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Senate
File
312
-
Introduced
SENATE
FILE
312
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
SSB
1052)
A
BILL
FOR
An
Act
enacting
the
physician
assistant
licensure
compact.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
NEW
SECTION
.
147J.1
Physician
assistant
1
licensure
compact.
2
1.
Purpose.
In
order
to
strengthen
access
to
medical
3
services,
and
in
recognition
of
the
advances
in
the
delivery
4
of
medical
services,
the
participating
states
of
the
physician
5
assistant
licensure
compact
have
allied
in
common
purpose
to
6
develop
a
comprehensive
process
that
complements
the
existing
7
authority
of
state
licensing
boards
to
license
and
discipline
8
physician
assistants
and
seeks
to
enhance
the
portability
9
of
a
license
to
practice
as
a
physician
assistant
while
10
safeguarding
the
safety
of
patients.
This
compact
allows
11
medical
services
to
be
provided
by
physician
assistants,
via
12
the
mutual
recognition
of
the
licensee’s
qualifying
license
by
13
other
compact
participating
states.
This
compact
also
adopts
14
the
prevailing
standard
for
physician
assistant
licensure
and
15
affirms
that
the
practice
and
delivery
of
medical
services
by
16
the
physician
assistant
occurs
where
the
patient
is
located
at
17
the
time
of
the
patient
encounter,
and
therefore
requires
the
18
physician
assistant
to
be
under
the
jurisdiction
of
the
state
19
licensing
board
where
the
patient
is
located.
State
licensing
20
boards
that
participate
in
this
compact
retain
the
jurisdiction
21
to
impose
adverse
action
against
a
compact
privilege
in
that
22
state
issued
to
a
physician
assistant
through
the
procedures
23
of
this
compact.
The
physician
assistant
licensure
compact
24
will
alleviate
burdens
for
military
families
by
allowing
active
25
duty
military
personnel
and
their
spouses
to
obtain
a
compact
26
privilege
based
on
having
an
unrestricted
license
in
good
27
standing
from
a
participating
state.
28
2.
Definitions.
In
this
compact:
29
a.
“Adverse
action”
means
any
administrative,
civil,
30
equitable,
or
criminal
action
permitted
by
a
state’s
laws
31
which
is
imposed
by
a
licensing
board
or
other
authority
32
against
a
physician
assistant
license
or
license
application
or
33
compact
privilege
such
as
license
denial,
censure,
revocation,
34
suspension,
probation,
monitoring
of
the
licensee,
or
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restriction
on
the
licensee’s
practice.
1
b.
“Compact
privilege”
means
the
authorization
granted
by
2
a
remote
state
to
allow
a
licensee
from
another
participating
3
state
to
practice
as
a
physician
assistant
to
provide
medical
4
services
and
other
licensed
activity
to
a
patient
located
in
5
the
remote
state
under
the
remote
state’s
laws
and
regulations.
6
c.
“Conviction”
means
a
finding
by
a
court
that
an
7
individual
is
guilty
of
a
felony
or
misdemeanor
offense
through
8
adjudication
or
entry
of
a
plea
of
guilt
or
no
contest
to
the
9
charge
by
the
offender.
10
d.
“Criminal
background
check”
means
the
submission
of
11
fingerprints
or
other
biometric-based
information
for
a
12
license
applicant
for
the
purpose
of
obtaining
that
applicant’s
13
criminal
history
record
information,
as
defined
in
28
C.F.R.
14
§20.3(d),
from
the
state’s
criminal
history
record
repository
15
as
defined
in
28
C.F.R.
§20.3(f).
16
e.
“Data
system”
means
the
repository
of
information
about
17
licensees,
including
but
not
limited
to
license
status
and
18
adverse
actions,
which
is
created
and
administered
under
the
19
terms
of
this
compact.
20
f.
“Executive
committee”
means
a
group
of
directors
and
ex
21
officio
individuals
elected
or
appointed
pursuant
to
subsection
22
7,
paragraph
“f”
,
subparagraph
(2).
23
g.
“Impaired
practitioner”
means
a
physician
assistant
whose
24
practice
is
adversely
affected
by
a
health-related
condition
25
that
impacts
the
physician
assistant’s
ability
to
practice.
26
h.
“Investigative
information”
means
information,
records,
27
or
documents
received
or
generated
by
a
licensing
board
28
pursuant
to
an
investigation.
29
i.
“Jurisprudence
requirement”
means
the
assessment
of
an
30
individual’s
knowledge
of
the
laws
and
rules
governing
the
31
practice
of
a
physician
assistant
in
a
state.
32
j.
“License”
means
current
authorization
by
a
state,
other
33
than
authorization
pursuant
to
a
compact
privilege,
for
a
34
physician
assistant
to
provide
medical
services,
which
would
be
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unlawful
without
current
authorization.
1
k.
“Licensee”
means
an
individual
who
holds
a
license
from
a
2
state
to
provide
medical
services
as
a
physician
assistant.
3
l.
“Licensing
board”
means
any
state
entity
authorized
to
4
license
and
otherwise
regulate
physician
assistants.
5
m.
“Medical
services”
means
health
care
services
provided
6
for
the
diagnosis,
prevention,
treatment,
cure,
or
relief
of
a
7
health
condition,
injury,
or
disease,
as
defined
by
a
state’s
8
laws
and
regulations.
9
n.
“Model
compact”
means
the
model
for
the
physician
10
assistant
licensure
compact
on
file
with
the
council
of
state
11
governments
or
other
entity
as
designated
by
the
commission.
12
o.
“Participating
state”
means
a
state
that
has
enacted
this
13
compact.
14
p.
“Physician
assistant”
means
an
individual
who
is
15
licensed
as
a
physician
assistant
in
a
state.
For
purposes
16
of
this
compact,
any
other
title
or
status
adopted
by
a
state
17
to
replace
the
term
“physician
assistant”
shall
be
deemed
18
synonymous
with
“physician
assistant”
and
shall
confer
the
19
same
rights
and
responsibilities
to
the
licensee
under
the
20
provisions
of
this
compact
at
the
time
of
its
enactment.
21
q.
“Physician
assistant
licensure
compact
commission”
,
22
“compact
commission”
,
or
“commission”
means
the
national
23
administrative
body
created
pursuant
to
subsection
7,
paragraph
24
“a”
,
of
this
compact.
25
r.
“Qualifying
license”
means
an
unrestricted
license
issued
26
by
a
participating
state
to
provide
medical
services
as
a
27
physician
assistant.
28
s.
“Remote
state”
means
a
participating
state
where
a
29
licensee
who
is
not
licensed
as
a
physician
assistant
is
30
exercising
or
seeking
to
exercise
the
compact
privilege.
31
t.
“Rule”
means
a
regulation
promulgated
by
an
entity
that
32
has
the
force
and
effect
of
law.
33
u.
“Significant
investigative
information”
means
34
investigative
information
that
a
licensing
board,
after
an
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inquiry
or
investigation
that
includes
notification
and
an
1
opportunity
for
the
physician
assistant
to
respond
if
required
2
by
state
law,
has
reason
to
believe
is
not
groundless
and,
if
3
proven
true,
would
indicate
more
than
a
minor
infraction.
4
v.
“State”
means
any
state,
commonwealth,
district,
or
5
territory
of
the
United
States.
6
3.
State
participation
in
this
compact.
7
a.
To
participate
in
this
compact,
a
participating
state
8
shall
do
all
of
the
following:
9
(1)
License
physician
assistants.
10
(2)
Participate
in
the
compact
commission’s
data
system.
11
(3)
Have
a
mechanism
in
place
for
receiving
and
12
investigating
complaints
against
licensees
and
license
13
applicants.
14
(4)
Notify
the
commission,
in
compliance
with
the
terms
15
of
this
compact
and
commission
rules,
of
any
adverse
action
16
against
a
licensee
or
license
applicant
and
the
existence
of
17
significant
investigative
information
regarding
a
licensee
or
18
license
applicant.
19
(5)
Fully
implement
a
criminal
background
check
20
requirement,
within
a
time
frame
established
by
commission
21
rule,
by
its
licensing
board
receiving
the
results
of
a
22
criminal
background
check
and
reporting
to
the
commission
23
whether
the
license
applicant
has
been
granted
a
license.
24
(6)
Comply
with
the
rules
of
the
compact
commission.
25
(7)
Utilize
passage
of
a
recognized
national
exam
such
26
as
the
NCCPA
PANCE
as
a
requirement
for
physician
assistant
27
licensure.
28
(8)
Grant
the
compact
privilege
to
a
holder
of
a
qualifying
29
license
in
a
participating
state.
30
b.
Nothing
in
this
compact
prohibits
a
participating
state
31
from
charging
a
fee
for
granting
the
compact
privilege.
32
4.
Compact
privilege.
33
a.
To
exercise
the
compact
privilege,
a
licensee
must
meet
34
all
of
the
following
requirements:
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(1)
Have
graduated
from
a
physician
assistant
program
1
accredited
by
the
accreditation
review
commission
on
education
2
for
the
physician
assistant,
inc.,
or
other
programs
authorized
3
by
commission
rule.
4
(2)
Hold
current
NCCPA
certification.
5
(3)
Have
no
felony
or
misdemeanor
conviction.
6
(4)
Have
never
had
a
controlled
substance
license,
permit,
7
or
registration
suspended
or
revoked
by
a
state
or
by
the
8
United
States
drug
enforcement
administration.
9
(5)
Have
a
unique
identifier
as
determined
by
commission
10
rule.
11
(6)
Hold
a
qualifying
license.
12
(7)
Have
had
no
revocation
of
a
license
or
limitation
or
13
restriction
on
any
license
currently
held
due
to
an
adverse
14
action.
15
(8)
If
a
licensee
has
had
a
limitation
or
restriction
on
16
a
license
or
compact
privilege
due
to
an
adverse
action,
two
17
years
must
have
elapsed
from
the
date
on
which
the
license
or
18
compact
privilege
is
no
longer
limited
or
restricted
due
to
the
19
adverse
action.
20
(9)
If
a
compact
privilege
has
been
revoked
or
is
limited
or
21
restricted
in
a
participating
state
for
conduct
that
would
not
22
be
a
basis
for
disciplinary
action
in
a
participating
state
in
23
which
the
licensee
is
practicing
or
applying
to
practice
under
24
a
compact
privilege,
that
participating
state
shall
have
the
25
discretion
not
to
consider
such
action
as
an
adverse
action
26
requiring
the
denial
or
removal
of
a
compact
privilege
in
that
27
state.
28
(10)
Notify
the
compact
commission
that
the
licensee
is
29
seeking
the
compact
privilege
in
a
remote
state.
30
(11)
Meet
any
jurisprudence
requirement
of
a
remote
state
31
in
which
the
licensee
is
seeking
to
practice
under
the
compact
32
privilege
and
pay
any
fees
applicable
to
satisfying
the
33
jurisprudence
requirement.
34
(12)
Report
to
the
commission
any
adverse
action
taken
by
a
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nonparticipating
state
within
thirty
days
after
the
action
is
1
taken.
2
b.
The
compact
privilege
is
valid
until
the
expiration
or
3
revocation
of
the
qualifying
license
unless
terminated
pursuant
4
to
an
adverse
action.
The
licensee
must
also
comply
with
all
5
of
the
requirements
of
paragraph
“a”
to
maintain
the
compact
6
privilege
in
a
remote
state.
If
the
participating
state
takes
7
adverse
action
against
a
qualifying
license,
the
licensee
shall
8
lose
the
compact
privilege
in
any
remote
state
in
which
the
9
licensee
has
a
compact
privilege
until
all
of
the
following
10
occur:
11
(1)
The
licensee
is
no
longer
limited
or
restricted.
12
(2)
Two
years
have
elapsed
from
the
date
on
which
the
13
license
is
no
longer
limited
or
restricted
due
to
the
adverse
14
action.
15
c.
Once
a
restricted
or
limited
license
satisfies
the
16
requirements
of
paragraph
“b”
,
subparagraphs
(1)
and
(2),
the
17
licensee
must
meet
the
requirements
of
paragraph
“a”
to
obtain
18
a
compact
privilege
in
any
remote
state.
19
d.
For
each
remote
state
in
which
a
physician
assistant
20
seeks
authority
to
prescribe
controlled
substances,
the
21
physician
assistant
shall
satisfy
all
requirements
imposed
by
22
such
state
in
granting
or
renewing
such
authority.
23
5.
Designation
of
the
state
from
which
licensee
is
applying
24
for
a
compact
privilege.
Upon
a
licensee’s
application
for
25
a
compact
privilege,
the
licensee
shall
identify
to
the
26
commission
the
participating
state
from
which
the
licensee
is
27
applying,
in
accordance
with
applicable
rules
adopted
by
the
28
commission,
and
subject
to
the
following
requirements:
29
a.
When
applying
for
a
compact
privilege,
the
licensee
30
shall
provide
the
commission
with
the
address
of
the
licensee’s
31
primary
residence
and
thereafter
shall
immediately
report
to
32
the
commission
any
change
in
the
address
of
the
licensee’s
33
primary
residence.
34
b.
When
applying
for
a
compact
privilege,
the
licensee
is
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required
to
consent
to
accept
service
of
process
by
mail
at
1
the
licensee’s
primary
residence
on
file
with
the
commission
2
with
respect
to
any
action
brought
against
the
licensee
by
the
3
commission
or
a
participating
state,
including
a
subpoena,
with
4
respect
to
any
action
brought
or
investigation
conducted
by
the
5
commission
or
a
participating
state.
6
6.
Adverse
actions.
7
a.
A
participating
state
in
which
a
licensee
is
licensed
8
shall
have
exclusive
power
to
impose
adverse
action
against
the
9
qualifying
license
issued
by
that
participating
state.
10
b.
In
addition
to
the
other
powers
conferred
by
state
law,
11
a
remote
state
shall
have
the
authority,
in
accordance
with
12
existing
state
due
process
law,
to
do
all
of
the
following:
13
(1)
Take
adverse
action
against
a
physician
assistant’s
14
compact
privilege
within
that
state
to
remove
a
licensee’s
15
compact
privilege
or
take
other
action
necessary
under
16
applicable
law
to
protect
the
health
and
safety
of
its
17
citizens.
18
(2)
Issue
subpoenas
for
both
hearings
and
investigations
19
that
require
the
attendance
and
testimony
of
witnesses
as
20
well
as
the
production
of
evidence.
Subpoenas
issued
by
a
21
licensing
board
in
a
participating
state
for
the
attendance
22
and
testimony
of
witnesses
or
the
production
of
evidence
from
23
another
participating
state
shall
be
enforced
in
the
latter
24
state
by
any
court
of
competent
jurisdiction,
according
to
the
25
practice
and
procedure
of
that
court
applicable
to
subpoenas
26
issued
in
proceedings
pending
before
it.
The
issuing
authority
27
shall
pay
any
witness
fees,
travel
expenses,
mileage
and
other
28
fees
required
by
the
service
statutes
of
the
state
in
which
the
29
witnesses
or
evidence
are
located.
30
(3)
Notwithstanding
subparagraph
(2),
subpoenas
may
not
be
31
issued
by
a
participating
state
to
gather
evidence
of
conduct
32
in
another
state
that
is
lawful
in
that
other
state
for
the
33
purpose
of
taking
adverse
action
against
a
licensee’s
compact
34
privilege
or
application
for
a
compact
privilege
in
that
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participating
state.
1
(4)
Nothing
in
this
compact
authorizes
a
participating
2
state
to
impose
discipline
against
a
physician
assistant’s
3
compact
privilege
or
to
deny
an
application
for
a
compact
4
privilege
in
that
participating
state
for
the
individual’s
5
otherwise
lawful
practice
in
another
state.
6
c.
For
purposes
of
taking
adverse
action,
the
participating
7
state
which
issued
the
qualifying
license
shall
give
the
same
8
priority
and
effect
to
reported
conduct
received
from
any
other
9
participating
state
as
it
would
if
the
conduct
had
occurred
10
within
the
participating
state
which
issued
the
qualifying
11
license.
In
so
doing,
that
participating
state
shall
apply
its
12
own
state
laws
to
determine
appropriate
action.
13
d.
A
participating
state,
if
otherwise
permitted
by
state
14
law,
may
recover
from
the
affected
physician
assistant
the
15
costs
of
investigations
and
disposition
of
cases
resulting
from
16
any
adverse
action
taken
against
that
physician
assistant.
17
e.
A
participating
state
may
take
adverse
action
based
18
on
the
factual
findings
of
a
remote
state,
provided
that
the
19
participating
state
follows
its
own
procedures
for
taking
the
20
adverse
action.
21
f.
Joint
investigations.
22
(1)
In
addition
to
the
authority
granted
to
a
participating
23
state
by
its
respective
state
physician
assistant
laws
and
24
regulations
or
other
applicable
state
law,
any
participating
25
state
may
participate
with
other
participating
states
in
joint
26
investigations
of
licensees.
27
(2)
Participating
states
shall
share
any
investigative,
28
litigation,
or
compliance
materials
in
furtherance
of
any
joint
29
or
individual
investigation
initiated
under
this
compact.
30
g.
If
an
adverse
action
is
taken
against
a
physician
31
assistant’s
qualifying
license,
the
physician
assistant’s
32
compact
privilege
in
all
remote
states
shall
be
deactivated
33
until
two
years
have
elapsed
after
all
restrictions
have
been
34
removed
from
the
state
license.
All
disciplinary
orders
by
the
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participating
state
which
issued
the
qualifying
license
that
1
impose
adverse
action
against
a
physician
assistant’s
license
2
shall
include
a
statement
that
the
physician
assistant’s
3
compact
privilege
is
deactivated
in
all
participating
states
4
during
the
pendency
of
the
order.
5
h.
If
any
participating
state
takes
adverse
action,
it
shall
6
promptly
notify
the
administrator
of
the
data
system.
7
7.
Establishment
of
the
physician
assistant
licensure
compact
8
commission.
9
a.
The
participating
states
hereby
create
and
establish
a
10
joint
government
agency
and
national
administrative
body
known
11
as
the
physician
assistant
licensure
compact
commission.
The
12
commission
is
an
instrumentality
of
the
compact
states
acting
13
jointly
and
not
an
instrumentality
of
any
one
state.
The
14
commission
shall
come
into
existence
on
or
after
the
effective
15
date
of
the
compact
as
set
forth
in
subsection
11,
paragraph
16
“a”
.
17
b.
Membership,
voting,
and
meetings.
18
(1)
Each
participating
state
shall
have
and
be
limited
to
19
one
delegate
selected
by
that
participating
state’s
licensing
20
board
or,
if
the
state
has
more
than
one
licensing
board,
21
selected
collectively
by
the
participating
state’s
licensing
22
boards.
23
(2)
The
delegate
shall
be
one
of
the
following:
24
(a)
A
current
physician
assistant,
physician,
or
public
25
member
of
a
licensing
board
or
physician
assistant
council
or
26
committee.
27
(b)
An
administrator
of
a
licensing
board.
28
(3)
Any
delegate
may
be
removed
or
suspended
from
office
as
29
provided
by
the
laws
of
the
state
from
which
the
delegate
is
30
appointed.
31
(4)
The
participating
state
licensing
board
shall
fill
any
32
vacancy
occurring
in
the
commission
within
sixty
days.
33
(5)
Each
delegate
shall
be
entitled
to
one
vote
on
all
34
matters
voted
on
by
the
commission
and
shall
otherwise
have
an
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opportunity
to
participate
in
the
business
and
affairs
of
the
1
commission.
A
delegate
shall
vote
in
person
or
by
such
other
2
means
as
provided
in
the
bylaws.
The
bylaws
may
provide
for
3
delegates’
participation
in
meetings
by
telecommunications,
4
video
conference,
or
other
means
of
communication.
5
(6)
The
commission
shall
meet
at
least
once
during
each
6
calendar
year.
Additional
meetings
shall
be
held
as
set
forth
7
in
this
compact
and
the
bylaws.
8
(7)
The
commission
shall
establish
by
rule
a
term
of
office
9
for
delegates.
10
c.
The
commission
shall
have
the
following
powers
and
11
duties:
12
(1)
Establish
a
code
of
ethics
for
the
commission.
13
(2)
Establish
the
fiscal
year
of
the
commission.
14
(3)
Establish
fees.
15
(4)
Establish
bylaws.
16
(5)
Maintain
its
financial
records
in
accordance
with
the
17
bylaws.
18
(6)
Meet
and
take
such
actions
as
are
consistent
with
the
19
provisions
of
this
compact
and
the
bylaws.
20
(7)
Promulgate
rules
to
facilitate
and
coordinate
21
implementation
and
administration
of
this
compact.
The
rules
22
shall
have
the
force
and
effect
of
law
and
shall
be
binding
in
23
all
participating
states.
24
(8)
Bring
and
prosecute
legal
proceedings
or
actions
in
the
25
name
of
the
commission,
provided
that
the
standing
of
any
state
26
licensing
board
to
sue
or
be
sued
under
applicable
law
shall
27
not
be
affected.
28
(9)
Purchase
and
maintain
insurance
and
bonds.
29
(10)
Borrow,
accept,
or
contract
for
services
of
personnel,
30
including
but
not
limited
to
employees
of
a
participating
31
state.
32
(11)
Hire
employees
and
engage
contractors,
elect
or
33
appoint
officers,
fix
compensation,
define
duties,
grant
such
34
individuals
appropriate
authority
to
carry
out
the
purposes
of
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this
compact,
and
establish
the
commission’s
personnel
policies
1
and
programs
relating
to
conflicts
of
interest,
qualifications
2
of
personnel,
and
other
related
personnel
matters.
3
(12)
Accept
any
and
all
appropriate
donations
and
grants
4
of
money,
equipment,
supplies,
materials,
and
services,
and
5
receive,
utilize,
and
dispose
of
the
same;
provided
that
at
all
6
times
the
commission
shall
avoid
any
appearance
of
impropriety
7
or
conflict
of
interest.
8
(13)
Lease,
purchase,
accept
appropriate
gifts
or
donations
9
of,
or
otherwise
own,
hold,
improve,
or
use
any
property,
real,
10
personal,
or
mixed;
provided
that
at
all
times
the
commission
11
shall
avoid
any
appearance
of
impropriety.
12
(14)
Sell,
convey,
mortgage,
pledge,
lease,
exchange,
13
abandon,
or
otherwise
dispose
of
any
property,
real,
personal,
14
or
mixed.
15
(15)
Establish
a
budget
and
make
expenditures.
16
(16)
Borrow
money.
17
(17)
Appoint
committees,
including
standing
committees
18
composed
of
members,
state
regulators,
state
legislators
or
19
their
representatives,
and
consumer
representatives,
and
such
20
other
interested
persons
as
may
be
designated
in
this
compact
21
and
the
bylaws.
22
(18)
Provide
and
receive
information
from,
and
cooperate
23
with,
law
enforcement
agencies.
24
(19)
Elect
a
chair,
vice
chair,
secretary,
and
treasurer
25
and
such
other
officers
of
the
commission
as
provided
in
the
26
commission’s
bylaws.
27
(20)
Reserve
for
itself,
in
addition
to
those
reserved
28
exclusively
to
the
commission
under
the
compact,
powers
that
29
the
executive
committee
may
not
exercise.
30
(21)
Approve
or
disapprove
a
state’s
participation
in
the
31
compact
based
upon
its
determination
as
to
whether
the
state’s
32
compact
legislation
departs
in
a
material
manner
from
the
model
33
compact
language.
34
(22)
Prepare
and
provide
to
the
participating
states
an
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annual
report.
1
(23)
Perform
such
other
functions
as
may
be
necessary
or
2
appropriate
to
achieve
the
purposes
of
this
compact
consistent
3
with
the
state
regulation
of
physician
assistant
licensure
and
4
practice.
5
d.
Meetings
of
the
commission.
6
(1)
All
meetings
of
the
commission
that
are
not
closed
7
pursuant
to
this
paragraph
shall
be
open
to
the
public.
Notice
8
of
public
meetings
shall
be
posted
on
the
commission’s
internet
9
site
at
least
thirty
days
prior
to
the
public
meeting.
10
(2)
Notwithstanding
subparagraph
(1),
the
commission
may
11
convene
a
public
meeting
by
providing
at
least
twenty-four
12
hours
prior
notice
on
the
commission’s
internet
site,
and
any
13
other
means
as
provided
in
the
commission’s
rules,
for
any
of
14
the
reasons
it
may
dispense
with
notice
of
proposed
rulemaking
15
under
subsection
9,
paragraph
“l”
.
16
(3)
The
commission
may
convene
in
a
closed,
nonpublic
17
meeting
or
nonpublic
part
of
a
public
meeting
to
receive
legal
18
advice
or
to
discuss
any
of
the
following:
19
(a)
Noncompliance
of
a
participating
state
with
its
20
obligations
under
this
compact.
21
(b)
The
employment,
compensation,
discipline
or
other
22
matters,
practices
or
procedures
related
to
specific
employees
23
or
other
matters
related
to
the
commission’s
internal
personnel
24
practices
and
procedures.
25
(c)
Current,
threatened,
or
reasonably
anticipated
26
litigation.
27
(d)
Negotiation
of
contracts
for
the
purchase,
lease,
or
28
sale
of
goods,
services,
or
real
estate.
29
(e)
Accusing
any
person
of
a
crime
or
formally
censuring
any
30
person.
31
(f)
Disclosure
of
trade
secrets
or
commercial
or
financial
32
information
that
is
privileged
or
confidential.
33
(g)
Disclosure
of
information
of
a
personal
nature
where
34
disclosure
would
constitute
a
clearly
unwarranted
invasion
of
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personal
privacy.
1
(h)
Disclosure
of
investigative
records
compiled
for
law
2
enforcement
purposes.
3
(i)
Disclosure
of
information
related
to
any
investigative
4
reports
prepared
by
or
on
behalf
of
or
for
use
of
the
5
commission
or
other
committee
charged
with
responsibility
of
6
investigation
or
determination
of
compliance
issues
pursuant
to
7
this
compact.
8
(j)
Legal
advice.
9
(k)
Matters
specifically
exempted
from
disclosure
by
10
federal
or
participating
states’
statutes.
11
(4)
If
a
meeting,
or
portion
of
a
meeting,
is
closed
12
pursuant
to
this
provision,
the
chair
of
the
meeting
or
the
13
chair’s
designee
shall
certify
that
the
meeting
or
portion
of
14
the
meeting
may
be
closed
and
shall
reference
each
relevant
15
exempting
provision.
16
(5)
The
commission
shall
keep
minutes
that
fully
and
clearly
17
describe
all
matters
discussed
in
a
meeting
and
shall
provide
18
a
full
and
accurate
summary
of
actions
taken,
including
a
19
description
of
the
views
expressed.
All
documents
considered
20
in
connection
with
an
action
shall
be
identified
in
such
21
minutes.
All
minutes
and
documents
of
a
closed
meeting
shall
22
remain
under
seal,
subject
to
release
by
a
majority
vote
of
the
23
commission
or
order
of
a
court
of
competent
jurisdiction.
24
e.
Financing
of
the
commission.
25
(1)
The
commission
shall
pay,
or
provide
for
the
payment
of,
26
the
reasonable
expenses
of
its
establishment,
organization,
and
27
ongoing
activities.
28
(2)
The
commission
may
accept
any
and
all
appropriate
29
revenue
sources,
donations,
and
grants
of
money,
equipment,
30
supplies,
materials,
and
services.
31
(3)
The
commission
may
levy
on
and
collect
an
annual
32
assessment
from
each
participating
state
and
may
impose
33
compact
privilege
fees
on
licensees
of
participating
states
34
to
whom
a
compact
privilege
is
granted
to
cover
the
cost
of
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the
operations
and
activities
of
the
commission
and
its
staff,
1
which
must
be
in
a
total
amount
sufficient
to
cover
its
annual
2
budget
as
approved
by
the
commission
each
year
for
which
3
revenue
is
not
provided
by
other
sources.
The
aggregate
annual
4
assessment
amount
levied
on
participating
states
shall
be
5
allocated
based
upon
a
formula
to
be
determined
by
commission
6
rule.
7
(a)
A
compact
privilege
expires
when
the
licensee’s
8
qualifying
license
in
the
participating
state
from
which
the
9
licensee
applied
for
the
compact
privilege
expires.
10
(b)
If
the
licensee
terminates
the
qualifying
license
11
through
which
the
licensee
applied
for
the
compact
privilege
12
before
its
scheduled
expiration,
and
the
licensee
has
a
13
qualifying
license
in
another
participating
state,
the
licensee
14
shall
inform
the
commission
that
it
is
changing
to
that
15
participating
state
the
participating
state
through
which
it
16
applies
for
a
compact
privilege
and
pay
to
the
commission
any
17
compact
privilege
fee
required
by
commission
rule.
18
(4)
The
commission
shall
not
incur
obligations
of
any
19
kind
prior
to
securing
the
funds
adequate
to
meet
the
same;
20
nor
shall
the
commission
pledge
the
credit
of
any
of
the
21
participating
states,
except
by
and
with
the
authority
of
the
22
participating
state.
23
(5)
The
commission
shall
keep
accurate
accounts
of
all
24
receipts
and
disbursements.
The
receipts
and
disbursements
25
of
the
commission
shall
be
subject
to
the
financial
review
26
and
accounting
procedures
established
under
its
bylaws.
All
27
receipts
and
disbursements
of
funds
handled
by
the
commission
28
shall
be
subject
to
an
annual
financial
review
by
a
certified
29
or
licensed
public
accountant,
and
the
report
of
the
financial
30
review
shall
be
included
in
and
become
part
of
the
annual
31
report
of
the
commission.
32
f.
The
executive
committee.
33
(1)
The
executive
committee
shall
have
the
power
to
act
on
34
behalf
of
the
commission
according
to
the
terms
of
this
compact
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and
commission
rules.
1
(2)
The
executive
committee
shall
be
composed
of
nine
2
members:
3
(a)
Seven
voting
members
who
are
elected
by
the
commission
4
from
the
current
membership
of
the
commission.
5
(b)
One
ex
officio,
nonvoting
member
from
a
recognized
6
national
physician
assistant
professional
association.
7
(c)
One
ex
officio,
nonvoting
member
from
a
recognized
8
national
physician
assistant
certification
organization.
9
(3)
The
ex
officio
members
will
be
selected
by
their
10
respective
organizations.
11
(4)
The
commission
may
remove
any
member
of
the
executive
12
committee
as
provided
in
its
bylaws.
13
(5)
The
executive
committee
shall
meet
at
least
annually.
14
(6)
The
executive
committee
shall
have
the
following
duties
15
and
responsibilities:
16
(a)
Recommend
to
the
commission
changes
to
the
commission’s
17
rules
or
bylaws,
changes
to
this
compact
legislation,
fees
to
18
be
paid
by
compact
participating
states
such
as
annual
dues,
19
and
any
commission
compact
fee
charged
to
licensees
for
the
20
compact
privilege.
21
(b)
Ensure
compact
administration
services
are
22
appropriately
provided,
contractual
or
otherwise.
23
(c)
Prepare
and
recommend
the
budget.
24
(d)
Maintain
financial
records
on
behalf
of
the
commission.
25
(e)
Monitor
compact
compliance
of
participating
states
and
26
provide
compliance
reports
to
the
commission.
27
(f)
Establish
additional
committees
as
necessary.
28
(g)
Exercise
the
powers
and
duties
of
the
commission
during
29
the
interim
between
commission
meetings,
except
for
issuing
30
proposed
rulemaking
or
adopting
commission
rules
or
bylaws,
or
31
exercising
any
other
powers
and
duties
exclusively
reserved
to
32
the
commission
by
the
commission’s
rules.
33
(h)
Perform
other
duties
as
provided
in
the
commission’s
34
rules
or
bylaws.
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(7)
All
meetings
of
the
executive
committee
at
which
it
1
votes
or
plans
to
vote
on
matters
in
exercising
the
powers
and
2
duties
of
the
commission
shall
be
open
to
the
public
and
public
3
notice
of
such
meetings
shall
be
given
as
public
meetings
of
4
the
commission
are
given.
5
(8)
The
executive
committee
may
convene
in
a
closed,
6
nonpublic
meeting
for
the
same
reasons
that
the
commission
may
7
convene
in
a
nonpublic
meeting
as
set
forth
in
subsection
7,
8
paragraph
“d”
,
subparagraph
(3),
and
shall
announce
the
closed
9
meeting
as
the
commission
is
required
to
under
subsection
7,
10
paragraph
“d”
,
subparagraph
(4),
and
keep
minutes
of
the
closed
11
meeting
as
the
commission
is
required
to
under
subsection
7,
12
paragraph
“d”
,
subparagraph
(5).
13
g.
Qualified
immunity,
defense,
and
indemnification.
14
(1)
The
members,
officers,
executive
director,
employees,
15
and
representatives
of
the
commission
shall
be
immune
from
16
suit
and
liability,
both
personally
and
in
their
official
17
capacities,
for
any
claim
for
damage
to
or
loss
of
property
or
18
personal
injury
or
other
civil
liability
caused
by
or
arising
19
out
of
any
actual
or
alleged
act,
error,
or
omission
that
20
occurred,
or
that
the
person
against
whom
the
claim
is
made
had
21
a
reasonable
basis
for
believing
occurred,
within
the
scope
of
22
commission
employment,
duties,
or
responsibilities;
provided
23
that
nothing
in
this
subparagraph
shall
be
construed
to
protect
24
any
such
person
from
suit
or
liability
for
any
damage,
loss,
25
injury,
or
liability
caused
by
the
intentional
or
willful
or
26
wanton
misconduct
of
that
person.
The
procurement
of
insurance
27
of
any
type
by
the
commission
shall
not
in
any
way
compromise
28
or
limit
the
immunity
granted
hereunder.
29
(2)
The
commission
shall
defend
any
member,
officer,
30
executive
director,
employee,
and
representative
of
the
31
commission
in
any
civil
action
seeking
to
impose
liability
32
arising
out
of
any
actual
or
alleged
act,
error,
or
omission
33
that
occurred
within
the
scope
of
commission
employment,
34
duties,
or
responsibilities,
or
as
determined
by
the
commission
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that
the
person
against
whom
the
claim
is
made
had
a
reasonable
1
basis
for
believing
occurred
within
the
scope
of
commission
2
employment,
duties,
or
responsibilities;
provided
that
nothing
3
in
this
subparagraph
shall
be
construed
to
prohibit
that
4
person
from
retaining
counsel
at
the
person’s
own
expense;
5
and
provided
further,
that
the
actual
or
alleged
act,
error,
6
or
omission
did
not
result
from
that
person’s
intentional
or
7
willful
or
wanton
misconduct.
8
(3)
The
commission
shall
indemnify
and
hold
harmless
9
any
member,
officer,
executive
director,
employee,
and
10
representative
of
the
commission
for
the
amount
of
any
11
settlement
or
judgment
obtained
against
that
person
arising
12
out
of
any
actual
or
alleged
act,
error,
or
omission
that
13
occurred
within
the
scope
of
commission
employment,
duties,
14
or
responsibilities,
or
that
such
person
had
a
reasonable
15
basis
for
believing
occurred
within
the
scope
of
commission
16
employment,
duties,
or
responsibilities,
provided
that
the
17
actual
or
alleged
act,
error,
or
omission
did
not
result
from
18
the
intentional
or
willful
or
wanton
misconduct
of
that
person.
19
(4)
Venue
is
proper
and
judicial
proceedings
by
or
against
20
the
commission
shall
be
brought
solely
and
exclusively
in
a
21
court
of
competent
jurisdiction
where
the
principal
office
of
22
the
commission
is
located.
The
commission
may
waive
venue
and
23
jurisdictional
defenses
in
any
proceedings
as
authorized
by
24
commission
rules.
25
(5)
Nothing
herein
shall
be
construed
as
a
limitation
on
26
the
liability
of
any
licensee
for
professional
malpractice
27
or
misconduct,
which
shall
be
governed
solely
by
any
other
28
applicable
state
laws.
29
(6)
Nothing
herein
shall
be
construed
to
designate
the
30
venue
or
jurisdiction
to
bring
actions
for
alleged
acts
of
31
malpractice,
professional
misconduct,
negligence,
or
other
32
such
civil
action
pertaining
to
the
practice
of
a
physician
33
assistant.
All
such
matters
shall
be
determined
exclusively
by
34
state
law
other
than
this
compact.
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(7)
Nothing
in
this
compact
shall
be
interpreted
to
waive
1
or
otherwise
abrogate
a
participating
state’s
state
action
2
immunity
or
state
action
affirmative
defense
with
respect
to
3
antitrust
claims
under
the
Sherman
Act,
Clayton
Act,
or
any
4
other
state
or
federal
antitrust
or
anticompetitive
law
or
5
regulation.
6
(8)
Nothing
in
this
compact
shall
be
construed
to
be
a
7
waiver
of
sovereign
immunity
by
the
participating
states
or
by
8
the
commission.
9
8.
Data
system.
10
a.
The
commission
shall
provide
for
the
development,
11
maintenance,
operation,
and
utilization
of
a
coordinated
data
12
and
reporting
system
containing
licensure,
adverse
action,
and
13
the
reporting
of
the
existence
of
significant
investigative
14
information
on
all
licensed
physician
assistants
and
applicants
15
denied
a
license
in
participating
states.
16
b.
Notwithstanding
any
other
state
law
to
the
contrary,
17
a
participating
state
shall
submit
a
uniform
data
set
to
the
18
data
system
on
all
physician
assistants
to
whom
this
compact
is
19
applicable,
utilizing
a
unique
identifier,
as
required
by
the
20
rules
of
the
commission,
including:
21
(1)
Identifying
information.
22
(2)
Licensure
data.
23
(3)
Adverse
actions
against
a
license
or
compact
privilege.
24
(4)
Any
denial
of
application
for
licensure,
and
the
reason
25
for
such
denial,
excluding
the
reporting
of
any
criminal
26
history
record
information
where
prohibited
by
law.
27
(5)
The
existence
of
significant
investigative
information.
28
(6)
Other
information
that
may
facilitate
the
29
administration
of
this
compact,
as
determined
by
the
rules
of
30
the
commission.
31
c.
Significant
investigative
information
pertaining
to
a
32
licensee
in
any
participating
state
shall
only
be
available
to
33
other
participating
states.
34
d.
The
commission
shall
promptly
notify
all
participating
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states
of
any
adverse
action
taken
against
a
licensee
or
an
1
individual
applying
for
a
license
that
has
been
reported
to
it.
2
This
adverse
action
information
shall
be
available
to
any
other
3
participating
state.
4
e.
Participating
states
contributing
information
to
the
data
5
system
may,
in
accordance
with
state
or
federal
law,
designate
6
information
that
may
not
be
shared
with
the
public
without
the
7
express
permission
of
the
contributing
state.
Notwithstanding
8
any
such
designation,
such
information
shall
be
reported
to
the
9
commission
through
the
data
system.
10
f.
Any
information
submitted
to
the
data
system
that
is
11
subsequently
expunged
pursuant
to
federal
law
or
the
laws
of
12
the
participating
state
contributing
the
information
shall
be
13
removed
from
the
data
system
upon
reporting
of
such
by
the
14
participating
state
to
the
commission.
15
g.
The
records
and
information
provided
to
a
participating
16
state
pursuant
to
this
compact
or
through
the
data
system,
17
when
certified
by
the
commission
or
an
agent
thereof,
18
shall
constitute
the
authenticated
business
records
of
the
19
commission,
and
shall
be
entitled
to
any
associated
hearsay
20
exception
in
any
relevant
judicial,
quasi-judicial,
or
21
administrative
proceedings
in
a
participating
state.
22
9.
Rulemaking.
23
a.
The
commission
shall
exercise
its
rulemaking
powers
24
pursuant
to
the
criteria
set
forth
in
this
subsection
and
25
the
rules
adopted
thereunder.
Commission
rules
shall
become
26
binding
as
of
the
date
specified
by
the
commission
for
each
27
rule.
28
b.
The
commission
shall
promulgate
reasonable
rules
in
order
29
to
effectively
and
efficiently
implement
and
administer
this
30
compact
and
achieve
its
purposes.
A
commission
rule
shall
31
be
invalid
and
not
have
force
or
effect
only
if
a
court
of
32
competent
jurisdiction
holds
that
the
rule
is
invalid
because
33
the
commission
exercised
its
rulemaking
authority
in
a
manner
34
that
is
beyond
the
scope
of
the
purposes
of
this
compact,
or
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the
powers
granted
in
this
subsection,
or
based
upon
another
1
applicable
standard
of
review.
2
c.
The
rules
of
the
commission
shall
have
the
force
of
3
law
in
each
participating
state,
provided
however
that
where
4
the
rules
of
the
commission
conflict
with
the
laws
of
the
5
participating
state
that
establish
the
medical
services
a
6
physician
assistant
may
perform
in
the
participating
state,
as
7
held
by
a
court
of
competent
jurisdiction,
the
rules
of
the
8
commission
shall
be
ineffective
in
that
state
to
the
extent
of
9
the
conflict.
10
d.
If
a
majority
of
the
legislatures
of
the
participating
11
states
rejects
a
commission
rule
by
enactment
of
a
statute
or
12
resolution
in
the
same
manner
used
to
adopt
this
compact
within
13
four
years
of
the
date
of
adoption
of
the
rule,
then
such
rule
14
shall
have
no
further
force
and
effect
in
any
participating
15
state
or
to
any
state
applying
to
participate
in
the
compact.
16
e.
Commission
rules
shall
be
adopted
at
a
regular
or
special
17
meeting
of
the
commission.
18
f.
Prior
to
promulgation
and
adoption
of
a
final
rule
or
19
rules
by
the
commission,
and
at
least
thirty
days
in
advance
20
of
the
meeting
at
which
the
rule
will
be
considered
and
voted
21
upon,
the
commission
shall
file
a
notice
of
proposed
rulemaking
22
using
all
of
the
following
methods:
23
(1)
On
the
internet
site
of
the
commission
or
other
publicly
24
accessible
platform.
25
(2)
To
persons
who
have
requested
notice
of
the
commission’s
26
notices
of
proposed
rulemaking.
27
(3)
In
such
other
ways
as
the
commission
may
by
rule
28
specify.
29
g.
The
notice
of
proposed
rulemaking
shall
include
all
of
30
the
following:
31
(1)
The
time,
date,
and
location
of
the
public
hearing
on
32
the
proposed
rule
and
the
proposed
time,
date,
and
location
of
33
the
meeting
in
which
the
proposed
rule
will
be
considered
and
34
voted
upon.
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(2)
The
text
of
the
proposed
rule
and
the
reason
for
the
1
proposed
rule.
2
(3)
A
request
for
comments
on
the
proposed
rule
from
any
3
interested
person
and
the
date
by
which
written
comments
must
4
be
received.
5
(4)
The
manner
in
which
interested
persons
may
submit
notice
6
to
the
commission
of
their
intention
to
attend
the
public
7
hearing
or
provide
any
written
comments.
8
h.
Prior
to
adoption
of
a
proposed
rule,
the
commission
9
shall
allow
persons
to
submit
written
data,
facts,
opinions,
10
and
arguments,
which
shall
be
made
available
to
the
public.
11
i.
If
the
hearing
is
to
be
held
via
electronic
means,
12
the
commission
shall
publish
the
mechanism
for
access
to
the
13
electronic
hearing.
14
(1)
All
persons
wishing
to
be
heard
at
the
hearing
shall
as
15
directed
in
the
notice
of
proposed
rulemaking,
not
less
than
16
five
business
days
before
the
scheduled
date
of
the
hearing,
17
notify
the
commission
of
their
desire
to
appear
and
testify
at
18
the
hearing.
19
(2)
Hearings
shall
be
conducted
in
a
manner
providing
each
20
person
who
wishes
to
comment
a
fair
and
reasonable
opportunity
21
to
comment
orally
or
in
writing.
22
(3)
All
hearings
shall
be
recorded.
A
copy
of
the
recording
23
and
the
written
comments,
data,
facts,
opinions,
and
arguments
24
received
in
response
to
the
proposed
rulemaking
shall
be
made
25
available
to
a
person
upon
request.
26
(4)
Nothing
in
this
paragraph
shall
be
construed
as
27
requiring
a
separate
hearing
on
each
proposed
rule.
Proposed
28
rules
may
be
grouped
for
the
convenience
of
the
commission
at
29
hearings
required
by
this
section.
30
j.
Following
the
public
hearing
the
commission
shall
31
consider
all
written
and
oral
comments
timely
received.
32
k.
The
commission
shall,
by
majority
vote
of
all
delegates,
33
take
final
action
on
the
proposed
rule
and
shall
determine
the
34
effective
date
of
the
rule,
if
adopted,
based
on
the
rulemaking
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record
and
the
full
text
of
the
rule.
1
(1)
If
adopted,
the
rule
shall
be
posted
on
the
commission’s
2
internet
site.
3
(2)
The
commission
may
adopt
changes
to
the
proposed
rule
4
provided
the
changes
do
not
enlarge
the
original
purpose
of
the
5
proposed
rule.
6
(3)
The
commission
shall
provide
on
its
internet
site
an
7
explanation
of
the
reasons
for
substantive
changes
made
to
the
8
proposed
rule
as
well
as
reasons
for
substantive
changes
not
9
made
that
were
recommended
by
commenters.
10
(4)
The
commission
shall
determine
a
reasonable
effective
11
date
for
the
rule.
Except
for
an
emergency
as
provided
in
12
paragraph
“l”
,
the
effective
date
of
the
rule
shall
be
no
sooner
13
than
thirty
days
after
the
commission
issued
the
notice
that
it
14
adopted
the
rule.
15
l.
Upon
determination
that
an
emergency
exists,
the
16
commission
may
consider
and
adopt
an
emergency
rule
with
17
twenty-four
hours
prior
notice,
without
the
opportunity
18
for
comment,
or
hearing,
provided
that
the
usual
rulemaking
19
procedures
provided
in
this
compact
and
in
this
subsection
20
shall
be
retroactively
applied
to
the
rule
as
soon
as
21
reasonably
possible,
in
no
event
later
than
ninety
days
after
22
the
effective
date
of
the
rule.
For
the
purposes
of
this
23
paragraph,
an
emergency
rule
is
one
that
must
be
adopted
24
immediately
by
the
commission
in
order
to
do
any
of
the
25
following:
26
(1)
Meet
an
imminent
threat
to
public
health,
safety,
or
27
welfare.
28
(2)
Prevent
a
loss
of
commission
or
participating
state
29
funds.
30
(3)
Meet
a
deadline
for
the
promulgation
of
a
commission
31
rule
that
is
established
by
federal
law
or
rule.
32
(4)
Protect
public
health
and
safety.
33
m.
The
commission
or
an
authorized
committee
of
the
34
commission
may
direct
revisions
to
a
previously
adopted
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commission
rule
for
purposes
of
correcting
typographical
1
errors,
errors
in
format,
errors
in
consistency,
or
grammatical
2
errors.
Public
notice
of
any
revisions
shall
be
posted
on
3
the
internet
site
of
the
commission.
The
revision
shall
be
4
subject
to
challenge
by
any
person
for
a
period
of
thirty
days
5
after
posting.
The
revision
may
be
challenged
only
on
grounds
6
that
the
revision
results
in
a
material
change
to
a
rule.
A
7
challenge
shall
be
made
as
set
forth
in
the
notice
of
revisions
8
and
delivered
to
the
commission
prior
to
the
end
of
the
notice
9
period.
If
no
challenge
is
made,
the
revision
will
take
10
effect
without
further
action.
If
the
revision
is
challenged,
11
the
revision
may
not
take
effect
without
the
approval
of
the
12
commission.
13
n.
No
participating
state’s
rulemaking
requirements
shall
14
apply
under
this
compact.
15
10.
Oversight,
dispute
resolution,
and
enforcement.
16
a.
Oversight.
17
(1)
The
executive
and
judicial
branches
of
state
government
18
in
each
participating
state
shall
enforce
this
compact
and
take
19
all
actions
necessary
and
appropriate
to
implement
the
compact.
20
(2)
Venue
is
proper
and
judicial
proceedings
by
or
against
21
the
commission
shall
be
brought
solely
and
exclusively
in
a
22
court
of
competent
jurisdiction
where
the
principal
office
of
23
the
commission
is
located.
The
commission
may
waive
venue
and
24
jurisdictional
defenses
to
the
extent
it
adopts
or
consents
25
to
participate
in
alternative
dispute
resolution
proceedings.
26
Nothing
herein
shall
affect
or
limit
the
selection
or
propriety
27
of
venue
in
any
action
against
a
licensee
for
professional
28
malpractice,
misconduct
or
any
such
similar
matter.
29
(3)
The
commission
shall
be
entitled
to
receive
service
30
of
process
in
any
proceeding
regarding
the
enforcement
or
31
interpretation
of
the
compact
or
the
commission’s
rules
and
32
shall
have
standing
to
intervene
in
such
a
proceeding
for
all
33
purposes.
Failure
to
provide
the
commission
with
service
of
34
process
shall
render
a
judgment
or
order
in
such
proceeding
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void
as
to
the
commission,
this
compact,
or
commission
rules.
1
b.
Default,
technical
assistance,
and
termination.
2
(1)
If
the
commission
determines
that
a
participating
3
state
has
defaulted
in
the
performance
of
its
obligations
4
or
responsibilities
under
this
compact
or
the
commission
5
rules,
the
commission
shall
provide
written
notice
to
the
6
defaulting
state
and
other
participating
states.
The
notice
7
shall
describe
the
default,
the
proposed
means
of
curing
the
8
default,
and
any
other
action
that
the
commission
may
take
and
9
shall
offer
remedial
training
and
specific
technical
assistance
10
regarding
the
default.
11
(2)
If
a
state
in
default
fails
to
cure
the
default,
the
12
defaulting
state
may
be
terminated
from
this
compact
upon
13
an
affirmative
vote
of
a
majority
of
the
delegates
of
the
14
participating
states,
and
all
rights,
privileges,
and
benefits
15
conferred
by
this
compact
upon
such
state
may
be
terminated
on
16
the
effective
date
of
termination.
A
cure
of
the
default
does
17
not
relieve
the
offending
state
of
obligations
or
liabilities
18
incurred
during
the
period
of
default.
19
(3)
Termination
of
participation
in
this
compact
shall
be
20
imposed
only
after
all
other
means
of
securing
compliance
have
21
been
exhausted.
Notice
of
intent
to
suspend
or
terminate
shall
22
be
given
by
the
commission
to
the
governor,
the
majority
and
23
minority
leaders
of
the
defaulting
state’s
legislature,
and
to
24
the
licensing
boards
of
each
of
the
participating
states.
25
(4)
A
state
that
has
been
terminated
is
responsible
for
26
all
assessments,
obligations,
and
liabilities
incurred
through
27
the
effective
date
of
termination,
including
obligations
that
28
extend
beyond
the
effective
date
of
termination.
29
(5)
The
commission
shall
not
bear
any
costs
related
30
to
a
state
that
is
found
to
be
in
default
or
that
has
been
31
terminated
from
this
compact,
unless
agreed
upon
in
writing
32
between
the
commission
and
the
defaulting
state.
33
(6)
The
defaulting
state
may
appeal
its
termination
from
34
the
compact
by
the
commission
by
petitioning
the
United
States
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district
court
for
the
District
of
Columbia
or
the
federal
1
district
where
the
commission
has
its
principal
offices.
2
The
prevailing
member
shall
be
awarded
all
costs
of
such
3
litigation,
including
reasonable
attorney
fees.
4
(7)
Upon
the
termination
of
a
state’s
participation
in
the
5
compact,
the
state
shall
immediately
provide
notice
to
all
6
licensees
within
that
state
of
such
termination.
7
(a)
Licensees
who
have
been
granted
a
compact
privilege
in
8
that
state
shall
retain
the
compact
privilege
for
one
hundred
9
eighty
days
following
the
effective
date
of
such
termination.
10
(b)
Licensees
who
are
licensed
in
that
state
who
have
been
11
granted
a
compact
privilege
in
a
participating
state
shall
12
retain
the
compact
privilege
for
one
hundred
eighty
days
unless
13
the
licensee
also
has
a
qualifying
license
in
a
participating
14
state
or
obtains
a
qualifying
license
in
a
participating
state
15
before
the
one-hundred-eighty-day
period
ends,
in
which
case
16
the
compact
privilege
shall
continue.
17
c.
Dispute
resolution.
18
(1)
Upon
request
by
a
participating
state,
the
commission
19
shall
attempt
to
resolve
disputes
related
to
this
compact
that
20
arise
among
participating
states
and
between
participating
and
21
nonparticipating
states.
22
(2)
The
commission
shall
promulgate
a
rule
providing
for
23
both
mediation
and
binding
dispute
resolution
for
disputes
as
24
appropriate.
25
d.
Enforcement.
26
(1)
The
commission,
in
the
reasonable
exercise
of
its
27
discretion,
shall
enforce
the
provisions
of
this
compact
and
28
rules
of
the
commission.
29
(2)
If
compliance
is
not
secured
after
all
means
to
30
secure
compliance
have
been
exhausted,
by
majority
vote,
the
31
commission
may
initiate
legal
action
in
the
United
States
32
district
court
for
the
District
of
Columbia
or
the
federal
33
district
where
the
commission
has
its
principal
offices,
34
against
a
participating
state
in
default
to
enforce
compliance
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with
the
provisions
of
this
compact
and
the
commission’s
1
promulgated
rules
and
bylaws.
The
relief
sought
may
include
2
both
injunctive
relief
and
damages.
In
the
event
judicial
3
enforcement
is
necessary,
the
prevailing
party
shall
be
awarded
4
all
costs
of
such
litigation,
including
reasonable
attorney
5
fees.
6
(3)
The
remedies
in
subparagraph
(2)
shall
not
be
the
7
exclusive
remedies
of
the
commission.
The
commission
may
8
pursue
any
other
remedies
available
under
federal
or
state
law.
9
e.
Legal
action
against
the
commission.
10
(1)
A
participating
state
may
initiate
legal
action
11
against
the
commission
in
the
United
States
district
court
for
12
the
District
of
Columbia
or
the
federal
district
where
the
13
commission
has
its
principal
offices
to
enforce
compliance
with
14
the
provisions
of
the
compact
and
its
rules.
The
relief
sought
15
may
include
both
injunctive
relief
and
damages.
In
the
event
16
judicial
enforcement
is
necessary,
the
prevailing
party
shall
17
be
awarded
all
costs
of
such
litigation,
including
reasonable
18
attorney
fees.
19
(2)
No
person
other
than
a
participating
state
shall
enforce
20
this
compact
against
the
commission.
21
11.
Date
of
implementation
of
the
physician
assistant
22
licensure
compact
commission.
23
a.
This
compact
shall
come
into
effect
on
the
date
on
24
which
this
compact
statute
is
enacted
into
law
in
the
seventh
25
participating
state.
26
(1)
On
or
after
the
effective
date
of
the
compact,
the
27
commission
shall
convene
and
review
the
enactment
of
each
of
28
the
states
that
enacted
the
compact
prior
to
the
commission
29
convening,
the
charter
participating
states,
to
determine
if
30
the
statute
enacted
by
each
such
charter
participating
state
is
31
materially
different
than
the
model
compact.
32
(a)
A
charter
participating
state
whose
enactment
is
found
33
to
be
materially
different
from
the
model
compact
shall
be
34
entitled
to
the
default
process
set
forth
in
subsection
10,
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paragraph
“b”
.
1
(b)
If
any
participating
state
later
withdraws
from
the
2
compact
or
its
participation
is
terminated,
the
commission
3
shall
remain
in
existence
and
the
compact
shall
remain
in
4
effect
even
if
the
number
of
participating
states
should
be
5
less
than
seven.
Participating
states
enacting
the
compact
6
subsequent
to
the
commission
convening
shall
be
subject
to
the
7
process
set
forth
in
subsection
7,
paragraph
“c”
,
subparagraph
8
(21),
to
determine
if
their
enactments
are
materially
9
different
from
the
model
compact
and
whether
they
qualify
for
10
participation
in
the
compact.
11
(2)
Participating
states
enacting
the
compact
subsequent
12
to
the
seven
initial
charter
participating
states
shall
be
13
subject
to
the
process
set
forth
in
subsection
7,
paragraph
14
“c”
,
subparagraph
(21),
to
determine
if
their
enactments
are
15
materially
different
from
the
model
compact
and
whether
they
16
qualify
for
participation
in
the
compact.
17
(3)
All
actions
taken
for
the
benefit
of
the
commission
18
or
in
furtherance
of
the
purposes
of
the
administration
of
19
the
compact
prior
to
the
effective
date
of
the
compact
or
the
20
commission
coming
into
existence
shall
be
considered
to
be
21
actions
of
the
commission
unless
specifically
repudiated
by
the
22
commission.
23
b.
Any
state
that
joins
this
compact
shall
be
subject
to
24
the
commission’s
rules
and
bylaws
as
they
exist
on
the
date
on
25
which
this
compact
becomes
law
in
that
state.
Any
rule
that
26
has
been
previously
adopted
by
the
commission
shall
have
the
27
full
force
and
effect
of
law
on
the
day
this
compact
becomes
28
law
in
that
state.
29
c.
Any
participating
state
may
withdraw
from
this
compact
by
30
enacting
a
statute
repealing
the
same.
31
(1)
A
participating
state’s
withdrawal
shall
not
take
32
effect
until
one
hundred
eighty
days
after
enactment
of
the
33
repealing
statute.
During
this
one-hundred-eighty-day
period,
34
all
compact
privileges
that
were
in
effect
in
the
withdrawing
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state
and
were
granted
to
licensees
licensed
in
the
withdrawing
1
state
shall
remain
in
effect.
If
any
licensee
licensed
in
the
2
withdrawing
state
is
also
licensed
in
another
participating
3
state
or
obtains
a
license
in
another
participating
state
4
within
the
one
hundred
eighty
days,
the
licensee’s
compact
5
privileges
in
other
participating
states
shall
not
be
affected
6
by
the
passage
of
the
one
hundred
eighty
days.
7
(2)
Withdrawal
shall
not
affect
the
continuing
requirement
8
of
the
state
licensing
board
of
the
withdrawing
state
to
9
comply
with
the
investigative,
and
adverse
action
reporting
10
requirements
of
this
compact
prior
to
the
effective
date
of
11
withdrawal.
12
(3)
Upon
the
enactment
of
a
statute
withdrawing
a
state
13
from
this
compact,
the
state
shall
immediately
provide
notice
14
of
such
withdrawal
to
all
licensees
within
that
state.
Such
15
withdrawing
state
shall
continue
to
recognize
all
licenses
16
granted
pursuant
to
this
compact
for
a
minimum
of
one
hundred
17
eighty
days
after
the
date
of
such
notice
of
withdrawal.
18
d.
Nothing
contained
in
this
compact
shall
be
construed
19
to
invalidate
or
prevent
any
physician
assistant
licensure
20
agreement
or
other
cooperative
arrangement
between
21
participating
states
and
between
a
participating
state
22
and
nonparticipating
state
that
does
not
conflict
with
the
23
provisions
of
this
compact.
24
e.
This
compact
may
be
amended
by
the
participating
states.
25
No
amendment
to
this
compact
shall
become
effective
and
binding
26
upon
any
participating
state
until
it
is
enacted
materially
in
27
the
same
manner
into
the
laws
of
all
participating
states
as
28
determined
by
the
commission.
29
12.
Construction
and
severability.
30
a.
This
compact
and
the
commission’s
rulemaking
authority
31
shall
be
liberally
construed
so
as
to
effectuate
the
purposes
32
and
the
implementation
and
administration
of
the
compact.
33
Provisions
of
the
compact
expressly
authorizing
or
requiring
34
the
promulgation
of
rules
shall
not
be
construed
to
limit
the
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commission’s
rulemaking
authority
solely
for
those
purposes.
1
b.
The
provisions
of
this
compact
shall
be
severable
and
2
if
any
phrase,
clause,
sentence,
or
provision
of
this
compact
3
is
held
by
a
court
of
competent
jurisdiction
to
be
contrary
to
4
the
constitution
of
any
participating
state,
a
state
seeking
5
participation
in
the
compact,
or
of
the
United
States,
or
6
the
applicability
thereof
to
any
government,
agency,
person
7
or
circumstance
is
held
to
be
unconstitutional
by
a
court
of
8
competent
jurisdiction,
the
validity
of
the
remainder
of
this
9
compact
and
the
applicability
thereof
to
any
other
government,
10
agency,
person
or
circumstance
shall
not
be
affected
thereby.
11
c.
Notwithstanding
paragraph
“b”
or
this
subsection
12,
the
12
commission
may
deny
a
state’s
participation
in
the
compact
or,
13
in
accordance
with
the
requirements
of
subsection
10,
paragraph
14
“b”
,
terminate
a
participating
state’s
participation
in
the
15
compact,
if
it
determines
that
a
constitutional
requirement
of
16
a
participating
state
is,
or
would
be
with
respect
to
a
state
17
seeking
to
participate
in
the
compact,
a
material
departure
18
from
the
compact.
Otherwise,
if
this
compact
shall
be
held
to
19
be
contrary
to
the
constitution
of
any
participating
state,
20
the
compact
shall
remain
in
full
force
and
effect
as
to
the
21
remaining
participating
states
and
in
full
force
and
effect
22
as
to
the
participating
state
affected
as
to
all
severable
23
matters.
24
13.
Binding
effect
of
compact.
25
a.
Nothing
in
this
compact
prevents
the
enforcement
of
any
26
other
law
of
a
participating
state
that
is
not
inconsistent
27
with
this
compact.
28
b.
Any
laws
in
a
participating
state
in
conflict
with
this
29
compact
are
superseded
to
the
extent
of
the
conflict.
30
c.
All
agreements
between
the
commission
and
the
31
participating
states
are
binding
in
accordance
with
their
32
terms.
33
EXPLANATION
34
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
35
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312
the
explanation’s
substance
by
the
members
of
the
general
assembly.
1
This
bill
establishes
the
physician
assistant
licensure
2
compact.
3
The
compact
establishes
a
system
whereby
a
physician
4
assistant
licensed
to
practice
in
one
participating
state
5
may
practice
in
another
participating
state
under
a
compact
6
privilege
without
applying
for
a
license
in
that
state.
The
7
compact
imposes
certain
minimum
requirements
on
the
licensure
8
of
physician
assistants
in
participating
states.
9
The
compact
creates
a
commission
to
administer
the
operation
10
of
the
compact.
The
commission
is
an
instrumentality
of
the
11
participating
states.
The
compact
includes
provisions
relating
12
to
the
establishment
and
membership
of
the
commission;
powers
13
of
the
commission;
meetings
and
voting
requirements
of
the
14
commission;
commission
bylaws
and
rules;
commission
committees;
15
commission
finances;
the
establishment
of
a
data
system;
16
compacting
state
compliance;
venue
for
judicial
proceedings;
17
defense
and
indemnification;
effective
dates
and
amendments
to
18
the
compact;
withdrawal,
default,
and
expulsion;
severability
19
and
construction;
and
the
binding
effect
of
the
compact
and
20
other
laws.
21
The
compact
becomes
effective
upon
the
adoption
of
the
22
compact
by
the
seventh
participating
state.
23
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