned by an appropriate authority and authorize 380
state EMS offices to afford immediate legal recognition to EMS 381
personnel licensed in a member state. This compact recognizes 382
that states have a vested interest in protecting the public's 383
health and safety through their licensing and regulation of EMS 384
personnel and that such state regulation shared among the member 385
states will best protect public health and safety. This compact 386
is designed to achieve the following purposes and objectives: 387
(1) Increase public access to EMS personnel. 388
(2) Enhance the states' ability to protect the public's 389
health and safety, especially patient safety. 390
(3) Encourage the cooperation of member states in the 391
areas of EMS personnel licensure and regulation. 392
(4) Support licensing of military members who are 393
separating from active-duty tours and their spouses. 394
(5) Facilitate the exchange of information between member 395
states regarding EMS personnel licensure, adverse action, and 396
significant investigatory information. 397
(6) Promote compliance with the laws governing EMS 398
personnel practice in each member state. 399
(7) Invest all member states with the authority to hold 400
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
EMS personnel accountable through the mutual recognition of 401
member state licenses. 402
403
ARTICLE II 404
DEFINITIONS 405
406
As used in this compact, the term: 407
(1) "Advanced emergency medical technician" or "AEMT" 408
means an individual licensed with cognitive knowledge and a 409
scope of practice that corresponds to that level in the National 410
EMS Education Standards and National EMS Scope of Practice 411
Model. 412
(2) "Adverse action" means any administrative, civil, 413
equitable, or criminal action permitted by a state's laws which 414
may be imposed against licensed EMS personnel by a state EMS 415
authority or state court, including, but not limited to, actions 416
against an individual's license such as revocation, suspension, 417
probation, consent agreement, monitoring, or other limitation or 418
encumbrance on the individual's practice, letters of reprimand 419
or admonition, fines, criminal convictions, and state court 420
judgments enforcing adverse actions by the state EMS authority. 421
(3) "Alternative program" means a voluntary, 422
nondisciplinary substance abuse recovery program approved by a 423
state EMS authority. 424
(4) "Certification" means the successful verification of 425
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
entry-level cognitive and psychomotor competency using a 426
reliable, validated, and legally defensible examination. 427
(5) "Commission" means the national administrative body of 428
which all states that have enacted the compact are members. 429
(6) "Emergency medical technician" or "EMT" means an 430
individual licensed with cognitive knowledge and a scope of 431
practice that corresponds to that level in the National EMS 432
Education Standards and National EMS Scope of Practice Model. 433
(7) "Home state" means a member state where an individual 434
is licensed to practice emergency medical services. 435
(8) "License" means the authorization by a state for an 436
individual to practice as an EMT, AEMT, paramedic, or a level in 437
between EMT and paramedic. 438
(9) "Medical director" means a physician licensed in a 439
member state who is accountable for the care delivered by EMS 440
personnel. 441
(10) "Member state" means a state that has enacted this 442
compact. 443
(11) "Paramedic" means an individual licensed with 444
cognitive knowledge and a scope of practice that corresponds to 445
that level in the National EMS Education Standards and National 446
EMS Scope of Practice Model. 447
(12) "Privilege to practice" means an individual's 448
authority to deliver emergency medical services in remote states 449
as authorized under this compact. 450
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(13) "Remote state" means a member state in which an 451
individual is not licensed. 452
(14) "Restricted" means the outcome of an adverse action 453
that limits a license or the privilege to practice. 454
(15) "Rule" means a written statement by the interstate 455
Commission adopted pursuant to Article XII of this compact that 456
is of general applicability; implements, interprets, or 457
prescribes a policy or provision of the compact; or is an 458
organizational, procedural, or practice requirement of the 459
commission and has the force and effect of statutory law in a 460
member state and includes the amendment, repeal, or suspension 461
of an existing rule. 462
(16) "Scope of practice" means defined parameters of 463
various duties or services that may be provided by an individual 464
with specific credentials. Whether regulated by rule, statute, 465
or court decision, it tends to represent the limits of services 466
an individual may perform. 467
(17) "Significant investigatory information" means: 468
(a) Investigative information that a state EMS authority, 469
after a preliminary inquiry that includes notification and an 470
opportunity to respond if required by state law, has reason to 471
believe, if proved true, would result in the imposition of an 472
adverse action on a license or privilege to practice; or 473
(b) Investigative information that indicates that the 474
individual represents an immediate threat to public health and 475
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
safety regardless of whether the individual has been notified 476
and had an opportunity to respond. 477
(18) "State" means any state, commonwealth, district, or 478
territory of the United States. 479
(19) "State EMS authority" means the board, office, or 480
other agency with the legislative mandate to license EMS 481
personnel. 482
483
ARTICLE III 484
HOME STATE LICENSURE 485
486
(1) Any member state in which an individual holds a 487
current license shall be deemed a home state for purposes of 488
this compact. 489
(2) Any member state may require an individual to obtain 490
and retain a license to be authorized to practice in the member 491
state under circumstances not authorized by the privilege to 492
practice under the terms of this compact. 493
(3) A home state's license authorizes an individual to 494
practice in a remote state under the privilege to practice only 495
if the home state: 496
(a) Currently requires the use of the National Registry of 497
Emergency Medical Technicians (NREMT) examination as a condition 498
of issuing initial licenses at the EMT and paramedic levels. 499
(b) Has a mechanism in place for receiving and 500
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
investigating complaints about individuals. 501
(c) Notifies the commission, in compliance with the terms 502
herein, of any adverse action or significant investigatory 503
information regarding an individual. 504
(d) No later than 5 years after activation of the compact, 505
requires a criminal background check of all applicants for 506
initial licensure, including the use of the results of 507
fingerprint or other biometric data checks compliant with the 508
requirements of the Federal Bureau of Investigation, with the 509
exception of federal employees who have suitability 510
determination in accordance with 5 C.F.R. s. 731.202 and submit 511
documentation of such as adopted in the rules of the commission. 512
(e) Complies with the rules of the commission. 513
514
ARTICLE IV 515
COMPACT PRIVILEGE TO PRACTICE 516
517
(1) Member states shall recognize the privilege to 518
practice of an individual licensed in another member state that 519
is in conformance with Article III. 520
(2) To exercise the privilege to practice under the terms 521
and provisions of this compact, an individual must: 522
(a) Be at least 18 years of age. 523
(b) Possess a current unrestricted license in a member 524
state as an EMT, AEMT, paramedic, or state recognized and 525
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licensed level with a scope of practice and authority between 526
EMT and paramedic. 527
(c) Practice under the supervision of a medical director. 528
(3) An individual providing patient care in a remote state 529
under the privilege to practice shall function within the scope 530
of practice authorized by the home state unless and until 531
modified by an appropriate authority in the remote state as may 532
be defined in the rules of the commission. 533
(4) Except as provided in subsection (3) of this article, 534
an individual practicing in a remote state will be subject to 535
the remote state's authority and laws. A remote state may, in 536
accordance with due process and that state's laws, restrict, 537
suspend, or revoke an individual's privilege to practice in the 538
remote state and may take any other necessary actions to protect 539
the health and safety of its citizens. If a remote state takes 540
action it shall promptly notify the home state and the 541
commission. 542
(5) If an individual's license in any home state is 543
restricted or suspended, the individual is not eligible to 544
practice in a remote state under the privilege to practice until 545
the individual's home state license is restored. 546
(6) If an individual's privilege to practice in any remote 547
state is restricted, suspended, or revoked, the individual is 548
not eligible to practice in any remote state until the 549
individual's privilege to practice is restored. 550
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551
ARTICLE V 552
CONDITIONS OF PRACTICE IN A REMOTE STATE 553
554
An individual may practice in a remote state under a 555
privilege to practice only in the performance of the 556
individual's EMS duties as assigned by an appropriate authority, 557
as defined in the rules of the commission, and under the 558
following circumstances: 559
(1) The individual originates a patient transport in a 560
home state and transports the patient to a remote state; 561
(2) The individual originates in the home state and enters 562
a remote state to pick up a patient and provide care and 563
transport of the patient to the home state; 564
(3) The individual enters a remote state to provide 565
patient care or transport within that remote state; 566
(4) The individual enters a remote state to pick up a 567
patient and provide care and transport to a third member state; 568
or 569
(5) Other conditions as determined by rules adopted by the 570
commission. 571
572
ARTICLE VI 573
RELATIONSHIP TO EMERGENCY MANAGEMENT ASSISTANCE COMPACT 574
575
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Upon a member state's Governor's declaration of a state of 576
emergency or disaster that activates the Emergency Management 577
Assistance Compact (EMAC), all relevant terms and provisions of 578
EMAC shall apply and to the extent any terms or provisions of 579
this compact conflicts with EMAC, the terms of EMAC shall 580
prevail with respect to any individual practicing in the remote 581
state in response to such declaration. 582
583
ARTICLE VII 584
VETERANS, SERVICE MEMBERS SEPARATING FROM ACTIVE-DUTY MILITARY, 585
AND THEIR SPOUSES 586
587
(1) Member states shall consider a veteran, an active 588
military service member, and a member of the National Guard and 589
Reserves separating from an active-duty tour, and a spouse 590
thereof, who holds a current valid and unrestricted NREMT 591
certification at or above the level of the state license being 592
sought as satisfying the minimum training and examination 593
requirements for such licensure. 594
(2) Member states shall expedite the processing of 595
licensure applications submitted by veterans, active military 596
service members, and members of the National Guard and Reserves 597
separating from an active-duty tour, and spouses thereof. 598
(3) All individuals functioning with a privilege to 599
practice under this article remain subject to the adverse 600
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actions provisions of Article VIII. 601
602
ARTICLE VIII 603
ADVERSE ACTIONS 604
605
(1) A home state shall have exclusive power to impose 606
adverse action against an individual's license issued by the 607
home state. 608
(2) If an individual's license in any home state is 609
restricted or suspended, the individual is not eligible to 610
practice in a remote state under the privilege to practice until 611
the individual's home state license is restored. 612
(a) All home state adverse action orders shall include a 613
statement that the individual's compact privileges are inactive. 614
The order may allow the individual to practice in remote states 615
with prior written authorization from both the home state and 616
remote state's EMS authority. 617
(b) An individual currently subject to adverse action in 618
the home state may not practice in any remote state without 619
prior written authorization from both the home state and remote 620
state's EMS authority. 621
(3) A member state shall report adverse actions and any 622
occurrences that the individual's compact privileges are 623
restricted, suspended, or revoked to the commission in 624
accordance with the rules of the commission. 625
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(4) A remote state may take adverse action on an 626
individual's privilege to practice within that state. 627
(5) Any member state may take adverse action against an 628
individual's privilege to practice in that state based on the 629
factual findings of another member state, so long as each state 630
follows its own procedures for imposing such adverse action. 631
(6) A home state's EMS authority shall investigate and 632
take appropriate action with respect to reported conduct in a 633
remote state as it would if such conduct had occurred within the 634
home state. In such cases, the home state's law shall control in 635
determining the appropriate adverse action. 636
(7) Nothing in this compact shall override a member 637
state's decision that participation in an alternative program 638
may be used in lieu of adverse action and that such 639
participation shall remain nonpublic if required by the member 640
state's laws. Member states must require individuals who enter 641
any alternative programs to agree not to practice in any other 642
member state during the term of the alternative program without 643
prior authorization from such other member state. 644
645
ARTICLE IX 646
ADDITIONAL POWERS INVESTED IN A MEMBER STATE'S EMS AUTHORITY 647
648
A member state's EMS authority, in addition to any other 649
powers granted under state law, is authorized under this compact 650
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to: 651
(1) Issue subpoenas for both hearings and investigations 652
that require the attendance and testimony of witnesses and the 653
production of evidence. Subpoenas issued by a member state's EMS 654
authority for the attendance and testimony of witnesses, or the 655
production of evidence from another member state, shall be 656
enforced in the remote state by any court of competent 657
jurisdiction, according to that court's practice and procedure 658
in considering subpoenas issued in its own proceedings. The 659
issuing state EMS authority shall pay any witness fees, travel 660
expenses, mileage, and other fees required by the service 661
statutes of the state where the witnesses or evidence are 662
located. 663
(2) Issue cease and desist orders to restrict, suspend, or 664
revoke an individual's privilege to practice in the state. 665
666
ARTICLE X 667
ESTABLISHMENT OF THE INTERSTATE COMMISSION FOR EMS PERSONNEL 668
PRACTICE 669
670
(1)(a) The compact states create and establish a joint 671
public agency known as the Interstate Commission for EMS 672
Personnel Practice. 673
(b) The commission is a body politic and an 674
instrumentality of the compact states. 675
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(c) Venue is proper and judicial proceedings by or against 676
the commission shall be brought solely and exclusively in a 677
court of competent jurisdiction where the principal office of 678
the commission is located. The commission may waive venue and 679
jurisdictional defenses to the extent it adopts or consents to 680
participate in alternative dispute resolution proceedings. 681
(d) Nothing in this compact shall be construed to be a 682
waiver of sovereign immunity. 683
(2)(a) Each member state shall have and be limited to one 684
delegate. The responsible official of the state EMS authority or 685
his or her designee shall be the delegate to this compact for 686
each member state. Any delegate may be removed or suspended from 687
office as provided by the law of the state from which the 688
delegate is appointed. Any vacancy occurring in the commission 689
shall be filled in accordance with the laws of the member state 690
in which the vacancy exists. In the event that more than one 691
board, office, or other agency with the legislative mandate to 692
license EMS personnel at and above the level of EMT exists, the 693
Governor of the state will determine which entity will be 694
responsible for assigning the delegate. 695
(b) Each delegate shall be entitled to one vote with 696
regard to the adoption of rules and creation of bylaws and shall 697
otherwise have an opportunity to participate in the business and 698
affairs of the commission. A delegate shall vote in person or by 699
such other means as provided in the bylaws. The bylaws may 700
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provide for delegates' participation in meetings by telephone or 701
other means of communication. 702
(c) The commission shall meet at least once during each 703
calendar year. Additional meetings shall be held as set forth in 704
the bylaws. 705
(d) All meetings shall be open to the public, and public 706
notice of meetings shall be given in the same manner as required 707
under the rulemaking provisions in Article XII. 708
(e) The commission may convene in a closed, nonpublic 709
meeting or nonpublic part of a public meeting to receive legal 710
advice or to discuss the following: 711
1. Noncompliance of a member state with its obligations 712
under the compact; 713
2. The employment, compensation, discipline or other 714
personnel matters, practices, or procedures related to specific 715
employees or other matters related to the commission's internal 716
personnel practices and procedures; 717
3. Current, threatened, or reasonably anticipated 718
litigation; 719
4. Negotiation of contracts for the purchase or sale of 720
goods, services, or real estate; 721
5. Accusing any person of a crime or formally censuring 722
any person; 723
6. Disclosure of trade secrets or commercial or financial 724
information that is privileged or confidential; 725
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7. Disclosure of information of a personal nature where 726
disclosure would constitute a clearly unwarranted invasion of 727
personal privacy; 728
8. Disclosure of investigatory records compiled for law 729
enforcement purposes; 730
9. Disclosure of information related to any investigatory 731
reports prepared by or on behalf of or for use of the commission 732
or other committee charged with responsibility of investigation 733
or determination of compliance issues pursuant to the compact; 734
10. Legal advice; or 735
11. Matters specifically exempted from disclosure by 736
federal or state statute. 737
(f) If a meeting, or portion of a meeting, is closed 738
pursuant to this provision, the commission's legal counsel or 739
designee shall certify that the meeting may be closed and shall 740
reference each relevant exempting provision. The commission 741
shall keep minutes that fully and clearly describe all matters 742
discussed in a meeting and shall provide a full and accurate 743
summary of actions taken, and the reasons therefor, including a 744
description of the views expressed. All documents considered in 745
connection with an action shall be identified in such minutes. 746
All minutes and documents of a closed meeting shall remain under 747
seal, subject to release by a majority vote of the commission or 748
order of a court of competent jurisdiction. 749
(3) The commission shall, by a majority vote of the 750
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delegates, prescribe bylaws or rules to govern its conduct as 751
may be necessary or appropriate to carry out the purposes and 752
exercise the powers of the compact, including, but not limited 753
to: 754
(a) Establishing the fiscal year of the commission. 755
(b) Providing reasonable standards and procedures: 756
1. Establishing and the meetings of other committees. 757
2. Governing any general or specific delegation of any 758
authority or function of the commission. 759
(c) Providing reasonable procedures for calling and 760
conducting meetings of the commission, ensuring reasonable 761
advance notice of all meetings, and providing an opportunity for 762
attendance of such meetings by interested parties, with 763
enumerated exceptions designed to protect the public's interest, 764
the privacy of individuals, and proprietary information, 765
including trade secrets. The commission may meet in closed 766
session only after a majority of the membership votes to close a 767
meeting in whole or in part. As soon as practicable, the 768
commission must make public a copy of the vote to close the 769
meeting revealing the vote of each member with no proxy votes 770
allowed. 771
(d) Establishing the titles, duties and authority, and 772
reasonable procedures for the election of the officers of the 773
commission. 774
(e) Providing reasonable standards and procedures for the 775
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establishment of the personnel policies and programs of the 776
commission. Notwithstanding any civil service or other similar 777
laws of any member state, the bylaws shall exclusively govern 778
the personnel policies and programs of the commission. 779
(f) Adopting a code of ethics to address permissible and 780
prohibited activities of commission members and employees. 781
(g) Providing a mechanism for winding up the operations of 782
the commission and the equitable disposition of any surplus 783
funds that may exist after the termination of the compact after 784
the payment or reserving of all of its debts and obligations. 785
(h) The commission shall publish its bylaws and file a 786
copy thereof, and a copy of any amendment thereto, with the 787
appropriate agency or officer in each of the member states, if 788
any. 789
(i) The commission shall maintain its financial records in 790
accordance with the bylaws. 791
(j) The commission shall meet and take such actions as are 792
consistent with the provisions of this compact and the bylaws. 793
(4) The commission shall have the following powers: 794
(a) The authority to adopt uniform rules to facilitate and 795
coordinate implementation and administration of this compact. 796
The rules shall have the force and effect of law and shall be 797
binding in all member states. 798
(b) To bring and prosecute legal proceedings or actions in 799
the name of the commission, provided that the standing of any 800
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state EMS authority or other regulatory body responsible for EMS 801
personnel licensure to sue or be sued under applicable law may 802
not be affected. 803
(c) To purchase and maintain insurance and bonds. 804
(d) To borrow, accept, or contract for services of 805
personnel, including, but not limited to, employees of a member 806
state. 807
(e) To hire employees, elect or appoint officers, fix 808
compensation, define duties, grant such individuals appropriate 809
authority to carry out the purposes of the compact, and 810
establish the commission's personnel policies and programs 811
relating to conflicts of interest, qualifications of personnel, 812
and other related personnel matters. 813
(f) To accept any and all appropriate donations and grants 814
of money, equipment, supplies, materials, and services; and 815
receive, use, and dispose of the same; provided that at all 816
times the commission shall strive to avoid any appearance of 817
impropriety or conflict of interest. 818
(g) To lease, purchase, accept appropriate gifts or 819
donations of, or otherwise to own, hold, improve, or use any 820
property, real, personal, or mixed; provided that at all times 821
the commission shall strive to avoid any appearance of 822
impropriety. 823
(h) To sell convey, mortgage, pledge, lease, exchange, 824
abandon, or otherwise dispose of any property real, personal, or 825
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mixed. 826
(i) To establish a budget and make expenditures. 827
(j) To borrow money. 828
(k) To appoint committees, including advisory committees 829
comprised of members, state regulators, state legislators or 830
their representatives, consumer representatives, and such other 831
interested persons as may be designated in this compact and the 832
bylaws. 833
(l) To provide and receive information from, and to 834
cooperate with, law enforcement agencies. 835
(m) To adopt and use an official seal. 836
(n) To perform such other functions as may be necessary or 837
appropriate to achieve the purposes of this compact consistent 838
with the state regulation of EMS personnel licensure and 839
practice. 840
(5)(a) The commission shall pay, or provide for the 841
payment of, the reasonable expenses of its establishment, 842
organization, and ongoing activities. 843
(b) The commission may accept any and all appropriate 844
revenue sources, donations, and grants of money, equipment, 845
supplies, materials, and services. 846
(c) The commission may levy on and collect an annual 847
assessment from each member state to cover the cost of the 848
operations and activities of the commission and its staff, which 849
must be in a total amount sufficient to cover its annual budget 850
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as approved each year for which revenue is not provided by other 851
sources. The aggregate annual assessment amount shall be 852
allocated based upon a formula to be determined by the 853
commission, which shall adopt a rule binding upon all member 854
states. 855
(d) The commission may not incur obligations of any kind 856
before securing the funds adequate to meet the same; nor shall 857
the commission pledge the credit of any of the member states, 858
except by and with the authority of the member state. 859
(e) The commission shall keep accurate accounts of all 860
receipts and disbursements. The receipts and disbursements of 861
the commission shall be subject to the audit and accounting 862
procedures established under its bylaws. However, all receipts 863
and disbursements of funds handled by the commission shall be 864
audited yearly by a certified or licensed public accountant, and 865
the report of the audit shall be included in and become part of 866
the annual report of the commission. 867
(6)(a) The members, officers, executive director, 868
employees and representatives of the commission shall be immune 869
from suit and liability, either personally or in their official 870
capacities, for any claim for damage to or loss of property or 871
personal injury or other civil liability caused by or arising 872
out of any actual or alleged act, error, or omission that 873
occurred, or that the person against whom the claim is made had 874
a reasonable basis for believing occurred within the scope of 875
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commission employment, duties, or responsibilities; provided 876
that nothing in this paragraph shall be construed to protect any 877
such person from suit or liability for any damage, loss, injury, 878
or liability caused by the intentional or willful or wanton 879
misconduct of that person. The procurement of insurance of any 880
type by the commission may not in any way compromise or limit 881
the immunity granted hereunder. 882
(b) The commission shall defend any member, officer, 883
executive director, employee, or representative of the 884
commission in any civil action seeking to impose liability 885
arising out of any actual or alleged act, error, or omission 886
that occurred within the scope of commission employment, duties, 887
or responsibilities, or that the person against whom the claim 888
is made had a reasonable basis for believing occurred within the 889
scope of commission employment, duties, or responsibilities; 890
provided that nothing herein shall be construed to prohibit that 891
person from retaining his or her own counsel; and provided 892
further, that the actual or alleged act, error, or omission did 893
not result from that person's intentional or willful or wanton 894
misconduct. 895
(c) The commission shall indemnify and hold harmless any 896
member, officer, executive director, employee, or representative 897
of the commission for the amount of any settlement or judgment 898
obtained against that person arising out of any actual or 899
alleged act, error, or omission that occurred within the scope 900
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of commission employment, duties, or responsibilities, or that 901
such person had a reasonable basis for believing occurred within 902
the scope of commission employment, duties, or responsibilities, 903
provided that the actual or alleged act, error, or omission did 904
not result from the intentional or willful or wanton misconduct 905
of that person. 906
907
ARTICLE XI 908
COORDINATED DATABASE 909
910
(1) The commission shall provide for the development and 911
maintenance of a coordinated database and reporting system 912
containing licensure, adverse action, and significant 913
investigatory information on all licensed individuals in member 914
states. 915
(2) Notwithstanding any other provision of state law to 916
the contrary, a member state shall submit a uniform data set to 917
the coordinated database on all individuals to whom this compact 918
is applicable as required by the rules of the commission, 919
including: 920
(a) Identifying information. 921
(b) Licensure data. 922
(c) Significant investigatory information. 923
(d) Adverse actions against an individual's license. 924
(e) An indicator that an individual's privilege to 925
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practice is restricted, suspended, or revoked. 926
(f) Nonconfidential information related to alternative 927
program participation. 928
(g) Any denial of application for licensure and the 929
reasons for such denial. 930
(h) Other information that may facilitate the 931
administration of this compact, as determined by the rules of 932
the commission. 933
(3) The coordinated database administrator shall promptly 934
notify all member states of any adverse action taken against, or 935
significant investigative information on, any individual in a 936
member state. 937
(4) Member states contributing information to the 938
coordinated database may designate information that may not be 939
shared with the public without the express permission of the 940
contributing state. 941
(5) Any information submitted to the coordinated database 942
that is subsequently required to be expunged by the laws of the 943
member state contributing the information shall be removed from 944
the coordinated database. 945
946
ARTICLE XII 947
RULEMAKING 948
949
(1) The commission shall exercise its rulemaking powers 950
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pursuant to the criteria set forth in this article and the rules 951
adopted thereunder. Rules and amendments shall become binding as 952
of the date specified in each rule or amendment. 953
(2) If a majority of the legislatures of the member states 954
reject a rule, by enactment of a statute or resolution in the 955
same manner used to adopt the compact, then such rule shall have 956
no further force and effect in any member state. 957
(3) Rules or amendments to the rules shall be adopted at a 958
regular or special meeting of the commission. 959
(4) Before the adoption of a final rule or rules by the 960
commission, and at least 60 days in advance of the meeting at 961
which the rule will be considered and voted upon, the commission 962
shall file a notice of proposed rulemaking: 963
(a) On the website of the commission. 964
(b) On the website of each member state EMS authority or 965
the publication in which each state would otherwise publish 966
proposed rules. 967
(5) The notice of proposed rulemaking shall include: 968
(a) The proposed time, date, and location of the meeting 969
in which the rule will be considered and voted upon. 970
(b) The text of the proposed rule or amendment and the 971
reason for the proposed rule. 972
(c) A request for comments on the proposed rule from any 973
interested person. 974
(d) The manner in which interested persons may submit 975
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notice to the commission of their intentions to attend the 976
public hearing and any written comments. 977
(6) Before adoption of a proposed rule, the commission 978
shall allow persons to submit written data, facts, opinions, and 979
arguments, which shall be made available to the public. 980
(7) The commission shall grant an opportunity for a public 981
hearing before it adopts a rule or amendment if a hearing is 982
requested by: 983
(a) At least 25 persons; 984
(b) A governmental subdivision or agency; or 985
(c) An association having at least 25 members. 986
(8)(a) If a hearing is held on the proposed rule or 987
amendment, the commission shall publish the place, time, and 988
date of the scheduled public hearing. 989
(b) Each person wishing to be heard at the hearing shall 990
notify the executive director of the commission or other 991
designated member in writing of his or her desire to appear and 992
testify at the hearing not less than 5 business days before the 993
scheduled date of the hearing. 994
(c) Hearings shall be conducted in a manner providing each 995
person who wishes to comment a fair and reasonable opportunity 996
to comment orally or in writing. 997
(d) No transcript of the hearing is required, unless a 998
written request for a transcript is made, in which case the 999
person requesting the transcript shall bear the cost of 1000
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producing the transcript. A recording may be made in lieu of a 1001
transcript under the same terms and conditions as a transcript. 1002
This subsection does not preclude the commission from making a 1003
transcript or recording of the hearing if it so chooses. 1004
(e) Nothing in this article shall be construed as 1005
requiring a separate hearing on each rule. Rules may be grouped 1006
for the convenience of the commission at hearings required by 1007
this article. 1008
(9) Following the scheduled hearing date, or by the close 1009
of business on the scheduled hearing date if the hearing was not 1010
held, the commission shall consider all written and oral 1011
comments received. 1012
(10) The commission shall, by majority vote of all 1013
members, take final action on the proposed rule and shall 1014
determine the effective date of the rule, if any, based on the 1015
rulemaking record and the full text of the rule. 1016
(11) If no written notice of intent to attend the public 1017
hearing by interested parties is received, the commission may 1018
proceed with adoption of the proposed rule without a public 1019
hearing. 1020
(12) Upon determination that an emergency exists, the 1021
commission may consider and adopt an emergency rule without 1022
prior notice, opportunity for comment, or hearing, provided that 1023
the usual rulemaking procedures provided in the compact and in 1024
this article shall be retroactively applied to the rule as soon 1025
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as reasonably possible, in no event later than 90 days after the 1026
effective date of the rule. For the purposes of this provision, 1027
an emergency rule is one that must be adopted immediately in 1028
order to: 1029
(a) Meet an imminent threat to public health, safety, or 1030
welfare; 1031
(b) Prevent a loss of commission or member state funds; 1032
(c) Meet a deadline for the adoption of an administrative 1033
rule that is established by federal law or rule; or 1034
(d) Protect public health and safety. 1035
(13) The commission or an authorized committee of the 1036
commission may direct revisions to a previously adopted rule or 1037
amendment for purposes of correcting typographical errors, 1038
errors in format, errors in consistency, or grammatical errors. 1039
Public notice of any revisions shall be posted on the website of 1040
the commission. The revision shall be subject to challenge by 1041
any person for a period of 30 days after posting. The revision 1042
may be challenged only on grounds that the revision results in a 1043
material change to a rule. A challenge shall be made in writing 1044
and delivered to the chair of the commission before the end of 1045
the notice period. If no challenge is made, the revision will 1046
take effect without further action. If the revision is 1047
challenged, the revision may not take effect without the 1048
approval of the commission. 1049
1050
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ARTICLE XIII 1051
OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT 1052
1053
(1)(a) The executive, legislative, and judicial branches 1054
of state government in each member state shall enforce this 1055
compact and take all actions necessary and appropriate to 1056
effectuate the compact's purposes and intent. The provisions of 1057
this compact and the rules adopted hereunder shall have standing 1058
as statutory law. 1059
(b) All courts shall take judicial notice of the compact 1060
and the rules in any judicial or administrative proceeding in a 1061
member state pertaining to the subject matter of this compact 1062
which may affect the powers, responsibilities, or actions of the 1063
commission. 1064
(c) The commission shall be entitled to receive service of 1065
process in any such proceeding, and shall have standing to 1066
intervene in such a proceeding for all purposes. Failure to 1067
provide service of process to the commission shall render a 1068
judgment or order void as to the commission, this compact, or 1069
adopted rules. 1070
(2)(a) If the commission determines that a member state 1071
has defaulted in the performance of its obligations or 1072
responsibilities under this compact or the adopted rules, the 1073
commission shall: 1074
1. Provide written notice to the defaulting state and 1075
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other member states of the nature of the default, the proposed 1076
means of curing the default or any other action to be taken by 1077
the commission. 1078
2. Provide remedial training and specific technical 1079
assistance regarding the default. 1080
(b) If a state in default fails to cure the default, the 1081
defaulting state may be terminated from the compact upon an 1082
affirmative vote of a majority of the member states, and all 1083
rights, privileges, and benefits conferred by this compact may 1084
be terminated on the effective date of termination. A cure of 1085
the default does not relieve the offending state of obligations 1086
or liabilities incurred during the period of default. 1087
(c) Termination of membership in the compact shall be 1088
imposed only after all other means of securing compliance have 1089
been exhausted. Notice of intent to suspend or terminate shall 1090
be given by the commission to the Governor, the majority and 1091
minority leaders of the defaulting state's legislature, and each 1092
of the member states. 1093
(d) A state that has been terminated is responsible for 1094
all assessments, obligations, and liabilities incurred through 1095
the effective date of termination, including obligations that 1096
extend beyond the effective date of termination. 1097
(e) The commission does not bear any costs related to a 1098
state that is found to be in default or that has been terminated 1099
from the compact, unless agreed upon in writing between the 1100
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commission and the defaulting state. 1101
(f) The defaulting state may appeal the action of the 1102
commission by petitioning the United States District Court for 1103
the District of Columbia or the federal district where the 1104
commission has its principal offices. The prevailing member 1105
shall be awarded all costs of such litigation, including 1106
reasonable attorney fees. 1107
(3)(a) Upon request by a member state, the commission 1108
shall attempt to resolve disputes related to the compact that 1109
arise among member states and between member and nonmember 1110
states. 1111
(b) The commission shall adopt a rule providing for both 1112
mediation and binding dispute resolution for disputes as 1113
appropriate. 1114
(4)(a) The commission, in the reasonable exercise of its 1115
discretion, shall enforce the provisions and rules of this 1116
compact. 1117
(b) By majority vote, the commission may initiate legal 1118
action in the United States District Court for the District of 1119
Columbia or the federal district where the commission has its 1120
principal offices against a member state in default to enforce 1121
compliance with the provisions of the compact and its adopted 1122
rules and bylaws. The relief sought may include both injunctive 1123
relief and damages. In the event judicial enforcement is 1124
necessary, the prevailing member shall be awarded all costs of 1125
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such litigation, including reasonable attorney fees. 1126
(c) The remedies herein may not be the exclusive remedies 1127
of the commission. The commission may pursue any other remedies 1128
available under federal or state law. 1129
1130
ARTICLE XIV 1131
DATE OF IMPLEMENTATION OF THE INTERSTATE COMMISSION FOR EMS 1132
PERSONNEL PRACTICE AND ASSOCIATED RULES, WITHDRAWAL, AND 1133
AMENDMENT 1134
1135
(1) The compact shall come into effect on the date on 1136
which the compact statute is enacted into law in the tenth 1137
member state. The provisions, which become effective at that 1138
time, shall be limited to the powers granted to the commission 1139
relating to assembly and the adoption of rules. Thereafter, the 1140
commission shall meet and exercise rulemaking powers necessary 1141
to the implementation and administration of the compact. 1142
(2) Any state that joins the compact subsequent to the 1143
commission's initial adoption of the rules shall be subject to 1144
the rules as they exist on the date on which the compact becomes 1145
law in that state. Any rule that has been previously adopted by 1146
the commission shall have the full force and effect of law on 1147
the day the compact becomes law in that state. 1148
(3) Any member state may withdraw from this compact by 1149
enacting a statute repealing the same. 1150
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(a) A member state's withdrawal does not take effect until 1151
6 months after enactment of the repealing statute. 1152
(b) Withdrawal does not affect the continuing requirement 1153
of the withdrawing state's EMS authority to comply with the 1154
investigative and adverse action reporting requirements of this 1155
act before the effective date of withdrawal. 1156
(4) Nothing contained in this compact shall be construed 1157
to invalidate or prevent any EMS personnel licensure agreement 1158
or other cooperative arrangement between a member state and a 1159
nonmember state that does not conflict with the provisions of 1160
this compact. 1161
(5) This compact may be amended by the member states. No 1162
amendment to this compact shall become effective and binding 1163
upon any member state until it is enacted into the laws of all 1164
member states. 1165
1166
ARTICLE XV 1167
CONSTRUCTION AND SEVERABILITY 1168
1169
This compact shall be liberally construed so as to 1170
effectuate the purposes thereof. If this compact shall be held 1171
contrary to the constitution of any state member thereto, the 1172
compact shall remain in full force and effect as to the 1173
remaining member states. This compact does not supersede state 1174
law or rules related to licensure of EMS agencies. 1175
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Section 6. Effective October 1, 2026, paragraph (c) of 1176
subsection (5) of section 409.814, Florida Statutes, is amended 1177
to read: 1178
409.814 Eligibility.—A child who has not reached 19 years 1179
of age whose family income is equal to or below 300 percent of 1180
the federal poverty level is eligible for the Florida Kidcare 1181
program as provided in this section. If an enrolled individual 1182
is determined to be ineligible for coverage, he or she must be 1183
immediately disenrolled from the respective Florida Kidcare 1184
program component. 1185
(5) The following children are not eligible to receive 1186
Title XXI-funded premium assistance for health benefits coverage 1187
under the Florida Kidcare program, except under Medicaid if the 1188
child would have been eligible for Medicaid under s. 409.903 or 1189
s. 409.904 as of June 1, 1997: 1190
(c) A child who is an alien, unless the child: 1191
1. Meets but who does not meet the definition of a 1192
lawfully residing child; 1193
2. Is an alien lawfully admitted for permanent residence 1194
as defined by the Immigration and Nationality Act, as amended; 1195
3. Is an alien who has been granted the status of Cuban 1196
and Haitian entrant as defined in the Refugee Education 1197
Assistance Act of 1980, as amended; or 1198
4. Lawfully resides in the United States in accordance 1199
with a Compact of Free Association referred to in the Personal 1200
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Responsibility and Work Opportunity Reconciliation Act of 1996. 1201
1202
This paragraph does not extend eligibility for the Florida 1203
Kidcare program to an undocumented immigrant. 1204
Section 7. Paragraph (g) is added to subsection (3) of 1205
section 409.818, Florida Statutes, to read: 1206
409.818 Administration.—In order to implement ss. 409.810-1207
409.821, the following agencies shall have the following duties: 1208
(3) The Agency for Health Care Administration, under the 1209
authority granted in s. 409.914(1), shall: 1210
(g) Regularly obtain from reliable data sources in 1211
accordance with applicable federal law address information for 1212
an enrollee. 1213
1214
The agency is designated the lead state agency for Title XXI of 1215
the Social Security Act for purposes of receipt of federal 1216
funds, for reporting purposes, and for ensuring compliance with 1217
federal and state regulations and rules. 1218
Section 8. Subsection (2) of section 409.902, Florida 1219
Statutes, is amended to read: 1220
409.902 Designated single state agency; payment 1221
requirements; program title; release of medical records.— 1222
(2)(a) Eligibility is restricted to United States citizens 1223
and nationals and to: 1224
1. An alien lawfully admitted for permanent residence as 1225
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defined by the Immigration and Nationality Act, as amended. 1226
2. An alien who has been granted the status of Cuban and 1227
Haitian entrant as defined in the Refugee Education Assistance 1228
Act of 1980, as amended. 1229
3. An individual who lawfully resides in the United States 1230
in accordance with a Compact of Free Association referred to in 1231
the Personal Responsibility and Work Opportunity Reconciliation 1232
Act of 1996 lawfully admitted noncitizens who meet the criteria 1233
provided in s. 414.095(3). 1234
(b)(a) Citizenship or immigration status must be verified. 1235
For eligible noncitizens, this includes verification of the 1236
validity of documents with the United States Citizenship and 1237
Immigration Services using the federal SAVE verification 1238
process. 1239
(c)(b) State funds may not be used to provide medical 1240
services to individuals who do not meet the requirements of this 1241
subsection unless the services are necessary to treat an 1242
emergency medical condition or are for pregnant women. Such 1243
services are authorized only to the extent provided under 1244
federal law and in accordance with federal regulations as 1245
provided in 42 C.F.R. s. 440.255. 1246
Section 9. Section 409.90201, Florida Statutes, is amended 1247
to read: 1248
409.90201 Recipient information address update process.—1249
The Agency for Health Care Administration and the Department of 1250
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Children and Families shall: 1251
(1) Regularly obtain from reliable data sources in 1252
accordance with applicable federal law address information for a 1253
recipient., in consultation with hospitals and nursing homes 1254
that serve Medicaid recipients, shall develop a process to 1255
(2) Update a recipient's address in the Medicaid 1256
eligibility system at the time a recipient is admitted to a 1257
hospital or nursing home,. if a recipient's address information 1258
in the Medicaid eligibility system needs to be updated, the 1259
update shall be completed within 10 days after the recipient's 1260
admission to a hospital or nursing home. 1261
(3) Review at least quarterly the public file of death 1262
information compiled by the Social Security Administration and 1263
act on matches between a recipient's information and the public 1264
file of death information in accordance with applicable federal 1265
law. 1266
Section 10. Paragraph (a) of subsection (12) of section 1267
409.904, Florida Statutes, is amended to read: 1268
409.904 Optional payments for eligible persons.—The agency 1269
may make payments for medical assistance and related services on 1270
behalf of the following persons who are determined to be 1271
eligible subject to the income, assets, and categorical 1272
eligibility tests set forth in federal and state law. Payment on 1273
behalf of these Medicaid eligible persons is subject to the 1274
availability of moneys and any limitations established by the 1275
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General Appropriations Act or chapter 216. 1276
(12) The agency shall make payments to Medicaid-covered 1277
services: 1278
(a) For eligible children and pregnant women, retroactive 1279
to the first day of the second month for a period of no more 1280
than 90 days before the month in which an application for 1281
Medicaid is submitted. 1282
Section 11. Subsection (13) is added to section 409.905, 1283
Florida Statutes, to read: 1284
409.905 Mandatory Medicaid services.—The agency may make 1285
payments for the following services, which are required of the 1286
state by Title XIX of the Social Security Act, furnished by 1287
Medicaid providers to recipients who are determined to be 1288
eligible on the dates on which the services were provided. Any 1289
service under this section shall be provided only when medically 1290
necessary and in accordance with state and federal law. 1291
Mandatory services rendered by providers in mobile units to 1292
Medicaid recipients may be restricted by the agency. Nothing in 1293
this section shall be construed to prevent or limit the agency 1294
from adjusting fees, reimbursement rates, lengths of stay, 1295
number of visits, number of services, or any other adjustments 1296
necessary to comply with the availability of moneys and any 1297
limitations or directions provided for in the General 1298
Appropriations Act or chapter 216. 1299
(13) PAYMENT.—A payment may not be made by the agency 1300
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under this part to a prohibited entity as defined in s. 71113 of 1301
Pub. L. No. 119-21. 1302
Section 12. Section 414.321, Florida Statutes, is created 1303
to read: 1304
414.321 Food assistance eligibility.—For purposes of 1305
eligibility determinations, the department shall: 1306
(1) Limit eligibility to individuals who are residents of 1307
the United States and: 1308
(a) Citizens or nationals of the United States; 1309
(b) Aliens lawfully admitted for permanent residence as 1310
defined in the Immigration and Nationality Act, as amended; 1311
(c) Aliens who have been granted the status of Cuban and 1312
Haitian entrant, as defined in the Refugee Education Assistance 1313
Act of 1980, as amended; or 1314
(d) Individuals who lawfully reside in the United States 1315
in accordance with the Compacts of Free Association referred to 1316
in the Personal Responsibility and Work Opportunity 1317
Reconciliation Act of 1996. 1318
(2) Require each applicant, and recipient for 1319
redetermination purposes, to provide documentation evidencing 1320
his or her shelter or utility expenses. 1321
(a) The department is prohibited from relying solely on an 1322
individual's self-attestation in determining shelter or utility 1323
expenses. 1324
(b) The department may adopt policies and procedures to 1325
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accommodate an applicant or recipient who, due to recent 1326
residency changes, is temporarily unable to furnish adequate 1327
documentation of shelter or utility expenses. 1328
Section 13. Section 414.332, Florida Statutes, is created 1329
to read: 1330
414.332 Food assistance payment accuracy plan.— 1331
(1) The department shall develop and implement a 1332
comprehensive food assistance payment accuracy improvement plan 1333
to reduce the state's payment error rate. The department shall 1334
reduce the payment error rate to below 6 percent by March 30, 1335
2026. The plan shall address the root causes of payment errors 1336
identified through an in-depth, data-driven analysis. The plan 1337
shall include, but is not limited to, all of the following: 1338
(a) Enhanced employee training and quality assurance. 1339
1. The department shall administer standardized training 1340
for all economic self-sufficiency program staff at least 1341
annually. Training must, at a minimum, review the most common 1342
reasons for payment errors and methods for preventing such 1343
errors, and include pre- and post-training testing to measure 1344
staff proficiency. 1345
2. The department shall establish a robust quality 1346
assurance review process that frequently reviews a statistically 1347
significant sample of cases before final benefit determination. 1348
This process must incorporate real-time, corrective feedback and 1349
on-the-job training for program staff and must not delay benefit 1350
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determinations. 1351
(b) Improvement in data sourcing. In contracting with 1352
entities providing data for verification of applicant and 1353
recipient information, the department shall maximize use of high 1354
quality automated data sources, including, but not limited to, 1355
comparing income and asset data with state, federal, and private 1356
sector data sources. 1357
(2) By July 1, 2026, the department shall submit the food 1358
assistance payment accuracy improvement plan to the Governor, 1359
the President of the Senate, and the Speaker of the House of 1360
Representatives. 1361
(3)(a) Beginning October 1, 2026, the department shall 1362
submit quarterly progress reports to the Governor, the President 1363
of the Senate, and the Speaker of the House of Representatives 1364
detailing: 1365
1. The state's most recent official and preliminary food 1366
assistance payment error rate. 1367
2. A detailed breakdown of the most frequent and highest 1368
dollar value errors, including categorization by agency or 1369
client error and whether the error resulted in over- or under-1370
payment. 1371
3. Specific actions taken by the department under the food 1372
assistance payment accuracy improvement plan during the 1373
preceding quarter and data demonstrating the results of those 1374
actions. 1375
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4. A detailed plan to correct the most recently identified 1376
deficiencies. 1377
(b) This subsection is repealed on October 1, 2028. 1378
Section 14. Subsection (2) of section 414.455, Florida 1379
Statutes, is amended to read: 1380
414.455 Supplemental Nutrition Assistance Program; 1381
legislative authorization; mandatory participation in employment 1382
and training programs.— 1383
(2) Unless prohibited by the Federal Government, the 1384
department must require a person who is receiving food 1385
assistance; who is 18 to 64 59 years of age, inclusive; who does 1386
not have children under the age of 14 18 in his or her home; who 1387
does not qualify for an exemption; and who is determined by the 1388
department to be eligible, to participate in an employment and 1389
training program. The department shall apply and comply with 1390
exemptions from work requirements in accordance with applicable 1391
federal law. 1392
Section 15. Subsection (2) of section 456.0575, Florida 1393
Statutes, is renumbered as subsection (3), and a new subsection 1394
(2) is added to that section, to read: 1395
456.0575 Duty to notify patients.— 1396
(2) A health care practitioner shall notify a patient in 1397
writing upon referring the patient to a nonparticipating 1398
provider for nonemergency services, as those terms are defined 1399
in s. 627.64194(1), or to a provider, as defined in s. 641.47, 1400
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that is not under contract with the patient's health maintenance 1401
organization. Such notice must state that the services will be 1402
provided on an out-of-network basis, which may result in 1403
additional cost-sharing responsibilities for the patient, and be 1404
documented in the patient's medical record. The practitioner or 1405
his or her employee may confirm the referral provider's 1406
participation by contacting the referral provider or the 1407
patient's health insurer or health maintenance organization, as 1408
necessary, or may rely on the online provider directory of the 1409
health insurer or health maintenance organization. Failure to 1410
comply with this subsection, without good cause, shall result in 1411
disciplinary action against the health care practitioner. 1412
Section 16. Paragraph (b) of subsection (10) of section 1413
456.073, Florida Statutes, is amended to read: 1414
456.073 Disciplinary proceedings.—Disciplinary proceedings 1415
for each board shall be within the jurisdiction of the 1416
department. 1417
(10) 1418
(b) The department shall report any significant 1419
investigation information relating to a nurse holding a 1420
multistate license to the coordinated licensure information 1421
system pursuant to s. 464.0095; any investigative information 1422
relating to an audiologist or a speech-language pathologist 1423
holding a compact privilege under the Audiology and Speech-1424
Language Pathology Interstate Compact to the data system 1425
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pursuant to s. 468.1335; any investigative information relating 1426
to a physical therapist or physical therapist assistant holding 1427
a compact privilege under the Physical Therapy Licensure Compact 1428
to the data system pursuant to s. 486.112; any significant 1429
investigatory information relating to a psychologist practicing 1430
under the Psychology Interjurisdictional Compact to the 1431
coordinated licensure information system pursuant to s. 1432
490.0075; and any significant investigatory information relating 1433
to a health care practitioner practicing under the Professional 1434
Counselors Licensure Compact to the data system pursuant to s. 1435
491.017; any significant investigatory information relating to a 1436
physician assistant holding compact privilege under the 1437
Physician Assistant Licensure Compact to the data system 1438
pursuant to s. 456.66; any significant investigatory information 1439
relating to an emergency medical technician or paramedic 1440
practicing under the Emergency Medical Services Personnel 1441
Licensure Interstate Compact pursuant to s. 401.466; and any 1442
investigative information relating to a clinical social worker 1443
practicing under the Social Work Licensure Interstate Compact to 1444
the data system pursuant to s. 491.022. 1445
Section 17. Subsection (5) of section 456.076, Florida 1446
Statutes, is amended to read: 1447
456.076 Impaired practitioner programs.— 1448
(5) A consultant shall enter into a participant contract 1449
with an impaired practitioner and shall establish the terms of 1450
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monitoring and shall include the terms in a participant 1451
contract. In establishing the terms of monitoring, the 1452
consultant may consider the recommendations of one or more 1453
approved evaluators, treatment programs, or treatment providers. 1454
A consultant may modify the terms of monitoring if the 1455
consultant concludes, through the course of monitoring, that 1456
extended, additional, or amended terms of monitoring are 1457
required for the protection of the health, safety, and welfare 1458
of the public. If the impaired practitioner is an audiologist or 1459
a speech-language pathologist practicing under the Audiology and 1460
Speech-Language Pathology Interstate Compact pursuant to s. 1461
468.1335, a physical therapist or physical therapist assistant 1462
practicing under the Physical Therapy Licensure Compact pursuant 1463
to s. 486.112, a psychologist practicing under the Psychology 1464
Interjurisdictional Compact pursuant to s. 490.0075, or a health 1465
care practitioner practicing under the Professional Counselors 1466
Licensure Compact pursuant to s. 491.017, a physician assistant 1467
practicing under the Physician Assistant Licensure Compact 1468
pursuant to s. 456.66, an emergency medical technician or 1469
paramedic practicing under the Emergency Medical Services 1470
Personnel Licensure Interstate Compact pursuant to s. 401.466, 1471
or a clinical social worker practicing under the Social Work 1472
Licensure Interstate Compact pursuant to s. 491.022, the terms 1473
of the monitoring contract must include the impaired 1474
practitioner's withdrawal from all practice under the compact 1475
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unless authorized by a member state. 1476
Section 18. Section 456.66, Florida Statutes, is created 1477
to read: 1478
456.66 Physician Assistant Licensure Compact.—The 1479
Physician Assistant Licensure Compact is enacted into law and 1480
entered into by this state with all other jurisdictions legally 1481
joining therein in the form substantially as follows: 1482
1483
ARTICLE I 1484
PURPOSE 1485
1486
In order to strengthen access to medical services, and in 1487
recognition of the advances in the delivery of medical services, 1488
the participating states of the Physician Assistant Licensure 1489
Compact have allied in common purpose to develop a comprehensive 1490
process that complements the existing authority of state 1491
licensing boards to license and discipline physician assistants 1492
and seeks to enhance the portability of a license to practice as 1493
a physician assistant while safeguarding the safety of patients. 1494
This compact allows medical services to be provided by physician 1495
assistants, via the mutual recognition of the licensee's 1496
qualifying license by other compact participating states. This 1497
compact also adopts the prevailing standard for physician 1498
assistant licensure and affirms that the practice and delivery 1499
of medical services by the physician assistant occurs where the 1500
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patient is located at the time of the patient encounter, and 1501
therefore requires the physician assistant to be under the 1502
jurisdiction of the state licensing board where the patient is 1503
located. State licensing boards that participate in this compact 1504
retain the jurisdiction to impose adverse action against a 1505
compact privilege in that state issued to a physician assistant 1506
through the procedures of this compact. The compact will 1507
alleviate burdens for military families by allowing active duty 1508
military personnel and their spouses to obtain a compact 1509
privilege based on having an unrestricted license in good 1510
standing from a participating state. 1511
1512
ARTICLE II 1513
DEFINITIONS 1514
1515
As used in this compact, the term: 1516
(1) "Adverse action" means any administrative, civil, 1517
equitable, or criminal action permitted by a state's laws which 1518
is imposed by a licensing board or other authority against a 1519
physician assistant license or license application or compact 1520
privilege such as license denial, censure, revocation, 1521
suspension, probation, monitoring of the licensee, or 1522
restriction on the licensee's practice. 1523
(2) "Compact privilege" means the authorization granted by 1524
a remote state to allow a licensee from another participating 1525
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state to practice as a physician assistant to provide medical 1526
services and other licensed activity to a patient located in the 1527
remote state under the remote state's laws and regulations. 1528
(3) "Conviction" means a finding by a court that an 1529
individual is guilty of a felony or misdemeanor offense through 1530
adjudication or entry of a plea of guilty or nolo contendere to 1531
the charge by the offender. 1532
(4) "Criminal background check" means the submission of 1533
fingerprints or other biometric-based information for a license 1534
applicant for the purpose of obtaining that applicant's criminal 1535
history record information, as defined in 28 C.F.R. s. 20.3(d), 1536
from the state's criminal history record repository, as defined 1537
in 28 C.F.R. s. 20.3(f). 1538
(5) "Data system" means the repository of information 1539
about licensees, including, but not limited to, license status 1540
and adverse actions, which is created and administered under the 1541
terms of this compact. 1542
(6) "Executive committee" means a group of directors and 1543
ex officio individuals elected or appointed pursuant to 1544
subsection (6) of Article VII. 1545
(7) "Impaired practitioner" means a physician assistant 1546
whose practice is adversely affected by a health-related 1547
condition that impacts his or her ability to practice. 1548
(8) "Investigative information" means information, 1549
records, or documents received or generated by a licensing board 1550
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pursuant to an investigation. 1551
(9) "Jurisprudence requirement" means the assessment of an 1552
individual's knowledge of the laws and rules governing the 1553
practice of a physician assistant in a state. 1554
(10) "License" means current authorization by a state, 1555
other than authorization pursuant to a compact privilege, for a 1556
physician assistant to provide medical services, which would be 1557
unlawful without current authorization. 1558
(11) "Licensee" means an individual who holds a license 1559
from a state to provide medical services as a physician 1560
assistant. 1561
(12) "Licensing board" means any state entity authorized 1562
to license and otherwise regulate physician assistants. 1563
(13) "Medical services" means health care services 1564
provided for the diagnosis, prevention, treatment, cure, or 1565
relief of a health condition, injury, or disease, as defined by 1566
a state's laws and regulations. 1567
(14) "Model compact" means the model for the compact on 1568
file with the Council of State Governments or other entity as 1569
designated by the commission. 1570
(15) "Participating state" means a state that has enacted 1571
this compact. 1572
(16) "Physician assistant" means an individual who is 1573
licensed as a physician assistant. For purposes of this compact, 1574
any other title or status adopted by a state to replace the term 1575
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"physician assistant" shall be deemed synonymous with "physician 1576
assistant" and shall confer the same rights and responsibilities 1577
to the licensee under this compact at the time of its enactment. 1578
(17) "Physician Assistant Licensure Compact Commission," 1579
"compact commission," or "commission" mean the national 1580
administrative body created pursuant to subsection (1) of 1581
Article VII. 1582
(18) "Qualifying license" means an unrestricted license 1583
issued by a participating state to provide medical services as a 1584
physician assistant. 1585
(19) "Remote state" means a participating state where a 1586
licensee who is not licensed as a physician assistant is 1587
exercising or seeking to exercise the compact privilege. 1588
(20) "Rule" means a regulation adopted by an entity that 1589
has the force and effect of law. 1590
(21) "Significant investigative information" means 1591
investigative information that a licensing board, after an 1592
inquiry or investigation that includes notification and an 1593
opportunity for the physician assistant to respond if required 1594
by state law, has reason to believe is not groundless and, if 1595
proven true, would indicate more than a minor infraction. 1596
(22) "State" means any state, commonwealth, district, or 1597
territory of the United States. 1598
1599
ARTICLE III 1600
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STATE PARTICIPATION 1601
1602
(1) To participate in this compact, a participating state 1603
shall: 1604
(a) License physician assistants. 1605
(b) Participate in the compact commission's data system. 1606
(c) Have a mechanism in place for receiving and 1607
investigating complaints against licensees and license 1608
applicants. 1609
(d) Notify the commission, in compliance with the terms of 1610
this compact and commission rules, of any adverse action against 1611
a licensee or license applicant and the existence of significant 1612
investigative information regarding a licensee or license 1613
applicant. 1614
(e) Fully implement a criminal background check 1615
requirement, within a timeframe established by commission rule, 1616
by its licensing board receiving the results of a criminal 1617
background check and reporting to the commission whether the 1618
license applicant has been granted a license. 1619
(f) Comply with the rules of the compact commission. 1620
(g) Use passage of a recognized national exam such as the 1621
NCCPA PANCE as a requirement for physician assistant licensure. 1622
(h) Grant the compact privilege to a holder of a 1623
qualifying license in a participating state. 1624
(2) This compact does not prohibit a participating state 1625
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from charging a fee for granting the compact privilege. 1626
1627
ARTICLE IV 1628
COMPACT PRIVILEGE 1629
1630
(1) To exercise the compact privilege, a licensee must: 1631
(a) Have graduated from a physician assistant program 1632
accredited by the Accreditation Review Commission on Education 1633
for the Physician Assistant, Inc., or other programs authorized 1634
by commission rule. 1635
(b) Hold current NCCPA certification. 1636
(c) Have no felony or misdemeanor conviction. 1637
(d) Have never had a controlled substance license, permit, 1638
or registration suspended or revoked by a state or by the United 1639
States Drug Enforcement Administration. 1640
(e) Have a unique identifier as determined by commission 1641
rule. 1642
(f) Hold a qualifying license. 1643
(g) Have not had a revocation of a license or limitation 1644
or restriction on any license currently held due to an adverse 1645
action. 1646
(h) If a licensee has had a limitation or restriction on a 1647
license or compact privilege due to an adverse action, 2 years 1648
must have elapsed from the date on which the license or compact 1649
privilege is no longer limited or restricted due to the adverse 1650
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action. 1651
(i) If a compact privilege has been revoked or is limited 1652
or restricted in a participating state for conduct that would 1653
not be a basis for disciplinary action in a participating state 1654
in which the licensee is practicing or applying to practice 1655
under a compact privilege, that participating state shall have 1656
the discretion not to consider such action as an adverse action 1657
requiring the denial or removal of a compact privilege in that 1658
state. 1659
(j) Notify the compact commission that the licensee is 1660
seeking the compact privilege in a remote state. 1661
(k) Meet any jurisprudence requirement of a remote state 1662
in which the licensee is seeking to practice under the compact 1663
privilege. 1664
(l) Report to the commission any adverse action taken by a 1665
nonparticipating state within 30 days after the action is taken. 1666
(2) The compact privilege is valid until the expiration or 1667
revocation of the qualifying license unless terminated pursuant 1668
to an adverse action. The licensee must comply with all of the 1669
requirements of subsection (1) to maintain the compact privilege 1670
in a remote state. If the participating state takes adverse 1671
action against a qualifying license, the licensee shall lose the 1672
compact privilege in any remote state in which the licensee has 1673
a compact privilege until all of the following occur: 1674
(a) The license is no longer limited or restricted. 1675
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(b) Two years have elapsed from the date on which the 1676
license is no longer limited or restricted due to the adverse 1677
action. 1678
(3) Once a restricted or limited license satisfies the 1679
requirements of subsection (2), the licensee must meet the 1680
requirements of subsection (1) to obtain a compact privilege in 1681
any remote state. 1682
(4) For each remote state in which a physician assistant 1683
seeks authority to prescribe controlled substances, the 1684
physician assistant shall satisfy all requirements imposed by 1685
such state in granting or renewing such authority. 1686
1687
ARTICLE V 1688
DESIGNATION OF THE STATE FROM WHICH LICENSEE 1689
IS APPLYING FOR COMPACT PRIVILEGE 1690
1691
Upon a licensee's application for a compact privilege, the 1692
licensee shall identify to the commission the participating 1693
state from which the licensee is applying, in accordance with 1694
applicable rules adopted by the commission, and subject to the 1695
following requirements: 1696
(1) When applying for a compact privilege, the licensee 1697
shall provide the commission with the address of the licensee's 1698
primary residence and thereafter shall immediately report to the 1699
commission any change in the address of the licensee's primary 1700
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residence. 1701
(2) When applying for a compact privilege, the licensee is 1702
required to consent to accept service of process by mail at the 1703
licensee's primary residence on file with the commission with 1704
respect to any action brought against the licensee by the 1705
commission or a participating state, including a subpoena, with 1706
respect to any action brought or investigation conducted by the 1707
commission or a participating state. 1708
1709
ARTICLE VI 1710
ADVERSE ACTIONS 1711
1712
(1) A participating state in which a licensee is licensed 1713
shall have exclusive power to impose adverse action against the 1714
qualifying license issued by that participating state. 1715
(2) In addition to the other powers conferred by state 1716
law, a remote state shall have the authority, in accordance with 1717
existing state due process law, to do all of the following: 1718
(a) Take adverse action against a physician assistant's 1719
compact privilege within that state to remove a licensee's 1720
compact privilege or take other action necessary under 1721
applicable law to protect the health and safety of its citizens. 1722
(b) Issue subpoenas for both hearings and investigations 1723
that require the attendance and testimony of witnesses as well 1724
as the production of evidence. Subpoenas issued by a licensing 1725
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board in a participating state for the attendance and testimony 1726
of witnesses or the production of evidence from another 1727
participating state shall be enforced in the latter state by any 1728
court of competent jurisdiction according to the practice and 1729
procedure of that court applicable to subpoenas issued in 1730
proceedings pending before it. The issuing authority shall pay 1731
any witness fees, travel expenses, mileage, and other fees 1732
required by the service statutes of the state in which the 1733
witnesses or evidence are located. 1734
(c) Notwithstanding paragraph (b), subpoenas may not be 1735
issued by a participating state to gather evidence of conduct in 1736
another state that is lawful in that other state for the purpose 1737
of taking adverse action against a licensee's compact privilege 1738
or application for a compact privilege in that participating 1739
state. 1740
(d) This compact does not authorize a participating state 1741
to impose discipline against a physician assistant's compact 1742
privilege or to deny an application for a compact privilege in 1743
that participating state for the individual's otherwise lawful 1744
practice in another state. 1745
(3) For purposes of taking adverse action, the 1746
participating state which issued the qualifying license shall 1747
give the same priority and effect to reported conduct received 1748
from any other participating state as it would if the conduct 1749
had occurred within the participating state which issued the 1750
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qualifying license. In so doing, the participating state shall 1751
apply its own state laws to determine appropriate action. 1752
(4) A participating state, if otherwise permitted by state 1753
law, may recover from the affected physician assistant the costs 1754
of investigations and disposition of cases resulting from any 1755
adverse action taken against that physician assistant. 1756
(5) A participating state may take adverse action based on 1757
the factual findings of a remote state, provided that the 1758
participating state follows its own procedures for taking the 1759
adverse action. 1760
(6)(a) In addition to the authority granted to a 1761
participating state by its applicable laws and regulations, any 1762
participating state may participate with other participating 1763
states in joint investigations of licensees. 1764
(b) Participating states shall share any investigative, 1765
litigation, or compliance materials in furtherance of any joint 1766
or individual investigation initiated under this compact. 1767
(7) If an adverse action is taken against a physician 1768
assistant's qualifying license, the physician assistant's 1769
compact privilege in all remote states shall be deactivated 1770
until 2 years after all restrictions have been removed from the 1771
state license. All disciplinary orders by the participating 1772
state which issued the qualifying license that imposes adverse 1773
action against a physician assistant's license shall include a 1774
statement that the physician assistant's compact privilege is 1775
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deactivated in all participating states during the pendency of 1776
the order. 1777
(8) If any participating state takes adverse action, it 1778
shall promptly notify the administrator of the data system. 1779
1780
ARTICLE VII 1781
ESTABLISHMENT OF THE COMPACT COMMISSION 1782
1783
(1) The participating states create and establish a joint 1784
government agency and national administrative body known as the 1785
Physician Assistant Licensure Compact Commission. The commission 1786
is an instrumentality of the compact states acting jointly and 1787
not an instrumentality of any one state. The commission shall 1788
come into existence on or after the effective date of the 1789
compact as provided in subsection (1) of Article XI. 1790
(2)(a) Each participating state shall have and be limited 1791
to one delegate selected by that participating state's licensing 1792
board or, if the state has more than one licensing board, 1793
selected collectively by the participating state's licensing 1794
boards. 1795
(b) The delegate shall be either: 1796
1. A current physician assistant, physician, or public 1797
member of a licensing board or physician assistant council or 1798
committee; or 1799
2. An administrator of a licensing board. 1800
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(c) Any delegate may be removed or suspended from office 1801
as provided by the laws of the state from which the delegate is 1802
appointed. 1803
(d) The participating state licensing board shall fill any 1804
vacancy occurring in the commission within 60 days. 1805
(e) Each delegate shall be entitled to one vote on all 1806
matters voted on by the commission and shall otherwise have an 1807
opportunity to participate in the business and affairs of the 1808
commission. A delegate shall vote in person or by such other 1809
means as provided in the bylaws. The bylaws may provide for 1810
delegates' participation in meetings by telecommunications, 1811
video conference, or other means of communication. 1812
(f) The commission shall meet at least once during each 1813
calendar year. Additional meetings shall be held as set forth in 1814
this compact and the bylaws. 1815
(g) The commission shall establish by rule a term of 1816
office for delegates. 1817
(3) The commission shall have all of the following powers 1818
and duties: 1819
(a) Establish a code of ethics for the commission. 1820
(b) Establish the fiscal year of the commission. 1821
(c) Establish bylaws. 1822
(d) Maintain its financial records in accordance with the 1823
bylaws. 1824
(e) Meet and take such actions as are consistent with the 1825
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provisions of this compact and the bylaws. 1826
(f) Adopt rules to facilitate and coordinate 1827
implementation and administration of this compact. The rules 1828
shall have the force and effect of law and shall be binding in 1829
all participating states. 1830
(g) Bring and prosecute legal proceedings or actions in 1831
the name of the commission, provided that the standing of any 1832
state licensing board to sue or be sued under applicable law may 1833
not be affected. 1834
(h) Purchase and maintain insurance and bonds. 1835
(i) Borrow, accept, or contract for services of personnel, 1836
including, but not limited to, employees of a participating 1837
state. 1838
(j) Hire employees and engage contractors, elect or 1839
appoint officers, fix compensation, define duties, grant such 1840
individuals appropriate authority to carry out the purposes of 1841
this compact, and establish the commission's personnel policies 1842
and programs relating to conflicts of interest, qualifications 1843
of personnel, and other related personnel matters. 1844
(k) Accept any and all appropriate donations and grants of 1845
money, equipment, supplies, materials, and services, and 1846
receive, use, and dispose of the same, provided that at all 1847
times the commission shall avoid any appearance of impropriety 1848
or conflict of interest. 1849
(l) Lease, purchase, accept appropriate gifts or donations 1850
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of, or otherwise own, hold, improve, or use any property, real, 1851
personal, or mixed, provided that at all times the commission 1852
shall avoid any appearance of impropriety. 1853
(m) Sell, convey, mortgage, pledge, lease, exchange, 1854
abandon, or otherwise dispose of any property, real, personal, 1855
or mixed. 1856
(n) Establish a budget and make expenditures. 1857
(o) Borrow money. 1858
(p) Appoint committees, including standing committees 1859
composed of members, state regulators, state legislators or 1860
their representatives, and consumer representatives, and such 1861
other interested persons as may be designated in this compact 1862
and the bylaws. 1863
(q) Provide and receive information from, and cooperate 1864
with, law enforcement agencies. 1865
(r) Elect a chair, vice chair, secretary, and treasurer 1866
and other officers of the commission as provided in the 1867
commission's bylaws. 1868
(s) Reserve for itself, in addition to those reserved 1869
exclusively to the commission under the compact, powers that the 1870
executive committee may not exercise. 1871
(t) Approve or disapprove a state's participation in the 1872
compact based upon its determination as to whether the state's 1873
compact legislation departs in a material manner from the model 1874
compact language. 1875
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(u) Prepare and provide to the participating states an 1876
annual report. 1877
(v) Perform such other functions as may be necessary or 1878
appropriate to achieve the purposes of this compact consistent 1879
with the state regulation of physician assistant licensure and 1880
practice. 1881
(4)(a) All meetings of the commission shall be open to the 1882
public. Notice of public meetings shall be posted on the 1883
commission's website at least 30 days before the public meeting. 1884
(b) Notwithstanding paragraph (a), the commission may 1885
convene a public meeting by providing at least 24 hours' prior 1886
notice on the commission's website, and any other means as 1887
provided in the commission's rules, for any of the reasons it 1888
may dispense with notice of proposed rulemaking under subsection 1889
(20) of Article IX. 1890
(c) The commission may convene in a closed, nonpublic 1891
meeting or nonpublic part of a public meeting to discuss any of 1892
the following information: 1893
1. Noncompliance of a participating state with its 1894
obligations under the compact; 1895
2. The employment, compensation, discipline, or other 1896
matters, practices, or procedures related to specific employees 1897
or other matters related to the commission's internal personnel 1898
practices and procedures; 1899
3. Current, threatened, or reasonably anticipated 1900
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litigation; 1901
4. Negotiation of contracts for the purchase, lease, or 1902
sale of goods, services, or real estate; 1903
5. Accusing any person of a crime or formally censuring 1904
any person; 1905
6. Disclosure of trade secrets or commercial or financial 1906
information that is privileged or confidential; 1907
7. Disclosure of information of a personal nature when 1908
disclosure of such information would constitute a clearly 1909
unwarranted invasion of personal privacy; 1910
8. Disclosure of investigative records compiled for law 1911
enforcement purposes; 1912
9. Disclosure of information related to any investigative 1913
reports prepared by or on behalf of or for use of the commission 1914
or other committee charged with responsibility of investigation 1915
or determination of compliance issues pursuant to the compact; 1916
10. Legal advice; or 1917
11. Matters specifically exempted from disclosure by 1918
federal or state statute. 1919
(d) If a meeting, or portion of a meeting, is closed 1920
pursuant to this article, the chair of the meeting or the 1921
chair's designee shall certify that the meeting or portion of 1922
the meeting may be closed and shall reference each relevant 1923
exempting provision. 1924
(e) The commission shall keep minutes that fully and 1925
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clearly describe all matters discussed in a meeting and shall 1926
provide a full and accurate summary of actions taken, including 1927
a description of the views expressed. All documents considered 1928
in connection with an action shall be identified in such 1929
minutes. All minutes and documents of a closed meeting shall 1930
remain under seal, subject to release by a majority vote of the 1931
commission or order of a court of competent jurisdiction. 1932
(5)(a) The commission shall pay, or provide for the 1933
payment of, the reasonable expenses of its establishment, 1934
organization, and ongoing activities. 1935
(b) The commission may accept any and all appropriate 1936
revenue sources, donations, and grants of money, equipment, 1937
supplies, materials, and services. 1938
(c) The commission may levy on and collect an annual 1939
assessment from each participating state to cover the cost of 1940
the operations and activities of the commission and its staff, 1941
which must be in a total amount sufficient to cover its annual 1942
budget as approved by the commission each year for which revenue 1943
is not provided by other sources. The aggregate annual 1944
assessment amount levied on participating states shall be 1945
allocated based upon a formula to be determined by commission 1946
rule. 1947
1. A compact privilege expires when the licensee's 1948
qualifying license in the participating state from which the 1949
licensee applied for the compact privilege expires. 1950
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2. If the licensee terminates the qualifying license 1951
through which the licensee applied for the compact privilege 1952
before its scheduled expiration, and the licensee has a 1953
qualifying license in another participating state, the licensee 1954
shall inform the commission that it is changing to that 1955
participating state the participating state through which it 1956
applies for a compact privilege and pay to the commission any 1957
compact privilege fee required by commission rule. 1958
(d) The commission may not incur obligations of any kind 1959
prior to securing the funds adequate to meet the same, nor shall 1960
the commission pledge the credit of any of the participating 1961
states, except by and with the authority of the participating 1962
state. 1963
(e) The commission shall keep accurate accounts of all 1964
receipts and disbursements. The receipts and disbursements of 1965
the commission shall be subject to the financial review and 1966
accounting procedures established under its bylaws. All receipts 1967
and disbursements of funds handled by the commission shall be 1968
subject to an annual financial review by a certified or licensed 1969
public accountant, and the report of the financial review shall 1970
be included in and become part of the annual report of the 1971
commission. 1972
(6)(a) The executive committee shall have the power to act 1973
on behalf of the commission according to the terms of this 1974
compact and commission rules. 1975
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(b) The executive committee shall be composed of nine 1976
members, including: 1977
1. Seven voting members who are elected by the commission 1978
from the current membership of the commission. 1979
2. One ex officio, nonvoting member from a recognized 1980
national physician assistant professional association. 1981
3. One ex officio, nonvoting member from a recognized 1982
national physician assistant certification organization. 1983
(c) The ex officio members will be selected by their 1984
respective organizations. 1985
(d) The commission may remove any member of the executive 1986
committee as provided in its bylaws. 1987
(e) The executive committee shall meet at least annually. 1988
(f) The executive committee shall have all of the 1989
following duties and responsibilities: 1990
1. Recommend to the commission changes to the commission's 1991
rules or bylaws, changes to this compact legislation, and fees 1992
to be paid by compact participating states, such as annual dues. 1993
2. Ensure compact administration services are 1994
appropriately provided, contractual or otherwise. 1995
3. Prepare and recommend the budget. 1996
4. Maintain financial records on behalf of the commission. 1997
5. Monitor compact compliance of participating states and 1998
provide compliance reports to the commission. 1999
6. Establish additional committees as necessary. 2000
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7. Exercise the powers and duties of the commission during 2001
the interim between commission meetings, except for issuing 2002
proposed rulemaking or adopting commission rules or bylaws, or 2003
exercising any other powers and duties exclusively reserved to 2004
the commission by the commission's rules. 2005
8. Perform other duties as provided in the commission's 2006
rules or bylaws. 2007
(7)(a) All meetings of the executive committee at which it 2008
votes or plans to vote on matters in exercising the powers and 2009
duties of the commission shall be open to the public and public 2010
notice of such meetings shall be given as public meetings of the 2011
commission are given. 2012
(b) The executive committee may convene in a closed, 2013
nonpublic meeting for the same reasons that the commission may 2014
convene in a nonpublic meeting as provided in paragraph (c) of 2015
subsection (4) and shall announce the closed meeting as the 2016
commission is required to under paragraph (d) of subsection (4) 2017
of this article and keep minutes of the closed meeting as the 2018
commission is required to under paragraph (e) of subsection (4) 2019
of this article. 2020
(c) The members, officers, executive director, employees, 2021
and representatives of the commission shall be immune from suit 2022
and liability, both personally and in their official capacities, 2023
for any claim for damage to or loss of property or personal 2024
injury or other civil liability caused by or arising out of any 2025
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actual or alleged act, error, or omission that occurred, or that 2026
the person against whom the claim is made had a reasonable basis 2027
for believing occurred within the scope of commission 2028
employment, duties, or responsibilities, provided that nothing 2029
in this paragraph shall be construed to protect any such person 2030
from suit or liability for any damage, loss, injury, or 2031
liability caused by the intentional or willful or wanton 2032
misconduct of that person. The procurement of insurance of any 2033
type by the commission does not in any way compromise or limit 2034
the immunity granted hereunder. 2035
(d) The commission shall defend any member, officer, 2036
executive director, employee, and representative of the 2037
commission in any civil action seeking to impose liability 2038
arising out of any actual or alleged act, error, or omission 2039
that occurred within the scope of commission employment, duties, 2040
or responsibilities, or as determined by the commission that the 2041
person against whom the claim is made had a reasonable basis for 2042
believing occurred within the scope of commission employment, 2043
duties, or responsibilities, provided that nothing herein shall 2044
be construed to prohibit that person from retaining his or her 2045
own counsel at his or her own expense, and provided further that 2046
the actual or alleged act, error, or omission did not result 2047
from that person's intentional or willful or wanton misconduct. 2048
(e) The commission shall indemnify and hold harmless any 2049
member, officer, executive director, employee, and 2050
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representative of the commission for the amount of any 2051
settlement or judgment obtained against that person arising out 2052
of any actual or alleged act, error, or omission that occurred 2053
within the scope of commission employment, duties, or 2054
responsibilities, or that such person had a reasonable basis for 2055
believing occurred within the scope of commission employment, 2056
duties, or responsibilities, provided that the actual or alleged 2057
act, error, or omission did not result from the intentional or 2058
willful or wanton misconduct of that person. 2059
(f) Venue is proper and judicial proceedings by or against 2060
the commission shall be brought solely and exclusively in a 2061
court of competent jurisdiction where the principal office of 2062
the commission is located. The commission may waive venue and 2063
jurisdictional defenses in any proceedings as authorized by 2064
commission rules. 2065
(g) This compact does not: 2066
1. Limit the liability of any licensee for professional 2067
malpractice or misconduct, which shall be governed solely by any 2068
other applicable state laws. 2069
2. Designate the venue or jurisdiction to bring actions 2070
for alleged acts of malpractice, professional misconduct, 2071
negligence, or other such civil action pertaining to the 2072
practice of a physician assistant. All such matters shall be 2073
determined exclusively by state law other than this compact. 2074
3. Waive or otherwise abrogate a participating state's 2075
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state action immunity or state action affirmative defense with 2076
respect to antitrust claims under the Sherman Act, the Clayton 2077
Act, or any other state or federal antitrust or anticompetitive 2078
law or regulation. 2079
4. Waive sovereign immunity by the participating states or 2080
by the commission. 2081
2082
ARTICLE VIII 2083
DATA SYSTEM 2084
2085
(1) The commission shall provide for the development, 2086
maintenance, operation, and use of a coordinated data and 2087
reporting system containing licensure, adverse action, and the 2088
reporting of the existence of significant investigative 2089
information on all licensed physician assistants and applicants 2090
denied a license in participating states. 2091
(2) Notwithstanding any other state law to the contrary, a 2092
participating state shall submit a uniform data set to the data 2093
system on all applicable physician assistants, using a unique 2094
identifier, as required by the rules of the commission, 2095
including all of the following: 2096
(a) Identifying information. 2097
(b) Licensure data. 2098
(c) Adverse actions against a license or compact 2099
privilege. 2100
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(d) Any denial of application for licensure, and the 2101
reason for such denial. This does not include the reporting of 2102
any criminal history record information where prohibited by law. 2103
(e) The existence of significant investigative 2104
information. 2105
(f) Other information that may facilitate the 2106
administration of this compact, as determined by the rules of 2107
the commission. 2108
(3) Significant investigative information pertaining to a 2109
licensee in any participating state shall only be available to 2110
other participating states. 2111
(4) The commission shall promptly notify all participating 2112
states of any reported adverse action taken against a licensee 2113
or an individual applying for a license. The adverse action 2114
information shall be available to all participating states. 2115
(5) Participating states contributing information to the 2116
data system may, in accordance with state or federal law, 2117
designate information that may not be shared with the public 2118
without the express permission of the contributing state. 2119
Notwithstanding any such designation, such information shall be 2120
reported to the commission through the data system. 2121
(6) Any information submitted to the data system that is 2122
subsequently expunged pursuant to state or federal law shall be 2123
removed from the data system upon reporting of such by the 2124
participating state to the commission. 2125
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(7) The records and information provided to a 2126
participating state pursuant to this compact or through the data 2127
system, when certified by the commission or an agent thereof, 2128
shall constitute the authenticated business records of the 2129
commission, and shall be entitled to any associated hearsay 2130
exception in any relevant judicial, quasi-judicial, or 2131
administrative proceedings in a participating state. 2132
2133
ARTICLE IX 2134
RULEMAKING 2135
2136
(1) The commission shall exercise its rulemaking powers 2137
pursuant to the criteria provided in this article and the rules 2138
adopted thereunder. Commission rules shall become binding as of 2139
the date specified by the commission for each rule. 2140
(2) The commission shall adopt reasonable rules in order 2141
to effectively and efficiently implement and administer this 2142
compact and achieve its purposes. A commission rule is invalid 2143
and does not have force or effect if a court of competent 2144
jurisdiction holds that the rule is invalid because the 2145
commission exercised its rulemaking authority in a manner that 2146
is beyond the scope of the purposes of this compact, or the 2147
powers granted hereunder, or based upon another applicable 2148
standard of review. 2149
(3) The rules of the commission shall have the force of 2150
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law in each participating state, provided, however, that where 2151
the rules of the commission conflict with the laws of the 2152
participating state that establish the medical services a 2153
physician assistant may perform in the participating state, as 2154
held by a court of competent jurisdiction, the rules of the 2155
commission shall be ineffective in that state to the extent of 2156
the conflict. 2157
(4) If a majority of the legislatures of the participating 2158
states rejects a commission rule, by enactment of a statute or 2159
resolution in the same manner used to adopt this compact within 2160
4 years after the date of adoption of the rule, then such rule 2161
shall have no further force and effect in any participating 2162
state or to any state applying to participate in the compact. 2163
(5) Commission rules shall be adopted at a regular or 2164
special meeting of the commission. 2165
(6) Before adoption of a final rule or rules by the 2166
commission, and at least 30 days before the meeting at which the 2167
rule will be considered and voted upon, the commission shall 2168
file a notice of proposed rulemaking: 2169
(a) On the website of the commission or other publicly 2170
accessible platform. 2171
(b) To persons who have requested notice of the 2172
commission's notices of proposed rulemaking. 2173
(c) In such other ways as the commission may by rule 2174
specify. 2175
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(7) The notice of proposed rulemaking shall include all of 2176
the following: 2177
(a) The time, date, and location of the public hearing on 2178
the proposed rule and the proposed time, date, and location of 2179
the meeting in which the proposed rule will be considered and 2180
voted upon. 2181
(b) The text of the proposed rule and the reason for the 2182
proposed rule. 2183
(c) A request for comments on the proposed rule from any 2184
interested person and the date by which written comments must be 2185
received. 2186
(d) The manner in which an interested person may submit 2187
notice to the commission of his or her intention to attend the 2188
public hearing or provide any written comments. 2189
(8) Before adoption of a proposed rule, the commission 2190
shall allow persons to submit written data, facts, opinions, and 2191
arguments, which shall be made available to the public. 2192
(9) If the hearing is to be held via electronic means, the 2193
commission shall publish the mechanism for access to the 2194
electronic hearing. 2195
(a) Any person wishing to be heard at the hearing shall, 2196
as directed in the notice of proposed rulemaking, at least 5 2197
business days before the scheduled date of the hearing, notify 2198
the commission of his or her desire to appear and testify at the 2199
hearing. 2200
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(b) Hearings shall be conducted in a manner providing each 2201
person who wishes to comment a fair and reasonable opportunity 2202
to comment orally or in writing. 2203
(c) All hearings shall be recorded. A copy of the 2204
recording and the written comments, data, facts, opinions, and 2205
arguments received in response to the proposed rulemaking shall 2206
be made available to a person upon request. 2207
(10) This article does not require a separate hearing on 2208
each proposed rule. Proposed rules may be grouped for the 2209
convenience of the commission at hearings required by this 2210
article. 2211
(11) Following the public hearing, the commission shall 2212
consider all written and oral comments timely received. 2213
(12) The commission shall, by a majority vote of all 2214
delegates, take final action on the proposed rule and shall 2215
determine the effective date of the rule, if adopted, based on 2216
the rulemaking record and the full text of the rule. 2217
(a) If adopted, the rule shall be posted on the 2218
commission's website. 2219
(b) The commission may adopt changes to the proposed rule 2220
provided the changes do not enlarge the original purpose of the 2221
proposed rule. 2222
(c) The commission shall provide on its website an 2223
explanation of the reasons for substantive changes made to the 2224
proposed rule as well as reasons for substantive changes not 2225
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made that were recommended by commenters. 2226
(d) The commission shall determine a reasonable effective 2227
date for the rule. Except for an emergency as provided in 2228
subsection (13), the effective date of the rule shall be at 2229
least 30 days after the commission issued the notice that it 2230
adopted the rule. 2231
(13)(a) Upon determination that an emergency exists, the 2232
commission may consider and adopt an emergency rule with 24 2233
hours' prior notice, without the opportunity for comment or 2234
hearing, provided that the usual rulemaking procedures provided 2235
in this compact and in this article shall be retroactively 2236
applied to the rule as soon as reasonably possible, but in no 2237
event later than 90 days after the effective date of the rule. 2238
For the purposes of this subsection, an emergency rule is one 2239
that must be adopted immediately by the commission in order to: 2240
1. Meet an imminent threat to public health, safety, or 2241
welfare; 2242
2. Prevent a loss of commission or participating state 2243
funds; 2244
3. Meet a deadline for the adoption of a commission rule 2245
that is established by federal law or rule; or 2246
4. Protect public health and safety. 2247
(14) The commission or an authorized committee of the 2248
commission may direct revisions to a previously adopted 2249
commission rule for purposes of correcting typographical errors, 2250
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errors in format, errors in consistency, or grammatical errors. 2251
Public notice of any revisions shall be posted on the website of 2252
the commission. The revision shall be subject to challenge by 2253
any person for a period of 30 days after posting. The revision 2254
may be challenged only on grounds that the revision results in a 2255
material change to a rule. A challenge shall be made as provided 2256
in the notice of revisions and delivered to the commission 2257
before the end of the notice period. If the revision is not 2258
challenged, the revision will take effect without further 2259
action. If the revision is challenged, the revision may not take 2260
effect without the approval of the commission. 2261
(15) A participating state's rulemaking requirements do 2262
not apply under this compact. 2263
2264
ARTICLE X 2265
OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT 2266
2267
(1) The executive and judicial branches of state 2268
government in each participating state shall enforce this 2269
compact and take all actions necessary and appropriate to 2270
implement the compact. 2271
(2) Venue is proper and judicial proceedings by or against 2272
the commission shall be brought solely and exclusively in a 2273
court of competent jurisdiction where the principal office of 2274
the commission is located. The commission may waive venue and 2275
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jurisdictional defenses to the extent it adopts or consents to 2276
participate in alternative dispute resolution proceedings. 2277
Nothing herein shall affect or limit the selection or propriety 2278
of venue in any action against a licensee for professional 2279
malpractice, misconduct, or any such similar matter. 2280
(3) The commission shall be entitled to receive service of 2281
process in any proceeding regarding the enforcement or 2282
interpretation of the compact or the commission's rules and 2283
shall have standing to intervene in such a proceeding for all 2284
purposes. Failure to provide the commission with service of 2285
process shall render a judgment or order in such proceeding void 2286
as to the commission, this compact, or commission rules. 2287
(4) If the commission determines that a participating 2288
state has defaulted in the performance of its obligations or 2289
responsibilities under this compact or the commission rules, the 2290
commission shall provide written notice to the defaulting state 2291
and other participating states. The notice shall describe the 2292
default, the proposed means of curing the default, and any other 2293
action that the commission may take and shall offer remedial 2294
training and specific technical assistance regarding the 2295
default. 2296
(5) If a state in default fails to cure the default, the 2297
defaulting state may be terminated from this compact upon an 2298
affirmative vote of a majority of the delegates of the 2299
participating states, and all rights, privileges, and benefits 2300
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conferred by this compact upon such state may be terminated on 2301
the effective date of termination. A cure of the default does 2302
not relieve the offending state of obligations or liabilities 2303
incurred during the period of default. 2304
(6) Termination of participation in this compact shall be 2305
imposed only after all other means of securing compliance have 2306
been exhausted. Notice of intent to suspend or terminate shall 2307
be given by the commission to the Governor, the majority and 2308
minority leaders of the defaulting state's legislature, and the 2309
licensing board of each of the participating states. 2310
(7) A state that has been terminated is responsible for 2311
all assessments, obligations, and liabilities incurred through 2312
the effective date of termination, including obligations that 2313
extend beyond the effective date of termination. 2314
(8) The commission may not bear any costs related to a 2315
state that is found to be in default or that has been terminated 2316
from this compact, unless agreed upon in writing between the 2317
commission and the defaulting state. 2318
(9) The defaulting state may appeal its termination from 2319
the compact by the commission by petitioning the United States 2320
District Court for the District of Columbia or the federal 2321
district where the commission has its principal offices. The 2322
prevailing member shall be awarded all costs of such litigation, 2323
including reasonable attorney fees. 2324
(10) Upon the termination of a state's participation in 2325
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the compact, the state shall immediately provide notice to all 2326
licensees within that state of such termination. 2327
(a) Licensees who have been granted a compact privilege in 2328
that state shall retain the compact privilege for 180 days after 2329
the effective date of such termination. 2330
(b) Licensees who are licensed in that state who have been 2331
granted a compact privilege in a participating state shall 2332
retain the compact privilege for 180 days unless the licensee 2333
also has a qualifying license in a participating state or 2334
obtains a qualifying license in a participating state before the 2335
180-day period ends, in which case the compact privilege shall 2336
continue. 2337
(11) Upon request by a participating state, the commission 2338
shall attempt to resolve disputes related to this compact that 2339
arise among participating states and between participating and 2340
nonparticipating states. 2341
(12) The commission shall adopt a rule providing for both 2342
mediation and binding dispute resolution for disputes, as 2343
appropriate. 2344
(13) The commission, in the reasonable exercise of its 2345
discretion, shall enforce this compact and the rules of the 2346
commission. 2347
(14) If compliance is not secured after all means to 2348
secure compliance have been exhausted, by majority vote, the 2349
commission may initiate legal action in the United States 2350
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District Court for the District of Columbia or the federal 2351
district where the commission has its principal offices against 2352
a participating state in default to enforce compliance with this 2353
compact and the commission's rules and bylaws. The relief sought 2354
may include both injunctive relief and damages. In the event 2355
judicial enforcement is necessary, the prevailing party shall be 2356
awarded all costs of such litigation, including reasonable 2357
attorney fees. 2358
(15) These remedies are not the exclusive remedies of the 2359
commission. The commission may pursue any other remedies 2360
available under state or federal law. 2361
(16) A participating state may initiate legal action 2362
against the commission in the United States District Court for 2363
the District of Columbia or the federal district where the 2364
commission has its principal offices to enforce compliance with 2365
the provisions of the compact and its rules. The relief sought 2366
may include both injunctive relief and damages. In the event 2367
judicial enforcement is necessary, the prevailing party shall be 2368
awarded all costs of such litigation, including reasonable 2369
attorney fees. 2370
(17) No person other than a participating state may 2371
enforce this compact against the commission. 2372
2373
ARTICLE XI 2374
DATE OF IMPLEMENTATION OF THE PHYSICIAN ASSISTANT LICENSURE 2375
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COMPACT COMMISSION 2376
2377
(1) This compact shall become effective on the date on 2378
which this compact is enacted into law in the seventh 2379
participating state. 2380
(a) On or after the effective date of the compact, the 2381
commission shall convene and review the enactment of each of the 2382
states that enacted the compact before the commission convening 2383
to determine if the statute enacted by each such charter 2384
participating state is materially different than the model 2385
compact. 2386
(b) A charter participating state whose enactment is found 2387
to be materially different from the model compact shall be 2388
entitled to the default process provided in subsection (4) of 2389
Article X. 2390
(c) If any participating state later withdraws from the 2391
compact or its participation is terminated, the commission shall 2392
remain in existence and the compact shall remain in effect even 2393
if the number of participating states should be less than seven. 2394
(2) Participating states enacting the compact subsequent 2395
to the commission convening shall be subject to the process set 2396
forth in paragraph (t) of subsection (3) of Article VII to 2397
determine if their enactments are materially different from the 2398
model compact and whether they qualify for participation in the 2399
compact. 2400
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(3) Participating states enacting the compact subsequent 2401
to the seven initial charter participating states shall be 2402
subject to the process set forth in paragraph (t) of subsection 2403
(3) of Article VII to determine if such enactments are 2404
materially different from the model compact and whether they 2405
qualify for participation in the compact. 2406
(4) All actions taken for the benefit of the commission or 2407
in furtherance of the purposes of the administration of the 2408
compact before the effective date of the compact or the 2409
commission coming into existence shall be considered to be 2410
actions of the commission unless specifically repudiated by the 2411
commission. 2412
(5) Any state that joins this compact shall be subject to 2413
the commission's rules and bylaws that exist on the date on 2414
which this compact becomes a law in that state. Any rule that 2415
has been previously adopted by the commission shall have the 2416
full force and effect of law on the day this compact becomes a 2417
law in that state. 2418
(6) Any participating state may withdraw from this compact 2419
by enacting a statute repealing the same. 2420
(a) A participating state's withdrawal does not take 2421
effect until 180 days after enactment of the repealing statute. 2422
During this 180 day-period, all compact privileges that were in 2423
effect in the withdrawing state and were granted to licensees 2424
licensed in the withdrawing state shall remain in effect. If any 2425
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licensee licensed in the withdrawing state is also licensed in 2426
another participating state or obtains a license in another 2427
participating state within the 180 days, the licensee's compact 2428
privileges in other participating states will not be affected by 2429
the passage of the 180 days. 2430
(b) Withdrawal does not affect the continuing requirement 2431
of the state licensing board of the withdrawing state to comply 2432
with the investigative and adverse action reporting requirements 2433
of this compact before the effective date of withdrawal. 2434
(c) Upon the enactment of a statute withdrawing a state 2435
from this compact, the state shall immediately provide notice of 2436
such withdrawal to all licensees within that state. Such 2437
withdrawing state shall continue to recognize all licenses 2438
granted pursuant to this compact for a minimum of 180 days after 2439
the date of such notice of withdrawal. 2440
(7) Nothing contained in this compact shall be construed 2441
to invalidate or prevent any physician assistant licensure 2442
agreement or other cooperative arrangement between participating 2443
states and between a participating state and nonparticipating 2444
state that does not conflict with the provisions of this 2445
compact. 2446
(8) This compact may be amended by the participating 2447
states. An amendment to this compact is not effective and 2448
binding upon any participating state until it is enacted 2449
materially in the same manner into the laws of all participating 2450
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states as determined by the commission. 2451
2452
ARTICLE XII 2453
CONSTRUCTION AND SEVERABILITY 2454
2455
(1) This compact and the commission's rulemaking authority 2456
shall be liberally construed so as to effectuate the purposes 2457
and the implementation and administration of the compact. 2458
Provisions of the compact expressly authorizing or requiring the 2459
adoption of rules may not be construed to limit the commission's 2460
rulemaking authority solely for those purposes. 2461
(2) The provisions of this compact are severable and if 2462
any phrase, clause, sentence, or provision of this compact is 2463
held by a court of competent jurisdiction to be contrary to the 2464
constitution of any participating state, a state seeking 2465
participation in the compact, or of the United States, or the 2466
applicability thereof to any government, agency, person, or 2467
circumstance is held to be unconstitutional by a court of 2468
competent jurisdiction, the validity of the remainder of this 2469
compact and the applicability thereof to any other government, 2470
agency, person, or circumstance may not be affected thereby. 2471
(3) Notwithstanding subsection (2) of this article, the 2472
commission may deny a state's participation in the compact or, 2473
in accordance with the requirements in subsections (4)-(10) of 2474
Article X, terminate a participating state's participation in 2475
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the compact, if it determines that a constitutional requirement 2476
of a participating state is, or would be with respect to a state 2477
seeking to participate in the compact, a material departure from 2478
the compact. Otherwise, if this compact shall be held to be 2479
contrary to the constitution of any participating state, the 2480
compact shall remain in full force and effect as to the 2481
remaining participating states and in full force and effect as 2482
to the participating state affected as to all severable matters. 2483
2484
ARTICLE XIII 2485
BINDING EFFECT OF COMPACT 2486
2487
(1) Nothing herein prevents the enforcement of any other 2488
law of a participating state that is not inconsistent with this 2489
compact. 2490
(2) Any laws in a participating state in conflict with 2491
this compact are superseded to the extent of the conflict. 2492
(3) All agreements between the commission and the 2493
participating states are binding in accordance with their terms. 2494
Section 19. Subsection (6) of section 458.307, Florida 2495
Statutes, is renumbered as subsection (7), and a new subsection 2496
(6) is added to that section to read: 2497
458.307 Board of Medicine.— 2498
(6) The Board of Medicine and the Board of Osteopathic 2499
Medicine shall jointly appoint an individual to serve as the 2500
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state's delegate on the Physician Assistant Licensure Compact 2501
Commission, as required under s. 456.66. 2502
Section 20. Subsections (7) through (16) of section 2503
458.347, Florida Statutes, are renumbered as subsections (8) 2504
through (17), respectively, paragraph (f) of subsection (6) is 2505
redesignated as paragraph (g), subsection (3) and present 2506
subsection (11) are amended, a new paragraph (f) is added to 2507
subsection (6), and a new subsection (7) is added to that 2508
section, to read: 2509
458.347 Physician assistants.— 2510
(3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician 2511
or group of physicians supervising a licensed physician 2512
assistant must be qualified in the medical areas in which the 2513
physician assistant is to perform and shall be individually or 2514
collectively responsible and liable for the performance and the 2515
acts and omissions of the physician assistant. A physician may 2516
not supervise as many more than 10 currently licensed physician 2517
assistants as the physician can effectively supervise and 2518
communicate with within the circumstances of the specific 2519
practice setting at any one time. A physician supervising a 2520
physician assistant pursuant to this section is may not be 2521
required to review and cosign charts or medical records prepared 2522
by such physician assistant. 2523
(6) PHYSICIAN ASSISTANT LICENSURE.— 2524
(f) The board may take adverse action against a physician 2525
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assistant's privilege to practice under the Physician Assistant 2526
Licensure Compact pursuant to s. 456.66 and may impose any 2527
penalties in s. 456.072(2) if the physician assistant commits an 2528
act specified in subsection (1) or s. 456.072(1). 2529
(7) EXEMPTION.—A person licensed as a physician assistant 2530
in another state who is practicing under the Physician Assistant 2531
Licensure Compact pursuant to s. 456.66, and only within the 2532
scope provided therein, is exempt from the licensure 2533
requirements of this section, as applicable. 2534
(11) DENIAL, SUSPENSION, OR REVOCATION OF LICENSURE.—The 2535
boards may deny, suspend, or revoke a physician assistant 2536
license if a board determines that the physician assistant has 2537
violated this chapter or s. 456.66. 2538
Section 21. Subsections (7) through (16) of section 2539
459.022, Florida Statutes, are renumbered as subsections (8) 2540
through (17), respectively, paragraph (f) of subsection (6) is 2541
redesignated as paragraph (g), subsection (3) and present 2542
subsection (11) are amended, a new paragraph (f) is added to 2543
subsection (6), and a new subsection (7) is added to that 2544
section, to read: 2545
459.022 Physician assistants.— 2546
(3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician 2547
or group of physicians supervising a licensed physician 2548
assistant must be qualified in the medical areas in which the 2549
physician assistant is to perform and shall be individually or 2550
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collectively responsible and liable for the performance and the 2551
acts and omissions of the physician assistant. A physician may 2552
not supervise as many more than 10 currently licensed physician 2553
assistants as the physician can effectively supervise and 2554
communicate with within the circumstances of the specific 2555
practice setting at any one time. A physician supervising a 2556
physician assistant pursuant to this section is may not be 2557
required to review and cosign charts or medical records prepared 2558
by such physician assistant. 2559
(6) PHYSICIAN ASSISTANT LICENSURE.— 2560
(f) The board may take adverse action against a physician 2561
assistant's privilege to practice under the Physician Assistant 2562
Licensure Compact pursuant to s. 456.66 and may impose any 2563
penalties in s. 456.072(2) if the physician assistant commits an 2564
act specified in subsection (1) or s. 456.072(1). 2565
(7) EXEMPTION.—A person licensed as a physician assistant 2566
in another state who is practicing under the Physician Assistant 2567
Licensure Compact pursuant to s. 456.66, and only within the 2568
scope provided therein, is exempt from the licensure 2569
requirements of this section, as applicable. 2570
(11) DENIAL, SUSPENSION, OR REVOCATION OF LICENSURE.—The 2571
boards may deny, suspend, or revoke a physician assistant 2572
license if a board determines that the physician assistant has 2573
violated this chapter or s. 456.66. 2574
Section 22. Paragraph (a) of subsection (3) of section 2575
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464.0123, Florida Statutes, is amended to read: 2576
464.0123 Autonomous practice by an advanced practice 2577
registered nurse.— 2578
(3) PRACTICE REQUIREMENTS.— 2579
(a) An advanced practice registered nurse who is 2580
registered under this section may: 2581
1. Engage in autonomous practice only in primary care 2582
practice, including family medicine, general pediatrics, and 2583
general internal medicine, as defined by board rule. 2584
2. For certified nurse midwives, engage in autonomous 2585
practice in the performance of the acts listed in s. 2586
464.012(4)(c). 2587
1.3. Perform the general functions of an advanced practice 2588
registered nurse under s. 464.012(3) and the acts within his or 2589
her specialty under s. 464.012(4) related to primary care. 2590
2.4. For a patient who requires the services of a health 2591
care facility, as defined in s. 408.032(8): 2592
a. Admit the patient to the facility. 2593
b. Manage the care received by the patient in the 2594
facility. 2595
c. Discharge the patient from the facility, unless 2596
prohibited by federal law or rule. 2597
2598
As used in this subparagraph, the term "health care facility" 2599
means a skilled nursing facility, hospice, or intermediate care 2600
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facility for the developmentally disabled. The term does not 2601
include a facility relying solely on spiritual means through 2602
prayer for healing. 2603
3.5. Provide a signature, certification, stamp, 2604
verification, affidavit, or endorsement that is otherwise 2605
required by law to be provided by a physician, except an 2606
advanced practice registered nurse registered under this section 2607
may not issue a physician certification under s. 381.986. 2608
Section 23. Section 466.017, Florida Statutes, is amended 2609
to read: 2610
466.017 Prescription of drugs; anesthesia.— 2611
(1) A dentist shall have the right to prescribe drugs or 2612
medicine, subject to limitations imposed by law; perform 2613
surgical operations within the scope of her or his practice and 2614
training; administer general or local anesthesia or sedation, 2615
subject to limitations imposed by law; and use such appliances 2616
as may be necessary to the proper practice of dentistry. 2617
(2) A dental hygienist under the general supervision of a 2618
dentist may prescribe, administer, and dispense fluoride, 2619
fluoride varnish, antimicrobial solutions for mouth rinsing, and 2620
other nonsystemic antimicrobial agents. The board may establish 2621
education and training requirements that a dental hygienist must 2622
complete before prescribing, dispensing, or administering a drug 2623
pursuant to this subsection. The board may adopt rules to 2624
administer this subsection. 2625
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(3)(2) Pharmacists licensed pursuant to chapter 465 may 2626
fill prescriptions of legally licensed dentists in this state 2627
for any drugs necessary for the practice of dentistry or of 2628
legally licensed dental hygienists in this state for drugs 2629
authorized in subsection (2). 2630
(4)(3) The board shall adopt rules which: 2631
(a) Define general anesthesia. 2632
(b) Specify which methods of general or local anesthesia 2633
or sedation, if any, are limited or prohibited for use by 2634
dentists. 2635
(c) Establish minimal training, education, experience, or 2636
certification for a dentist to use general anesthesia or 2637
sedation, which rules may exclude, in the board's discretion, 2638
those dentists using general anesthesia or sedation in a 2639
competent and effective manner as of the effective date of the 2640
rules. 2641
(d) Establish further requirements relating to the use of 2642
general anesthesia or sedation, including, but not limited to, 2643
office equipment and the training of dental assistants or dental 2644
hygienists who work with dentists using general anesthesia or 2645
sedation. 2646
(e) Establish an administrative mechanism enabling the 2647
board to verify compliance with training, education, experience, 2648
equipment, or certification requirements of dentists, dental 2649
hygienists, and dental assistants adopted pursuant to this 2650
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subsection. The board may charge a fee to defray the cost of 2651
verifying compliance with requirements adopted pursuant to this 2652
paragraph. 2653
(5)(4) A dentist or dental hygienist who administers or 2654
employs the use of any form of anesthesia must possess a 2655
certification in either basic cardiopulmonary resuscitation for 2656
health professionals or advanced cardiac life support approved 2657
by the American Heart Association or the American Red Cross or 2658
an equivalent agency-sponsored course with recertification every 2659
2 years. Each dental office that which uses any form of 2660
anesthesia must have immediately available and in good working 2661
order such resuscitative equipment, oxygen, and other 2662
resuscitative drugs as are specified by rule of the board in 2663
order to manage possible adverse reactions. 2664
(6)(5) A dental hygienist under the direct supervision of 2665
a dentist may administer local anesthesia, including intraoral 2666
block anesthesia, soft tissue infiltration anesthesia, or both, 2667
to a nonsedated patient who is 18 years of age or older, if the 2668
following criteria are met: 2669
(a) The dental hygienist has successfully completed a 2670
course in the administration of local anesthesia which is 2671
offered by a dental or dental hygiene program accredited by the 2672
Commission on Dental Accreditation of the American Dental 2673
Association or approved by the board. The course must include a 2674
minimum of 30 hours of didactic instruction and 30 hours of 2675
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clinical experience, and instruction in: 2676
1. Theory of pain control. 2677
2. Selection-of-pain-control modalities. 2678
3. Anatomy. 2679
4. Neurophysiology. 2680
5. Pharmacology of local anesthetics. 2681
6. Pharmacology of vasoconstrictors. 2682
7. Psychological aspects of pain control. 2683
8. Systematic complications. 2684
9. Techniques of maxillary anesthesia. 2685
10. Techniques of mandibular anesthesia. 2686
11. Infection control. 2687
12. Medical emergencies involving local anesthesia. 2688
(b) The dental hygienist presents evidence of current 2689
certification in basic or advanced cardiac life support. 2690
(c) The dental hygienist possesses a valid certificate 2691
issued under subsection (7) (6). 2692
(7)(6) Any dental hygienist seeking a certificate to 2693
administer local anesthesia must apply to the department, remit 2694
an application fee, and submit proof of successful completion of 2695
a course in the administration of local anesthesia pursuant to 2696
subsection (6) (5). The board shall certify, and the department 2697
shall issue a certificate to, any dental hygienist who fulfills 2698
the qualifications of subsection (6) (5). The board shall 2699
establish a one-time application fee not to exceed $35. The 2700
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certificate is not subject to renewal but is part of the dental 2701
hygienist's permanent record and must be prominently displayed 2702
at the location at which where the dental hygienist is 2703
authorized to administer local anesthesia. The board shall adopt 2704
rules necessary to administer subsection (6) (5) and this 2705
subsection. 2706
(8)(7) A licensed dentist may operate utilize an X-ray 2707
machine, expose dental X-ray films, and interpret or read such 2708
films. Notwithstanding The provisions of part IV of chapter 468 2709
to the contrary notwithstanding, a licensed dentist may 2710
authorize or direct a dental assistant to operate such equipment 2711
and expose such films under her or his direction and 2712
supervision, pursuant to rules adopted by the board in 2713
accordance with s. 466.024 which ensure that the said assistant 2714
is competent by reason of training and experience to operate the 2715
X-ray said equipment in a safe and efficient manner. The board 2716
may charge a fee not to exceed $35 to defray the cost of 2717
verifying compliance with requirements adopted pursuant to this 2718
section. 2719
(9)(8) Notwithstanding The provisions of s. 465.0276 2720
notwithstanding, a dentist need not register with the board or 2721
comply with the continuing education requirements of that 2722
section if the dentist confines her or his dispensing activity 2723
to the dispensing of fluorides and chlorhexidine chlorohexidine 2724
rinse solutions; provided that the dentist complies with and is 2725
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subject to all laws and rules applicable to pharmacists and 2726
pharmacies, including, but not limited to, chapters 465, 499, 2727
and 893, and all applicable federal laws and regulations, when 2728
dispensing such products. 2729
(10)(9) Any adverse incident that occurs in an office 2730
maintained by a dentist must be reported to the department. The 2731
required notification to the department must be submitted in 2732
writing by certified mail and postmarked within 48 hours after 2733
the incident occurs. 2734
(11)(10) A dentist practicing in this state must notify 2735
the board in writing by certified mail within 48 hours after any 2736
adverse incident that occurs in the dentist's outpatient 2737
facility. A complete written report must be filed with the board 2738
within 30 days after the incident occurs. 2739
(12)(11) Any certified registered dental hygienist 2740
administering local anesthesia must notify the board in writing 2741
by registered mail within 48 hours after any adverse incident 2742
that was related to or the result of the administration of local 2743
anesthesia. A complete written report must be filed with the 2744
board within 30 days after the mortality or other adverse 2745
incident. 2746
(13)(12) A failure by the dentist or dental hygienist to 2747
timely and completely comply with all the reporting requirements 2748
in this section is the basis for disciplinary action by the 2749
board pursuant to s. 466.028(1). 2750
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(14)(13) The department shall review each adverse incident 2751
and determine whether it involved conduct by a health care 2752
professional subject to disciplinary action, in which case s. 2753
456.073 applies. Disciplinary action, if any, shall be taken by 2754
the board under which the health care professional is licensed. 2755
(15)(14) As used in subsections (10)-(14) (9)-(13), the 2756
term "adverse incident" means any mortality that occurs during 2757
or as the result of a dental procedure, or an incident that 2758
results in a temporary or permanent physical or mental injury 2759
that requires hospitalization or emergency room treatment of a 2760
dental patient which occurs during or as a direct result of the 2761
use of general anesthesia, deep sedation, moderate sedation, 2762
pediatric moderate sedation, oral sedation, minimal sedation 2763
(anxiolysis), nitrous oxide, or local anesthesia. 2764
(16)(15) The board may adopt rules to administer this 2765
section. 2766
Section 24. Subsections (1), (6), and (8) of section 2767
466.024, Florida Statutes, are amended to read: 2768
466.024 Delegation of duties; expanded functions.— 2769
(1) A dentist may not delegate irremediable tasks to a 2770
dental hygienist or dental assistant, except as provided by law. 2771
A dentist may delegate remediable tasks to a dental hygienist or 2772
dental assistant when such tasks pose no risk to the patient. A 2773
dentist may only delegate remediable tasks so defined by law or 2774
rule of the board. The board by rule shall designate which tasks 2775
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are remediable and delegable, except that the following are by 2776
law found to be remediable and delegable: 2777
(a) Taking impressions for study casts but not for the 2778
purpose of fabricating any intraoral restorations or orthodontic 2779
appliance. 2780
(b) Placing periodontal dressings. 2781
(c) Removing periodontal or surgical dressings. 2782
(d) Removing sutures. 2783
(e) Placing or removing rubber dams. 2784
(f) Placing or removing matrices. 2785
(g) Placing or removing temporary restorations. 2786
(h) Applying cavity liners, varnishes, or bases. 2787
(i) Polishing amalgam restorations. 2788
(j) Polishing clinical crowns of the teeth for the purpose 2789
of removing stains but not changing the existing contour of the 2790
tooth. 2791
(k) Obtaining bacteriological cytological specimens not 2792
involving cutting of the tissue. 2793
(l) Administering local anesthesia pursuant to s. 2794
466.017(6) s. 466.017(5). 2795
(m) Performing dental hygiene assessment, dental hygiene 2796
diagnosis, and dental hygiene treatment planning for dental 2797
hygiene services. 2798
(n) Prescribing, administering, or dispensing prescription 2799
drugs pursuant to s. 466.017(2). 2800
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2801
This subsection does not limit delegable tasks to those 2802
specified herein. 2803
(6) Notwithstanding subsection (1) or subsection (2), a 2804
dentist may delegate the tasks of gingival curettage, and root 2805
planing, and the tasks listed in paragraphs (1)(m) and (1)(n) to 2806
a dental hygienist but not to a dental assistant. 2807
(8) Notwithstanding subsection (1) or subsection (2), a 2808
dentist may not delegate to anyone other than another licensed 2809
dentist: 2810
(a) Any prescription of drugs or medications requiring the 2811
written order or prescription of a licensed dentist or 2812
physician, except as provided in paragraph (1)(n). 2813
(b) Any diagnosis for treatment or treatment planning, 2814
except as provided in paragraph (1)(m). 2815
Section 25. Section 491.022, Florida Statutes, is created 2816
to read: 2817
491.022 Social Work Licensure Interstate Compact.—The 2818
Social Work Licensure Interstate Compact is hereby enacted into 2819
law and entered into by this state with all other states legally 2820
joining therein in the form substantially as follows: 2821
2822
ARTICLE I 2823
PURPOSE 2824
2825
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(1) The purpose of this compact is to facilitate 2826
interstate practice of regulated social workers by improving 2827
public access to competent social work services. 2828
(2) The compact preserves the regulatory authority of 2829
member states to protect public health and safety through the 2830
current system of licensure. This compact is designed to achieve 2831
all of the following objectives: 2832
(a) Increase public access to social work services. 2833
(b) Reduce overly burdensome and duplicative requirements 2834
associated with holding multiple licenses. 2835
(c) Enhance member states' ability to protect the public 2836
health and safety. 2837
(d) Encourage the cooperation of member states in 2838
regulating multistate practice. 2839
(e) Promote mobility and address workforce shortages by 2840
eliminating the necessity for licenses in multiple states by 2841
providing for the mutual recognition of other member state 2842
licenses. 2843
(f) Support military families. 2844
(g) Facilitate the exchange of licensure and disciplinary 2845
information among member states. 2846
(h) Authorize all member states to hold a regulated social 2847
worker accountable for abiding by a member state's laws, 2848
regulations, and applicable professional standards in the member 2849
state in which the client is located at the time care is 2850
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rendered. 2851
(i) Allow for the use of telehealth to facilitate 2852
increased access to social work services. 2853
2854
ARTICLE II 2855
DEFINITIONS 2856
2857
As used in this compact, the term: 2858
(1) "Active military member" means any individual with 2859
full-time duty status in the active Armed Forces of the United 2860
States, including members of the National Guard and Reserve. 2861
(2) "Adverse action" means any administrative, civil, 2862
equitable, or criminal action permitted by a state's laws which 2863
is imposed by a licensing authority or other authority against a 2864
regulated social worker, including actions against an 2865
individual's license or multistate authorization to practice 2866
such as revocation, suspension, probation, monitoring of the 2867
licensee, limitation on the licensee's practice, or any other 2868
encumbrance on licensure affecting a regulated social worker's 2869
authorization to practice, including issuance of a cease and 2870
desist action. 2871
(3) "Alternative program" means a nondisciplinary 2872
monitoring or practice remediation process approved by a 2873
licensing authority to address practitioners with an impairment. 2874
(4) "Charter member states" means member states that have 2875
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enacted legislation to adopt this compact where such legislation 2876
predates the effective date of this compact as described in 2877
Article XIV. 2878
(5) "Commission" means the government agency whose 2879
membership consists of all states that have enacted this 2880
compact, which is known as the Social Work Licensure Compact 2881
Commission, as described in Article X, and which shall operate 2882
as an instrumentality of the member states. 2883
(6) "Current significant investigative information" means: 2884
(a) Investigative information that a licensing authority, 2885
after a preliminary inquiry that includes notification and an 2886
opportunity for the regulated social worker to respond, has 2887
reason to believe is not groundless and, if proved true, would 2888
indicate more than a minor infraction as may be defined by the 2889
commission; or 2890
(b) Investigative information that indicates that the 2891
regulated social worker represents an immediate threat to public 2892
health and safety, as may be defined by the commission, 2893
regardless of whether the regulated social worker has been 2894
notified and has had an opportunity to respond. 2895
(7) "Data system" means a repository of information about 2896
licensees, including continuing education, examination, 2897
licensure, current significant investigative information, 2898
disqualifying events, multistate licenses, and adverse action 2899
information or other information as required by the commission. 2900
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(8) "Disqualifying event" means any adverse action or 2901
incident which results in an encumbrance that disqualifies or 2902
makes the licensee ineligible to obtain, retain, or renew a 2903
multistate license. 2904
(9) "Domicile" means the jurisdiction in which the 2905
licensee resides and intends to remain indefinitely. 2906
(10) "Encumbrance" means a revocation or suspension of, or 2907
any limitation on, the full and unrestricted practice of social 2908
work licensed and regulated by a licensing authority. 2909
(11) "Executive committee" means a group of delegates 2910
elected or appointed to act on behalf of, and within the powers 2911
granted to them by, the compact and commission. 2912
(12) "Home state" means the member state that is the 2913
licensee's primary domicile. 2914
(13) "Impairment" means a condition that may impair a 2915
practitioner's ability to engage in full and unrestricted 2916
practice as a regulated social worker without some type of 2917
intervention and may include alcohol and drug dependence, mental 2918
health impairment, and neurological or physical impairments. 2919
(14) "Licensee" means an individual who currently holds a 2920
license from a state to practice as a regulated social worker. 2921
(15) "Licensing authority" means the board or agency of a 2922
member state, or an equivalent, that is responsible for the 2923
licensing and regulation of regulated social workers. 2924
(16) "Member state" means a state, commonwealth, district, 2925
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or territory of the United States that has enacted this compact. 2926
(17) "Multistate authorization to practice" means a 2927
legally authorized privilege to practice, which is equivalent to 2928
a license, associated with a multistate license permitting the 2929
practice of social work in a remote state. 2930
(18) "Multistate license" means a license to practice as a 2931
regulated social worker issued by a home state licensing 2932
authority that authorizes the regulated social worker to 2933
practice in all member states under multistate authorization to 2934
practice. 2935
(19) "Qualifying National Exam" means a national licensing 2936
examination approved by the commission. 2937
(20) "Regulated social worker" means any clinical, 2938
master's, or bachelor's social worker licensed by a member state 2939
regardless of the title used by that member state. 2940
(21) "Remote state" means a member state other than the 2941
licensee's home state. 2942
(22) "Rules" or "rules of the commission" means a 2943
regulation or regulations duly adopted by the commission, as 2944
authorized by the compact, that have the force of law. 2945
(23) "Single state license" means a social work license 2946
issued by any state that authorizes practice only within the 2947
issuing state and does not include multistate authorization to 2948
practice in any member state. 2949
(24) "Social work" or "social work services" means the 2950
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application of social work theory, knowledge, methods, and 2951
ethics and the professional use of self to restore or enhance 2952
social, psychosocial, or biopsychosocial functioning of 2953
individuals, couples, families, groups, organizations, and 2954
communities through the care and services provided by a 2955
regulated social worker as provided in the member state's 2956
statutes and regulations in the state where the services are 2957
being provided. 2958
(25) "State" means any state, commonwealth, district, or 2959
territory of the United States that regulates the practice of 2960
social work. 2961
(26) "Unencumbered license" means a license that 2962
authorizes a regulated social worker to engage in the full and 2963
unrestricted practice of social work. 2964
2965
ARTICLE III 2966
STATE PARTICIPATION IN THE COMPACT 2967
2968
(1) To be eligible to participate in the compact, a 2969
potential member state must currently meet all of the following 2970
criteria: 2971
(a) License and regulate the practice of social work at 2972
the clinical, master's, or bachelor's level. 2973
(b) Require applicants for licensure to graduate from a 2974
program that: 2975
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1. Is operated by a college or university recognized by 2976
the licensing authority; 2977
2. Is accredited, or in candidacy by an institution that 2978
subsequently becomes accredited, by an accrediting agency 2979
recognized by either: 2980
a. The Council for Higher Education Accreditation or its 2981
successor; or 2982
b. The United States Department of Education; and 2983
3. Corresponds to the licensure sought as outlined in 2984
Article IV. 2985
(c) Require applicants for clinical licensure to complete 2986
a period of supervised practice. 2987
(d) Have a mechanism in place for receiving, 2988
investigating, and adjudicating complaints about licensees. 2989
(2) To maintain membership in the compact, a member state 2990
shall: 2991
(a) Require that applicants for a multistate license pass 2992
a Qualifying National Exam for the corresponding category of 2993
multistate license sought as outlined in Article IV. 2994
(b) Participate fully in the commission's data system, 2995
including using the commission's unique identifier as defined in 2996
rules. 2997
(c) Notify the commission, in compliance with the terms of 2998
the compact and rules, of any adverse action or the availability 2999
of current significant investigative information regarding a 3000
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licensee. 3001
(d) Implement procedures for considering the criminal 3002
history records of applicants for a multistate license. Such 3003
procedures shall include the submission of fingerprints or other 3004
biometric-based information by applicants for the purpose of 3005
obtaining an applicant's criminal history record information 3006
from the Federal Bureau of Investigation and the agency 3007
responsible for retaining that state's criminal records. 3008
(e) Comply with the rules of the commission. 3009
(f) Require an applicant to obtain or retain a license in 3010
the home state and meet the home state's qualifications for 3011
licensure or renewal of licensure, as well as all other 3012
applicable home state laws. 3013
(g) Authorize a licensee holding a multistate license in 3014
any member state to practice in accordance with the terms of the 3015
compact and rules of the commission. 3016
(h) Designate a delegate to participate in the commission 3017
meetings. 3018
(3) A member state meeting the requirements under 3019
subsections (1) and (2) shall designate the categories of social 3020
work licensure that are eligible for issuance of a multistate 3021
license for applicants in such member state. To the extent that 3022
any member state does not meet the requirements for 3023
participation in the compact at any particular category of 3024
social work licensure, such member state may choose, but is not 3025
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obligated, to issue a multistate license to applicants who 3026
otherwise meet the requirements of Article IV for issuance of a 3027
multistate license in such category or categories of licensure. 3028
(4) The home state may charge a fee for granting the 3029
multistate license. 3030
3031
ARTICLE IV 3032
SOCIAL WORKER PARTICIPATION IN THE COMPACT 3033
3034
(1) To be eligible for a multistate license under this 3035
compact, an applicant, regardless of category, must meet all of 3036
the following requirements: 3037
(a) Hold or be eligible for an active, unencumbered 3038
license in the home state. 3039
(b) Pay any applicable fees, including any member state 3040
fee, for the multistate license. 3041
(c) Submit, in connection with an application for a 3042
multistate license, fingerprints or other biometric data for the 3043
purpose of obtaining criminal history record information from 3044
the Federal Bureau of Investigation and the agency responsible 3045
for retaining that state's criminal records. 3046
(d) Notify the home state of any adverse action, 3047
encumbrance, or restriction on any professional license taken by 3048
any member state or nonmember state within 30 days after the 3049
date the action was taken. 3050
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(e) Meet any continuing competence requirements 3051
established by the home state. 3052
(f) Abide by the laws, regulations, and applicable 3053
standards in the member state where the client is located at the 3054
time care is rendered. 3055
(2) An applicant for a clinical-category multistate 3056
license must meet all of the following requirements: 3057
(a) Fulfill a competency requirement, which shall be 3058
satisfied by: 3059
1. Passage of a clinical-category Qualifying National 3060
Exam; 3061
2. Licensure of the applicant in his or her home state at 3062
the clinical category, beginning before such time as a 3063
Qualifying National Exam was required by the home state and 3064
accompanied by a period of continuous social work licensure 3065
thereafter, all of which may be further governed by the rules of 3066
the commission; or 3067
3. The substantial equivalency of the foregoing competency 3068
requirements which the commission may determine by rule. 3069
(b) Attain at least a master's degree in social work from 3070
a program that is: 3071
1. Operated by a college or university recognized by a 3072
licensing authority. 3073
2. Accredited, or in candidacy that subsequently becomes 3074
accredited, by an accrediting agency recognized by either: 3075
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a. The Council for Higher Education Accreditation or its 3076
successor; or 3077
b. The United States Department of Education. 3078
(c) Fulfill a practice requirement, which shall be 3079
satisfied by demonstrating completion of: 3080
1. A period of postgraduate supervised clinical practice 3081
equal to a minimum of 3,000 hours; 3082
2. A minimum of 2 years of full-time postgraduate 3083
supervised clinical practice; or 3084
3. The substantial equivalency of the foregoing practice 3085
requirements which the commission may determine by rule. 3086
(3) An applicant for a master's-category multistate 3087
license must meet all of the following requirements: 3088
(a) Fulfill a competency requirement, which shall be 3089
satisfied by: 3090
1. Passage of a masters-category Qualifying National Exam; 3091
2. Licensure of the applicant in his or her home state at 3092
the master's category, beginning before such time as a 3093
Qualifying National Exam was required by the home state at the 3094
master's category and accompanied by a continuous period of 3095
social work licensure thereafter, all of which may be further 3096
governed by the rules of the commission; or 3097
3. The substantial equivalency of the foregoing competency 3098
requirements which the commission may determine by rule. 3099
(b) Attain at least a master's degree in social work from 3100
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a program that is: 3101
1. Operated by a college or university recognized by a 3102
licensing authority. 3103
2. Accredited, or in candidacy by an institution that 3104
subsequently becomes accredited, by an accrediting agency 3105
recognized by either: 3106
a. The Council for Higher Education Accreditation or its 3107
successor; or 3108
b. The United States Department of Education. 3109
(4) An applicant for a bachelor's-category multistate 3110
license must meet all of the following requirements: 3111
(a) Fulfill a competency requirement, which shall be 3112
satisfied by: 3113
1. Passage of a bachelor's-category Qualifying National 3114
Exam; 3115
2. Licensure of the applicant in his or her home state at 3116
the bachelor's category, beginning before such time as a 3117
Qualifying National Exam was required by the home state and 3118
accompanied by a period of continuous social work licensure 3119
thereafter, all of which may be further governed by the rules of 3120
the commission; or 3121
3. The substantial equivalency of the foregoing competency 3122
requirements which the commission may determine by rule. 3123
(b) Attain at least a bachelor's degree in social work 3124
from a program that is: 3125
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1. Operated by a college or university recognized by the 3126
licensing authority. 3127
2. Accredited, or in candidacy that subsequently becomes 3128
accredited, by an accrediting agency recognized by either: 3129
a. The Council for Higher Education Accreditation or its 3130
successor; or 3131
b. The United States Department of Education. 3132
(5) The multistate license for a regulated social worker 3133
is subject to the renewal requirements of the home state. The 3134
regulated social worker must maintain compliance with the 3135
requirements of subsection (1) to be eligible to renew a 3136
multistate license. 3137
(6) The regulated social worker's services in a remote 3138
state are subject to that member state's regulatory authority. A 3139
remote state may, in accordance with due process and that member 3140
state's laws, remove a regulated social worker's multistate 3141
authorization to practice in the remote state for a specific 3142
period of time, impose fines, and take any other necessary 3143
actions to protect the health and safety of its citizens. 3144
(7) If a multistate license is encumbered, the regulated 3145
social worker's multistate authorization to practice shall be 3146
deactivated in all remote states until the multistate license is 3147
no longer encumbered. 3148
(8) If a multistate authorization to practice is 3149
encumbered in a remote state, the regulated social worker's 3150
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multistate authorization to practice may be deactivated in that 3151
state until the multistate authorization to practice is no 3152
longer encumbered. 3153
3154
ARTICLE V 3155
ISSUANCE OF A MULTISTATE LICENSE 3156
3157
(1) Upon receipt of an application for multistate license, 3158
the home state licensing authority shall determine the 3159
applicant's eligibility for a multistate license in accordance 3160
with Article IV. 3161
(2) If such applicant is eligible pursuant to Article IV, 3162
the home state licensing authority shall issue a multistate 3163
license that authorizes the applicant or regulated social worker 3164
to practice in all member states under a multistate 3165
authorization to practice. 3166
(3) Upon issuance of a multistate license, the home state 3167
licensing authority shall designate whether the regulated social 3168
worker holds a multistate license in the bachelor's, master's, 3169
or clinical category of social work. 3170
(4) A multistate license issued by a home state to a 3171
resident in that state shall be recognized by all compact member 3172
states as authorizing social work practice under a multistate 3173
authorization to practice corresponding to each category of 3174
licensure regulated in each member state. 3175
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3176
ARTICLE VI 3177
AUTHORITY OF SOCIAL WORK LICENSURE COMPACT COMMISSION 3178
AND MEMBER STATE LICENSING AUTHORITIES 3179
3180
(1) This compact, or any rule of the commission, does not 3181
limit, restrict, or in any way reduce the ability of a member 3182
state to: 3183
(a) Enact and enforce laws, regulations, or other rules 3184
related to the practice of social work in that state when those 3185
laws, regulations, or other rules are not inconsistent with the 3186
provisions of this compact. 3187
(b) Take adverse action against a licensee's single state 3188
license to practice social work in that state. 3189
(c) Take adverse action against a licensee's multistate 3190
authorization to practice social work in that state. 3191
(2) This compact, or any rule of the commission, does not 3192
limit, restrict, or in any way reduce the ability of a 3193
licensee's home state to take adverse action against a 3194
licensee's multistate license based upon information provided by 3195
a remote state. 3196
(3) This compact does not affect the requirements 3197
established by a member state for the issuance of a single state 3198
license. 3199
3200
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ARTICLE VII 3201
REISSUANCE OF A MULTISTATE LICENSE BY A NEW HOME STATE 3202
3203
(1) A licensee can hold a multistate license, issued by 3204
his or her home state, in only one member state at any given 3205
time. 3206
(2) If a licensee changes his or her home state by moving 3207
between two member states: 3208
(a) The licensee shall immediately apply for the 3209
reissuance of his or her multistate license in his or her new 3210
home state. The licensee shall pay all applicable fees and 3211
notify the prior home state in accordance with the rules of the 3212
commission. 3213
(b) Upon receipt of an application to reissue a multistate 3214
license, the new home state shall verify that the multistate 3215
license is active, unencumbered, and eligible for reissuance 3216
under the terms of the compact and the rules of the commission. 3217
The multistate license issued by the prior home state will be 3218
deactivated and all member states notified in accordance with 3219
the applicable rules adopted by the commission. 3220
(c) Before the reissuance of the multistate license, the 3221
new home state shall conduct procedures for considering the 3222
criminal history records of the licensee. Such procedures shall 3223
include the submission of fingerprints or other biometric-based 3224
information by applicants for the purpose of obtaining an 3225
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applicant's criminal history record information from the Federal 3226
Bureau of Investigation and the agency responsible for retaining 3227
that state's criminal records. 3228
(d) If required for initial licensure, the new home state 3229
may require completion of jurisprudence requirements in the new 3230
home state. 3231
(e) Notwithstanding any other provision of this compact, 3232
if a licensee does not meet the requirements provided in this 3233
compact for the reissuance of a multistate license by the new 3234
home state, then the licensee shall be subject to the new home 3235
state requirements for the issuance of a single state license in 3236
that state. 3237
(3) If a licensee changes his or her primary state of 3238
residence by moving from a member state to a nonmember state, or 3239
from a nonmember state to a member state, then the licensee 3240
shall be subject to the state requirements for the issuance of a 3241
single state license in the new home state. 3242
(4) This compact does not interfere with a licensee's 3243
ability to hold a single state license in multiple states; 3244
however, for the purposes of this compact, a licensee shall have 3245
only one home state, and only one multistate license. 3246
(5) This compact does not interfere with the requirements 3247
established by a member state for the issuance of a single state 3248
license. 3249
3250
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ARTICLE VIII 3251
MILITARY FAMILIES 3252
3253
An active military member or his or her spouse shall 3254
designate a home state where the individual has a multistate 3255
license. The individual may retain his or her home state 3256
designation during the period the servicemember is on active 3257
duty. 3258
3259
ARTICLE IX 3260
ADVERSE ACTIONS 3261
3262
(1) In addition to the other powers conferred by general 3263
law, a remote state shall have the authority, in accordance with 3264
existing state due process law, to: 3265
(a) Take adverse action against a regulated social 3266
worker's multistate authorization to practice only within that 3267
member state, and issue subpoenas for both hearings and 3268
investigations that require the attendance and testimony of 3269
witnesses as well as the production of evidence. Subpoenas 3270
issued by a licensing authority in a member state for the 3271
attendance and testimony of witnesses or the production of 3272
evidence from another member state shall be enforced in the 3273
latter state by any court of competent jurisdiction, according 3274
to the practice and procedure of that court applicable to 3275
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subpoenas issued in proceedings pending before it. The issuing 3276
licensing authority shall pay any witness fees, travel expenses, 3277
mileage, and other fees required by the service statutes of the 3278
state in which the witnesses or evidence are located. 3279
(b) Only the home state shall have the power to take 3280
adverse action against a regulated social worker's multistate 3281
license. 3282
(2) For purposes of taking adverse action, the home state 3283
shall give the same priority and effect to reported conduct 3284
received from a member state as it would if the conduct had 3285
occurred within the home state. In so doing, the home state 3286
shall apply its own state laws to determine appropriate action. 3287
(3) The home state shall complete any pending 3288
investigations of a regulated social worker who changes his or 3289
her home state during the course of the investigations. The home 3290
state shall also have the authority to take appropriate actions 3291
and shall promptly report the conclusions of the investigations 3292
to the administrator of the data system. The administrator of 3293
the data system shall promptly notify the new home state of any 3294
adverse actions. 3295
(4) A member state, if otherwise permitted by state law, 3296
may recover from the affected regulated social worker the costs 3297
of investigations and dispositions of cases resulting from any 3298
adverse action taken against that regulated social worker. 3299
(5) A member state may take adverse action based on the 3300
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factual findings of another member state, provided that the 3301
member state follows its own procedures for taking the adverse 3302
action. 3303
(6)(a) In addition to the authority granted to a member 3304
state by its respective social work practice act or other 3305
applicable state law, any member state may participate with 3306
other member states in joint investigations of licensees. 3307
(b) Member states shall share any investigative, 3308
litigation, or compliance materials in furtherance of any joint 3309
or individual investigation initiated under the compact. 3310
(7) If adverse action is taken by the home state against 3311
the multistate license of a regulated social worker, the 3312
regulated social worker's multistate authorization to practice 3313
in all other member states shall be deactivated until all 3314
encumbrances have been removed from the multistate license. All 3315
home state disciplinary orders that impose adverse action 3316
against the license of a regulated social worker shall include a 3317
statement that the regulated social worker's multistate 3318
authorization to practice is deactivated in all member states 3319
until all conditions of the decision, order, or agreement are 3320
satisfied. 3321
(8) If a member state takes adverse action, it shall 3322
promptly notify the administrator of the data system. The 3323
administrator of the data system shall promptly notify the home 3324
state and all other member states of any adverse actions by 3325
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remote states. 3326
(9) This compact does not override a member state's 3327
decision that participation in an alternative program may be 3328
used in lieu of adverse action. 3329
(10) This compact does not authorize a member state to 3330
demand the issuance of subpoenas for attendance and testimony of 3331
witnesses or the production of evidence from another member 3332
state for lawful actions within that member state. 3333
(11) This compact does not authorize a member state to 3334
impose discipline against a regulated social worker who holds a 3335
multistate authorization to practice for lawful actions within 3336
another member state. 3337
3338
ARTICLE X 3339
ESTABLISHMENT OF SOCIAL WORK LICENSURE 3340
COMPACT COMMISSION 3341
3342
(1) The compact member states hereby create and establish 3343
a joint government agency whose membership consists of all 3344
member states that have enacted the compact known as the Social 3345
Work Licensure Compact Commission. The commission is an 3346
instrumentality of the compact states acting jointly and not an 3347
instrumentality of any one state. The commission shall come into 3348
existence on or after the effective date of the compact as 3349
provided in Article XIV. 3350
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(2)(a) Each member state shall have and be limited to one 3351
delegate appointed by that member state's licensing authority. 3352
The delegate shall be either: 3353
1. A current member of the state licensing authority at 3354
the time of appointment who is a regulated social worker or 3355
public member of the state licensing authority; or 3356
2. An administrator of the licensing authority or his or 3357
her designee. 3358
(b) The commission shall by rule or bylaw establish a term 3359
of office for delegates and may by rule or bylaw establish term 3360
limits. 3361
(c) The commission may recommend removal or suspension of 3362
any delegate from office. 3363
(d) A member state's licensing authority shall fill any 3364
vacancy of its delegate occurring on the commission within 60 3365
days after the vacancy. 3366
(e) Each delegate shall be entitled to one vote on all 3367
matters before the commission requiring a vote by commission 3368
delegates. 3369
(f) A delegate shall vote in person or by such other means 3370
as provided in the bylaws. The bylaws may provide for delegates 3371
to meet by telecommunication, video conference, or other similar 3372
electronic means. 3373
(g) The commission shall meet at least once during each 3374
calendar year. Additional meetings may be held as provided in 3375
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the bylaws. The commission may meet by telecommunication, video 3376
conference, or other similar electronic means. 3377
(3) The commission shall have the following powers: 3378
(a) Establish the fiscal year of the commission. 3379
(b) Establish code of conduct and conflict of interest 3380
policies. 3381
(c) Establish and amend rules and bylaws. 3382
(d) Maintain its financial records in accordance with the 3383
bylaws. 3384
(e) Meet and take such actions as are consistent with the 3385
provisions of this compact, the commission's rules, and the 3386
bylaws. 3387
(f) Initiate and conclude legal proceedings or actions in 3388
the name of the commission, provided that the standing of any 3389
licensing authority to sue or be sued under applicable law may 3390
not be affected. 3391
(g) Maintain and certify records and information provided 3392
to a member state as the authenticated business records of the 3393
commission, and designate an agent to do so on the commission's 3394
behalf. 3395
(h) Purchase and maintain insurance and bonds. 3396
(i) Borrow, accept, or contract for services of personnel, 3397
including, but not limited to, employees of a member state. 3398
(j) Conduct an annual financial review. 3399
(k) Hire employees, elect or appoint officers, fix 3400
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compensation, define duties, grant such individuals appropriate 3401
authority to carry out the purposes of the compact, and 3402
establish the commission's personnel policies and programs 3403
relating to conflicts of interest, qualifications of personnel, 3404
and other related personnel matters. 3405
(l) Assess and collect fees. 3406
(m) Accept any and all appropriate gifts, donations, 3407
grants of money, other sources of revenue, equipment, supplies, 3408
materials, and services, and receive, utilize, and dispose of 3409
the same; provided that at all times the commission shall avoid 3410
any appearance of impropriety or conflict of interest. 3411
(n) Lease, purchase, retain, own, hold, improve, or use 3412
any property, real, personal, or mixed, or any undivided 3413
interest therein. 3414
(o) Sell, convey, mortgage, pledge, lease, exchange, 3415
abandon, or otherwise dispose of any property, real, personal, 3416
or mixed. 3417
(p) Establish a budget and make expenditures. 3418
(q) Borrow money. 3419
(r) Appoint committees, including standing committees, 3420
composed of members, state regulators, state legislators or 3421
their representatives, consumer representatives, and such other 3422
interested persons as may be designated in this compact and the 3423
bylaws. 3424
(s) Provide and receive information from, and cooperate 3425
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with, law enforcement agencies. 3426
(t) Establish and elect an executive committee, including 3427
a chair and a vice chair. 3428
(u) Determine whether a state's adopted language is 3429
materially different from the model compact language such that 3430
the state would not qualify for participation in the compact. 3431
(v) Perform such other functions as may be necessary or 3432
appropriate to achieve the purposes of this compact. 3433
(4)(a) The executive committee shall have the power to act 3434
on behalf of the commission according to the terms of this 3435
compact. The powers, duties, and responsibilities of the 3436
executive committee shall include: 3437
1. Oversee the day-to-day activities of the administration 3438
of the compact, including enforcement and compliance with the 3439
provisions of the compact, its rules and bylaws, and other such 3440
duties as deemed necessary. 3441
2. Recommend to the commission changes to the rules or 3442
bylaws, changes to this compact legislation, fees charged to 3443
compact member states, fees charged to licensees, and other 3444
fees. 3445
3. Ensure compact administration services are 3446
appropriately provided, including by contract. 3447
4. Prepare and recommend the budget. 3448
5. Maintain financial records on behalf of the commission. 3449
6. Monitor compact compliance of member states and provide 3450
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compliance reports to the commission. 3451
7. Establish additional committees as necessary. 3452
8. Exercise the powers and duties of the commission during 3453
the interim between commission meetings, except for adopting or 3454
amending rules, adopting or amending bylaws, and exercising any 3455
other powers and duties reserved expressly for use by the 3456
commission by rule or bylaw. 3457
9. Other duties as provided in the rules or bylaws of the 3458
commission. 3459
(b) The executive committee shall be composed of up to 11 3460
members, including: 3461
1. The chair and vice chair of the commission shall be 3462
voting members of the executive committee. 3463
2. The commission shall elect five voting members from the 3464
current membership of the commission. 3465
3. Up to four ex-officio, nonvoting members from four 3466
recognized national social work organizations, selected by their 3467
respective organizations. 3468
(c) The commission may remove any member of the executive 3469
committee as provided in the commission's bylaws. 3470
(d) The executive committee shall meet at least annually. 3471
1. Executive committee meetings shall be open to the 3472
public, except that the executive committee may meet in a 3473
closed, nonpublic meeting as provided in subsection (7). 3474
2. The executive committee shall give 7 days' notice of 3475
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its meetings, posted on its website and as determined to provide 3476
notice to persons with an interest in the business of the 3477
commission. 3478
3. The executive committee may hold a special meeting in 3479
accordance with subsection (6). 3480
(5) The commission shall adopt and provide to the member 3481
states an annual report. 3482
(6) All meetings shall be open to the public, except that 3483
the commission may meet in a closed, nonpublic meeting as 3484
provided in subsection (7). 3485
(a) Public notice for all meetings of the full commission 3486
of meetings shall be given in the same manner as required under 3487
the rulemaking provisions in Article XII, except that the 3488
commission may hold a special meeting as provided in paragraph 3489
(b). 3490
(b) The commission may hold a special meeting when it must 3491
meet to conduct emergency business by giving 48 hours' notice to 3492
all commissioners, on the commission's website, and by other 3493
means as provided in the commission's rules. The commission's 3494
legal counsel shall certify that the commission's need to meet 3495
qualifies as an emergency. 3496
(7)(a) The commission or the executive committee or other 3497
committee of the commission may convene in a closed, nonpublic 3498
meeting if the commission or the committee needs to receive 3499
legal advice or discuss any of the following: 3500
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1. Noncompliance of a member state with its obligations 3501
under the compact. 3502
2. The employment, compensation, or discipline of, or 3503
other matters, practices, or procedures related to, specific 3504
employees. 3505
3. Current or threatened discipline of a licensee by the 3506
commission or by a member state's licensing authority. 3507
4. Current, threatened, or reasonably anticipated 3508
litigation. 3509
5. Negotiation of contracts for the purchase, lease, or 3510
sale of goods, services, or real estate. 3511
6. Accusing any person of a crime or formally censuring 3512
any person. 3513
7. Trade secrets or commercial or financial information 3514
that is privileged or confidential. 3515
8. Information of a personal nature when disclosure would 3516
constitute a clearly unwarranted invasion of personal privacy. 3517
9. Investigative records compiled for law enforcement 3518
purposes. 3519
10. Information related to any investigative reports 3520
prepared by, or on behalf of or for the use of, the commission 3521
or other committee charged with responsibility of investigation 3522
or determination of compliance issues pursuant to the compact. 3523
11. Matters specifically exempted from disclosure by 3524
federal or member state law. 3525
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12. Other matters as adopted by commission rule. 3526
(b) If a meeting, or portion of a meeting, is closed, the 3527
presiding officer shall state that the meeting will be closed 3528
and reference each relevant exempting provision, and such 3529
reference shall be recorded in the minutes. 3530
(c) The commission shall keep minutes that fully and 3531
clearly describe all matters discussed in a meeting and shall 3532
provide a full and accurate summary of actions taken, and the 3533
reasons therefor, including a description of the views 3534
expressed. All documents considered in connection with an action 3535
shall be identified in such minutes. All minutes and documents 3536
of a closed meeting shall remain under seal, subject to release 3537
only by a majority vote of the commission or order of a court of 3538
competent jurisdiction. 3539
(8)(a) The commission shall pay, or provide for the 3540
payment of, the reasonable expenses of its establishment, 3541
organization, and ongoing activities. 3542
(b) The commission may accept any and all appropriate 3543
revenue sources as provided in paragraph (3)(m). 3544
(c) The commission may levy on and collect an annual 3545
assessment from each member state and impose fees on licensees 3546
of member states to whom it grants a multistate license to cover 3547
the cost of the operations and activities of the commission and 3548
its staff, which must be in a total amount sufficient to cover 3549
its annual budget as approved each year for which revenue is not 3550
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provided by other sources. The aggregate annual assessment 3551
amount for member states shall be allocated based upon a formula 3552
that the commission shall adopt by rule. 3553
(d) The commission may not incur obligations of any kind 3554
prior to securing the funds adequate to meet the same; nor shall 3555
the commission pledge the credit of any of the member states, 3556
except by and with the authority of the member state. 3557
(e) The commission shall keep accurate accounts of all 3558
receipts and disbursements. The receipts and disbursements of 3559
the commission shall be subject to the financial review and 3560
accounting procedures established under its bylaws. However, all 3561
receipts and disbursements of funds handled by the commission 3562
shall be subject to an annual financial review by a certified or 3563
licensed public accountant, and the report of the financial 3564
review shall be included in and become part of the annual report 3565
of the commission. 3566
(9)(a) The members, officers, executive director, 3567
employees, and representatives of the commission shall be immune 3568
from suit and liability, both personally and in their official 3569
capacity, for any claim for damage to or loss of property or 3570
personal injury or other civil liability caused by or arising 3571
out of any actual or alleged act, error, or omission that 3572
occurred, or that the person against whom the claim is made had 3573
a reasonable basis for believing occurred within the scope of 3574
commission employment, duties, or responsibilities; provided 3575
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that this paragraph does not protect any such person from suit 3576
or liability for any damage, loss, injury, or liability caused 3577
by the intentional or willful or wanton misconduct of that 3578
person. The procurement of insurance of any type by the 3579
commission may not in any way compromise or limit the immunity 3580
granted hereunder. 3581
(b) The commission shall defend any member, officer, 3582
executive director, employee, and representative of the 3583
commission in any civil action seeking to impose liability 3584
arising out of any actual or alleged act, error, or omission 3585
that occurred within the scope of commission employment, duties, 3586
or responsibilities, or as determined by the commission that the 3587
person against whom the claim is made had a reasonable basis for 3588
believing occurred within the scope of commission employment, 3589
duties, or responsibilities; provided that nothing herein shall 3590
be construed to prohibit that person from retaining his or her 3591
own counsel at his or her own expense; and provided further that 3592
the actual or alleged act, error, or omission did not result 3593
from the intentional or willful or wanton misconduct of that 3594
person. 3595
(c) The commission shall indemnify and hold harmless any 3596
member, officer, executive director, employee, and 3597
representative of the commission for the amount of any 3598
settlement or judgment obtained against that person arising out 3599
of any actual or alleged act, error, or omission that occurred 3600
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within the scope of commission employment, duties, or 3601
responsibilities, or, as determined by the commission, that the 3602
person against whom the claim is made had a reasonable basis for 3603
believing occurred within the scope of commission employment, 3604
duties, or responsibilities, provided that the actual or alleged 3605
act, error, or omission did not result from the intentional or 3606
willful or wanton misconduct of that person. 3607
(d) Nothing herein shall be construed as a limitation on 3608
the liability of any licensee for professional malpractice or 3609
misconduct, which shall be governed solely by any other 3610
applicable state laws. 3611
(e) This compact may not be interpreted to waive or 3612
otherwise abrogate a member state's state action immunity or 3613
state action affirmative defense with respect to antitrust 3614
claims under the Sherman Antitrust Act, Clayton Antitrust Act of 3615
1914, or any other state or federal antitrust or anticompetitive 3616
law or regulation. 3617
(f) This compact may not be construed to be a waiver of 3618
sovereign immunity by the member states or by the commission. 3619
3620
ARTICLE XI 3621
DATA SYSTEM 3622
3623
(1) The commission shall provide for the development, 3624
maintenance, operation, and utilization of a coordinated data 3625
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system. 3626
(2) The commission shall assign each applicant for a 3627
multistate license a unique identifier, as determined by the 3628
rules of the commission. 3629
(3) Notwithstanding any other provision of state law to 3630
the contrary, a member state shall submit a uniform data set to 3631
the data system on all individuals to whom this compact is 3632
applicable as required by the rules of the commission, 3633
including: 3634
(a) Identifying information. 3635
(b) Licensure data. 3636
(c) Adverse actions against a license and information 3637
related thereto. 3638
(d) Nonconfidential information related to alternative 3639
program participation, the beginning and ending dates of such 3640
participation, and other information related to such 3641
participation not made confidential under member state law. 3642
(e) Any denial of application for licensure, and the 3643
reason for such denial. 3644
(f) The presence of current significant investigative 3645
information. 3646
(g) Other information that may facilitate the 3647
administration of this compact or the protection of the public, 3648
as determined by the rules of the commission. 3649
(4) The records and information provided to a member state 3650
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pursuant to this compact or through the data system, when 3651
certified by the commission or an agent thereof, shall 3652
constitute the authenticated business records of the commission, 3653
and shall be entitled to any associated hearsay exception in any 3654
relevant judicial, quasi-judicial, or administrative proceedings 3655
in a member state. 3656
(5)(a) Current significant investigative information 3657
pertaining to a licensee in any member state will only be 3658
available to other member states. 3659
(b) It is the responsibility of the member states to 3660
report any adverse action against a licensee and to monitor the 3661
database to determine whether adverse action has been taken 3662
against a licensee. Adverse action information pertaining to a 3663
licensee in any member state will be available to any other 3664
member state. 3665
(6) Member states contributing information to the data 3666
system may designate information that may not be shared with the 3667
public without the express permission of the contributing state. 3668
(7) Any information submitted to the data system that is 3669
subsequently expunged pursuant to federal law or the laws of the 3670
member state contributing the information shall be removed from 3671
the data system. 3672
3673
ARTICLE XII 3674
RULEMAKING 3675
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3676
(1) The commission shall adopt reasonable rules in order 3677
to effectively and efficiently implement and administer the 3678
purposes and provisions of the compact. A rule shall be invalid 3679
and have no force or effect only if a court of competent 3680
jurisdiction holds that the rule is invalid because the 3681
commission exercised its rulemaking authority in a manner that 3682
is beyond the scope and purposes of the compact, or the powers 3683
granted hereunder, or based upon another applicable standard of 3684
review. 3685
(2) The rules of the commission shall have the force of 3686
law in each member state; however, if the rules of the 3687
commission conflict with the laws, regulations, and applicable 3688
standards that govern the practice of social work as held by a 3689
court of competent jurisdiction, the rules of the commission are 3690
ineffective in that state to the extent of the conflict. 3691
(3) The commission shall exercise its rulemaking powers 3692
pursuant to the criteria provided in this article and the rules 3693
adopted thereunder. Rules shall become binding on the day 3694
following adoption or the date specified in the rule or 3695
amendment, whichever is later. 3696
(4) If a majority of the legislatures of the member states 3697
rejects a rule or portion of a rule, by enactment of a statute 3698
or resolution in the same manner used to adopt the compact 3699
within 4 years after the date of adoption of the rule, then such 3700
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rule shall have no further force and effect in any member state. 3701
(5) Rules shall be adopted at a regular or special meeting 3702
of the commission. 3703
(6) Before adoption of a proposed rule, the commission 3704
shall hold a public hearing and allow persons to provide oral 3705
and written comments, data, facts, opinions, and arguments. 3706
(7) Before adoption of a proposed rule by the commission, 3707
and at least 30 days in advance of the meeting at which the 3708
commission will hold a public hearing on the proposed rule, the 3709
commission shall provide a notice of proposed rulemaking: 3710
(a) On the website of the commission or other publicly 3711
accessible platform. 3712
(b) To persons who have requested notice of the 3713
commission's notices of proposed rulemaking. 3714
(c) In such other way as the commission may by rule 3715
specify. 3716
(8) The notice of proposed rulemaking shall include: 3717
(a) The time, date, and location of the public hearing at 3718
which the commission will hear public comments on the proposed 3719
rule and, if different, the time, date, and location of the 3720
meeting where the commission will consider and vote on the 3721
proposed rule. 3722
(b) If the hearing is held via telecommunication, video 3723
conference, or other similar electronic means, the mechanism for 3724
access to the hearing. 3725
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(c) The text of the proposed rule and the reason therefor. 3726
(d) A request for comments on the proposed rule from any 3727
interested person. 3728
(e) The manner in which interested persons may submit 3729
written comments. 3730
(9) All hearings will be recorded. A copy of the recording 3731
and all written comments and documents received by the 3732
commission in response to the proposed rule shall be available 3733
to the public. 3734
(10) This article does not require a separate hearing on 3735
each rule. Rules may be grouped for the convenience of the 3736
commission at hearings required by this article. 3737
(11) The commission shall, by majority vote of all 3738
members, take final action on the proposed rule based on the 3739
rulemaking record and the full text of the rule. 3740
(a) The commission may adopt changes to the proposed rule 3741
provided the changes do not enlarge the original purpose of the 3742
proposed rule. 3743
(b) The commission shall provide an explanation of the 3744
reasons for substantive changes made to the proposed rule as 3745
well as reasons for substantive changes not made that were 3746
recommended by commenters. 3747
(c) The commission shall determine a reasonable effective 3748
date for the rule. Except for an emergency as provided in 3749
subsection (12), the effective date of the rule shall be no 3750
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sooner than 30 days after issuing the notice that the commission 3751
adopted or amended the rule. 3752
(12) Upon determination that an emergency exists, the 3753
commission may consider and adopt an emergency rule with 48 3754
hours' notice, with opportunity to comment, provided that the 3755
usual rulemaking procedures provided in the compact and in this 3756
article shall be retroactively applied to the rule as soon as 3757
reasonably possible, but in no event later than 90 days after 3758
the effective date of the rule. For the purposes of this 3759
subsection, an emergency rule is one that must be adopted 3760
immediately in order to: 3761
(a) Meet an imminent threat to public health, safety, or 3762
welfare; 3763
(b) Prevent a loss of commission or member state funds; 3764
(c) Meet a deadline for the adoption of a rule that is 3765
established by federal law or rule; or 3766
(d) Protect public health and safety. 3767
(13) The commission or an authorized committee of the 3768
commission may direct revisions to a previously adopted rule for 3769
purposes of correcting typographical errors, errors in format, 3770
errors in consistency, or grammatical errors. Public notice of 3771
any revisions shall be posted on the website of the commission. 3772
The revision shall be subject to challenge by any person for a 3773
period of 30 days after posting. The revision may be challenged 3774
only on grounds that the revision results in a material change 3775
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to a rule. A challenge shall be made in writing and delivered to 3776
the commission prior to the end of the notice period. If no 3777
challenge is made, the revision will take effect without further 3778
action. If the revision is challenged, the revision may not take 3779
effect without the approval of the commission. 3780
(14) No member state's rulemaking requirements shall apply 3781
under this compact. 3782
3783
ARTICLE XIII 3784
OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT 3785
3786
(1)(a) The executive and judicial branches of state 3787
government in each member state shall enforce this compact and 3788
take all actions necessary and appropriate to implement the 3789
compact. 3790
(b) Except as otherwise provided in this compact, venue is 3791
proper and judicial proceedings by or against the commission 3792
shall be brought solely and exclusively in a court of competent 3793
jurisdiction where the principal office of the commission is 3794
located. The commission may waive venue and jurisdictional 3795
defenses to the extent it adopts or consents to participate in 3796
alternative dispute resolution proceedings. Nothing herein shall 3797
affect or limit the selection or propriety of venue in any 3798
action against a licensee for professional malpractice, 3799
misconduct, or any such similar matter. 3800
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(c) The commission shall be entitled to receive service of 3801
process in any proceeding regarding the enforcement or 3802
interpretation of the compact and shall have standing to 3803
intervene in such a proceeding for all purposes. Failure to 3804
provide the commission service of process shall render a 3805
judgment or order void as to the commission, this compact, or 3806
adopted rules. 3807
(2)(a) If the commission determines that a member state 3808
has defaulted in the performance of its obligations or 3809
responsibilities under this compact or the adopted rules, the 3810
commission shall provide written notice to the defaulting state. 3811
The notice of default shall describe the default, the proposed 3812
means of curing the default, and any other action that the 3813
commission may take, and shall offer training and specific 3814
technical assistance regarding the default. 3815
(b) The commission shall provide a copy of the notice of 3816
default to the other member states. 3817
(3) If a state in default fails to cure the default, the 3818
defaulting state may be terminated from the compact upon an 3819
affirmative vote of a majority of the delegates of the member 3820
states, and all rights, privileges, and benefits conferred on 3821
that state by this compact may be terminated on the effective 3822
date of termination. A cure of the default does not relieve the 3823
offending state of obligations or liabilities incurred during 3824
the period of default. 3825
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(4) Termination of membership in the compact shall be 3826
imposed only after all other means of securing compliance have 3827
been exhausted. Notice of intent to suspend or terminate shall 3828
be given by the commission to the Governor, the majority and 3829
minority leaders of the defaulting state's legislature, the 3830
defaulting state's state licensing authority, and the licensing 3831
authority of each member state. 3832
(5) A state that has been terminated is responsible for 3833
all assessments, obligations, and liabilities incurred through 3834
the effective date of termination, including obligations that 3835
extend beyond the effective date of termination. 3836
(6) Upon the termination of a state's membership from this 3837
compact, that state shall immediately provide notice to all 3838
licensees within that state of such termination. The terminated 3839
state shall continue to recognize all licenses granted pursuant 3840
to this compact for a minimum of 6 months after the date of said 3841
notice of termination. 3842
(7) The commission may not bear any costs related to a 3843
state that is found to be in default or that has been terminated 3844
from the compact, unless agreed upon in writing between the 3845
commission and the defaulting state. 3846
(8) The defaulting state may appeal the action of the 3847
commission by petitioning the United States District Court for 3848
the District of Columbia or the federal district where the 3849
commission has its principal offices. The prevailing party shall 3850
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be awarded all costs of such litigation, including reasonable 3851
attorney fees. 3852
(9)(a) Upon request by a member state, the commission 3853
shall attempt to resolve disputes related to the compact that 3854
arise among member states and between member and nonmember 3855
states. 3856
(b) The commission shall adopt a rule providing for both 3857
mediation and binding dispute resolution for disputes as 3858
appropriate. 3859
(10)(a) By majority vote as provided by rule, the 3860
commission may initiate legal action against a member state in 3861
default in the United States District Court for the District of 3862
Columbia or the federal district where the commission has its 3863
principal offices to enforce compliance with the provisions of 3864
the compact and its adopted rules. The relief sought may include 3865
both injunctive relief and damages. In the event judicial 3866
enforcement is necessary, the prevailing party shall be awarded 3867
all costs of such litigation, including reasonable attorney 3868
fees. The remedies herein may not be the exclusive remedies of 3869
the commission. The commission may pursue any other remedies 3870
available under federal or the defaulting member state's law. 3871
(b) A member state may initiate legal action against the 3872
commission in the United States District Court for the District 3873
of Columbia or the federal district where the commission has its 3874
principal offices to enforce compliance with the provisions of 3875
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the compact and its adopted rules. The relief sought may include 3876
both injunctive relief and damages. In the event judicial 3877
enforcement is necessary, the prevailing party shall be awarded 3878
all costs of such litigation, including reasonable attorney 3879
fees. 3880
(c) Only a member state may enforce this compact against 3881
the commission. 3882
3883
ARTICLE XIV 3884
EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT 3885
3886
(1) The compact shall come into effect on the date on 3887
which the compact statute is enacted into law in the seventh 3888
member state. 3889
(2)(a) On or after the effective date of the compact, the 3890
commission shall convene and review the enactment of each of the 3891
first seven charter member states to determine if the statute 3892
enacted by each such charter member state is materially 3893
different than the model compact statute. 3894
1. A charter member state whose enactment is found to be 3895
materially different from the model compact statute shall be 3896
entitled to the default process provided in Article XIII. 3897
2. If any member state is later found to be in default, or 3898
is terminated or withdraws from the compact, the commission 3899
shall remain in existence and the compact shall remain in effect 3900
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even if the number of member states should be less than seven. 3901
(b) Member states enacting the compact subsequent to the 3902
seven initial charter member states shall be subject to the 3903
process provided in paragraph (3)(u) of Article X to determine 3904
if their enactments are materially different from the model 3905
compact statute and whether they qualify for participation in 3906
the compact. 3907
(c) All actions taken for the benefit of the commission or 3908
in furtherance of the purposes of the administration of the 3909
compact prior to the effective date of the compact or the 3910
commission coming into existence shall be considered to be 3911
actions of the commission unless specifically repudiated by the 3912
commission. 3913
(d) Any state that joins the compact subsequent to the 3914
commission's initial adoption of the rules and bylaws shall be 3915
subject to the rules and bylaws as they exist on the date on 3916
which the compact becomes law in that state. Any rule that has 3917
been previously adopted by the commission shall have the full 3918
force and effect of law on the day the compact becomes law in 3919
that state. 3920
(3) Any member state may withdraw from this compact by 3921
enacting a statute repealing the same. 3922
(a) A member state's withdrawal may not take effect until 3923
180 days after enactment of the repealing statute. 3924
(b) Withdrawal may not affect the continuing requirement 3925
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of the withdrawing state's licensing authority to comply with 3926
the investigative and adverse action reporting requirements of 3927
this compact before the effective date of withdrawal. 3928
(c) Upon the enactment of a statute withdrawing from this 3929
compact, a state shall immediately provide notice of such 3930
withdrawal to all licensees within that state. Notwithstanding 3931
any subsequent statutory enactment to the contrary, such 3932
withdrawing state shall continue to recognize all licenses 3933
granted pursuant to this compact for a minimum of 180 days after 3934
the date of such notice of withdrawal. 3935
(4) This compact does not invalidate or prevent any 3936
licensure agreement or other cooperative arrangement between a 3937
member state and a nonmember state that does not conflict with 3938
the provisions of this compact. 3939
(5) This compact may be amended by the member states. Any 3940
amendment to this compact is not effective and binding upon any 3941
member state until it is enacted into the laws of all member 3942
states. 3943
3944
ARTICLE XV 3945
CONSTRUCTION AND SEVERABILITY 3946
3947
(1) This compact and the commission's rulemaking authority 3948
shall be liberally construed so as to effectuate the purposes 3949
and the implementation and administration of the compact. 3950
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Provisions of the compact expressly authorizing or requiring the 3951
adoption of rules may not be construed to limit the commission's 3952
rulemaking authority solely for those purposes. 3953
(2) The provisions of this compact shall be severable, and 3954
if any phrase, clause, sentence, or provision of this compact is 3955
held by a court of competent jurisdiction to be contrary to the 3956
constitution of any member state, a state seeking participation 3957
in the compact, or the United States, or the application thereof 3958
to any government, agency, person, or circumstance is held to be 3959
unconstitutional by a court of competent jurisdiction, the 3960
validity of the remainder of this compact and the applicability 3961
thereof to any other government, agency, person, or circumstance 3962
may not be affected thereby. 3963
(3) Notwithstanding subsection (2), the commission may 3964
deny a state's participation in the compact or, in accordance 3965
with the requirements of subsection (3) of Article XIII, 3966
terminate a member state's participation in the compact, if it 3967
determines that a constitutional requirement of a member state 3968
is a material departure from the compact. Otherwise, if this 3969
compact shall be held to be contrary to the constitution of any 3970
member state, the compact shall remain in full force and effect 3971
as to the remaining member states and in full force and effect 3972
as to the member state affected as to all severable matters. 3973
3974
ARTICLE XVI 3975
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CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS 3976
3977
(1) A licensee providing services in a remote state under 3978
a multistate authorization to practice shall adhere to the laws 3979
and regulations, including laws, regulations, and applicable 3980
standards, of the remote state where the client is located at 3981
the time care is rendered. 3982
(2) Nothing herein shall prevent or inhibit the 3983
enforcement of any other law of a member state that is not 3984
inconsistent with the compact. 3985
(3) Any laws, statutes, regulations, or other legal 3986
requirements in a member state in conflict with the compact are 3987
superseded to the extent of the conflict. 3988
(4) All permissible agreements between the commission and 3989
the member states are binding in accordance with their terms. 3990
Section 26. Subsection (9) is added to section 491.004, 3991
Florida Statutes, to read: 3992
491.004 Board of Clinical Social Work, Marriage and Family 3993
Therapy, and Mental Health Counseling.— 3994
(9) The board shall appoint an individual to serve as the 3995
state's delegate on the Social Work Licensure Compact 3996
Commission, as required under s. 491.022. 3997
Section 27. Subsection (6) of section 491.005, Florida 3998
Statutes, is amended to read: 3999
491.005 Licensure by examination.— 4000
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(6) EXEMPTIONS EXEMPTION.— 4001
(a) A person licensed as a clinical social worker, 4002
marriage and family therapist, or mental health counselor in 4003
another state who is practicing under the Professional 4004
Counselors Licensure Compact pursuant to s. 491.017, and only 4005
within the scope provided therein, is exempt from the licensure 4006
requirements of this section, as applicable. 4007
(b) A person licensed as a clinical social worker in 4008
another state who is practicing under the Social Work Licensure 4009
Interstate Compact pursuant to s. 491.022, and only within the 4010
scope provided therein, is exempt from the licensure 4011
requirements of this section, as applicable. 4012
Section 28. Subsection (4) is added to section 491.006, 4013
Florida Statutes, to read: 4014
491.006 Licensure or certification by endorsement.— 4015
(4) A person licensed as a clinical social worker in 4016
another state who is practicing under the Social Work Licensure 4017
Interstate Compact pursuant to s. 491.022, and only within the 4018
scope provided therein, is exempt from the licensure 4019
requirements of this section, as applicable. 4020
Section 29. Subsection (1) of section 491.009, Florida 4021
Statutes, is amended, and paragraph (c) is added to subsection 4022
(2) of that section, to read: 4023
491.009 Discipline.— 4024
(1) The following acts constitute grounds for denial of a 4025
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license or disciplinary action, as specified in s. 456.072(2), 4026
or s. 491.017, or s. 491.022: 4027
(a) Attempting to obtain, obtaining, or renewing a 4028
license, registration, or certificate under this chapter by 4029
bribery or fraudulent misrepresentation or through an error of 4030
the board or the department. 4031
(b) Having a license, registration, or certificate to 4032
practice a comparable profession revoked, suspended, or 4033
otherwise acted against, including the denial of certification 4034
or licensure by another state, territory, or country. 4035
(c) Being convicted or found guilty of, regardless of 4036
adjudication, or having entered a plea of nolo contendere to, a 4037
crime in any jurisdiction which directly relates to the practice 4038
of his or her profession or the ability to practice his or her 4039
profession. However, in the case of a plea of nolo contendere, 4040
the board shall allow the person who is the subject of the 4041
disciplinary proceeding to present evidence in mitigation 4042
relevant to the underlying charges and circumstances surrounding 4043
the plea. 4044
(d) False, deceptive, or misleading advertising or 4045
obtaining a fee or other thing of value on the representation 4046
that beneficial results from any treatment will be guaranteed. 4047
(e) Advertising, practicing, or attempting to practice 4048
under a name other than one's own. 4049
(f) Maintaining a professional association with any person 4050
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who the applicant, licensee, registered intern, or 4051
certificateholder knows, or has reason to believe, is in 4052
violation of this chapter or of a rule of the department or the 4053
board. 4054
(g) Knowingly aiding, assisting, procuring, or advising 4055
any nonlicensed, nonregistered, or noncertified person to hold 4056
himself or herself out as licensed, registered, or certified 4057
under this chapter. 4058
(h) Failing to perform any statutory or legal obligation 4059
placed upon a person licensed, registered, or certified under 4060
this chapter. 4061
(i) Willfully making or filing a false report or record; 4062
failing to file a report or record required by state or federal 4063
law; willfully impeding or obstructing the filing of a report or 4064
record; or inducing another person to make or file a false 4065
report or record or to impede or obstruct the filing of a report 4066
or record. Such report or record includes only a report or 4067
record which requires the signature of a person licensed, 4068
registered, or certified under this chapter. 4069
(j) Paying a kickback, rebate, bonus, or other 4070
remuneration for receiving a patient or client, or receiving a 4071
kickback, rebate, bonus, or other remuneration for referring a 4072
patient or client to another provider of mental health care 4073
services or to a provider of health care services or goods; 4074
referring a patient or client to oneself for services on a fee-4075
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paid basis when those services are already being paid for by 4076
some other public or private entity; or entering into a 4077
reciprocal referral agreement. 4078
(k) Committing any act upon a patient or client which 4079
would constitute sexual battery or which would constitute sexual 4080
misconduct as defined pursuant to s. 491.0111. 4081
(l) Making misleading, deceptive, untrue, or fraudulent 4082
representations in the practice of any profession licensed, 4083
registered, or certified under this chapter. 4084
(m) Soliciting patients or clients personally, or through 4085
an agent, through the use of fraud, intimidation, undue 4086
influence, or a form of overreaching or vexatious conduct. 4087
(n) Failing to make available to a patient or client, upon 4088
written request, copies of tests, reports, or documents in the 4089
possession or under the control of the licensee, registered 4090
intern, or certificateholder which have been prepared for and 4091
paid for by the patient or client. 4092
(o) Failing to respond within 30 days to a written 4093
communication from the department or the board concerning any 4094
investigation by the department or the board, or failing to make 4095
available any relevant records with respect to any investigation 4096
about the licensee's, registered intern's, or 4097
certificateholder's conduct or background. 4098
(p) Being unable to practice the profession for which he 4099
or she is licensed, registered, or certified under this chapter 4100
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with reasonable skill or competence as a result of any mental or 4101
physical condition or by reason of illness; drunkenness; or 4102
excessive use of drugs, narcotics, chemicals, or any other 4103
substance. In enforcing this paragraph, upon a finding by the 4104
State Surgeon General, the State Surgeon General's designee, or 4105
the board that probable cause exists to believe that the 4106
licensee, registered intern, or certificateholder is unable to 4107
practice the profession because of the reasons stated in this 4108
paragraph, the department shall have the authority to compel a 4109
licensee, registered intern, or certificateholder to submit to a 4110
mental or physical examination by psychologists, physicians, or 4111
other licensees under this chapter, designated by the department 4112
or board. If the licensee, registered intern, or 4113
certificateholder refuses to comply with such order, the 4114
department's order directing the examination may be enforced by 4115
filing a petition for enforcement in the circuit court in the 4116
circuit in which the licensee, registered intern, or 4117
certificateholder resides or does business. The licensee, 4118
registered intern, or certificateholder against whom the 4119
petition is filed may not be named or identified by initials in 4120
any public court records or documents, and the proceedings shall 4121
be closed to the public. The department shall be entitled to the 4122
summary procedure provided in s. 51.011. A licensee, registered 4123
intern, or certificateholder affected under this paragraph shall 4124
at reasonable intervals be afforded an opportunity to 4125
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demonstrate that he or she can resume the competent practice for 4126
which he or she is licensed, registered, or certified with 4127
reasonable skill and safety to patients. 4128
(q) Performing any treatment or prescribing any therapy 4129
which, by the prevailing standards of the mental health 4130
professions in the community, would constitute experimentation 4131
on human subjects, without first obtaining full, informed, and 4132
written consent. 4133
(r) Failing to meet the minimum standards of performance 4134
in professional activities when measured against generally 4135
prevailing peer performance, including the undertaking of 4136
activities for which the licensee, registered intern, or 4137
certificateholder is not qualified by training or experience. 4138
(s) Delegating professional responsibilities to a person 4139
who the licensee, registered intern, or certificateholder knows 4140
or has reason to know is not qualified by training or experience 4141
to perform such responsibilities. 4142
(t) Violating a rule relating to the regulation of the 4143
profession or a lawful order of the department or the board 4144
previously entered in a disciplinary hearing. 4145
(u) Failure of the licensee, registered intern, or 4146
certificateholder to maintain in confidence a communication made 4147
by a patient or client in the context of such services, except 4148
as provided in s. 491.0147. 4149
(v) Making public statements which are derived from test 4150
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data, client contacts, or behavioral research and which identify 4151
or damage research subjects or clients. 4152
(w) Violating any provision of this chapter or chapter 4153
456, or any rules adopted pursuant thereto. 4154
(2) 4155
(c) The board may take adverse action against a clinical 4156
social worker's privilege to practice under the Social Work 4157
Licensure Interstate Compact pursuant to s. 491.022 and may 4158
impose any of the penalties in s. 456.072(2) if the clinical 4159
social worker commits an act specified in subsection (1) or s. 4160
456.072(1). 4161
Section 30. Subsection (7) of section 627.6471, Florida 4162
Statutes, is renumbered as subsection (8), and a new subsection 4163
(7) is added to that section to read: 4164
627.6471 Contracts for reduced rates of payment; 4165
limitations; coinsurance and deductibles.— 4166
(7) Any insurer issuing a policy of health insurance in 4167
this state shall apply the payment for a service provided to an 4168
insured by a nonpreferred provider toward the insured's 4169
deductible and out-of-pocket maximum as if the service had been 4170
provided by a preferred provider if all of the following apply: 4171
(a) The insured requests that the insurer apply the 4172
payment for the service provided to the insured by the 4173
nonpreferred provider toward the insured's deductible and out-4174
of-pocket maximum. 4175
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(b) The service provided to the insured by the 4176
nonpreferred provider is within the scope of services covered 4177
under the insured's policy. 4178
(c) The amount that the nonpreferred provider charged the 4179
insured for the service is the same as or less than: 4180
1. The average amount that the insured's preferred 4181
provider network charges for the service; or 4182
2. The statewide average amount for the service based on 4183
data reported on the Florida Health Price Finder website. 4184
Section 31. Paragraphs (m), (n), and (o) are added to 4185
subsection (10) of section 768.28, Florida Statutes, to read: 4186
768.28 Waiver of sovereign immunity in tort actions; 4187
recovery limits; civil liability for damages caused during a 4188
riot; limitation on attorney fees; statute of limitations; 4189
exclusions; indemnification; risk management programs.— 4190
(10) 4191
(m) For purposes of this section, the individual appointed 4192
under s. 456.66 as the state's delegate for the Physician 4193
Assistant Licensure Compact Commission, when serving in that 4194
capacity, and any administrator, officer, executive director, 4195
employee, or representative of the Physician Assistant Licensure 4196
Compact Commission, when acting within the scope of his or her 4197
employment, duties, or responsibilities in this state, is 4198
considered an agent of the state. The commission shall pay any 4199
claims or judgments pursuant to this section and may maintain 4200
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insurance coverage to pay any such claims or judgments. 4201
(n) For purposes of this section, the individual appointed 4202
under s. 401.466 as the state's delegate for the Interstate 4203
Commission for EMS Personnel Practice, when serving in that 4204
capacity, and any administrator, officer, executive director, 4205
employee, or representative of the Emergency Medical Services 4206
Personnel Licensure Interstate Compact Commission, when acting 4207
within the scope of his or her employment, duties, or 4208
responsibilities in this state, is considered an agent of the 4209
state. The commission shall pay any claims or judgments pursuant 4210
to this section and may maintain insurance coverage to pay any 4211
such claims or judgments. 4212
(o) For purposes of this section, the individual appointed 4213
under s. 491.004(9) as the state's delegate on the Social Work 4214
Licensure Compact Commission, pursuant to s. 491.022, and any 4215
administrator, officer, executive director, employee, or 4216
representative of the commission, when acting within the scope 4217
of his or her employment, duties, or responsibilities in this 4218
state, is considered an agent of the state. The commission shall 4219
pay any claims or judgments pursuant to this section and may 4220
maintain insurance coverage to pay any such claims or judgments. 4221
Section 32. Except as otherwise expressly provided in this 4222
act, this act shall take effect July 1, 2026. 4223