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HB-4103, As Passed Senate, July 3, 2026
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SENATE SUBSTITUTE FOR
HOUSE BILL NO. 4103
A bill to amend 1978 PA 368, entitled
"Public health code,"
(MCL 333.1101 to 333.25211) by adding section 16188.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 16188. (1) The occupational therapy licensure compact is 1
enacted into law and entered into by this state as a party with all 2
jurisdictions that legally join in the compact, in the form 3
substantially as follows: 4
OCCUPATIONAL THERAPY LICENSURE COMPACT 5
SECTION 1. PURPOSE 6
The purpose of this Compact is to facilitate interstate 7
practice of Occupational Therapy with the goal of improving public 8
access to Occupational Therapy services. The Practice of 9
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Occupational Therapy occurs in the State where the patient/client 1
is located at the time of the patient/client encounter. The Compact 2
preserves the regulatory authority of States to protect public 3
health and safety through the current system of State licensure. 4
This Compact is designed to achieve the following objectives: 5
A. Increase public access to Occupational Therapy services by 6
providing for the mutual recognition of other Member State 7
licenses; 8
B. Enhance the States' ability to protect the public's health 9
and safety; 10
C. Encourage the cooperation of Member States in regulating 11
multi-State Occupational Therapy Practice; 12
D. Support spouses of relocating military members; 13
E. Enhance the exchange of licensure, investigative, and 14
disciplinary information between Member States; 15
F. Allow a Remote State to hold a provider of services with a 16
Compact Privilege in that State accountable to that State's 17
practice standards; and 18
G. Facilitate the use of Telehealth technology in order to 19
increase access to Occupational Therapy services. 20
SECTION 2. DEFINITIONS 21
As used in this Compact, and except as otherwise provided, the 22
following definitions shall apply: 23
A. "Active Duty Military" means full-time duty status in the 24
active uniformed service of the United States, including members of 25
the National Guard and Reserve on active duty orders pursuant to 10 26
USC Chapter 1209 and 10 USC Chapter 1211. 27
B. "Adverse Action" means any administrative, civil, 28
equitable, or criminal action permitted by a State's laws which is 29
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imposed by a Licensing Board or other authority against an 1
Occupational Therapist or Occupational Therapy Assistant, including 2
actions against an individual's license or Compact Privilege such 3
as censure, revocation, suspension, probation, monitoring of the 4
Licensee, or restriction on the Licensee's practice. 5
C. "Alternative Program" means a non-disciplinary monitoring 6
process approved by an Occupational Therapy Licensing Board. 7
D. "Compact Privilege" means the authorization, which is 8
equivalent to a license, granted by a Remote State to allow a 9
Licensee from another Member State to practice as an Occupational 10
Therapist or practice as an Occupational Therapy Assistant in the 11
Remote State under its laws and rules. The Practice of Occupational 12
Therapy occurs in the Member State where the patient/client is 13
located at the time of the patient/client encounter. 14
E. "Continuing Competence/Education" means a requirement, as a 15
condition of license renewal, to provide evidence of participation 16
in, and/or completion of, educational and professional activities 17
relevant to practice or area of work. 18
F. "Current Significant Investigative Information" means 19
Investigative Information that a Licensing Board, after an inquiry 20
or investigation that includes notification and an opportunity for 21
the Occupational Therapist or Occupational Therapy Assistant to 22
respond, if required by State law, has reason to believe is not 23
groundless and, if proved true, would indicate more than a minor 24
infraction. 25
G. "Data System" means a repository of information about 26
Licensees, including but not limited to license status, 27
Investigative Information, Compact Privileges, and Adverse Actions. 28
H. "Encumbered License" means a license in which an Adverse 29
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Action restricts the Practice of Occupational Therapy by the 1
Licensee or said Adverse Action has been reported to the National 2
Practitioners Data Bank (NPDB). 3
I. "Executive Committee" means a group of directors elected or 4
appointed to act on behalf of, and within the powers granted to 5
them by, the Commission. 6
J. "Home State" means the Member State that is the Licensee's 7
Primary State of Residence. 8
K. "Impaired Practitioner" means individuals whose 9
professional practice is adversely affected by substance abuse, 10
addiction, or other health-related conditions. 11
L. "Investigative Information" means information, records, 12
and/or documents received or generated by an Occupational Therapy 13
Licensing Board pursuant to an investigation. 14
M. "Jurisprudence Requirement" means the assessment of an 15
individual's knowledge of the laws and rules governing the Practice 16
of Occupational Therapy in a State. 17
N. "Licensee" means an individual who currently holds an 18
authorization from the State to practice as an Occupational 19
Therapist or as an Occupational Therapy Assistant. 20
O. "Member State" means a State that has enacted the Compact. 21
P. "Occupational Therapist" means an individual who is 22
licensed by a State to practice Occupational Therapy. 23
Q. "Occupational Therapy Assistant" means an individual who is 24
licensed by a State to assist in the Practice of Occupational 25
Therapy. 26
R. "Occupational Therapy," "Occupational Therapy Practice," 27
and the "Practice of Occupational Therapy" mean the care and 28
services provided by an Occupational Therapist or an Occupational 29
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Therapy Assistant as set forth in the Member State's statutes and 1
regulations. 2
S. "Occupational Therapy Compact Commission" or "Commission" 3
means the national administrative body whose membership consists of 4
all States that have enacted the Compact. 5
T. "Occupational Therapy Licensing Board" or "Licensing Board" 6
means the agency of a State that is authorized to license and 7
regulate Occupational Therapists and Occupational Therapy 8
Assistants. 9
U. "Primary State of Residence" means the state (also known as 10
the Home State) in which an Occupational Therapist or Occupational 11
Therapy Assistant who is not Active Duty Military declares a 12
primary residence for legal purposes as verified by: driver's 13
license, federal income tax return, lease, deed, mortgage or voter 14
registration or other verifying documentation as further defined by 15
Commission Rules. 16
V. "Remote State" means a Member State other than the Home 17
State, where a Licensee is exercising or seeking to exercise the 18
Compact Privilege. 19
W. "Rule" means a regulation promulgated by the Commission 20
that has the force of law. 21
X. "State" means any state, commonwealth, district, or 22
territory of the United States of America that regulates the 23
Practice of Occupational Therapy. 24
Y. "Single-State License" means an Occupational Therapist or 25
Occupational Therapy Assistant license issued by a Member State 26
that authorizes practice only within the issuing State and does not 27
include a Compact Privilege in any other Member State. 28
Z. "Telehealth" means the application of telecommunication 29
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technology to deliver Occupational Therapy services for assessment, 1
intervention and/or consultation. 2
SECTION 3. STATE PARTICIPATION IN THE COMPACT 3
A. To participate in the Compact, a Member State shall: 4
1. License Occupational Therapists and Occupational Therapy 5
Assistants; 6
2. Participate fully in the Commission's Data System, 7
including but not limited to using the Commission's unique 8
identifier as defined in Rules of the Commission; 9
3. Have a mechanism in place for receiving and investigating 10
complaints about Licensees; 11
4. Notify the Commission, in compliance with the terms of the 12
Compact and Rules, of any Adverse Action or the availability of 13
Investigative Information regarding a Licensee; 14
5. Implement or utilize procedures for considering the 15
criminal history records of applicants for an initial Compact 16
Privilege. These procedures shall include the submission of 17
fingerprints or other biometric-based information by applicants for 18
the purpose of obtaining an applicant's criminal history record 19
information from the Federal Bureau of Investigation and the agency 20
responsible for retaining that State's criminal records; 21
a. A Member State shall, within a time frame established by 22
the Commission, require a criminal background check for a Licensee 23
seeking/applying for a Compact Privilege whose Primary State of 24
Residence is that Member State, by receiving the results of the 25
Federal Bureau of Investigation criminal record search, and shall 26
use the results in making licensure decisions. 27
b. Communication between a Member State, the Commission and 28
among Member States regarding the verification of eligibility for 29
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licensure through the Compact shall not include any information 1
received from the Federal Bureau of Investigation relating to a 2
federal criminal records check performed by a Member State under 3
Public Law 92-544. 4
6. Comply with the Rules of the Commission; 5
7. Utilize only a recognized national examination as a 6
requirement for licensure pursuant to the Rules of the Commission; 7
and 8
8. Have Continuing Competence/Education requirements as a 9
condition for license renewal. 10
B. A Member State shall grant the Compact Privilege to a 11
Licensee holding a valid unencumbered license in another Member 12
State in accordance with the terms of the Compact and Rules. 13
C. Member States may charge a fee for granting a Compact 14
Privilege. 15
D. A Member State shall provide for the State's delegate to 16
attend all Occupational Therapy Compact Commission meetings. 17
E. Individuals not residing in a Member State shall continue 18
to be able to apply for a Member State's Single-State License as 19
provided under the laws of each Member State. However, the Single-20
State License granted to these individuals shall not be recognized 21
as granting the Compact Privilege in any other Member State. 22
F. Nothing in this Compact shall affect the requirements 23
established by a Member State for the issuance of a Single-State 24
License. 25
SECTION 4. COMPACT PRIVILEGE 26
A. To exercise the Compact Privilege under the terms and 27
provisions of the Compact, the Licensee shall: 28
1. Hold a license in the Home State; 29
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2. Have a valid United States Social Security Number or 1
National Practitioner Identification number; 2
3. Have no encumbrance on any State license; 3
4. Be eligible for a Compact Privilege in any Member State in 4
accordance with Section 4D, F, G, and H; 5
5. Have paid all fines and completed all requirements 6
resulting from any Adverse Action against any license or Compact 7
Privilege, and two years have elapsed from the date of such 8
completion; 9
6. Notify the Commission that the Licensee is seeking the 10
Compact Privilege within a Remote State(s); 11
7. Pay any applicable fees, including any State fee, for the 12
Compact Privilege; 13
8. Complete a criminal background check in accordance with 14
Section 3A(5); 15
a. The Licensee shall be responsible for the payment of any 16
fee associated with the completion of a criminal background check. 17
9. Meet any Jurisprudence Requirements established by the 18
Remote State(s) in which the Licensee is seeking a Compact 19
Privilege; and 20
10. Report to the Commission Adverse Action taken by any non-21
Member State within 30 days from the date the Adverse Action is 22
taken. 23
B. The Compact Privilege is valid until the expiration date of 24
the Home State license. The Licensee must comply with the 25
requirements of Section 4A to maintain the Compact Privilege in the 26
Remote State. 27
C. A Licensee providing Occupational Therapy in a Remote State 28
under the Compact Privilege shall function within the laws and 29
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regulations of the Remote State. 1
D. Occupational Therapy Assistants practicing in a Remote 2
State shall be supervised by an Occupational Therapist licensed or 3
holding a Compact Privilege in that Remote State. 4
E. A Licensee providing Occupational Therapy in a Remote State 5
is subject to that State's regulatory authority. A Remote State 6
may, in accordance with due process and that State's laws, remove a 7
Licensee's Compact Privilege in the Remote State for a specific 8
period of time, impose fines, and/or take any other necessary 9
actions to protect the health and safety of its citizens. The 10
Licensee may be ineligible for a Compact Privilege in any State 11
until the specific time for removal has passed and all fines are 12
paid. 13
F. If a Home State license is encumbered, the Licensee shall 14
lose the Compact Privilege in any Remote State until the following 15
occur: 16
1. The Home State license is no longer encumbered; and 17
2. Two years have elapsed from the date on which the Home 18
State license is no longer encumbered in accordance with Section 19
4F(1). 20
G. Once an Encumbered License in the Home State is restored to 21
good standing, the Licensee must meet the requirements of Section 22
4A to obtain a Compact Privilege in any Remote State. 23
H. If a Licensee's Compact Privilege in any Remote State is 24
removed, the individual may lose the Compact Privilege in any other 25
Remote State until the following occur: 26
1. The specific period of time for which the Compact Privilege 27
was removed has ended; 28
2. All fines have been paid and all conditions have been met; 29
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3. Two years have elapsed from the date of completing 1
requirements for Section 4H(1) and (2); and 2
4. The Compact Privileges are reinstated by the Commission, 3
and the compact Data System is updated to reflect reinstatement. 4
I. If a Licensee's Compact Privilege in any Remote State is 5
removed due to an erroneous charge, privileges shall be restored 6
through the compact Data System. 7
J. Once the requirements of Section 4H have been met, the 8
Licensee must meet the requirements in Section 4A to obtain a 9
Compact Privilege in a Remote State. 10
SECTION 5: OBTAINING A NEW HOME STATE LICENSE BY VIRTUE OF COMPACT 11
PRIVILEGE 12
A. An Occupational Therapist or Occupational Therapy Assistant 13
may hold a Home State license, which allows for Compact Privileges 14
in Member States, in only one Member State at a time. 15
B. If an Occupational Therapist or Occupational Therapy 16
Assistant changes Primary State of Residence by moving between two 17
Member States: 18
1. The Occupational Therapist or Occupational Therapy 19
Assistant shall file an application for obtaining a new Home State 20
license by virtue of a Compact Privilege, pay all applicable fees, 21
and notify the current and new Home State in accordance with 22
applicable Rules adopted by the Commission. 23
2. Upon receipt of an application for obtaining a new Home 24
State license by virtue of compact privilege, the new Home State 25
shall verify that the Occupational Therapist or Occupational 26
Therapy Assistant meets the pertinent criteria outlined in Section 27
4 via the Data System, without need for primary source verification 28
except for: 29
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a. An FBI fingerprint based criminal background check if not 1
previously performed or updated pursuant to applicable Rules 2
adopted by the Commission in accordance with Public Law 92-544; 3
b. Other criminal background check as required by the new Home 4
State; and 5
c. Submission of any requisite Jurisprudence Requirements of 6
the new Home State. 7
3. The former Home State shall convert the former Home State 8
license into a Compact Privilege once the new Home State has 9
activated the new Home State license in accordance with applicable 10
Rules adopted by the Commission. 11
4. Notwithstanding any other provision of this Compact, if the 12
Occupational Therapist or Occupational Therapy Assistant cannot 13
meet the criteria in Section 4, the new Home State shall apply its 14
requirements for issuing a new Single-State License. 15
5. The Occupational Therapist or the Occupational Therapy 16
Assistant shall pay all applicable fees to the new Home State in 17
order to be issued a new Home State license. 18
C. If an Occupational Therapist or Occupational Therapy 19
Assistant changes Primary State of Residence by moving from a 20
Member State to a non-Member State, or from a non-Member State to a 21
Member State, the State criteria shall apply for issuance of a 22
Single-State License in the new State. 23
D. Nothing in this Compact shall interfere with a Licensee's 24
ability to hold a Single-State License in multiple States; however, 25
for the purposes of this Compact, a Licensee shall have only one 26
Home State license. 27
E. Nothing in this Compact shall affect the requirements 28
established by a Member State for the issuance of a Single-State 29
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License. 1
SECTION 6. ACTIVE DUTY MILITARY PERSONNEL OR THEIR SPOUSES 2
A. Active Duty Military personnel, or their spouses, shall 3
designate a Home State where the individual has a current license 4
in good standing. The individual may retain the Home State 5
designation during the period the service member is on active duty. 6
Subsequent to designating a Home State, the individual shall only 7
change their Home State through application for licensure in the 8
new State or through the process described in Section 5. 9
SECTION 7. ADVERSE ACTIONS 10
A. A Home State shall have exclusive power to impose Adverse 11
Action against an Occupational Therapist's or Occupational Therapy 12
Assistant's license issued by the Home State. 13
B. In addition to the other powers conferred by State law, a 14
Remote State shall have the authority, in accordance with existing 15
State due process law, to: 16
1. Take Adverse Action against an Occupational Therapist's or 17
Occupational Therapy Assistant's Compact Privilege within that 18
Member State. 19
2. Issue subpoenas for both hearings and investigations that 20
require the attendance and testimony of witnesses as well as the 21
production of evidence. Subpoenas issued by a Licensing Board in a 22
Member State for the attendance and testimony of witnesses or the 23
production of evidence from another Member State shall be enforced 24
in the latter State by any court of competent jurisdiction, 25
according to the practice and procedure of that court applicable to 26
subpoenas issued in proceedings pending before it. The issuing 27
authority shall pay any witness fees, travel expenses, mileage and 28
other fees required by the service statutes of the State in which 29
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the witnesses or evidence are located. 1
C. For purposes of taking Adverse Action, the Home State shall 2
give the same priority and effect to reported conduct received from 3
a Member State as it would if the conduct had occurred within the 4
Home State. In so doing, the Home State shall apply its own State 5
laws to determine appropriate action. 6
D. The Home State shall complete any pending investigations of 7
an Occupational Therapist or Occupational Therapy Assistant who 8
changes Primary State of Residence during the course of the 9
investigations. The Home State, where the investigations were 10
initiated, shall also have the authority to take appropriate 11
action(s) and shall promptly report the conclusions of the 12
investigations to the OT Compact Commission Data System. The 13
Occupational Therapy Compact Commission Data System administrator 14
shall promptly notify the new Home State of any Adverse Actions. 15
E. A Member State, if otherwise permitted by State law, may 16
recover from the affected Occupational Therapist or Occupational 17
Therapy Assistant the costs of investigations and disposition of 18
cases resulting from any Adverse Action taken against that 19
Occupational Therapist or Occupational Therapy Assistant. 20
F. A Member State may take Adverse Action based on the factual 21
findings of the Remote State, provided that the Member State 22
follows its own procedures for taking the Adverse Action. 23
G. Joint Investigations 24
1. In addition to the authority granted to a Member State by 25
its respective State Occupational Therapy laws and regulations or 26
other applicable State law, any Member State may participate with 27
other Member States in joint investigations of Licensees. 28
2. Member States shall share any investigative, litigation, or 29
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compliance materials in furtherance of any joint or individual 1
investigation initiated under the Compact. 2
H. If an Adverse Action is taken by the Home State against an 3
Occupational Therapist's or Occupational Therapy Assistant's 4
license, the Occupational Therapist's or Occupational Therapy 5
Assistant's Compact Privilege in all other Member States shall be 6
deactivated until all encumbrances have been removed from the State 7
license. All Home State disciplinary orders that impose Adverse 8
Action against an Occupational Therapist's or Occupational Therapy 9
Assistant's license shall include a Statement that the Occupational 10
Therapist's or Occupational Therapy Assistant's Compact Privilege 11
is deactivated in all Member States during the pendency of the 12
order. 13
I. If a Member State takes Adverse Action, it shall promptly 14
notify the administrator of the Data System. The administrator of 15
the Data System shall promptly notify the Home State of any Adverse 16
Actions by Remote States. 17
J. Nothing in this Compact shall override a Member State's 18
decision that participation in an Alternative Program may be used 19
in lieu of Adverse Action. 20
SECTION 8. ESTABLISHMENT OF THE OCCUPATIONAL THERAPY COMPACT 21
COMMISSION. 22
A. The Compact Member States hereby create and establish a 23
joint public agency known as the Occupational Therapy Compact 24
Commission: 25
1. The Commission is an instrumentality of the Compact States. 26
2. Venue is proper and judicial proceedings by or against the 27
Commission shall be brought solely and exclusively in a court of 28
competent jurisdiction where the principal office of the Commission 29
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is located. The Commission may waive venue and jurisdictional 1
defenses to the extent it adopts or consents to participate in 2
alternative dispute resolution proceedings. 3
3. Nothing in this Compact shall be construed to be a waiver 4
of sovereign immunity. 5
B. Membership, Voting, and Meetings 6
1. Each Member State shall have and be limited to one (1) 7
delegate selected by that Member State's Licensing Board. 8
2. The delegate shall be either: 9
a. A current member of the Licensing Board, who is an 10
Occupational Therapist, Occupational Therapy Assistant, or public 11
member; or 12
b. An administrator of the Licensing Board. 13
3. Any delegate may be removed or suspended from office as 14
provided by the law of the State from which the delegate is 15
appointed. 16
4. The Member State board shall fill any vacancy occurring in 17
the Commission within 90 days. 18
5. Each delegate shall be entitled to one (1) vote with regard 19
to the promulgation of Rules and creation of bylaws and shall 20
otherwise have an opportunity to participate in the business and 21
affairs of the Commission. A delegate shall vote in person or by 22
such other means as provided in the bylaws. The bylaws may provide 23
for delegates' participation in meetings by telephone or other 24
means of communication. 25
6. The Commission shall meet at least once during each 26
calendar year. Additional meetings shall be held as set forth in 27
the bylaws. 28
7. The Commission shall establish by Rule a term of office for 29
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delegates. 1
C. The Commission shall have the following powers and duties: 2
1. Establish a Code of Ethics for the Commission; 3
2. Establish the fiscal year of the Commission; 4
3. Establish bylaws; 5
4. Maintain its financial records in accordance with the 6
bylaws; 7
5. Meet and take such actions as are consistent with the 8
provisions of this Compact and the bylaws; 9
6. Promulgate uniform Rules to facilitate and coordinate 10
implementation and administration of this Compact. The Rules shall 11
have the force and effect of law and shall be binding in all Member 12
States; 13
7. Bring and prosecute legal proceedings or actions in the 14
name of the Commission, provided that the standing of any State 15
Occupational Therapy Licensing Board to sue or be sued under 16
applicable law shall not be affected; 17
8. Purchase and maintain insurance and bonds; 18
9. Borrow, accept, or contract for services of personnel, 19
including, but not limited to, employees of a Member State; 20
10. Hire employees, elect or appoint officers, fix 21
compensation, define duties, grant such individuals appropriate 22
authority to carry out the purposes of the Compact, and establish 23
the Commission's personnel policies and programs relating to 24
conflicts of interest, qualifications of personnel, and other 25
related personnel matters; 26
11. Accept any and all appropriate donations and grants of 27
money, equipment, supplies, materials and services, and receive, 28
utilize and dispose of the same; provided that at all times the 29
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Commission shall avoid any appearance of impropriety and/or 1
conflict of interest; 2
12. Lease, purchase, accept appropriate gifts or donations of, 3
or otherwise own, hold, improve or use, any property, real, 4
personal or mixed; provided that at all times the Commission shall 5
avoid any appearance of impropriety; 6
13. Sell, convey, mortgage, pledge, lease, exchange, abandon, 7
or otherwise dispose of any property real, personal, or mixed; 8
14. Establish a budget and make expenditures; 9
15. Borrow money; 10
16. Appoint committees, including standing committees composed 11
of members, State regulators, State legislators or their 12
representatives, and consumer representatives, and such other 13
interested persons as may be designated in this Compact and the 14
bylaws; 15
17. Provide and receive information from, and cooperate with, 16
law enforcement agencies; 17
18. Establish and elect an Executive Committee; and 18
19. Perform such other functions as may be necessary or 19
appropriate to achieve the purposes of this Compact consistent with 20
the State regulation of Occupational Therapy licensure and 21
practice. 22
D. The Executive Committee 23
The Executive Committee shall have the power to act on behalf 24
of the Commission according to the terms of this Compact. 25
1. The Executive Committee shall be composed of nine members: 26
a. Seven voting members who are elected by the Commission from 27
the current membership of the Commission; 28
b. One ex-officio, nonvoting member from a recognized national 29
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Occupational Therapy professional association; and 1
c. One ex-officio, nonvoting member from a recognized national 2
Occupational Therapy certification organization. 3
2. The ex-officio members will be selected by their respective 4
organizations. 5
3. The Commission may remove any member of the Executive 6
Committee as provided in bylaws. 7
4. The Executive Committee shall meet at least annually. 8
5. The Executive Committee shall have the following Duties and 9
responsibilities: 10
a. Recommend to the entire Commission changes to the Rules or 11
bylaws, changes to this Compact legislation, fees paid by Compact 12
Member States such as annual dues, and any Commission Compact fee 13
charged to Licensees for the Compact Privilege; 14
b. Ensure Compact administration services are appropriately 15
provided, contractual or otherwise; 16
c. Prepare and recommend the budget; 17
d. Maintain financial records on behalf of the Commission; 18
e. Monitor Compact compliance of Member States and provide 19
compliance reports to the Commission; 20
f. Establish additional committees as necessary; and 21
g. Perform other duties as provided in Rules or bylaws. 22
E. Meetings of the Commission 23
1. All meetings shall be open to the public, and public notice 24
of meetings shall be given in the same manner as required under the 25
Rulemaking provisions in Section 10. 26
2. The Commission or the Executive Committee or other 27
committees of the Commission may convene in a closed, non-public 28
meeting if the Commission or Executive Committee or other 29
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committees of the Commission must discuss: 1
a. Non-compliance of a Member State with its obligations under 2
the Compact; 3
b. The employment, compensation, discipline or other matters, 4
practices or procedures related to specific employees or other 5
matters related to the Commission's internal personnel practices 6
and procedures; 7
c. Current, threatened, or reasonably anticipated litigation; 8
d. Negotiation of contracts for the purchase, lease, or sale 9
of goods, services, or real estate; 10
e. Accusing any person of a crime or formally censuring any 11
person; 12
f. Disclosure of trade secrets or commercial or financial 13
information that is privileged or confidential; 14
g. Disclosure of information of a personal nature where 15
disclosure would constitute a clearly unwarranted invasion of 16
personal privacy; 17
h. Disclosure of investigative records compiled for law 18
enforcement purposes; 19
i. Disclosure of information related to any investigative 20
reports prepared by or on behalf of or for use of the Commission or 21
other committee charged with responsibility of investigation or 22
determination of compliance issues pursuant to the Compact; or 23
j. Matters specifically exempted from disclosure by federal or 24
Member State statute. 25
3. If a meeting, or portion of a meeting, is closed pursuant 26
to this provision, the Commission's legal counsel or designee shall 27
certify that the meeting may be closed and shall reference each 28
relevant exempting provision. 29
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4. The Commission shall keep minutes that fully and clearly 1
describe all matters discussed in a meeting and shall provide a 2
full and accurate summary of actions taken, and the reasons 3
therefore, including a description of the views expressed. All 4
documents considered in connection with an action shall be 5
identified in such minutes. All minutes and documents of a closed 6
meeting shall remain under seal, subject to release by a majority 7
vote of the Commission or order of a court of competent 8
jurisdiction. 9
F. Financing of the Commission 10
1. The Commission shall pay, or provide for the payment of, 11
the reasonable expenses of its establishment, organization, and 12
ongoing activities. 13
2. The Commission may accept any and all appropriate revenue 14
sources, donations, and grants of money, equipment, supplies, 15
materials, and services. 16
3. The Commission may levy on and collect an annual assessment 17
from each Member State or impose fees on other parties to cover the 18
cost of the operations and activities of the Commission and its 19
staff, which must be in a total amount sufficient to cover its 20
annual budget as approved by the Commission each year for which 21
revenue is not provided by other sources. The aggregate annual 22
assessment amount shall be allocated based upon a formula to be 23
determined by the Commission, which shall promulgate a Rule binding 24
upon all Member States. 25
4. The Commission shall not incur obligations of any kind 26
prior to securing the funds adequate to meet the same; nor shall 27
the Commission pledge the credit of any of the Member States, 28
except by and with the authority of the Member State. 29
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EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
5. The Commission shall keep accurate accounts of all receipts 1
and disbursements. The receipts and disbursements of the Commission 2
shall be subject to the audit and accounting procedures established 3
under its bylaws. However, all receipts and disbursements of funds 4
handled by the Commission shall be audited yearly by a certified or 5
licensed public accountant, and the report of the audit shall be 6
included in and become part of the annual report of the Commission. 7
G. Qualified Immunity, Defense, and Indemnification 8
1. The members, officers, executive director, employees and 9
representatives of the Commission shall be immune from suit and 10
liability, either personally or in their official capacity, for any 11
claim for damage to or loss of property or personal injury or other 12
civil liability caused by or arising out of any actual or alleged 13
act, error or omission that occurred, or that the person against 14
whom the claim is made had a reasonable basis for believing 15
occurred within the scope of Commission employment, duties or 16
responsibilities; provided that nothing in this paragraph shall be 17
construed to protect any such person from suit and/or liability for 18
any damage, loss, injury, or liability caused by the intentional or 19
willful or wanton misconduct of that person. 20
2. The Commission shall defend any member, officer, executive 21
director, employee, or representative of the Commission in any 22
civil action seeking to impose liability arising out of any actual 23
or alleged act, error, or omission that occurred within the scope 24
of Commission employment, duties, or responsibilities, or that the 25
person against whom the claim is made had a reasonable basis for 26
believing occurred within the scope of Commission employment, 27
duties, or responsibilities; provided that nothing herein shall be 28
construed to prohibit that person from retaining his or her own 29
22
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
counsel; and provided further, that the actual or alleged act, 1
error, or omission did not result from that person's intentional or 2
willful or wanton misconduct. 3
3. The Commission shall indemnify and hold harmless any 4
member, officer, executive director, employee, or representative of 5
the Commission for the amount of any settlement or judgment 6
obtained against that person arising out of any actual or alleged 7
act, error or omission that occurred within the scope of Commission 8
employment, duties, or responsibilities, or that such person had a 9
reasonable basis for believing occurred within the scope of 10
Commission employment, duties, or responsibilities, provided that 11
the actual or alleged act, error, or omission did not result from 12
the intentional or willful or wanton misconduct of that person. 13
SECTION 9. DATA SYSTEM 14
A. The Commission shall provide for the development, 15
maintenance, and utilization of a coordinated database and 16
reporting system containing licensure, Adverse Action, and 17
Investigative Information on all licensed individuals in Member 18
States. 19
B. A Member State shall submit a uniform data set to the Data 20
System on all individuals to whom this Compact is applicable 21
(utilizing a unique identifier) as required by the Rules of the 22
Commission, including: 23
1. Identifying information; 24
2. Licensure data; 25
3. Adverse Actions against a license or Compact Privilege; 26
4. Non-confidential information related to Alternative Program 27
participation; 28
5. Any denial of application for licensure, and the reason(s) 29
23
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
for such denial; 1
6. Other information that may facilitate the administration of 2
this Compact, as determined by the Rules of the Commission; and 3
7. Current Significant Investigative Information. 4
C. Current Significant Investigative Information and other 5
Investigative Information pertaining to a Licensee in any Member 6
State will only be available to other Member States. 7
D. The Commission shall promptly notify all Member States of 8
any Adverse Action taken against a Licensee or an individual 9
applying for a license. Adverse Action information pertaining to a 10
Licensee in any Member State will be available to any other Member 11
State. 12
E. Member States contributing information to the Data System 13
may designate information that may not be shared with the public 14
without the express permission of the contributing State. 15
F. Any information submitted to the Data System that is 16
subsequently required to be expunged by the laws of the Member 17
State contributing the information shall be removed from the Data 18
System. 19
SECTION 10. RULEMAKING 20
A. The Commission shall exercise its Rulemaking powers 21
pursuant to the criteria set forth in this Section and the Rules 22
adopted thereunder. Rules and amendments shall become binding as of 23
the date specified in each Rule or amendment. 24
B. The Commission shall promulgate reasonable rules in order 25
to effectively and efficiently achieve the purposes of the Compact. 26
Notwithstanding the foregoing, in the event the Commission 27
exercises its rulemaking authority in a manner that is beyond the 28
scope of the purposes of the Compact, or the powers granted 29
24
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
hereunder, then such an action by the Commission shall be invalid 1
and have no force and effect. 2
C. If a majority of the legislatures of the Member States 3
rejects a Rule, by enactment of a statute or resolution in the same 4
manner used to adopt the Compact within 4 years of the date of 5
adoption of the Rule, then such Rule shall have no further force 6
and effect in any Member State. 7
D. Rules or amendments to the Rules shall be adopted at a 8
regular or special meeting of the Commission. 9
E. Prior to promulgation and adoption of a final Rule or Rules 10
by the Commission, and at least thirty (30) days in advance of the 11
meeting at which the Rule will be considered and voted upon, the 12
Commission shall file a Notice of Proposed Rulemaking: 13
1. On the website of the Commission or other publicly 14
accessible platform; and 15
2. On the website of each Member State Occupational Therapy 16
Licensing Board or other publicly accessible platform or the 17
publication in which each State would otherwise publish proposed 18
Rules. 19
F. The Notice of Proposed Rulemaking shall include: 20
1. The proposed time, date, and location of the meeting in 21
which the Rule will be considered and voted upon; 22
2. The text of the proposed Rule or amendment and the reason 23
for the proposed Rule; 24
3. A request for comments on the proposed Rule from any 25
interested person; and 26
4. The manner in which interested persons may submit notice to 27
the Commission of their intention to attend the public hearing and 28
any written comments. 29
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EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
G. Prior to adoption of a proposed Rule, the Commission shall 1
allow persons to submit written data, facts, opinions, and 2
arguments, which shall be made available to the public. 3
H. The Commission shall grant an opportunity for a public 4
hearing before it adopts a Rule or amendment if a hearing is 5
requested by: 6
1. At least twenty five (25) persons; 7
2. A State or federal governmental subdivision or agency; or 8
3. An association or organization having at least twenty five 9
(25) members. 10
I. If a hearing is held on the proposed Rule or amendment, the 11
Commission shall publish the place, time, and date of the scheduled 12
public hearing. If the hearing is held via electronic means, the 13
Commission shall publish the mechanism for access to the electronic 14
hearing. 15
1. All persons wishing to be heard at the hearing shall notify 16
the executive director of the Commission or other designated member 17
in writing of their desire to appear and testify at the hearing not 18
less than five (5) business days before the scheduled date of the 19
hearing. 20
2. Hearings shall be conducted in a manner providing each 21
person who wishes to comment a fair and reasonable opportunity to 22
comment orally or in writing. 23
3. All hearings will be recorded. A copy of the recording will 24
be made available on request. 25
4. Nothing in this section shall be construed as requiring a 26
separate hearing on each Rule. Rules may be grouped for the 27
convenience of the Commission at hearings required by this section. 28
J. Following the scheduled hearing date, or by the close of 29
26
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
business on the scheduled hearing date if the hearing was not held, 1
the Commission shall consider all written and oral comments 2
received. 3
K. If no written notice of intent to attend the public hearing 4
by interested parties is received, the Commission may proceed with 5
promulgation of the proposed Rule without a public hearing. 6
L. The Commission shall, by majority vote of all members, take 7
final action on the proposed Rule and shall determine the effective 8
date of the Rule, if any, based on the Rulemaking record and the 9
full text of the Rule. 10
M. Upon determination that an emergency exists, the Commission 11
may consider and adopt an emergency Rule without prior notice, 12
opportunity for comment, or hearing, provided that the usual 13
Rulemaking procedures provided in the Compact and in this section 14
shall be retroactively applied to the Rule as soon as reasonably 15
possible, in no event later than ninety (90) days after the 16
effective date of the Rule. For the purposes of this provision, an 17
emergency Rule is one that must be adopted immediately in order to: 18
1. Meet an imminent threat to public health, safety, or 19
welfare; 20
2. Prevent a loss of Commission or Member State funds; 21
3. Meet a deadline for the promulgation of an administrative 22
Rule that is established by federal law or Rule; or 23
4. Protect public health and safety. 24
N. The Commission or an authorized committee of the Commission 25
may direct revisions to a previously adopted Rule or amendment for 26
purposes of correcting typographical errors, errors in format, 27
errors in consistency, or grammatical errors. Public notice of any 28
revisions shall be posted on the website of the Commission. The 29
27
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
revision shall be subject to challenge by any person for a period 1
of thirty (30) days after posting. The revision may be challenged 2
only on grounds that the revision results in a material change to a 3
Rule. A challenge shall be made in writing and delivered to the 4
chair of the Commission prior to the end of the notice period. If 5
no challenge is made, the revision will take effect without further 6
action. If the revision is challenged, the revision may not take 7
effect without the approval of the Commission. 8
SECTION 11. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT 9
A. Oversight 10
1. The executive, legislative, and judicial branches of State 11
government in each Member State shall enforce this Compact and take 12
all actions necessary and appropriate to effectuate the Compact's 13
purposes and intent. The provisions of this Compact and the Rules 14
promulgated hereunder shall have standing as statutory law. 15
2. All courts shall take judicial notice of the Compact and 16
the Rules in any judicial or administrative proceeding in a Member 17
State pertaining to the subject matter of this Compact which may 18
affect the powers, responsibilities, or actions of the Commission. 19
3. The Commission shall be entitled to receive service of 20
process in any such proceeding, and shall have standing to 21
intervene in such a proceeding for all purposes. Failure to provide 22
service of process to the Commission shall render a judgment or 23
order void as to the Commission, this Compact, or promulgated 24
Rules. 25
B. Default, Technical Assistance, and Termination 26
1. If the Commission determines that a Member State has 27
defaulted in the performance of its obligations or responsibilities 28
under this Compact or the promulgated Rules, the Commission shall: 29
28
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
a. Provide written notice to the defaulting State and other 1
Member States of the nature of the default, the proposed means of 2
curing the default and/or any other action to be taken by the 3
Commission; and 4
b. Provide remedial training and specific technical assistance 5
regarding the default. 6
2. If a State in default fails to cure the default, the 7
defaulting State may be terminated from the Compact upon an 8
affirmative vote of a majority of the Member States, and all 9
rights, privileges and benefits conferred by this Compact may be 10
terminated on the effective date of termination. A cure of the 11
default does not relieve the offending State of obligations or 12
liabilities incurred during the period of default. 13
3. Termination of membership in the Compact shall be imposed 14
only after all other means of securing compliance have been 15
exhausted. Notice of intent to suspend or terminate shall be given 16
by the Commission to the governor, the majority and minority 17
leaders of the defaulting State's legislature, and each of the 18
Member States. 19
4. A State that has been terminated is responsible for all 20
assessments, obligations, and liabilities incurred through the 21
effective date of termination, including obligations that extend 22
beyond the effective date of termination. 23
5. The Commission shall not bear any costs related to a State 24
that is found to be in default or that has been terminated from the 25
Compact, unless agreed upon in writing between the Commission and 26
the defaulting State. 27
6. The defaulting State may appeal the action of the 28
Commission by petitioning the United States District Court for the 29
29
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
District of Columbia or the federal district where the Commission 1
has its principal offices. The prevailing member shall be awarded 2
all costs of such litigation, including reasonable attorney's fees. 3
C. Dispute Resolution 4
1. Upon request by a Member State, the Commission shall 5
attempt to resolve disputes related to the Compact that arise among 6
Member States and between member and non-Member States. 7
2. The Commission shall promulgate a Rule providing for both 8
mediation and binding dispute resolution for disputes as 9
appropriate. 10
D. Enforcement 11
1. The Commission, in the reasonable exercise of its 12
discretion, shall enforce the provisions and Rules of this Compact. 13
2. By majority vote, the Commission may initiate legal action 14
in the United States District Court for the District of Columbia or 15
the federal district where the Commission has its principal offices 16
against a Member State in default to enforce compliance with the 17
provisions of the Compact and its promulgated Rules and bylaws. The 18
relief sought may include both injunctive relief and damages. In 19
the event judicial enforcement is necessary, the prevailing member 20
shall be awarded all costs of such litigation, including reasonable 21
attorney's fees. 22
3. The remedies herein shall not be the exclusive remedies of 23
the Commission. The Commission may pursue any other remedies 24
available under federal or State law. 25
SECTION 12. DATE OF IMPLEMENTATION OF THE INTERSTATE COMMISSION FOR 26
OCCUPATIONAL THERAPY PRACTICE AND ASSOCIATED RULES, WITHDRAWAL, AND 27
AMENDMENT 28
A. The Compact shall come into effect on the date on which the 29
30
EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
Compact statute is enacted into law in the tenth Member State. The 1
provisions, which become effective at that time, shall be limited 2
to the powers granted to the Commission relating to assembly and 3
the promulgation of Rules. Thereafter, the Commission shall meet 4
and exercise Rulemaking powers necessary to the implementation and 5
administration of the Compact. 6
B. Any State that joins the Compact subsequent to the 7
Commission's initial adoption of the Rules shall be subject to the 8
Rules as they exist on the date on which the Compact becomes law in 9
that State. Any Rule that has been previously adopted by the 10
Commission shall have the full force and effect of law on the day 11
the Compact becomes law in that State. 12
C. Any Member State may withdraw from this Compact by enacting 13
a statute repealing the same. 14
1. A Member State's withdrawal shall not take effect until six 15
(6) months after enactment of the repealing statute. 16
2. Withdrawal shall not affect the continuing requirement of 17
the withdrawing State's Occupational Therapy Licensing Board to 18
comply with the investigative and Adverse Action reporting 19
requirements of this act prior to the effective date of withdrawal. 20
D. Nothing contained in this Compact shall be construed to 21
invalidate or prevent any Occupational Therapy licensure agreement 22
or other cooperative arrangement between a Member State and a non-23
Member State that does not conflict with the provisions of this 24
Compact. 25
E. This Compact may be amended by the Member States. No 26
amendment to this Compact shall become effective and binding upon 27
any Member State until it is enacted into the laws of all Member 28
States. 29
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EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
SECTION 13. CONSTRUCTION AND SEVERABILITY 1
This Compact shall be liberally construed so as to effectuate 2
the purposes thereof. The provisions of this Compact shall be 3
severable and if any phrase, clause, sentence or provision of this 4
Compact is declared to be contrary to the constitution of any 5
Member State or of the United States or the applicability thereof 6
to any government, agency, person, or circumstance is held invalid, 7
the validity of the remainder of this Compact and the applicability 8
thereof to any government, agency, person, or circumstance shall 9
not be affected thereby. If this Compact shall be held contrary to 10
the constitution of any Member State, the Compact shall remain in 11
full force and effect as to the remaining Member States and in full 12
force and effect as to the Member State affected as to all 13
severable matters. 14
SECTION 14. BINDING EFFECT OF COMPACT AND OTHER LAWS 15
A. A Licensee providing Occupational Therapy in a Remote State 16
under the Compact Privilege shall function within the laws and 17
regulations of the Remote State. 18
B. Nothing herein prevents the enforcement of any other law of 19
a Member State that is not inconsistent with the Compact. 20
C. Any laws in a Member State in conflict with the Compact are 21
superseded to the extent of the conflict. 22
D. Any lawful actions of the Commission, including all Rules 23
and bylaws promulgated by the Commission, are binding upon the 24
Member States. 25
E. All agreements between the Commission and the Member States 26
are binding in accordance with their terms. 27
F. In the event any provision of the Compact exceeds the 28
constitutional limits imposed on the legislature of any Member 29
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EMR H00845'25 (S-1)_HB4103_APS_1 qw6biv
State, the provision shall be ineffective to the extent of the 1
conflict with the constitutional provision in question in that 2
Member State. 3
(2) As used in this article, subsection (1) may be cited as 4
the "occupational therapy licensure compact". 5
Enacting section 1. This amendatory act takes effect 18 months 6
after the date it is enacted into law. 7
Enacting section 2. This amendatory act does not take effect 8
unless House Bill No. 4104 of the 103rd Legislature is enacted into 9
law. 10