Establishes the "Respiratory Care Interstate Compact"

SECOND REGULAR SESSION
HOUSE BILL NO. 2644
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE BUSH.
5045H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o amend chapter 334, RSMo, by adding thereto thirteen new sections relating to the
respiratory care interstate compact.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 334, RSMo, is amended by adding thereto thirteen new sections,
2 to be known as sections 334.1950, 334.1953, 334.1956, 334.1959, 334.1962, 334.1965,
3 334.1968, 334.1971, 334.1974, 334.1977, 334.1980, 334.1983, and 334.1986, to read as
4 follows:
334.1950. 1. Sections 334.1950 to 334.1986 shall be known and may be cited as
2 the "Respiratory Car e Interstate Compact".
3 2. The purpose of this Compact is to facilitate the interstate Practice of
4 Respiratory Therapy with the goal of impr oving public access to Respiratory Therapy
5 services by pr oviding Respiratory Therapists licensed in a Member State the ability to
6 practice in other Member States. The Compact pr eserves the reg ulatory authority of
7 states to pr otect public health and safety thr ough the curr ent system of State licensur e.
8 3. This Compact is designed to achieve the following objectives:
9 (1) Increas e public access to Respiratory Therapy services by creat ing a
10 r esponsible, streamli ned pathway for Licensees to practice in Member States with the
11 goal of improv ing outcomes for patients;
12 (2) Enhance States' ability to pr otect the public's health and safety;
13 (3) Pr omote the cooperation of Member States in r egulating the Practice of
14 Respiratory Therapy within those Member States;
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
15 (4) Ease administrative burdens on States by encouraging the cooperation of
16 Member States in regu lating multi-state Respiratory Therapy practice;
17 (5) Support relo cating Active Military Members and their spouses; and
18 (6) Pr omote mobility and addr ess workfor ce shortages.
334.1953. As used in this Compact, unless the context r equir es otherwise, the
2 following definitions shall apply:
3 (1) "Active Military Member" means any person with a full-time duty status in
4 the armed force s of the United States, including members of the National Guard and
5 Reserve.
6 (2) "Adverse Action" means any administrative, civil, equitable, or criminal
7 action permitted by a State's laws which is imposed by any State authority with
8 r egulatory authority over Respiratory Therapists, such as license denial, censur e,
9 r evocation, suspension, pr obation, monitoring of the Licensee, or r estriction on the
10 Licensee's practice, not including participation in an Alternative Pr ogram.
11 (3) "Alternative Pr ogram" means a non-disciplinary monitoring or practice
12 r emediation proc ess applicable to a Respiratory Therapist appr oved by any State
13 authority with regul atory authority over Respiratory Therapists. This includes, but is
14 not limited to, pr ograms to which Licensees with substance abuse or addiction issues ar e
15 r eferr ed in lieu of Adverse Action.
16 (4) "Charter Member States" means those Member States who wer e the first
17 seven states to enact the Compact into the laws of their State.
18 (5) "Commission" or "Respiratory Car e Interstate Compact Commission"
19 means the government instrumentality and body politic whose membership consists of
20 all Member States that have enacted the Compact.
21 (6) "Commissioner" means the individual appointed by a Member State to serve
22 as the member of the Commission for that Member State.
23 (7) "Compact" means the Respiratory Car e Interstate Compact.
24 (8) "Compact Privilege" means the authorization granted by a Remote State to
25 allow a Licensee fr om another Member State to practice as a Respiratory Therapist in
26 the Remote State under the Remote State's laws and Rules. The Practice of Respiratory
27 Therapy occurs in the Member State wher e the patient is located at the time of the
28 patient encounter .
29 (9) "Criminal Backgr ound Check" means the submission by the Member State
30 of fingerprints or other biometric-based information on license applicants at the time of
31 initial licensing for the purpose of obtaining that applicant's criminal history rec ord
32 information, as defined in 28 C.F .R. § 20.3(d) or successor pro vision, from the Federal
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33 Bur eau of Investigation and the State's criminal history recor d rep ository , as defined in
34 28 C.F .R. § 20.3(f) or successor provi sion.
35 (10) "Data System" means the Commission's r epository of information about
36 Licensees as further set forth in section 334.1971.
37 (1 1) "Domicile" means the jurisdiction which is the Licensee's principal home
38 for legal purposes.
39 (12) "Encumber ed License" means a license that a State's Respiratory Therapy
40 Licensing Authority has limited in any way .
41 (13) "Executive Committee" means a gr oup of directors elected or appointed to
42 act on behalf of, and within the powers granted to them by the Commission.
43 (14) "Home State" except as set forth in section 334.1962, means the Member
44 State that is the Licensee's primary Domicile.
45 (15) "Home State License" means an active license to practice Respiratory
46 Therapy in a Home State that is not an Encumbered License.
47 (16) "Jurisprudence Requirem ent" means an assessment of an individual's
48 knowledge of the State laws and regu lations governing the Practice of Respiratory
49 Therapy in such State.
50 (17) "Licensee" means an individual who curren tly holds an authorization fr om
51 the State to practice as a Respiratory Therapist.
52 (18) "Member State" means a State that has enacted the Compact and been
53 admitted to the Commission in accordance with the pr ovisions her ein and Commission
54 Rules.
55 (19) "Model Compact" means the model for the Respiratory Care Interstate
56 Compact on file with The Council of State Governments or other entity as designated by
57 the Commission.
58 (20) "Remote State" means a Member State wher e a Licensee is exer cising or
59 seeking to exerci se the Compact Privilege.
60 (21) "Respiratory Therapist" or "Respiratory Care Practitioner" means an
61 individual who holds a cred ential issued by the National Board for Respiratory Car e (or
62 its successor) and holds a license in a State to practice Respiratory Therapy . For
63 purposes of this Compact, any other title or status adopted by a State to r eplace the
64 term "Respiratory Therapist" or "Respiratory Car e Practitioner" shall be deemed
65 synonymous with "Respiratory Therapist" and shall confer the same rights and
66 r esponsibilities to the Licensee under the pr ovisions of this Compact at the time of its
67 enactment.
68 (22) "Respiratory Therapy ," "Respiratory Therapy Practice," "Respiratory
69 Car e," "the Practice of Respiratory Car e," and "the Practice of Respiratory Therapy"
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70 means the care and services pro vided by or under the direction and supervision of a
71 Respiratory Therapist or Respiratory Car e Practitioner .
72 (23) "Respiratory Therapy Licensing Authority" means the agency , board, or
73 other body of a State that is res ponsible for licensing and regul ation of Respiratory
74 Therapists.
75 (24) "Rule" means a r egulation pr omulgated by an entity that has the for ce and
76 effect of law .
77 (25) "Scope of Practice" means the proc edures, actions, and pro cesses a
78 Respiratory Therapist licensed in a State or practicing under a Compact Privilege in a
79 State is permitted to undertake in that State and the circ umstances under which the
80 Respiratory Therapist is permitted to undertake those procedur es, actions, and
81 pr ocesses. Such pr ocedur es, actions, and pr ocesses, and the circums tances under
82 which they may be undertaken may be established thr ough means, including, but not
83 limited to, statute, reg ulations, case law , and other pro cesses available to the State
84 Respiratory Therapy Licensing Authority or other government agency .
85 (26) "Significant Investigative Information" means information, record s, and
86 documents received or generated by a State Respiratory Therapy Licensing Authority
87 pursuant to an investigation for which a determination has been made that ther e is
88 pr obable cause to believe that the Licensee has violated a statute or reg ulation that is
89 consider ed mor e than a minor infraction for which the State Respiratory Therapy
90 Licensing Authority could pursue Adverse Action against the Licensee.
91 (27) "State" means any state, commonwealth, district, or territory of the United
92 States.
334.1956. 1. In order to participate in this Compact and ther eafter continue as a
2 Member State, a Member State shall:
3 (1) Enact a Compact that is not materially differen t fr om the Model Compact;
4 (2) License Respiratory Therapists;
5 (3) Participate in the Commission's Data System;
6 (4) Have a mechanism in place for receivi ng and investigating complaints
7 against Licensees and Compact Privilege holders;
8 (5) Notify the Commission, in compliance with the terms of this Compact and
9 Commission Rules, of any Adverse Action against a Licensee, a Compact Privilege
10 holder , or a license applicant;
11 (6) Notify the Commission, in compliance with the terms of this Compact and
12 Commission Rules, of the existence of Significant Investigative Information;
13 (7) Comply with the Rules of the Commission;
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14 (8) Grant the Compact Privilege to a holder of an active Home State License and
15 otherwise meet the applicable r equir ements of section 334.1959 in a Member State; and
16 (9) Complete a Criminal Backgr ound Check for each new Licensee at the time of
17 initial licensur e. Wher e expr essly authorized or permitted by federal law , whether such
18 federal law is in effect prior to, at, or after the time of a Member State's enactment of
19 this Compact, a Member State's enactment of this Compact shall her eby authorize the
20 Member State's Respiratory Therapy Licensing Authority to perform Criminal
21 Backgr ound Checks as defined herei n. The absence of such a federal law as
22 described in this subdivision shall not preven t or pr eclude such authorization where it
23 may be derived or granted thr ough means other than the enactment of this Compact.
24 2. Nothing in this Compact pr ohibits a Member State fr om charging a fee for
25 granting and ren ewing the Compact Privilege.
334.1959. 1. T o exercise the Compact Privilege under the terms and pr ovisions
2 of the Compact, the Licensee shall:
3 (1) Hold and maintain an active Home State License as a Respiratory Therapist;
4 (2) Hold and maintain an active cred ential fr om the National Board for
5 Respiratory Care (or its successor) that would qualify them for licensur e in the Remote
6 State in which they ar e seeking the privilege;
7 (3) Have not had any Adverse Action against a license within the pr evious two
8 (2) years;
9 (4) Notify the Commission that the Licensee is seeking the Compact Privilege
10 within a Remote State or States;
11 (5) Pay any applicable fees, including any State and Commission fees and
12 r enewal fees, for the Compact Privilege;
13 (6) Meet any Jurisprudence Require ments established by the Remote State in
14 which the Licensee is seeking a Compact Privilege;
15 (7) Report to the Commission Adverse Action taken by any non-Member State
16 within thirty (30) days fr om the date the Adverse Action is taken;
17 (8) Report to the Commission, when applying for a Compact Privilege, the
18 addr ess of the Licensee's Domicile and ther eafter pro mptly report to the Commission
19 any change in the addr ess of the Licensee's Domicile within thirty (30) days of the
20 effective date of the change in addr ess; and
21 (9) Consent to accept service of process by mail at the Licensee's Domicile on
22 r ecord with the Commission with res pect to any action br ought against the Licensee by
23 the Commission or a Member State, and consent to accept service of a subpoena by mail
24 at the Licensee's Domicile on reco rd with the Commission with res pect to any action
25 br ought or investigation conducted by the Commission or a Member State.
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26 2. The Compact Privilege is valid until the expiration date or rev ocation of the
27 Home State License unless terminated pursuant to Adverse Action. The Licensee must
28 comply with all of the r equir ements of subsection 1 of this section to maintain the
29 Compact Privilege in a Remote State. If those req uirements are met, no Adverse
30 Actions are taken, and the Licensee has paid any applicable Compact Privilege renew al
31 fees, then the Licensee will maintain the Licensee's Compact Privilege.
32 3. A Licensee pr oviding Respiratory Therapy in a Remote State under the
33 Compact Privilege shall function within the Scope of Practice authorized by the Remote
34 State for the type of Respiratory Therapist license the Licensee holds. Such proced ures,
35 actions, pr ocesses, and the cir cumstances under which they may be undertaken may be
36 established thr ough means, including, but not limited to, statute, regu lations, case law ,
37 and other pr ocesses available to the State Respiratory Therapy Licensing Authority or
38 other government agency .
39 4. If a Licensee's Compact Privilege in a Remote State is rem oved by the Remote
40 State, the individual shall lose or be ineligible for the Compact privilege in that Remote
41 State until the Compact Privilege is no longer limited or re stricted by that State.
42 5. If a Home State License is encumber ed, the Licensee shall lose the Compact
43 Privilege in all Remote States until the following occur:
44 (1) The Home State License is no longer encumber ed; and
45 (2) T wo (2) years have elapsed fr om the date on which the license is no longer
46 encumber ed due to the Adverse Action.
47 6. Once a Licensee with a res tricted or limited license meets the req uirements of
48 subdivisions (1) and (2) of subsection 5 of this section, the Licensee must also meet the
49 r equir ements of subsection 1 of this section to obtain a Compact Privilege in a Remote
50 State.
334.1962. 1. An Active Military Member , or their spouse, shall designate a
2 Home State wher e the individual has a curren t license in good standing. The individual
3 may ret ain the Home State designation during the period the service member is on
4 active duty .
5 2. An Active Military Member and their spouse shall not be req uired to pay to
6 the Commission for a Compact Privilege any fee that may otherwise be charged by the
7 Commission. If a Remote State chooses to charge a fee for a Compact Privilege, it may
8 choose to charge a red uced fee or no fee to an Active Military Member and their spouse
9 for a Compact Privilege.
334.1965. 1. A Member State in which a Licensee is licensed shall have authority
2 to impose Adverse Action against the license issued by that Member State.
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3 2. A Member State may take Adverse Action based on Significant Investigative
4 Information of a Remote State or the Home State, so long as the Member State follows
5 its own pr ocedur es for imposing Adverse Action.
6 3. Nothing in this Compact shall override a Member State's decision that
7 participation in an Alternative Pr ogram may be used in lieu of Adverse Action and that
8 such participation shall rem ain non-public if requ ired by the Member State's laws.
9 4. A Remote State shall have the authority to:
10 (1) T ake Adverse Actions as set forth her ein against a Licensee's Compact
11 Privilege in that State;
12 (2) Issue subpoenas for both hearings and investigations that requ ire the
13 attendance and testimony of witnesses, and the pr oduction of evidence.
14 (a) Subpoenas may be issued by a Respiratory Therapy Licensing Authority in a
15 Member State for the attendance and testimony of witnesses and the pr oduction of
16 evidence.
17 (b) Subpoenas issued by a Respiratory Therapy Licensing Authority in a
18 Member State for the attendance and testimony of witnesses shall be enforced in the
19 latter State by any court of competent jurisdiction in the latter State, according to the
20 practice and pr ocedur e of that court applicable to subpoenas issued in proceed ings
21 pending befor e it.
22 (c) Subpoenas issued by a Respiratory Therapy Licensing Authority in a
23 Member State for pr oduction of evidence fr om another Member State shall be enfor ced
24 in the latter State, according to the practice and proced ure of that court applicable to
25 subpoenas issued in the pr oceedings pending befor e it.
26 (d) The issuing authority shall pay any witness fees, travel expenses, mileage,
27 and other fees req uired by the service statutes of the State where the witnesses or
28 evidence ar e located;
29 (3) Unless otherwise pr ohibited by State law , recover fr om the Licensee the costs
30 of investigations and disposition of cases res ulting fr om any Adverse Action taken
31 against that Licensee;
32 (4) Notwithstanding subdivision (2) of this subsection, a Member State may not
33 issue a subpoena to gather evidence of conduct in another Member State that is lawful in
34 such other Member State for the purpose of taking Adverse Action against a Licensee's
35 Compact Privilege or application for a Compact Privilege in that Member State; and
36 (5) Nothing in this Compact authorizes a Member State to impose discipline
37 against a Respiratory Therapist's Compact Privilege in that Member State for the
38 individual's otherwise lawful practice in another State.
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39 5. (1) In addition to the authority granted to a Member State by its res pective
40 Respiratory Therapy Practice act or other applicable state law , a Member State may
41 participate with other Member States in joint investigations of Licensees, pr ovided,
42 however , that a Member State receivi ng such a req uest has no obligation to respond to
43 any subpoena issued rega rding an investigation of conduct or practice that was lawful in
44 a Member State at the time it was undertaken.
45 (2) Member States shall share any Significant Investigative Information,
46 litigation, or compliance materials in furtherance of any joint or individual investigation
47 initiated under the Compact. In sharing such information between Member State
48 Respiratory Therapy Licensing Authorities, all information obtained shall be kept
49 confidential, except as otherwise mutually agreed upon by the sharing and receivi ng
50 Member States.
51 6. Nothing in this Compact may permit a Member State to take any Adverse
52 Action against a Licensee or holder of a Compact Privilege for conduct or practice that
53 was legal in the Member State at the time it was undertaken.
54 7. Nothing in this Compact may permit a Member State to take disciplinary
55 action against a Licensee or holder of a Compact Privilege for conduct or practice that
56 was legal in the Member State at the time it was undertaken.
334.1968. 1. The Compact Member States her eby creat e and establish a joint
2 government agency whose membership consists of all Member States that have enacted
3 the Compact known as the Respiratory Car e Interstate Compact Commission. The
4 Commission is an instrumentality of the Compact Member States acting jointly and not
5 an instrumentality of any one State. The Commission shall come into existence on or
6 after the effective date of the Compact, as set forth in section 334.1980.
7 2. (1) Each Member State shall have and be limited to one (1) Commissioner
8 selected by that Member State's Respiratory Therapy Licensing Authority .
9 (2) The Commissioner shall be an administrator or their designated staff
10 member of the Member State's Respiratory Therapy Licensing Authority .
11 (3) The Commission shall by Rule or bylaw establish a term of office for
12 Commissioners and may by Rule or bylaw establish term limits.
13 (4) The Commission may reco mmend to a Member State the r emoval or
14 suspension of any Commissioner fr om office.
15 (5) A Member State's Respiratory Therapy Licensing Authority shall fill any
16 vacancy of its Commissioner occurring on the Commission within sixty (60) days of the
17 vacancy .
18 (6) Each Commissioner shall be entitled to one vote on all matters before the
19 Commission requ iring a vote by Commissioners.
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20 (7) A Commissioner shall vote in person or by such other means as prov ided in
21 the bylaws. The bylaws may pr ovide for Commissioners to meet by telecommunication,
22 videoconfer ence, or other means of communication.
23 (8) The Commission shall meet at least once during each calendar year .
24 Additional meetings may be held as set forth in the bylaws.
25 3. The Commission shall have the following powers:
26 (1) Establish and amend the fiscal year of the Commission;
27 (2) Establish and amend bylaws and policies, including but not limited to, a code
28 of conduct and conflict of inter est;
29 (3) Establish and amend Rules, which shall be binding in all Member States;
30 (4) Maintain its financial r ecords in accordance with the bylaws;
31 (5) Meet and take such actions as ar e consistent with the pr ovisions of this
32 Compact, the Commission's Rules, and the bylaws;
33 (6) Initiate and conduct legal proceed ings or actions in the name of the
34 Commission, pr ovided that the standing of any Respiratory Therapy Licensing
35 Authority to sue or be sued under applicable law shall not be affected;
36 (7) Maintain and certify reco rds and information provi ded to a Member State as
37 the authenticated business record s of the Commission, and designate an agent to do so
38 on the Commission's behalf;
39 (8) Purchase and maintain insurance and bonds;
40 (9) Accept or contract for services of personnel, including, but not limited to,
41 employees of a Member State;
42 (10) Conduct an annual financial rev iew;
43 (1 1) Hir e employees, elect or appoint officers, fix compensation, define duties,
44 grant such individuals appr opriate authority to carry out the purposes of the Compact,
45 and establish the Commission's personnel policies and pr ograms r elating to conflicts of
46 inter est, qualifications of personnel, and other re lated personnel matters;
47 (12) Assess and collect fees;
48 (13) Accept any and all appr opriate gifts, donations, grants of money , other
49 sour ces of r evenue, equipment, supplies, materials, and services, and receive, utilize, and
50 dispose of the same, prov ided that at all times:
51 (a) The Commission shall avoid any appearance of impro priety; and
52 (b) The Commission shall avoid any appearance of conflict of interes t;
53 (14) Lease, pur chase, ret ain, own, hold, impr ove, or use any pr operty , r eal,
54 personal, or mixed, or any undivided interes t ther ein;
55 (15) Sell, convey , mortgage, pledge, lease, exchange, abandon, or otherwise
56 dispose of any pr operty real, personal, or mixed;
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57 (16) Establish a budget and make expenditur es;
58 (17) Borrow money in a fiscally res ponsible manner;
59 (18) Appoint committees, including standing committees, composed of
6 0 Commissioners, State r egulators, State legislators or their repr esentatives, and
61 consumer r epresent atives, and such other interes ted persons as may be designated in
62 this Compact and the bylaws;
63 (19) Pr ovide and r eceive information fr om, and cooperate with, law enforcem ent
64 agencies;
65 (20) Establish and elect an Executive Committee, including a chair , vice-chair ,
66 secr etary , tr easurer , and such other offices as the Commission shall establish by Rule or
67 bylaw;
68 (21) Enter into contracts or arrangements for the management of the affairs of
69 the Commission;
70 (22) Determine whether a State's adopted language is materially differ ent fr om
71 the Model Compact language such that the State would not qualify for participation in
72 the Compact; and
73 (23) Perform such other functions as may be necessary or appr opriate to achieve
74 the purposes of this Compact.
75 4. (1) The Executive Committee shall have the power to act on behalf of the
76 Commission according to the terms of this Compact. The powers, duties, and
77 r esponsibilities of the Executive Committee shall include:
78 (a) Overseeing the day-to-day activities of the administration of the Compact,
79 including enforcem ent and compliance with the pr ovisions of the Compact, its Rules and
80 bylaws, and other such duties as deemed necessary;
81 (b) Recommending to the Commission changes to the Rules or bylaws, changes
82 to this Compact legislation, fees charged to Compact Member States, fees charged to
83 Licensees, and other fees;
84 (c) Ensuring Compact administration services ar e appr opriately pr ovided,
85 including by contract;
86 (d) Pr eparing and recommending the budget;
87 (e) Maintaining financial reco rds on behalf of the Commission;
88 (f) Monitoring Compact compliance of Member States and pro viding
8 9 compliance rep orts to the Commission;
90 (g) Establishing additional committees as necessary;
91 (h) Exer cising the powers and duties of the Commission during the interim
92 between Commission meetings, except for adopting or amending Rules, adopting or
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93 amending bylaws, and exer cising any other powers and duties expr essly res erved to the
94 Commission by Rule or bylaw; and
95 (i) Performing other duties as pr ovided in the Rules or bylaws of the
96 Commission.
97 (2) The Executive Committee shall be composed of up to nine (9) members, as
98 further set forth in the bylaws of the Commission:
99 (a) Seven (7) voting members who ar e elected by the Commission fr om the
100 curr ent membership of the Commission; and
101 (b) T wo (2) ex-officio, non-voting members.
102 (3) The Commission may rem ove any member of the Executive Committee as
103 pr ovided in the Commission's bylaws.
104 (4) The Executive Committee shall meet at least annually .
105 (a) Executive Committee meetings shall be open to the public, except that the
106 Executive Committee may meet in a closed, non-public meeting as pr ovided in
107 subdivision (4) of subsection 6 of this section;
108 (b) The Executive Committee shall give advance notice of its meetings, posted on
109 its website and as determined to pr ovide notice to persons with an interes t in the
110 business of the Commission; and
111 (c) The Executive Committee may hold a special meeting in accordance with
112 subdivision (2) of subsection 6 of this section.
113 5. The Commission shall adopt and pr ovide to the Member States an annual
114 r eport.
115 6. (1) All meetings of the Commission that are not closed pursuant to
116 subdivision (4) of this subsection shall be open to the public. Notice of public meetings
117 shall be posted on the Commission's website at least thirty (30) days prior to the public
118 meeting.
119 (2) Notwithstanding subdivision (1) of this subsection, the Commission may
120 convene an emergency public meeting by pr oviding at least twenty-four (24) hours prior
121 notice on the Commission's website, and any other means as pr ovided in the
122 Commission's Rules, for any of the re asons it may dispense with notice of pro posed
123 rulemaking under subsection 7 of section 334.1974. The Commission's legal counsel
124 shall certify that one of the rea sons justifying an emergency public meeting has been
125 met.
126 (3) Notice of all Commission meetings shall prov ide the time, date, and location
127 of the meeting, and if the meeting is to be held or accessible via telecommunication,
128 video conference , or other electr onic means, the notice shall include the mechanism for
129 access to the meeting.
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130 (4) The Commission or the Executive Committee may convene in a closed, non-
131 public meeting for the Commission or Executive Committee to r eceive or solicit legal
132 advice or to discuss:
133 (a) Non-compliance of a Member State with its obligations under the Compact;
134 (b) The employment, compensation, discipline or other matters, practices or
135 pr ocedur es r elated to specific employees;
136 (c) Curr ent or thr eatened discipline of a Licensee or Compact Privilege holder
137 by the Commission or by a Member State's Respiratory Therapy Licensing Authority;
138 (d) Curre nt, thr eatened, or reas onably anticipated litigation;
139 (e) Negotiation of contracts for the pur chase, lease, or sale of goods, services, or
140 r eal estate;
141 (f) Accusing any person of a crime or formally censuring any person;
142 (g) T rade secr ets or commer cial or financial information that is privileged or
143 confidential;
144 (h) Information of a personal natur e wher e disclosure would constitute a clearly
145 unwarranted invasion of personal privacy;
146 (i) Investigative record s compiled for law enfor cement purposes;
147 (j) Information r elated to any investigative repo rts prepa red by or on behalf of
148 or for use of the Commission or other committee charged with r esponsibility of
149 investigation or determination of compliance issues pursuant to the Compact;
150 (k) Legal advice;
151 (l) Matters specifically exempted fr om disclosur e by federal or Member State
152 law; or
153 (m) Other matters as pr omulgated by the Commission by Rule.
154 (5) If a meeting, or portion of a meeting, is closed, the pr esiding officer shall state
155 that the meeting will be closed and ref eren ce each relev ant exempting provi sion, and
156 such re feren ce shall be recor ded in the minutes.
157 (6) The Commission shall keep minutes in accordance with Commission Rules
158 and bylaws. All documents consider ed in connection with an action shall be identified in
159 such minutes. All minutes and documents of a closed meeting shall re main under seal,
160 subject to rel ease only by a majority vote of the Commission or order of a court of
161 competent jurisdiction.
162 7. (1) The Commission shall pay , or pr ovide for the payment of, the reas onable
163 expenses of its establishment, organization, and ongoing activities.
164 (2) The Commission may accept any and all appr opriate r evenue sources as
165 pr ovided herein .
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166 (3) The Commission may levy on and collect an annual assessment fr om each
167 Member State and impose fees on Licensees of Member States to whom it grants a
168 Compact Privilege to cover the cost of the operations and activities of the Commission
169 and its staff. The aggr egate annual assessment amount for Member States, if any , shall
170 be allocated based upon a formula that the Commission shall pr omulgate by Rule.
171 (4) The Commission shall not incur obligations of any kind prior to securing the
172 funds or a loan adequate to meet the same; nor shall the Commission pledge the credit
173 of any of the Member States, except by and with the authority of the Member State.
174 (5) The Commission shall keep accurate accounts of all re ceipts and
1 7 5 disbursements. The r eceipts and disbursements of the Commission shall be subject
176 to the financial r eview and accounting pr ocedur es established under its bylaws.
177 However , all r eceipts and disbursements of funds handled by the Commission shall be
178 subject to an annual financial r eview by a certified or licensed public accountant, and
179 the re port of the financial review shall be included in and become part of the annual
180 r eport of the Commission.
181 8. (1) Nothing herei n shall be construed as a limitation on the liability of any
182 Licensee for profes sional malpractice or misconduct, which shall be governed solely by
183 any other applicable state laws.
184 (2) The Member States, Commissioners, officers, executive dir ectors, employees,
185 and agents of the Commission shall be immune fr om suit and liability , both personally
186 and in their official capacity , for any claim for damage to or loss of pro perty or personal
187 injury or other civil liability caused by or arising out of any actual or alleged act, error ,
188 or omission that occurr ed, or that the person against whom the claim is made had a
189 r easonable basis for believing occurr ed within the scope of Commission employment,
190 duties or r esponsibilities; prov ided that nothing in this subdivision shall be construed to
191 pr otect any such person fro m suit or liability for any damage, loss, injury , or liability
192 caused by the intentional or willful or wanton misconduct of that person. The
193 pr ocur ement of insurance of any type by the Commission shall not in any way
194 compr omise or limit the immunity granted hereu nder .
195 (3) The Commission shall defend any Commissioner , officer , executive direc tor ,
196 employee, and agent of the Commission in any civil action seeking to impose liability
197 arising out of any actual or alleged act, erro r , or omission that occurr ed within the scope
198 of Commission employment, duties, or res ponsibilities, or as determined by the
199 Commission that the person against whom the claim is made had a r easonable basis for
200 believing occurr ed within the scope of Commission employment, duties, or
2 0 1 r esponsibilities; pr ovided that nothing her ein shall be construed to pr ohibit that
202 person fro m ret aining their own counsel at their own expense; and pr ovided further ,
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203 that the actual or alleged act, error , or omission did not res ult fr om that person's
204 intentional or willful or wanton misconduct.
205 (4) The Commission shall indemnify and hold harmless any Commissioner ,
206 member , officer , executive dir ector , employee, and agent of the Commission for the
207 amount of any settlement or judgment obtained against that person arising out of any
208 actual or alleged act, error , or omission that occurr ed within the scope of Commission
209 employment, duties, or res ponsibilities, or that such person had a reas onable basis for
210 believing occurr ed within the scope of Commission employment, duties, or
2 1 1 r esponsibilities, prov ided that the actual or alleged act, erro r , or omission did not
212 r esult fr om the intentional or willful or wanton misconduct of that person.
213 (5) Nothing in this Compact shall be interpr eted to waive or otherwise abr ogate
214 a Member State's state action immunity or state action affirmative defense with res pect
215 to antitrust claims under the Sherman Act, Clayton Act, or any other State or federal
216 antitrust or anticompetitive law or regu lation.
217 (6) Nothing in this Compact shall be construed to be a waiver of soverei gn
218 immunity by the Member States or by the Commission.
334.1971. 1. The Commission shall prov ide for the development, maintenance,
2 operation, and utilization of a coordinated database and r eporting system containing
3 licensur e, Adverse Action, and the pr esence of Significant Investigative Information.
4 2. Notwithstanding any other pro vision of State law to the contrary , a Member
5 State shall submit a uniform data set to the Data System as requ ired by the Rules of the
6 Commission, including but not limited to:
7 (1) Identifying information;
8 (2) Licensure data;
9 (3) Adverse Actions against a Licensee, license applicant, or Compact Privilege
10 holder and information rela ted ther eto;
11 (4) Non-confidential information rel ated to Alternative Pr ogram participation,
12 the beginning and ending dates of such participation, and other information rel ated to
13 such participation not made confidential under Member State law;
14 (5) Any denial of application for licensur e, and the reas on or rea sons for such
15 denial;
16 (6) The pr esence of curr ent Significant Investigative Information; and
17 (7) Other information that may facilitate the administration of this Compact or
18 the pro tection of the public, as determined by the Rules of the Commission.
19 3. No Member State shall submit any information which constitutes criminal
20 history reco rd information, as defined by applicable federal law , to the Data System
21 established her eunder .
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22 4. The r ecords and information pr ovided to a Member State pursuant to this
23 Compact or thr ough the Data System, when certified by the Commission or an agent
24 ther eof, shall constitute the authenticated business rec ords of the Commission, and shall
25 be entitled to any associated hearsay exception in any rele vant judicial, quasi-judicial or
26 administrative pr oceedings in a Member State.
27 5. Significant Investigative Information pertaining to a Licensee in any Member
28 State will only be available to other Member States.
29 6. It is the res ponsibility of the Member States to re port any Adverse Action
30 against a Licensee and to monitor the database to determine whether Adverse Action
31 has been taken against a Licensee. Adverse Action information pertaining to a Licensee
32 in any Member State will be available to any other Member State.
33 7. Member States contributing information to the Data System may designate
34 information that may not be shared with the public without the express permission of
35 the contributing State.
36 8. Any information submitted to the Data System that is subsequently expunged
37 pursuant to federal law or the laws of the Member State contributing the information
38 shall be re moved fr om the Data System.
334.1974. 1. The Commission shall promulg ate re asonable Rules in order to
2 effectively and efficiently implement and administer the purposes and pro visions of the
3 Compact. A Rule shall be invalid and have no for ce or effect only if a court of
4 competent jurisdiction holds that the Rule is invalid because the Commission exer cised
5 its rulemaking authority in a manner that is beyond the scope and purposes of the
6 Compact, or the powers granted hereunder , or based upon another applicable standard
7 of review .
8 2. For purposes of the Compact, the Rules of the Commission shall have the
9 for ce of law in each Member State.
10 3. The Commission shall exer cise its rulemaking powers pursuant to the criteria
11 set forth in this section and the Rules adopted ther eunder . Rules shall become binding
12 as of the date specified in each Rule.
13 4. If a majority of the legislatur es of the Member States rej ects a Rule or portion
14 of a Rule, by enactment of a statute or res olution in the same manner used to adopt the
15 Compact within four (4) years of the date of adoption of the Rule, then such Rule shall
16 have no further for ce and effect in any Member State.
17 5. Rules shall be adopted at a reg ular or special meeting of the Commission.
18 6. Prior to adoption of a pr oposed Rule, the Commission shall hold a public
19 hearing and allow persons to pro vide oral and written comments, data, facts, opinions,
20 and arguments.
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21 7. Prior to adoption of a pr oposed Rule by the Commission, and at least thirty
22 (30) days in advance of the meeting at which the Commission will hold a public hearing
23 on the prop osed Rule, the Commission shall provi de a notice of prop osed rulemaking:
24 (1) On the website of the Commission or other publicly accessible platform;
25 (2) T o persons who have requ ested notice of the Commission's notices of
26 pr oposed rulemaking; and
27 (3) In such other way or ways as the Commission may by Rule specify .
28 8. The notice of pr oposed rulemaking shall include:
29 (1) The time, date, and location of the public hearing at which the Commission
30 will hear public comments on the pro posed Rule and, if differ ent, the time, date, and
31 location of the meeting wher e the Commission will consider and vote on the pro posed
32 Rule;
33 (2) If the hearing is held via telecommunication, video conference, or other
34 electr onic means, the Commission shall include the mechanism for access to the hearing
35 in the notice of prop osed rulemaking;
36 (3) The text of the pr oposed Rule and the reas on ther efor;
37 (4) A requ est for comments on the pr oposed Rule fr om any interes ted person;
38 and
39 (5) The manner in which interes ted persons may submit written comments.
40 9. All hearings will be r ecorded. A copy of the recor ding and all written
41 comments and documents receiv ed by the Commission in res ponse to the prop osed Rule
42 shall be available to the public.
43 10. Nothing in this section shall be construed as requi ring a separate hearing on
44 each Rule. Rules may be gr ouped for the convenience of the Commission at hearings
45 r equir ed by this section.
46 1 1. The Commission shall, by majority vote of all Commissioners, take final
47 action on the prop osed Rule based on the rulemaking record and the full text of the
48 Rule.
49 (1) The Commission may adopt changes to the pro posed Rule pro vided the
50 changes are consistent with the original purpose of the prop osed Rule.
51 (2) The Commission shall pro vide an explanation of the r easons for substantive
52 changes made to the pr oposed Rule as well as r easons for substantive changes not made
53 that wer e r ecommended by commenters.
54 (3) The Commission shall determine a reas onable effective date for the Rule.
55 Except for an emergency as pr ovided in subsection 12 of this section, the effective date
56 of the Rule shall be no sooner than thirty (30) days after issuing the notice that it
57 adopted or amended the Rule.
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58 12. Upon determination that an emergency exists, the Commission may consider
59 and adopt an emergency Rule with twenty-four (24) hours' notice, and with opportunity
60 to comment, pro vided that the usual rulemaking pr ocedur es prov ided in the Compact
61 and in this section shall be ret roact ively applied to the Rule as soon as reas onably
62 possible, in no event later than ninety (90) days after the effective date of the Rule. For
63 the purposes of this provi sion, an emergency Rule is one that must be adopted
64 immediately in order to:
65 (1) Meet an imminent thr eat to public health, safety , or welfare;
66 (2) Pr event a loss of Commission or Member State funds;
67 (3) Meet a deadline for the pr omulgation of a Rule that is established by federal
68 law or Rule; or
69 (4) Pr otect public health and safety .
70 13. The Commission or an authorized committee of the Commission may direct
71 r evisions to a pr eviously adopted Rule for purposes of corr ecting typographical errors,
72 err ors in format, err ors in consistency , or grammatical err ors. Public notice of any
73 r evisions shall be posted on the website of the Commission. The r evision shall be subject
74 to challenge by any person for a period of thirty (30) days after posting. The revi sion
75 may be challenged only on gr ounds that the r evision res ults in a material change to a
76 Rule. A challenge shall be made in writing and deliver ed to the Commission prior to the
77 end of the notice period. If no challenge is made, the r evision will take effect without
78 further action. If the r evision is challenged, the revi sion may not take effect without the
79 appr oval of the Commission.
80 14. (1) No Member State's rulemaking pr ocess or proc edural r equir ements shall
81 apply to the Commission.
82 (2) The Commission shall have no authority over any Member State's
83 rulemaking pr ocess or proced ural requ irem ents that do not pertain to the Compact.
84 15. Nothing in this Compact, nor any Rule or regul ation of the Commission,
85 shall be construed to limit, res trict, or in any way r educe the ability of a Member State
86 to enact and enfor ce laws, r egulations, or other Rules r elated to the Practice of
87 Respiratory Therapy in that State, wher e those laws, reg ulations, or other Rules are not
88 inconsistent with the prov isions of this Compact.
334.1977. 1. (1) The executive and judicial branches of State government in
2 each Member State shall enforce this Compact and take all actions necessary and
3 appr opriate to implement the Compact.
4 (2) V enue is prop er and judicial proc eedings by or against the Commission shall
5 be bro ught solely and exclusively in a court of competent jurisdiction wher e the
6 principal office of the Commission is located. The Commission may waive venue and
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7 jurisdictional defenses to the extent it adopts or consents to participate in alternative
8 dispute reso lution pr oceedings. Nothing herei n shall affect or limit the selection or
9 pr opriety of venue in any action against a Licensee for profes sional malpractice,
10 misconduct or any such similar matter .
11 (3) The Commission shall be entitled to recei ve service of process in any
12 pr oceeding r egarding the enforcem ent or interpr etation of the Compact and shall have
13 standing to intervene in such a proceed ing for all purposes. Failur e to pr ovide the
14 Commission service of pr ocess shall rend er a judgment or order void as to the
15 Commission, this Compact, or pr omulgated Rules.
16 2. (1) If the Commission determines that a Member State has defaulted in the
17 performance of its obligations or r esponsibilities under this Compact or the
1 8 pr omulgated Rules, the Commission shall pr ovide written notice to the defaulting
19 State. The notice of default shall describe the default, the pro posed means of curing the
20 default, and any other action that the Commission may take, and shall offer training
21 and specific technical assistance reg arding the default.
22 (2) The Commission shall pr ovide a copy of the notice of default to the other
23 Member States.
24 3. If a State in default fails to cur e the default, the defaulting State may be
25 terminated fr om the Compact upon an affirmative vote of a majority of the
26 Commissioners of the Member States, and all rights, privileges and benefits conferr ed
27 on that State by this Compact may be terminated on the effective date of termination. A
28 cur e of the default does not reli eve the offending State of obligations or liabilities
29 incurr ed during the period of default.
30 4. T ermination of membership in the Compact shall be imposed only after all
31 other means of securing compliance have been exhausted. Notice of intent to suspend or
32 terminate shall be given by the Commission to the governor , the majority and minority
33 leaders of the defaulting State's legislature, the defaulting State's Respiratory Therapy
34 Licensing Authority and each of the Member States' Respiratory Therapy Licensing
35 Authorities.
36 5. A State that has been terminated is res ponsible for all assessments,
37 obligations, and liabilities incurr ed thr ough the effective date of termination, including
38 obligations that extend beyond the effective date of termination, if necessary .
39 6. Upon the termination of a State's membership fr om this Compact, that State
40 shall immediately provi de notice to all Licensees and Compact Privilege holders (of
41 which the Commission has a record ) within that State of such termination. The
42 terminated State shall continue to r ecognize all licenses granted pursuant to this
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43 Compact for a minimum of one hundred eighty (180) days after the date of said notice of
44 termination.
45 7. The Commission shall not bear any costs r elated to a State that is found to be
46 in default or that has been terminated fr om the Compact, unless agr eed upon in writing
47 between the Commission and the defaulting State.
48 8. The defaulting State may appeal the action of the Commission by petitioning
49 the U.S. District Court for the District of Columbia or the federal district wher e the
50 Commission has its principal offices. The pr evailing party shall be awarded all costs of
51 such litigation, including reas onable attorney's fees.
52 9. (1) Upon r equest by a Member State, the Commission shall attempt to r esolve
53 disputes r elated to the Compact that arise among Member States and between Member
54 and non-Member States.
55 (2) The Commission shall pr omulgate a Rule prov iding for both mediation and
56 binding dispute r esolution for disputes, as appr opriate.
57 10. (1) By majority vote, as may be further pro vided by Rule, the Commission
58 may initiate legal action against a Member State in default in the United States District
59 Court for the District of Columbia or the federal district wher e the Commission has its
60 principal offices to enforce compliance with the pr ovisions of the Compact and its
61 pr omulgated Rules. A Member State by enactment of this Compact consents to venue
62 and jurisdiction in such court for the purposes set forth her ein. The relief sought may
63 include both injunctive rel ief and damages. In the event judicial enforcem ent is
64 necessary , the preva iling party shall be awarded all costs of such litigation, including
65 r easonable attorney's fees. The rem edies here in shall not be the exclusive rem edies of
66 the Commission. The Commission may pursue any other rem edies available under
67 federal or the defaulting Member State's law .
68 (2) A Member State may initiate legal action against the Commission in the U.S.
69 District Court for the District of Columbia or the federal district wher e the Commission
70 has its principal offices to enforce compliance with the pr ovisions of the Compact and its
71 pr omulgated Rules. The rel ief sought may include both injunctive re lief and damages.
72 In the event judicial enforcem ent is necessary , the pr evailing party shall be awarded all
73 costs of such litigation, including r easonable attorney's fees.
74 (3) No person other than a Member State shall enforce this Compact against the
75 Commission.
334.1980. 1. The Compact shall come into effect on the date on which the
2 Compact statute is enacted into law in the seventh Member State ("Effective Date").
3 (1) On or after the Effective Date of the Compact, the Commission shall convene
4 and review the enactment of each of the first seven Member States ("Charter Member
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5 States") to determine if the statute enacted by each such Charter Member State is
6 materially differ ent than the Model Compact.
7 (a) A Charter Member State whose enactment is found to be materially differ ent
8 fr om the Model Compact shall be entitled to the default pro cess set forth in section
9 334.1977.
10 (b) If any Member State is later found to be in default, or is terminated or
11 withdraws fr om the Compact, the Commission shall rem ain in existence and the
12 Compact shall rem ain in effect even if the number of Member States should be less than
13 seven.
14 (2) Member States enacting the Compact subsequent to the seven initial Charter
15 Member States shall be subject to the pro cess set forth her ein and Commission Rule to
16 determine if their enactments are materially differ ent fr om the Model Compact and
17 whether they qualify for participation in the Compact.
18 (3) All actions taken for the benefit of the Commission or in furtherance of the
19 purposes of the administration of the Compact prior to the effective date of the Compact
20 or the Commission coming into existence shall be considere d to be actions of the
21 Commission unless specifically rep udiated by the Commission. The Commission shall
22 own and have all rights to any intellectual pr operty developed on behalf or in
23 furtherance of the Commission by individuals or entities involved in organizing or
24 establishing the Commission, as may be further set forth in Rules of the Commission.
25 (4) Any State that joins the Compact subsequent to the Commission's initial
26 adoption of the Rules and bylaws shall be subject to the Rules and bylaws as they exist
27 on the date on which the Compact becomes law in that State. Any Rule that has been
28 pr eviously adopted by the Commission shall have the full for ce and effect of law on the
29 date the Compact becomes law in that State.
30 2. Any Member State may withdraw fr om this Compact by enacting a statute
31 r epealing the same.
32 (1) A Member State's withdrawal shall not take effect until one hundr ed eighty
33 (180) days after enactment of the repeal ing statute.
34 (2) Withdra wal shall not affect the continuing r equir ement of the withdrawing
35 State's Respiratory Therapy Licensing Authority to comply with the investigative and
36 Adverse Action rep orting req uirements of this Compact prior to the effective date of
37 withdrawal.
38 (3) Upon the enactment of a statute withdrawing fr om this Compact, a State
39 shall immediately provi de notice of such withdrawal to all Licensees and Compact
40 Privilege holders (of which the Commission has a re cord) within that State.
4 1 Notwithstanding any subsequent statutory enactment to the contrary , such
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42 withdrawing State shall continue to recogn ize all licenses granted pursuant to this
43 Compact for a minimum of one hundred eighty (180) days after the date of such notice
44 of withdrawal.
45 3. Nothing contained in this Compact shall be construed to invalidate or pr event
46 any licensur e agr eement or other cooperative arrangement between a Member State
47 and a non-Member State that does not conflict with the provi sions of this Compact.
48 4. This Compact may be amended by the Member States. No amendment to this
49 Compact shall become effective and binding upon any Member State until it is enacted
50 into the laws of all Member States.
334.1983. 1. This Compact and the Commission's rulemaking authority shall be
2 liberally construed so as to effectuate the purposes and the implementation and
3 administration of the Compact. Pr ovisions of the Compact expr essly authorizing or
4 r equiring the promulg ation of Rules shall not be construed to limit the Commission's
5 rulemaking authority solely for those purposes.
6 2. The pr ovisions of this Compact shall be severable, and if any phrase, clause,
7 sentence or provi sion of this Compact is held by a court of competent jurisdiction to be
8 contrary to the constitution of any Member State, a State seeking participation in the
9 Compact, or of the United States, or the applicability ther eof to any government,
10 agency , person or circ umstance is held to be unconstitutional by a court of competent
11 jurisdiction, the validity of the rem ainder of this Compact and the applicability ther eof
12 to any other government, agency , person or circu mstance shall not be affected ther eby .
13 3. Notwithstanding subsection 2 of this section, the Commission may deny a
14 State's participation in the Compact or , in accordance with the re quir ements of section
15 334.1977, terminate a Member State's participation in the Compact, if it determines that
16 a constitutional requi rem ent of a Member State is a material departur e fr om the
17 Compact. Otherwise, if this Compact shall be held to be contrary to the constitution of
18 any Member State, the Compact shall rem ain in full for ce and effect as to the rem aining
19 Member States and in full forc e and effect as to the Member State affected as to all
20 severable matters.
334.1986. 1. Nothing herei n shall pr event or inhibit the enforcem ent of any
2 other law of a Member State that is not inconsistent with the Compact.
3 2. Any laws, statutes, r egulations, or other legal re quir ements in a Member State
4 in conflict with the Compact ar e superseded to the extent of the conflict, including any
5 subsequently enacted State laws.
6 3. All permissible agr eements between the Commission and the Member States
7 ar e binding in accordance with their terms.
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8 4. Other than as expr essly set forth her ein, nothing in this Compact will impact
9 initial licensur e.
✔
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