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SECOND REGULAR SESSION
HOUSE COMMITTEE SUBSTITUTE FOR
SENA TE BILL NO. 1092
103RD GENERAL ASSEMBL Y
4990H.07C JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal sections 324.009, 332.081, 337.600, and 345.050, RSMo, and to enact in lieu
thereof forty-six new sections relating to professional licensure.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 324.009, 332.081, 337.600, and 345.050, RSMo, are repealed
2 and forty-six new sections enacted in lieu thereof, to be known as sections 324.004, 324.009,
3 324.218, 324.1800, 324.1805, 324.1810, 324.1815, 324.1820, 324.1825, 324.1830, 324.1835,
4 324.1840, 324.1845, 324.1850, 324.1855, 324.1860, 324.1865, 332.081, 332.700, 332.705,
5 332.710, 332.715, 332.720, 332.725, 332.730, 332.735, 332.740, 332.745, 332.750, 332.755,
6 332.760, 334.1800, 334.1805, 334.1810, 334.1815, 334.1820, 334.1825, 334.1830, 334.1835,
7 334.1840, 334.1845, 334.1850, 334.1855, 334.1860, 337.600, and 345.050, to read as
8 follows:
324.004 . 1. Any person who has at least thr ee years of work experience in an
2 occupation or pro fession in another state, the District of Columbia, or any combination
3 of such jurisdictions, and whose work experience involved the practice of an occupation
4 or profes sion for which a license is not r equir ed in the jurisdiction or jurisdictions in
5 which the person worked but is r equir ed in this state, may submit an application for a
6 one-time nonr enewable two-year temporary license in this state in the occupation or
7 pr ofession, along with pr oof of at least thr ee years of work experience in the occupation
8 or pr ofession and a fee as set by regu lation of the oversight body , to the r elevant
9 oversight body in this state. The oversight body shall make a determination of
10 qualification within forty-five days of r eceiving a completed application.
11 2. The oversight body shall req uir e an applicant under this section to take and
12 pass the examination specific to the occupation or pr ofession which is re quir ed for
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.
13 licensur e by those individuals applying pursuant to the pr ovisions of the oversight
14 body's statutory and regu latory authority . An oversight body that administers an
15 examination on the laws of this state as part of its licensing application requi rem ents
16 may requi re an applicant under this section to take and pass an examination specific to
17 the laws of this state.
18 3. The oversight body shall not issue a one-time nonr enewable temporary license
19 to any applicant described in subsection 1 of this section who has had any license in the
20 r elevant occupation or pr ofession r evoked by an oversight body outside of this state,
21 who is curr ently under investigation, who has a complaint pending, or who is curr ently
22 under disciplinary action.
23 4. (1) Except as pr ovided in subdivision (2) of this subsection, applicants for the
24 one-time temporary nonr enewable license under this section shall be citizens of the
25 United States or lawfully present noncitizens authorized to work in the United States
26 under federal law and shall submit legal pr oof of citizenship or employment
27 authorization that is acceptable for the employment eligibility verification under
28 federal law as part of the application. If the holder of a one-time nonr enewable
29 temporary license issued under this section loses lawful pr esence or federal work
30 authorization, the one-time nonr enewable temporary license shall automatically be
31 r evoked.
32 (2) Applicants for the one-time nonr enewable temporary license under this
33 section in an occupation reg ulated by the board of therapeutic massage shall be citizens
34 of the United States and shall submit legal pr oof of citizenship as part of the application.
35 5. If an applicant is not curr ently r esiding in this state, the oversight body shall
36 conditionally appr ove the application contingent upon rece ipt of pr oof of domicile in
37 this state within sixty days of the applicant r eceiving the temporary license. If the
38 applicant fails to pr ovide proo f within sixty days of receiv ing the temporary license, the
39 oversight body may terminate the temporary license and the applicant may reap ply for
40 a temporary license.
41 6. The pr ovisions of this section shall not apply to the following:
42 (1) Any occupation whose oversight body has enter ed into a licensing compact
43 with another state for the regul ation of practice under the oversight body's jurisdiction.
44 The pro visions of this section shall not be construed to alter the authority granted by , or
45 any r equirements pr omulgated pursuant to, any interjurisdictional or interstate
46 compacts adopted by this state or any rec iproci ty agr eements with other states, and
47 whenever possible the pr ovisions of this section shall be interpret ed so as to imply no
48 conflict between it and any compact or any r ecipro city agr eement with other states;
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49 (2) Any occupation set forth in subsection 6 of section 290.257 or any electrical
50 contractor licensed under sections 324.900 to 324.945;
51 (3) Any occupation whose r egulators or licensees are requ ired to comply with
52 specific federal statutory , regu latory , and administrative requ irem ents in order to
53 practice in this state; or
54 (4) Assistant physicians licensed under chapter 334.
55 7. The one-time nonr enewable temporary license shall expir e after two years.
56 Upon expiration, the individual shall be req uire d to apply for a permanent license in
57 accordance with the license r equir ements for the occupation for which he or she held the
58 temporary license.
59 8. Notwithstanding any other provi sion of law to the contrary , a license issued
60 under this section shall be valid only in this state and shall not make a licensee eligible to
61 be part of an interstate compact. An applicant who is licensed in another state pursuant
62 to an interstate compact shall not be eligible for licensur e by an oversight body under
63 the pro visions of this section.
64 9. Notwithstanding any other provi sion of law to the contrary , a license issued
65 under this section shall be valid only in this state and shall not make a licensee eligible to
66 obtain a license by reci proci ty in another state.
67 10. As used in this section, the term "oversight body" means any board,
68 department, agency , or office of a jurisdiction that issues occupational or profession al
69 licenses.
70 1 1. The division of profes sional r egistration may pro mulgate rules to implement
71 the pr ovisions of this section. Any rule or portion of a rule, as that term is defined in
72 section 536.010, that is crea ted under the authority delegated in this section shall
73 become effective only if it complies with and is subject to all of the provi sions of chapter
74 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable
75 and if any of the powers vested with the general assembly pursuant to chapter 536 to
76 r eview , to delay the effective date, or to disappr ove and annul a rule are subsequently
77 held unconstitutional, then the grant of rulemaking authority and any rule pr oposed or
78 adopted after August 28, 2026, shall be invalid and void.
324.009. 1. For purposes of this section, the following terms mean:
2 (1) "License", a license, certificate, registration, permit, accreditation, or military
3 occupational speciality that enables a person to legally practice an occupation or profession in
4 a particular jurisdiction;
5 (2) "Military", the Armed Forces of the United States including the Air Force, Army ,
6 Coast Guard, Marine Corps, Navy , Space Force, National Guard and any other military
7 branch that is designated by Congress as part of the Armed Forces of the United States, and
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8 all reserve components and auxiliaries. Such term also includes the military reserves and
9 militia of any United States territory or state;
10 (3) "Missouri law enforcement officer", any person employed by or otherwise serving
11 in a position for the state or a local governmental entity in the state of Missouri as a police
12 of ficer , peace of ficer certified under chapter 590, auxiliary police of ficer , sheriff, sheriff 's
13 deputy , member of the patrol as that term is defined in section 43.010, or in some like position
14 involving the enforcement of the law and protection of the public interest at the risk of that
15 person's life and who is a permanent resident of the state of Missouri or who is domiciled in
16 the state of Missouri;
17 (4) "Nonresident military or law enforcement spouse":
18 (a) A nonresident spouse of an active duty member of the Armed Forces of the United
19 States who has been transferred or is scheduled to be transferred to the state of Missouri, or
20 who has been transferred or is scheduled to be transferred to an adjacent state and is or will be
21 domiciled in the state of Missouri, or has moved to the state of Missouri on a permanent
22 change-of-station basis; or
23 (b) A nonresident spouse of a person residing outside the state of Missouri who has
24 accepted an offer of employment from and with the state or a local governmental entity in the
25 state of Missouri and who will become a Missouri law enforcement of ficer upon the
26 commencement of such employment;
27 (5) "Oversight body", any board, department, agency , or of fice of a jurisdiction that
28 issues licenses;
29 (6) "Resident military or law enforcement spouse", a spouse of an active duty
30 member of the Armed Forces of the United States who has been transferred or is scheduled to
31 be transferred to the state of Missouri or an adjacent state and who is a permanent resident of
32 the state of Missouri, who is domiciled in the state of Missouri, or who has Missouri as his or
33 her home of record, or a spouse of a Missouri law enforcement of ficer .
34 2. Any person who holds a valid current license issued by another state, a branch or
35 unit of the military , a territory of the United States, or the District of Columbia, and who has
36 been licensed for at least one year in such other jurisdiction, may submit an application for a
37 license in Missouri in the same occupation or profession, and at the same practice level, for
38 which he or she holds the current license, along with proof of current licensure and proof of
39 licensure for at least one year in the other jurisdiction, to the relevant oversight body in this
40 state.
41 3. The oversight body in this state shall:
42 (1) W ithin six months of receiving an application described in subsection 2 of this
43 section, waive any examination, educational, or experience requirements for licensure in this
44 state for the applicant if it determines that there were minimum education requirements and, if
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45 applicable, work experience and clinical supervision requirements in ef fect and the other
46 [ state ] jurisdiction verifies that the person met those requirements in order to be licensed or
47 certified in that [ state ] jurisdiction . An oversight body that administers an examination on
48 laws of this state as part of its licensing application requirement may require an applicant to
49 take and pass an examination specific to the laws of this state; or
50 (2) W ithin thirty days of receiving an application described in subsection 2 of this
51 section from a nonresident military or law enforcement spouse or a resident military or law
52 enforcement spouse, waive any examination, educational, or experience requirements for
53 licensure in this state for the applicant and issue such applicant a license under this section if
54 such applicant otherwise meets the requirements of this section.
55 4. (1) The oversight body shall not waive any examination, educational, or
56 experience requirements for any applicant who has had his or her license revoked by an
57 oversight body outside the state; who is currently under investigation, who has a complaint
58 pending, or who is currently under disciplinary action, except as provided in subdivision (2)
59 of this subsection, with an oversight body outside the state; who does not hold a license in
60 good standing with an oversight body outside the state; who has a criminal record that would
61 disqualify him or her for licensure in Missouri; or who does not hold a valid current license in
62 the other jurisdiction on the date the oversight body receives his or her application under this
63 section.
64 (2) If another jurisdiction has taken disciplinary action against an applicant, the
65 oversight body shall determine if the cause for the action was corrected and the matter
66 resolved. If the matter has not been resolved by that jurisdiction, the oversight body may
67 deny a license until the matter is resolved.
68 5. Nothing in this section shall prohibit the oversight body from denying a license to
69 an applicant under this section for any reason described in any section associated with the
70 occupation or profession for which the applicant seeks a license.
71 6. Any person who is licensed under the provisions of this section shall be subject to
72 the applicable oversight body's jurisdiction and all rules and regulations pertaining to the
73 practice of the licensed occupation or profession in this state. Any health care provi der
74 licensed under the pr ovisions of this section shall be deemed fully licensed to practice
75 within the pr ofession's scope of practice in this state and may pr ovide telehealth services
76 as described in section 191.1 145 to the same extent and in the same manner as a health
77 car e pr ovider who r eceived his or her license without a waiver of any requ irem ents.
78 7. This section shall not be construed to waive any requirement for an applicant to
79 pay any fees, post any bonds or surety bonds, or submit proof of insurance associated with the
80 license the applicant seeks.
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81 8. This section shall not apply to business, professional, or occupational licenses
82 issued or required by political subdivisions.
83 9. The provisions of this section shall not impede an oversight body's authority to
84 require an applicant to submit fingerprints as part of the application process.
85 10. The provisions of this section shall not be construed to alter the authority granted
86 by , or any requirements promulgated pursuant to, any interjurisdictional or interstate
87 compacts adopted by Missouri statute or any reciprocity agreements with other states in
88 ef fect, and whenever possible this section shall be interpreted so as to imply no conflict
89 between it and any compact, or any reciprocity agreements with other states in ef fect.
90 1 1. Notwithstanding any other provision of law , a license issued under this section
91 shall be valid only in this state and shall not make a licensee eligible to be part of an interstate
92 compact. An applicant who is licensed in another state pursuant to an interstate compact shall
93 not be eligible for licensure by an oversight body under the provisions of this section.
94 12. The provisions of this section shall not apply to any occupation set forth in
95 subsection 6 of section 290.257, or any electrical contractor licensed under sections 324.900
96 to 324.945.
324.218. 1. An applicant who has not pr eviously taken or passed an examination
2 r ecognized by the committee and who meets the qualifications of subsection 2 of section
3 324.210 may obtain without examination a nonr enewable temporary license by paying a
4 temporary-license fee and submitting to the committee an agre ement-to-supervise form
5 that is signed by a licensed dietitian who has agr eed to supervise the applicant. Such
6 temporary licensee may practice dietetics, but any such practice shall be under the
7 supervision of a dietitian licensed in this state.
8 2. (1) Any dietitian who has agr eed to supervise a temporary licensee shall hold
9 an unencumber ed license to practice dietetics in this state and shall prov ide the
10 committee pr oof of active dietetics practice in this state for a minimum of one year
11 befor e supervising the temporary licensee.
12 (2) The supervising dietitian shall not be an immediate family member of the
13 temporary licensee. The committee shall define the term "immediate family member"
14 for purposes of this subdivision and the scope of such supervision by rule.
15 3. (1) The dietitian who has agr eed to supervise the applicant for a temporary
16 license shall submit to the committee a signed and notarized form pr escribed by the
17 committee attesting that the applicant for a temporary license shall begin employment
18 at a location in this state within seven days of issuance of the temporary license.
19 (2) If the temporary licensee's employment described in subdivision (1) of this
20 subsection ceases, the supervising dietitian shall notify the committee within thr ee days
21 of such cessation.
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22 4. A licensed dietitian shall not supervise mor e than one temporary licensee at a
23 time.
24 5. The temporary license obtained by an applicant under this section shall expir e
25 the date the committee is notified by the supervising dietitian that the temporary
26 licensee's employment has ceased or within one hundred eighty days of its issuance,
27 whichever occurs first.
324.1800. 1. Sections 324.1800 to 324.1865 shall be known and may be cited as
2 the "Dietitian Licensur e Compact".
3 2. The purpose of this Compact is to facilitate interstate Practice of Dietetics
4 with the goal of impro ving public access to dietetics services. This Compact preserves
5 the regu latory authority of States to pr otect public health and safety thr ough the
6 curr ent system of State licensur e, while also pr oviding for licensur e portability thr ough
7 a Compact Privilege granted to qualifying pro fessionals.
8 3. This Compact is designed to achieve the following objectives:
9 (1) Increas e public access to dietetics services;
10 (2) Pr ovide opportunities for interstate practice by Licensed Dietitians who meet
11 uniform req uire ments;
12 (3) Eliminate the necessity for Licenses in multiple States;
13 (4) Reduce administrative burden on Member States and Licensees;
14 (5) Enhance the States' ability to pr otect the public's health and safety;
15 (6) Encourage the cooperation of Member States in regul ating multistate
16 practice of Licensed Dietitians;
17 (7) Support relo cating Active Military Members and their spouses;
18 (8) Enhance the exchange of licensure , investigative, and disciplinary
1 9 information among Member States; and
20 (9) V est all Member States with the authority to hold a Licensed Dietitian
21 accountable for meeting all State practice laws in the State in which the patient is
22 located at the time care is ren dered .
324.1805. As used in this Compact, and except as otherwise pr ovided, the
2 following definitions shall apply:
3 (1) "ACEND" means the Accred itation Council for Education in Nutrition and
4 Dietetics or its successor organization.
5 (2) "Active Military Member" means any individual with full-time duty status in
6 the active armed for ces of the United States, including members of the National Guard
7 and Reserve.
8 (3) "Adverse Action" means any administrative, civil, equitable or criminal
9 action permitted by a State's laws which is imposed by a Licensing Authority or other
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10 authority against a Licensee, including actions against an individual's License or
11 Compact Privilege such as revocation , suspension, pr obation, monitoring of the
12 Licensee, limitation on the Licensee's practice, or any other Encumbrance on licensur e
13 affecting a Licensee's authorization to practice, including issuance of a cease and desist
14 action.
15 (4) "Alternative Pr ogram" means a non-disciplinary monitoring or practice
16 r emediation pro cess appr oved by a Licensing Authority .
17 (5) "Charter Member State" means any Member State which enacted this
18 Compact by law before the Effective Date specified in section 324.1855.
19 (6) "Continuing Education" means a req uire ment, as a condition of License
20 r enewal, to pr ovide evidence of participation in, and completion of, educational and
21 pr ofessional activities releva nt to practice or ar ea of work.
22 (7) "CDR" means the Commission on Dietetic Registration or its successor
23 organization.
24 (8) "Compact Commission" means the government agency whose membership
25 consists of all States that have enacted this Compact, which is known as the Dietitian
26 Licensur e Compact Commission, as described in section 324.1835, and which shall
27 operate as an instrumentality of the Member States.
28 (9) "Compact Privilege" means a legal authorization, which is equivalent to a
29 License, permitting the Practice of Dietetics in a Remote State.
30 (10) "Current Significant Investigative Information" means:
31 (a) Investigative Information that a Licensing Authority , after a pr eliminary
32 inquiry that includes notification and an opportunity for the subject Licensee to
33 r espond, if requi red by State law , has rea son to believe is not gr oundless and, if prov ed
34 true, would indicate mor e than a minor infraction; or
35 (b) Investigative Information that indicates that the subject Licensee rep res ents
36 an immediate thr eat to public health and safety r egardless of whether the subject
37 Licensee has been notified and had an opportunity to res pond.
38 (1 1) "Data System" means a repo sitory of information about Licensees,
39 including, but not limited to, Continuing Education, examination, licensure ,
4 0 investigative, Compact Privilege and Adverse Action information.
41 (12) "Encumber ed License" means a License in which an Adverse Action
42 r estricts a Licensee's ability to practice dietetics.
43 (13) "Encumbrance" means a r evocation or suspension of, or any limitation on a
44 Licensee's full and unr estricted Practice of Dietetics by a Licensing Authority .
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45 (14) "Executive Committee" means a gr oup of delegates elected or appointed to
46 act on behalf of, and within the powers granted to them by , this Compact, and the
47 Compact Commission.
48 (15) "Home State" means the Member State that is the Licensee's primary State
49 of res idence or that has been designated pursuant to section 324.1825.
50 (16) "Investigative Information" means information, record s, and documents
51 r eceived or generated by a Licensing Authority pursuant to an investigation.
52 (17) "Jurisprudence Requirem ent" means an assessment of an individual's
53 knowledge of the State laws and r egulations governing the Practice of Dietetics in such
54 State.
55 (18) "License" means an authorization fr om a Member State to either:
56 (a) Engage in the Practice of Dietetics (including medical nutrition therapy); or
57 (b) Use the title "dietitian," "licensed dietitian," "licensed dietitian nutritionist,"
58 "certified dietitian," or other title describing a substantially similar practitioner as the
59 Compact Commission may further define by Rule.
60 (19) "Licensee" or "Licensed Dietitian" means an individual who curr ently
61 holds a License and who meets all of the requ irem ents outlined in section 324.1815.
62 (20) "Licensing Authority" means the board or agency of a State, or equivalent,
63 that is res ponsible for the licensing and r egulation of the Practice of Dietetics.
64 (21) "Member State" means a State that has enacted the Compact.
65 (22) "Practice of Dietetics" means the synthesis and application of dietetics as
66 defined by state law and regu lations, primarily for the pro vision of nutrition car e
67 services, including medical nutrition therapy , in person or via telehealth, to pr event,
68 manage, or tr eat diseases or medical conditions and pr omote wellness.
69 (23) "Registered Dietitian" means a person who:
70 (a) Has completed applicable education, experience, examination, and
7 1 r ecertification re quir ements appr oved by CDR;
72 (b) Is creden tialed by CDR as a r egistere d dietitian or a registe red dietitian
73 nutritionist; and
74 (c) Is legally authorized to use the title regi stered dietitian or reg istered dietitian
75 nutritionist and the corr esponding abbr eviations "RD" or "RDN."
76 (24) "Remote State" means a Member State other than the Home State, wher e a
77 Licensee is exer cising or seeking to exerci se a Compact Privilege.
78 (25) "Rule" means a regul ation pr omulgated by the Compact Commission that
79 has the for ce of law .
80 (26) "Single State License" means a License issued by a Member State within
81 the issuing State and does not include a Compact Privilege in any other Member State.
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82 (27) "State" means any state, commonwealth, district, or territory of the United
83 States of America.
84 (28) "Unencumber ed License" means a License that authorizes a Licensee to
85 engage in the full and unr estricted Practice of Dietetics.
324.1810. 1. T o participate in the Compact, a State must curre ntly:
2 (1) License and r egulate the Practice of Dietetics; and
3 (2) Have a mechanism in place for receivi ng and investigating complaints about
4 Licensees.
5 2. A Member State shall:
6 (1) Participate fully in the Compact Commission's Data System, including using
7 the unique identifier as defined in Rules;
8 (2) Notify the Compact Commission, in compliance with the terms of the
9 Compact and Rules, of any Adverse Action or the availability of Curren t Significant
10 Investigative Information regard ing a Licensee;
11 (3) Implement or utilize pr ocedur es for considering the criminal history reco rd
12 information of applicants for an initial Compact Privilege. These proced ures shall
13 include the submission of fingerprints or other biometric-based information by
14 applicants for the purpose of obtaining an applicant's criminal history re cord
15 information fr om the Federal Bureau of Investigation and the agency res ponsible for
16 r etaining that State's criminal reco rds;
17 (a) A Member State must fully implement a criminal history reco rd information
18 r equir ement, within a time frame established by Rule, which includes receivi ng the
19 r esults of the Federal Burea u of Investigation r ecord sear ch and shall use those r esults
20 in determining Compact Privilege eligibility .
21 (b) Communication between a Member State and the Compact Commission or
22 among Member States regard ing the verification of eligibility for a Compact Privilege
23 shall not include any information recei ved fr om the Federal Burea u of Investigation
24 r elating to a federal criminal history record information check performed by a Member
25 State;
26 (4) Comply with and enfor ce the Rules of the Compact Commission;
27 (5) Requir e an applicant for a Compact Privilege to obtain or ret ain a License in
28 the Licensee's Home State and meet the Home State's qualifications for licensur e or
29 r enewal of licensur e, as well as all other applicable State laws; and
30 (6) Recognize a Compact Privilege granted to a Licensee who meets all of the
31 r equir ements outlined in section 324.1815 in accordance with the terms of the Compact
32 and Rules.
33 3. Member States may set and collect a fee for granting a Compact Privilege.
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34 4. Individuals not r esiding in a Member State shall continue to be able to apply
35 for a Member State's Single State License as pr ovided under the laws of each Member
36 State. However , the Single State License granted to these individuals shall not be
37 r ecognized as granting a Compact Privilege to engage in the Practice of Dietetics in any
38 other Member State.
39 5. Nothing in this Compact shall affect the r equir ements established by a
40 Member State for the issuance of a Single State License.
41 6. At no point shall the Compact Commission have the power to define the
42 r equir ements for the issuance of a Single State License to practice dietetics. The
43 Member States shall ret ain sole jurisdiction over the pr ovision of these re quir ements.
324.1815. 1. T o exercise the Compact Privilege under the terms and pr ovisions
2 of the Compact, the Licensee shall:
3 (1) Satisfy one of the following:
4 (a) Hold a valid curr ent regi stration that gives the applicant the right to use the
5 term Register ed Dietitian; or
6 (b) Complete all of the following:
7 a. An education pr ogram which is either:
8 (i) A master's degree or doctoral degr ee that is progr ammatically accred ited by:
9 i. ACEND; or
10 ii. A dietetics accr editing agency recog nized by the United States Department of
11 Education, which the Compact Commission may by Rule determine, and fr om a college
12 or university accre dited at the time of graduation by the appr opriate region al
13 accr editing agency recogn ized by the Council on Higher Education Accr editation and
14 the United States Department of Education.
15 (ii) An academic degree fr om a college or university in a for eign country
16 equivalent to the degree described in item (i) that is pr ogrammatically accredi ted by:
17 i. ACEND; or
18 ii. A dietetics accr editing agency recog nized by the United States Department of
19 Education, which the Compact Commission may by Rule determine.
20 b. A planned, documented, supervised practice experience in dietetics that is
21 pr ogrammatically accr edited by:
22 (i) ACEND; or
23 (ii) A dietetics accred iting agency recog nized by the United States Department of
24 Education which the Compact Commission may by Rule determine and which involves
25 at least 1000 hours of practice experience under the supervision of a Register ed Dietitian
26 or a Licensed Dietitian.
27 c. Successful completion of either:
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28 (i) The Registration Examination for Dietitians administer ed by CDR; or
29 (ii) A national cr edentialing examination for dietitians appr oved by the Compact
30 Commission by Rule; such completion being no mor e than five years prior to the date of
31 the Licensee's application for initial licensur e and accompanied by a period of
32 continuous licensur e ther eafter , all of which may be further governed by the Rules of the
33 Compact Commission;
34 (2) Hold an Unencumbered License in the Home State;
35 (3) Notify the Compact Commission that the Licensee is seeking a Compact
36 Privilege within a Remote State or States;
37 (4) Pay any applicable fees, including any State fee, for the Compact Privilege;
38 (5) Meet any Jurisprudence Requirem ents established by the Remote State or
39 States in which the Licensee is seeking a Compact Privilege; and
40 (6) Report to the Compact Commission any Adverse Action, Encumbrance, or
41 r estriction on a License taken by any non-Member State within 30 days fr om the date
42 the action is taken.
43 2. The Compact Privilege is valid until the expiration date of the Home State
44 License. T o maintain a Compact Privilege, r enewal of the Compact Privilege shall be
45 congruent with the ren ewal of the Home State License as the Compact Commission may
46 define by Rule. The Licensee must comply with the req uiremen ts of subsection 1 of this
47 section to maintain the Compact Privilege in the Remote State or States.
48 3. A Licensee exerci sing a Compact Privilege shall adher e to the laws and
49 r egulations of the Remote State. Licensees shall be res ponsible for educating themselves
50 on, and complying with, any and all State laws relat ing to the Practice of Dietetics in
51 such Remote State.
52 4. Notwithstanding anything to the contrary pr ovided in this Compact or State
53 law , a Licensee exer cising a Compact Privilege shall not be r equir ed to complete
54 Continuing Education Requir ements r equir ed by a Remote State. A Licensee exerc ising
55 a Compact Privilege is only requi red to meet any Continuing Education Requireme nts
56 as requ ired by the Home State.
324.1820. 1. A Licensee may hold a Home State License, which allows for a
2 Compact Privilege in other Member States, in only one Member State at a time.
3 2. If a Licensee changes Home State by moving between two Member States:
4 (1) The Licensee shall file an application for obtaining a new Home State License
5 based on a Compact Privilege, pay all applicable fees, and notify the curr ent and new
6 Home State in accordance with the Rules of the Compact Commission.
7 (2) Upon r eceipt of an application for obtaining a new Home State License by
8 virtue of a Compact Privilege, the new Home State shall verify that the Licensee meets
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9 the criteria in section 324.1815 via the Data System, and requi re that the Licensee
10 complete the following:
11 (a) Federal Bureau of Investigation fingerprint based criminal history rec ord
12 information check;
13 (b) Any other criminal history record information r equir ed by the new Home
14 State; and
15 (c) Any Jurisprudence Requirem ents of the new Home State.
16 (3) The former Home State shall convert the former Home State License into a
17 Compact Privilege once the new Home State has activated the new Home State License
18 in accordance with applicable Rules adopted by the Compact Commission.
19 (4) Notwithstanding any other pr ovision of this Compact, if the Licensee cannot
20 meet the criteria in section 324.1815, the new Home State may apply its r equir ements
21 for issuing a new Single State License.
22 (5) The Licensee shall pay all applicable fees to the new Home State in order to
23 be issued a new Home State License.
24 3. If a Licensee changes their State of r esidence by moving fr om a Member State
25 to a non-Member State, or fr om a non-Member State to a Member State, the State
26 criteria shall apply for issuance of a Single State License in the new State.
27 4. Nothing in this Compact shall interfer e with a Licensee's ability to hold a
28 Single State License in multiple States; however , for the purposes of this Compact, a
29 Licensee shall have only one Home State License.
30 5. Nothing in this Compact shall affect the r equir ements established by a
31 Member State for the issuance of a Single State License.
324.1825. An Active Military Member , or their spouse, shall designate a Home
2 State wher e the individual has a curr ent License in good standing. The individual may
3 r etain the Home State designation during the period the service member is on active
4 duty .
324.1830. 1. In addition to the other powers conferred by State law , a Remote
2 State shall have the authority , in accordance with existing State due proce ss law , to:
3 (1) T ake Adverse Action against a Licensee's Compact Privilege within that
4 Member State; and
5 (2) Issue subpoenas for both hearings and investigations that requ ire the
6 attendance and testimony of witnesses as well as the prod uction of evidence. Subpoenas
7 issued by a Licensing Authority in a Member State for the attendance and testimony of
8 witnesses or the pr oduction of evidence from another Member State shall be enforced in
9 the latter State by any court of competent jurisdiction, according to the practice and
10 pr ocedur e applicable to subpoenas issued in pr oceedings pending before that court. The
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11 issuing authority shall pay any witness fees, travel expenses, mileage, and other fees
12 r equir ed by the service statutes of the State in which the witnesses or evidence are
13 located.
14 2. Only the Home State shall have the power to take Adverse Action against a
15 Licensee's Home State License.
16 3. For purposes of taking Adverse Action, the Home State shall give the same
17 priority and effect to reported conduct received fr om a Member State as it would if the
18 conduct had occurr ed within the Home State. In so doing, the Home State shall apply
19 its own State laws to determine appr opriate action.
20 4. The Home State shall complete any pending investigations of a Licensee who
21 changes Home States during the course of the investigations. The Home State shall also
22 have authority to take appr opriate action or actions and shall pr omptly r eport the
23 conclusions of the investigations to the administrator of the Data System. The
24 administrator of the Data System shall pr omptly notify the new Home State of any
25 Adverse Actions.
26 5. A Member State, if otherwise permitted by State law , may reco ver fr om the
27 affected Licensee the costs of investigations and dispositions of cases res ulting fr om any
28 Adverse Action taken against that Licensee.
29 6. A Member State may take Adverse Action based on the factual findings of
30 another Remote State, pro vided that the Member State follows its own proce dures for
31 taking the Adverse Action.
32 7. (1) In addition to the authority granted to a Member State by its res pective
33 State law , any Member State may participate with other Member States in joint
34 investigations of Licensees.
35 (2) Member States shall share any investigative, litigation, or compliance
36 materials in furtherance of any joint investigation initiated under the Compact.
37 8. If Adverse Action is taken by the Home State against a Licensee's Home State
38 License res ulting in an Encumbrance on the Home State License, the Licensee's
39 Compact Privilege or Privileges in all other Member States shall be revok ed until all
40 Encumbrances have been rem oved from the Home State License. All Home State
41 disciplinary orders that impose Adverse Action against a Licensee shall include a
42 statement that the Licensee's Compact Privileges ar e rev oked in all Member States
43 during the pendency of the order .
44 9. Once an Encumber ed License in the Home State is r estor ed to an
45 Unencumber ed License (as certified by the Home State's Licensing Authority), the
46 Licensee must meet the req uirements of subsection 1 of section 324.1815 and follow the
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47 administrative requ irem ents to reapp ly to obtain a Compact Privilege in any Remote
48 State.
49 10. If a Member State takes Adverse Action, it shall pr omptly notify the
50 administrator of the Data System. The administrator of the Data System shall pr omptly
51 notify the other Member States of any Adverse Actions.
52 1 1. Nothing in this Compact shall override a Member State's decision that
53 participation in an Alternative Pr ogram may be used in lieu of Adverse Action.
324.1835. 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 Dietitian Licensur e Compact Commission. The Compact
4 Commission is an instrumentality of the Compact States acting jointly and not an
5 instrumentality of any one State. The Compact Commission shall come into existence
6 on or after the effective date of the Compact as set forth in section 324.1855.
7 2. (1) Each Member State shall have and be limited to one (1) delegate selected
8 by that Member State's Licensing Authority .
9 (2) The delegate shall be the primary administrator of the Licensing Authority
10 or their designee.
11 (3) The Compact Commission shall by Rule or bylaw establish a term of office
12 for delegates and may by Rule or bylaw establish term limits.
13 (4) The Compact Commission may recomm end rem oval or suspension of any
14 delegate fr om office.
15 (5) A Member State's Licensing Authority shall fill any vacancy of its delegate
16 occurring on the Compact Commission within 60 days of the vacancy .
17 (6) Each delegate shall be entitled to one vote on all matters before the Compact
18 Commission requ iring a vote by the delegates.
19 (7) Delegates shall meet and vote by such means as set forth in the bylaws. The
20 bylaws may pr ovide for delegates to meet and vote in-person or by telecommunication,
21 video conferenc e, or other means of communication.
22 (8) The Compact Commission shall meet at least once during each calendar year .
23 Additional meetings may be held as set forth in the bylaws. The Compact Commission
24 may meet in person or by telecommunication, video conferen ce, or other means of
25 communication.
26 3. The Compact Commission shall have the following powers:
27 (1) Establish the fiscal year of the Compact Commission;
28 (2) Establish code of conduct and conflict of interes t policies;
29 (3) Establish and amend Rules and bylaws;
30 (4) Maintain its financial r ecords in accordance with the bylaws;
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31 (5) Meet and take such actions as ar e consistent with the pr ovisions of this
32 Compact, the Compact Commission's Rules, and the bylaws;
33 (6) Initiate and conclude legal pr oceedings or actions in the name of the
34 Compact Commission, prov ided that the standing of any Licensing Authority to sue or
35 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 records of the Compact Commission, and designate an agent
38 to do so on the Compact Commission's behalf;
39 (8) Purchase and maintain insurance and bonds;
40 (9) Borrow , accept, or contract for services of personnel, including, but not
41 limited to, 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 Compact Commission's personnel policies and pr ograms relat ing to
46 conflicts of interes t, qualifications of personnel, and other r elated personnel matters;
47 (12) Assess and collect fees;
48 (13) Accept any and all appr opriate donations, grants of money , other sources of
49 r evenue, equipment, supplies, materials, services, and gifts, and r eceive, utilize, and
50 dispose of the same; pr ovided that at all times the Compact Commission shall avoid any
51 actual or appearance of impr opriety or conflict of interes t;
52 (14) Lease, pur chase, ret ain, own, hold, impr ove, or use any pr operty , r eal,
53 personal, or mixed, or any undivided interes t ther ein;
54 (15) Sell, convey , mortgage, pledge, lease, exchange, abandon, or otherwise
55 dispose of any pr operty real, personal, or mixed;
56 (16) Establish a budget and make expenditur es;
57 (17) Borrow money;
58 (18) Appoint committees, including standing committees, composed of members,
59 State r egulators, State legislators or their re pr esentatives, and consumer
6 0 r epresent atives, and such other interes ted persons as may be designated in this
61 Compact or the bylaws;
62 (19) Pr ovide and r eceive information fr om, and cooperate with, law enforcem ent
63 agencies;
64 (20) Establish and elect an Executive Committee, including a chair and a vice
65 chair;
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66 (21) Determine whether a State's adopted language is materially differ ent fr om
67 the model compact language such that the State would not qualify for participation in
68 the Compact; and
69 (22) Perform such other functions as may be necessary or appr opriate to achieve
70 the purposes of this Compact.
71 4. (1) The Executive Committee shall have the power to act on behalf of the
72 Compact Commission according to the terms of this Compact. The powers, duties, and
73 r esponsibilities of the Executive Committee shall include:
74 (a) Oversee the day-to-day activities of the administration of the Compact
75 including enforcem ent and compliance with the pr ovisions of the Compact, its Rules and
76 bylaws, and other such duties as deemed necessary;
77 (b) Recommend to the Compact Commission changes to the Rules or bylaws,
78 changes to this Compact legislation, fees charged to Compact Member States, fees
79 charged to Licensees, and other fees;
80 (c) Ensur e Compact administration services ar e appr opriately pr ovided,
81 including by contract;
82 (d) Pr epare and rec ommend the budget;
83 (e) Maintain financial r ecords on behalf of the Compact Commission;
84 (f) Monitor Compact compliance of Member States and pro vide compliance
85 r eports to the Compact Commission;
86 (g) Establish additional committees as necessary;
87 (h) Exer cise the powers and duties of the Compact Commission during the
88 interim between Compact Commission meetings, except for adopting or amending
89 Rules, adopting or amending bylaws, and exerci sing any other powers and duties
90 expr essly r eserved to the Compact Commission by Rule or bylaw; and
91 (i) Other duties as prov ided in the Rules or bylaws of the Compact Commission.
92 (2) The Executive Committee shall be composed of nine members:
93 (a) The chair and vice chair of the Compact Commission shall be voting
94 members of the Executive Committee;
95 (b) Five voting members fr om the curren t membership of the Compact
96 Commission, elected by the Compact Commission;
97 (c) One ex-officio, nonvoting member fr om a r ecognized profession al association
98 r epresent ing dietitians; and
99 (d) One ex-officio, nonvoting member fr om a re cognized national cr edentialing
100 organization for dietitians.
101 (3) The Compact Commission may r emove any member of the Executive
102 Committee as pr ovided in the Compact Commission's bylaws.
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103 (4) (a) The Executive Committee shall meet at least annually .
104 (b) Executive Committee meetings shall be open to the public, except that the
105 Executive Committee may meet in a closed, non-public meeting as pr ovided in
106 subdivision (2) of subsection 6 of this section.
107 (c) The Executive Committee shall give 30 days' notice of its meetings, posted on
108 the website of the Compact Commission and as determined to pr ovide notice to persons
109 with an interes t in the business of the Compact Commission.
110 (d) The Executive Committee may hold a special meeting in accordance with
111 paragraph (c) of subdivision (1) of subsection 6 of this section.
112 5. The Compact Commission shall adopt and pro vide to the Member States an
113 annual r eport.
114 6. (1) (a) All meetings shall be open to the public, except that the Compact
115 Commission may meet in a closed, non-public meeting as pr ovided in subdivision (2) of
116 this subsection.
117 (b) Public notice for all meetings of the full Compact Commission shall be given
118 in the same manner as requi red under the rulemaking pr ovisions in section 324.1845,
119 except that the Compact Commission may hold a special meeting as prov ided in
120 paragraph (c) of this subdivision.
121 (c) The Compact Commission may hold a special meeting when it must meet to
122 conduct emergency business by giving 24 hours' notice to all Member States, on the
123 Compact Commission's website, and other means as pro vided in the Compact
124 Commission's Rules. The Compact Commission's legal counsel shall certify that the
125 Compact Commission's need to meet qualifies as an emergency .
126 (2) The Compact Commission or the Executive Committee or other committees
127 of the Compact Commission may convene in a closed, non-public meeting for the
128 Compact Commission or Executive Committee or other committees of the Compact
129 Commission to receiv e legal advice or to discuss:
130 (a) Non-compliance of a Member State with its obligations under the Compact;
131 (b) The employment, compensation, discipline, or other matters, practices, or
132 pr ocedur es r elated to specific employees;
133 (c) Curr ent or thr eatened discipline of a Licensee by the Compact Commission
134 or by a Member State's Licensing Authority;
135 (d) Curre nt, thr eatened, or reas onably anticipated litigation;
136 (e) Negotiation of contracts for the pur chase, lease, or sale of goods, services, or
137 r eal estate;
138 (f) Accusing any person of a crime or formally censuring any person;
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139 (g) T rade secr ets or commer cial or financial information that is privileged or
140 confidential;
141 (h) Information of a personal natur e wher e disclosure would constitute a clearly
142 unwarranted invasion of personal privacy;
143 (i) Investigative record s compiled for law enfor cement purposes;
144 (j) Information r elated to any investigative repo rts prepa red by or on behalf of
145 or for use of the Compact Commission or other committee charged with res ponsibility
146 of investigation or determination of compliance issues pursuant to the Compact;
147 (k) Matters specifically exempted fr om disclosur e by federal or Member State
148 law; or
149 (l) Other matters as specified in the Rules of the Compact Commission.
150 (3) If a meeting, or portion of a meeting, is closed, the pr esiding officer shall state
151 that the meeting will be closed and ref eren ce each relev ant exempting provi sion, and
152 such re feren ce shall be recor ded in the minutes.
153 (4) The Compact Commission shall keep minutes that fully and clearly describe
154 all matters discussed in a meeting and shall prov ide a full and accurate summary of
155 actions taken, and the reas ons ther efor , including a description of the views expr essed.
156 All documents consider ed in connection with an action shall be identified in such
157 minutes. All minutes and documents of a closed meeting shall r emain under seal,
158 subject to r elease only by a majority vote of the Compact Commission or order of a
159 court of competent jurisdiction.
160 7. (1) The Compact Commission shall pay , or provi de for the payment of, the
161 r easonable expenses of its establishment, organization, and ongoing activities.
162 (2) The Compact Commission may accept any and all appr opriate reven ue
163 sour ces as pr ovided in subdivision (13) of subsection 3 of this section.
164 (3) The Compact Commission may levy on and collect an annual assessment
165 fr om each Member State and impose fees on Licensees of Member States to whom it
166 grants a Compact Privilege to cover the cost of the operations and activities of the
167 Compact Commission and its staff, which must, in a total amount, be sufficient to cover
168 its annual budget as appr oved each year for which revenu e is not prov ided by other
169 sour ces. The aggr egate annual assessment amount for Member States shall be allocated
170 based upon a formula that the Compact Commission shall promul gate by Rule.
171 (4) The Compact Commission shall not incur obligations of any kind prior to
172 securing the funds adequate to meet the same; nor shall the Compact Commission
173 pledge the cr edit of any of the Member States, except by and with the authority of the
174 Member State.
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175 (5) The Compact Commission shall keep accurate accounts of all recei pts and
176 disbursements. The r eceipts and disbursements of the Compact Commission shall be
177 subject to the financial rev iew and accounting proce dures established under its bylaws.
178 However , all receip ts and disbursements of funds handled by the Compact Commission
179 shall be subject to an annual financial review by a certified or licensed public
180 accountant, and the r eport of the financial revi ew shall be included in and become part
181 of the annual repo rt of the Compact Commission.
182 8. (1) The members, officers, executive director , employees and repr esentatives
183 of the Compact Commission shall be immune fr om suit and liability , both personally
184 and in their official capacity , for any claim for damage to or loss of pro perty or personal
185 injury or other civil liability caused by or arising out of any actual or alleged act, error ,
186 or omission that occurr ed, or that the person against whom the claim is made had a
187 r easonable basis for believing occurr ed within the scope of Compact Commission
188 employment, duties, or r esponsibilities; pr ovided that nothing in this subdivision shall
189 be construed to protect any such person fr om suit or liability for any damage, loss,
190 injury , or liability caused by the intentional or willful or wanton misconduct of that
191 person. The pr ocure ment of insurance of any type by the Compact Commission shall
192 not in any way compromis e or limit the immunity granted her eunder .
193 (2) The Compact Commission shall defend any member , officer , executive
194 dir ector , employee, and r epresent ative of the Compact Commission in any civil action
195 seeking to impose liability arising out of any actual or alleged act, error , or omission that
196 occurr ed within the scope of Compact Commission employment, duties, or
1 9 7 r esponsibilities, or as determined by the Compact Commission that the person
198 against whom the claim is made had a rea sonable basis for believing occurr ed within the
199 scope of Compact Commission employment, duties, or r esponsibilities; pr ovided that
200 nothing her ein shall be construed to pro hibit that person fr om ret aining their own
201 counsel at their own expense; and pr ovided further , that the actual or alleged act, error ,
202 or omission did not res ult fr om that person's intentional or willful or wanton
203 misconduct.
204 (3) The Compact Commission shall indemnify and hold harmless any member ,
205 officer , executive dir ector , employee, and repr esentative of the Compact Commission for
206 the amount of any settlement or judgment obtained against that person arising out of
207 any actual or alleged act, erro r , or omission that occurr ed within the scope of Compact
208 Commission employment, duties, or r esponsibilities, or that such person had a
209 r easonable basis for believing occurr ed within the scope of Compact Commission
210 employment, duties, or r esponsibilities, pro vided that the actual or alleged act, error , or
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211 omission did not r esult fr om the intentional or willful or wanton misconduct of that
212 person.
213 (4) Nothing herei n shall be construed as a limitation on the liability of any
214 Licensee for profes sional malpractice or misconduct, which shall be governed solely by
215 any other applicable State laws.
216 (5) Nothing in this Compact shall be interpr eted to waive or otherwise abr ogate
217 a Member State's state action immunity or state action affirmative defense with res pect
218 to antitrust claims under the Sherman Act, Clayton Act, or any other State or federal
219 antitrust or anticompetitive law or regu lation.
220 (6) Nothing in this Compact shall be construed to be a waiver of soverei gn
221 immunity by the Member States or by the Compact Commission.
324.1840. 1. The Compact Commission shall prov ide for the development,
2 maintenance, operation, and utilization of a coordinated Data System.
3 2. The Compact Commission shall assign each applicant for a Compact Privilege
4 a unique identifier , as determined by the Rules.
5 3. Notwithstanding any other pro vision of State law to the contrary , a Member
6 State shall submit a uniform data set to the Data System on all individuals to whom this
7 Compact is applicable as r equir ed by the Rules of the Compact Commission, including:
8 (1) Identifying information;
9 (2) Licensure data;
10 (3) Adverse Actions against a License or Compact Privilege and information
11 r elated ther eto;
12 (4) Non-confidential information rel ated to Alternative Pr ogram participation,
13 the beginning and ending dates of such participation, and other information rel ated to
14 such participation not made confidential under Member State law;
15 (5) Any denial of application for licensur e, and the reas on or rea sons for such
16 denial;
17 (6) The pr esence of Curr ent Significant Investigative Information; and
18 (7) Other information that may facilitate the administration of this Compact or
19 the pro tection of the public, as determined by the Rules of the Compact Commission.
20 4. The r ecords and information pr ovided to a Member State pursuant to this
21 Compact or thr ough the Data System, when certified by the Compact Commission or an
22 agent ther eof, shall constitute the authenticated business rec ords of the Compact
23 Commission, and shall be entitled to any associated hearsay exception in any r elevant
24 judicial, quasi-judicial, or administrative proceed ings in a Member State.
25 5. Curren t Significant Investigative Information pertaining to a Licensee in any
26 Member State will only be available to other Member States.
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27 6. It is the res ponsibility of the Member States to re port any Adverse Action
28 against a Licensee and to monitor the Data System to determine whether any Adverse
29 Action has been taken against a Licensee. Adverse Action information pertaining to a
30 Licensee in any Member State will be available to any other Member State.
31 7. Member States contributing information to the Data System may designate
32 information that may not be shared with the public without the express permission of
33 the contributing State.
34 8. Any information submitted to the Data System that is subsequently expunged
35 pursuant to federal law or the laws of the Member State contributing the information
36 shall be re moved fr om the Data System.
324.1845. 1. The Compact Commission shall pr omulgate rea sonable Rules in
2 order to effectively and efficiently implement and administer the purposes and
3 pr ovisions of the Compact. A Rule shall be invalid and have no for ce or effect only if a
4 court of competent jurisdiction holds that the Rule is invalid because the Compact
5 Commission exercised its rulemaking authority in a manner that is beyond the scope
6 and purposes of the Compact, or the powers granted hereunder , or based upon another
7 applicable standard of revie w .
8 2. The Rules of the Compact Commission shall have the for ce of law in each
9 Member State, pr ovided however that where the Rules conflict with the laws or
10 r egulations of a Member State that relat e to the pr ocedur es, actions, and proce sses a
11 Licensed Dietitian is permitted to undertake in that State and the cir cumstances under
12 which they may do so, as held by a court of competent jurisdiction, the Rules of the
13 Compact Commission shall be ineffective in that State to the extent of the conflict.
14 3. The Compact Commission shall exercise its rulemaking powers pursuant to
15 the criteria set forth in this Section and the Rules adopted ther eunder . Rules shall
16 become binding on the day following adoption or as of the date specified in the Rule or
17 amendment, whichever is later .
18 4. If a majority of the legislatur es of the Member States rej ects a Rule or portion
19 of a Rule, by enactment of a statute or res olution in the same manner used to adopt the
20 Compact within four (4) years of the date of adoption of the Rule, then such Rule shall
21 have no further for ce and effect in any Member State.
22 5. Rules shall be adopted at a reg ular or special meeting of the Compact
23 Commission.
24 6. Prior to adoption of a pr oposed Rule, the Compact Commission shall hold a
25 public hearing and allow persons to prov ide oral and written comments, data, facts,
26 opinions, and arguments.
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27 7. Prior to adoption of a pr oposed Rule by the Compact Commission, and at
28 least thirty (30) days in advance of the meeting at which the Compact Commission will
29 hold a public hearing on the pr oposed Rule, the Compact Commission shall pro vide a
30 Notice of Pr oposed rulemaking:
31 (1) On the website of the Compact Commission or other publicly accessible
32 platform;
33 (2) T o persons who have req uested notice of the Compact Commission's notices
34 of prop osed rulemaking; and
35 (3) In such other way or ways as the Compact Commission may by Rule specify .
36 8. The Notice of Pr oposed rulemaking shall include:
37 (1) The time, date, and location of the public hearing at which the Compact
38 Commission will hear public comments on the pro posed Rule and, if differe nt, the time,
39 date, and location of the meeting wher e the Compact Commission will consider and vote
40 on the prop osed Rule;
41 (2) If the hearing is held via telecommunication, video conference, or other
42 means of communication, the Compact Commission shall include the mechanism for
43 access to the hearing in the Notice of Pr oposed rulemaking;
44 (3) The text of the pr oposed Rule and the reas on ther efor;
45 (4) A requ est for comments on the pr oposed Rule fr om any interes ted person;
46 and
47 (5) The manner in which interes ted persons may submit written comments.
48 9. All hearings will be r ecorded. A copy of the recor ding and all written
49 comments and documents receiv ed by the Compact Commission in res ponse to the
50 pr oposed Rule shall be available to the public.
51 10. Nothing in this Section shall be construed as r equiring a separate hearing on
52 each Rule. Rules may be gr ouped for the convenience of the Compact Commission at
53 hearings requ ired by this Section.
54 1 1. (1) The Compact Commission shall, by majority vote of all members, take
55 final action on the prop osed Rule based on the rulemaking r ecord and the full text of the
56 Rule.
57 (2) The Compact Commission may adopt changes to the pr oposed Rule pr ovided
58 the changes do not enlarge the original purpose of the pr oposed Rule.
59 (3) The Compact Commission shall prov ide an explanation of the reas ons for
60 substantive changes made to the prop osed Rule as well as reas ons for substantive
61 changes not made that were recommended by commenters.
62 (4) The Compact Commission shall determine a reas onable effective date for the
63 Rule. Except for an emergency as pro vided in subsection 12 of this section, the effective
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64 date of the Rule shall be no sooner than 30 days after issuing the notice that it adopted
65 or amended the Rule.
66 12. Upon determination that an emergency exists, the Compact Commission
67 may consider and adopt an emergency Rule with 24 hours' notice, with opportunity to
68 comment, pr ovided that the usual rulemaking pr ocedur es pro vided in the Compact and
69 in this Section shall be retr oactively applied to the Rule as soon as reas onably possible,
70 in no event later than ninety (90) days after the effective date of the Rule. For the
71 purposes of this pro vision, an emergency Rule is one that must be adopted immediately
72 in order to:
73 (1) Meet an imminent thr eat to public health, safety , or welfare;
74 (2) Pr event a loss of Compact Commission or Member State funds;
75 (3) Meet a deadline for the pr omulgation of a Rule that is established by federal
76 law or rule; or
77 (4) Pr otect public health and safety .
78 13. The Compact Commission or an authorized committee of the Compact
79 Commission may dir ect r evision to a pr eviously adopted Rule for purposes of corr ecting
80 typographical erro rs, err ors in format, erro rs in consistency , or grammatical errors.
81 Public notice of any revision shall be posted on the website of the Compact Commission.
82 The revision shall be subject to challenge by any person for a period of thirty (30) days
83 after posting. The revision may be challenged only on grou nds that the rev ision r esults
84 in a material change to a Rule. A challenge shall be made in writing and deliver ed to the
85 Compact Commission prior to the end of the notice period. If no challenge is made, the
86 r evision will take effect without further action. If the r evision is challenged, the rev ision
87 may not take effect without the appr oval of the Compact Commission.
88 14. No Member State's rulemaking requ irem ents shall apply under this
89 Compact.
324.1850. 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 this Compact.
4 (2) Except as otherwise pr ovided in this Compact, venue is pro per and judicial
5 pr oceedings by or against the Compact Commission shall be brou ght solely and
6 exclusively in a court of competent jurisdiction wher e the principal office of the
7 Compact Commission is located. The Compact Commission may waive venue and
8 jurisdictional defenses to the extent it adopts or consents to participate in alternative
9 dispute reso lution pr oceedings. Nothing herei n shall affect or limit the selection or
10 pr opriety of venue in any action against a Licensee for profes sional malpractice,
11 misconduct, or any such similar matter .
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12 (3) The Compact Commission shall be entitled to r eceive service of pro cess in
13 any proceed ing rega rding the enfor cement or interpr etation of the Compact and shall
14 have standing to intervene in such a pro ceeding for all purposes. Failur e to pr ovide the
15 Compact Commission service of pr ocess shall rend er a judgment or order void as to the
16 Compact Commission, this Compact, or promulg ated Rules.
17 2. (1) If the Compact Commission determines that a Member State has
18 defaulted in the performance of its obligations or res ponsibilities under this Compact or
19 the pro mulgated Rules, the Compact Commission shall pro vide written notice to the
20 defaulting State. The notice of default shall describe the default, the pr oposed means of
21 curing the default, and any other action that the Compact Commission may take and
22 shall offer training and specific technical assistance reg arding the default.
23 (2) The Compact Commission shall pr ovide a copy of the notice of default to the
24 other Member States.
25 3. If a State in default fails to cur e the default, the defaulting State may be
26 terminated fro m the Compact upon an affirmative vote of a majority of the delegates of
27 the Member States, and all rights, privileges, and benefits conferr ed on that State by
28 this Compact may be terminated on the effective date of termination. A cur e of the
29 default does not reliev e the offending State of obligations or liabilities incurr ed during
30 the period of default.
31 4. T ermination of membership in the Compact shall be imposed only after all
32 other means of securing compliance have been exhausted. Notice of intent to suspend or
33 terminate shall be given by the Compact Commission to the governor , the majority and
34 minority leaders of the defaulting State's legislature, the defaulting State's Licensing
35 Authority , and each of the Member States' Licensing Authority .
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.
39 6. Upon the termination of a State's membership fr om this Compact, that State
40 shall immediately pr ovide notice to all Licensees within that State of such termination.
41 The terminated State shall continue to recog nize all Compact Privileges granted
42 pursuant to this Compact for a minimum of six months after the date of said notice of
43 termination.
44 7. The Compact Commission shall not bear any costs r elated to a State that is
45 found to be in default or that has been terminated fr om the Compact, unless agr eed
46 upon in writing between the Compact Commission and the defaulting State.
47 8. The defaulting State may appeal the action of the Compact Commission by
48 petitioning the U.S. District Court for the District of Columbia or the federal district
HCS SB 1092 25
49 wher e the Compact Commission has its principal offices. The pr evailing party shall be
50 awarded all costs of such litigation, including reas onable attorney's fees.
51 9. (1) Upon requ est by a Member State, the Compact Commission shall attempt
52 to res olve disputes r elated to the Compact that arise among Member States and between
53 Member and non-Member States.
54 (2) The Compact Commission shall promulg ate a Rule pro viding for both
55 mediation and binding dispute r esolution for disputes as appr opriate.
56 10. (1) By supermajority vote, the Compact Commission may initiate legal
57 action against a Member State in default in the United States District Court for the
58 District of Columbia or the federal district wher e the Compact Commission has its
59 principal offices to enforce compliance with the pr ovisions of the Compact and its
60 pr omulgated Rules. The rel ief sought may include both injunctive re lief and damages.
61 In the event judicial enforcem ent is necessary , the pr evailing party shall be awarded all
62 costs of such litigation, including reas onable attorney's fees. The rem edies herei n shall
63 not be the exclusive rem edies of the Compact Commission. The Compact Commission
64 may pursue any other rem edies available under federal or the defaulting Member
65 State's law .
66 (2) A Member State may initiate legal action against the Compact Commission
67 in the U.S. District Court for the District of Columbia or the federal district where the
68 Compact Commission has its principal offices to enfor ce compliance with the pr ovisions
69 of the Compact and its pro mulgated Rules. The relie f sought may include both
70 injunctive reli ef and damages. In the event judicial enforcem ent is necessary , the
71 pr evailing party shall be awarded all costs of such litigation, including reas onable
72 attorney's fees.
73 (3) No party other than a Member State shall enfor ce this Compact against the
74 Compact Commission.
324.1855. 1. (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.
3 (2) (a) On or after the effective date of the Compact, the Compact Commission
4 shall convene and review the enactment of each of the first seven Member States
5 ("Charter Member States") to determine if the statute enacted by each such Charter
6 Member State is materially differ ent than the model Compact statute.
7 (b) A Charter Member State whose enactment is found to be materially differ ent
8 fr om the model Compact statute shall be entitled to the default process set forth in
9 section 324.1850.
10 (c) If any Member State is later found to be in default, or is terminated, or
11 withdraws fr om the Compact, the Compact Commission shall r emain in existence and
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12 the Compact shall rem ain in effect even if the number of Member States should be less
13 than seven.
14 (3) Member States enacting the Compact subsequent to the seven initial Charter
15 Member States shall be subject to the pro cess set forth in subdivision (21) of subsection
16 3 of section 324.1835 to determine if their enactments are materially differ ent fr om the
17 model Compact statute and whether they qualify for participation in the Compact.
18 (4) All actions taken for the benefit of the Compact Commission or in
19 furtherance of the purposes of the administration of the Compact prior to the effective
20 date of the Compact or the Compact Commission coming into existence shall be
21 consider ed to be actions of the Compact Commission unless specifically rep udiated by
22 the Compact Commission.
23 (5) Any State that joins the Compact subsequent to the Compact Commission's
24 initial adoption of the Rules and bylaws shall be subject to the Rules and bylaws as they
25 exist on the date on which the Compact becomes law in that State. Any Rule that has
26 been pr eviously adopted by the Compact Commission shall have the full for ce and effect
27 of law on the day the Compact becomes law in that State.
28 2. (1) Any Member State may withdraw fr om this Compact by enacting a
29 statute repeal ing the same.
30 (2) A Member State's withdrawal shall not take effect until 180 days after
31 enactment of the rep ealing statute.
32 (3) Withdra wal shall not affect the continuing r equir ement of the withdrawing
33 State's Licensing Authority to comply with the investigative and Adverse Action
34 r eporting req uirements of this Compact prior to the effective date of withdrawal.
35 (4) Upon the enactment of a statute withdrawing fr om this Compact, a State
36 shall immediately provi de notice of such withdrawal to all Licensees within that State.
37 Notwithstanding any subsequent statutory enactment to the contrary , such withdrawing
38 State shall continue to recog nize all Compact Privileges granted pursuant to this
39 Compact for a minimum of 180 days after the date of such notice of withdrawal.
40 3. Nothing contained in this Compact shall be construed to invalidate or pr event
41 any licensur e agr eement or other cooperative arrangement between a Member State
42 and a non-Member State that does not conflict with the provi sions of this Compact.
43 4. This Compact may be amended by the Member States. No amendment to this
44 Compact shall become effective and binding upon any Member State until it is enacted
45 into the laws of all Member States.
324.1860. 1. This Compact and the Compact Commission's rulemaking
2 authority shall be liberally construed so as to effectuate the purposes and the
3 implementation and administration of the Compact. Pr ovisions of the Compact
HCS SB 1092 27
4 expr essly authorizing or req uiring the pr omulgation of Rules shall not be construed to
5 limit the Compact Commission's 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 prov ision 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 cir cumstance 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 Compact Commission may
14 deny a State's participation in the Compact or , in accordance with the r equir ements of
15 subsection 2 of section 324.1850, terminate a Member State's participation in the
16 Compact, if it determines that a constitutional r equir ement of a Member State is a
17 material departure fro m the Compact. Otherwise, if this Compact shall be held to be
18 contrary to the constitution of any Member State, the Compact shall r emain in full for ce
19 and effect as to the r emaining Member States and in full for ce and effect as to the
20 Member State affected as to all severable matters.
324.1865. 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.
5 3. All permissible agreements between the Compact Commission and the
6 Member States are binding in accordance with their terms.
332.081. 1. Notwithstanding any other provision of law to the contrary , hospitals
2 licensed under chapter 197 shall be authorized to employ any or all of the following oral
3 health providers:
4 (1) A dentist licensed under this chapter for the purpose of treating on hospital
5 premises those patients who present with a dental condition and such treatment is necessary to
6 ameliorate the condition for which they presented such as severe pain or tooth abscesses;
7 (2) An oral and maxillofacial surgeo n licensed under this chapter for the purpose of
8 treating oral conditions that need to be ameliorated as part of treating the underlying cause of
9 the patient's medical needs including, but not limited to, head and neck cancer , HIV or AIDS,
10 severe trauma resulting in admission to the hospital, or gan transplant, diabetes, or seizure
11 disorders. It shall be a condition of treatment that such patients are admitted to the hospital on
12 either an in- or out-patient basis; and
13 (3) A maxillofacial prosthodontist licensed under this chapter for the purpose of
14 treating and supporting patients of a head and neck cancer team or other complex care or
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15 sur gical team for the fabrication of appliances following ablative sur gery , surgery to correct
16 birth anomalies, extensive radiation treatment of the head or neck, or trauma-related sur gery .
17 2. No person or other entity shall practice dentistry in Missouri or provide dental
18 services as [ defined ] described in section 332.071 unless and until the board has issued to the
19 person a certificate certifying that the person has been duly registered as a dentist in Missouri
20 or the board has issued such certificate to an entity that has been duly registered to provide
21 dental services by licensed dentists and dental hygienists and unless and until the board has
22 issued to the person a license, to be renewed each period, as provided in this chapter , to
23 practice dentistry or as a dental hygienist, or has issued to the person or entity a permit, to be
24 renewed each period, to provide dental services in Missouri. Nothing in this chapter shall be
25 so construed as to make it unlawful for:
26 (1) A legally qualified physician or surge on, who does not practice dentistry as a
27 specialty , from extracting teeth;
28 (2) A dentist licensed in a state other than Missouri from making a clinical
29 demonstration before a meeting of dentists in Missouri;
30 (3) Dental students in any accredited dental school to practice dentistry under the
31 personal direction of instructors;
32 (4) Dental hygiene students in any accredited dental hygiene school to practice dental
33 hygiene under the personal direction of instructors;
34 (5) A duly registered and licensed dental hygienist in Missouri to practice dental
35 hygiene as defined in section 332.091;
36 (6) A dental assistant, certified dental assistant, or expanded functions dental assistant
37 to be delegated duties as defined in section 332.093;
38 (7) A duly registered dentist or dental hygienist to teach in an accredited dental or
39 dental hygiene school;
40 (8) A person who has been granted a dental faculty permit under section 332.183 to
41 practice dentistry in the scope of his or her employment at an accredited dental school,
42 college, or program in Missouri;
43 (9) A duly qualified anesthesiologist or nurse anesthetist to administer an anesthetic
44 in connection with dental services or dental surgery;
45 (10) A person to practice dentistry in or for:
46 (a) The United States Armed Forces;
47 (b) The United States Public Health Service;
48 (c) Migrant, community , or health care for the homeless health centers provided in
49 Section 330 of the Public Health Service Act (42 U.S.C. Section 254b);
50 (d) Federally qualified health centers as defined in Section 1905(l) (42 U.S.C. Section
51 1396d(l)) of the Social Security Act;
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52 (e) Governmental entities, including county health departments; or
53 (f) The United States V eterans Bureau; or
54 (1 1) A dentist licensed in a state other than Missouri to evaluate a patient or render an
55 oral, written, or otherwise documented dental opinion when providing testimony or records
56 for the purpose of a civil or criminal action before any judicial or administrative proceeding
57 of this state or other forum in this state.
58 3. No corporation shall practice dentistry as defined in section 332.071 unless that
59 corporation is or ganized under the provisions of chapter 355 or 356 provided that a
60 corporation org anized under the provisions of chapter 355 and qualifying as an or ganization
61 under 26 U.S.C. Section 501(c)(3) may only employ dentists and dental hygienists licensed in
62 this state to render dental services to Medicaid recipients, low-income individuals who have
63 available income below two hundred percent of the federal poverty level, and all participants
64 in the SCHIP program, unless such limitation is contrary to or inconsistent with federal or
65 state law or regulation. This subsection shall not apply to:
66 (1) A hospital licensed under chapter 197 that provides care and treatment only to
67 children under the age of eighteen at which a person regulated under this chapter provides
68 dental care within the scope of his or her license or registration;
69 (2) A federally qualified health center as defined in Section 1905(l) of the Social
70 Security Act (42 U.S.C. Section 1396d(l)), or a migrant, community , or health care for the
71 homeless health center provided for in Section 330 of the Public Health Services Act (42
72 U.S.C. Section 254b) at which a person regulated under this chapter provides dental care
73 within the scope of his or her license or registration;
74 (3) A city or county health department or ganized under chapter 192 or chapter 205 at
75 which a person regulated under this chapter provides dental care within the scope of his or her
76 license or registration;
77 (4) A social welfare board or ganized under section 205.770, a city health department
78 operating under a city charter , or a city-county health department at which a person regulated
79 under this chapter provides dental care within the scope of his or her license or registration;
80 (5) Any entity that has received a permit from the dental board and does not receive
81 compensation from the patient or from any third party on the patient's behalf at which a
82 person regulated under this chapter provides dental care within the scope of his or her license
83 or registration; or
84 (6) Any hospital nonprofit corporation exempt from taxation under Section 501(c)(3)
85 of the Internal Revenue Code, as amended, that engages in its operations and provides dental
86 services at facilities owned by a city , county , or other political subdivision of the state , or any
87 entity contracted with the state to pr ovide car e in a corr ectional center , as such term is
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88 defined in section 217.010, at which a person regulated under this chapter provides dental
89 care within the scope of his or her license or registration.
90
91 If any of the entities exempted from the requirements of this subsection are unable to provide
92 services to a patient due to the lack of a qualified provider and a referral to another entity is
93 made, the exemption shall extend to the person or entity that subsequently provides services
94 to the patient.
95 4. No unincorporated or ganization shall practice dentistry as defined in section
96 332.071 unless such org anization is exempt from federal taxation under Section 501(c)(3) of
97 the Internal Revenue Code of 1986, as amended, and provides dental treatment without
98 compensation from the patient or any third party on their behalf as a part of a broader
99 program of social services including food distribution. Nothing in this chapter shall prohibit
100 or ganizations under this subsection from employing any person regulated by this chapter .
101 5. A dentist shall not enter into a contract that allows a person who is not a dentist to
102 influence or interfere with the exercise of the dentist's independent professional judgment.
103 6. A not-for- profit corporation or ganized under the provisions of chapter 355 and
104 qualifying as an or ganization under 26 U.S.C. Section 501(c)(3), an unincorporated
105 or ganization operating pursuant to subsection 4 of this section, or any other person should not
106 direct or interfere or attempt to direct or interfere with a licensed dentist's professional
107 judgment and competent practice of dentistry . Nothing in this subsection shall be so
108 construed as to make it unlawful for not-for -profit or ganizations to enforce employment
109 contracts, corporate policy and procedure manuals, or quality improvement or assurance
110 requirements.
111 7. All entities defined in subsection 3 of this section and those exempted under
112 subsection 4 of this section shall apply for a permit to employ dentists and dental hygienists
113 licensed in this state to render dental services, and the entity shall apply for the permit in
114 writing on forms provided by the Missouri dental board. The board shall not char ge a fee of
115 any kind for the issuance or renewal of such permit. The provisions of this subsection shall
116 not apply to a federally qualified health center as defined in Section 1905(l) of the Social
117 Security Act (42 U.S.C. Section 1396d(l)).
118 8. Any entity that obtains a permit to render dental services in this state is subject to
119 discipline pursuant to section 332.321. If the board concludes that the person or entity has
120 committed an act or is engaging in a course of conduct that would be grounds for disciplinary
121 action, the board may file a complaint before the administrative hearing commission. The
122 board may refuse to issue or renew the permit of any entity for one or any combination of
123 causes stated in subsection 2 of section 332.321. The board shall notify the applicant in
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124 writing of the reasons for the refusal and shall advise the applicant of his or her right to file a
125 complaint with the administrative hearing commission as provided by chapter 621.
126 9. A federally qualified health center as defined in Section 1905(l) of the Social
127 Security Act (42 U.S.C. Section 1396d(l)) shall register with the board. The information
128 provided to the board as part of the registration shall include the name of the health center , the
129 nonprofit status of the health center , sites where dental services will be provided, and the
130 names of all persons employed by , or contracting with, the health center who are required to
131 hold a license pursuant to this chapter . The registration shall be renewed every twenty-four
132 months. The board shall not char ge a fee of any kind for the issuance or renewal of the
133 registration. The registration of the health center shall not be subject to discipline pursuant to
134 section 332.321. Nothing in this subsection shall prohibit disciplinary action against a
135 licensee of this chapter who is employed by , or contracts with, such health center for the
136 actions of the licensee in connection with such employment or contract.
137 10. The board may promulgate rules and regulations to ensure not-for -profit
138 corporations are rendering care to the patient populations as set forth herein, including
139 requirements for covered not-for -profit corporations to report patient census data to the board.
140 The provisions of this subsection shall not apply to a federally qualified health center as
141 defined in Section 1905(l) of the Social Security Act (42 U.S.C. Section 1396d(l)).
142 1 1. All not-for-p rofit corporations or ganized or operated pursuant to the provisions of
143 chapter 355 and qualifying as an or ganization under 26 U.S.C. Section 501(c)(3), or the
144 requirements relating to migrant, community , or health care for the homeless health centers
145 provided in Section 330 of the Public Health Service Act (42 U.S.C. Section 254b) and
146 federally qualified health centers as defined in Section 1905(l) (42 U.S.C. Section 1396d(l))
147 of the Social Security Act, that employ persons who practice dentistry or dental hygiene in
148 this state shall do so in accordance with the relevant laws of this state except to the extent that
149 such laws are contrary to, or inconsistent with, federal statute or regulation.
332.700. Sections 332.700 to 332.760 shall be known and cited as the Dentist and
2 Dental Hygienist Compact. The purposes of this Compact ar e to facilitate the interstate
3 practice of dentistry and dental hygiene and impro ve public access to dentistry and
4 dental hygiene services by pr oviding Dentists and Dental Hygienists licensed in a
5 Participating State the ability to practice in Participating States in which they ar e not
6 licensed. The Compact does this by establishing a pathway for Dentists and Dental
7 Hygienists licensed in a Participating State to obtain a Compact Privilege that
8 authorizes them to practice in another Participating State in which they are not licensed.
9 The Compact enables Participating States to pr otect the public health and safety with
10 r espect to the practice of such Dentists and Dental Hygienists, thr ough the State's
HCS SB 1092 32
11 authority to re gulate the practice of dentistry and dental hygiene in the State. The
12 Compact:
13 (1) Enables Dentists and Dental Hygienists who qualify for a Compact Privilege
14 to practice in other Participating States without satisfying burdensome and duplicative
15 r equir ements associated with securing a License to practice in those States;
16 (2) Pr omotes mobility and addresse s workfor ce shortages thr ough each
17 Participating State's acceptance of a Compact Privilege to practice in that State;
18 (3) Increas es public access to qualified, licensed Dentists and Dental Hygienists
19 by creat ing a res ponsible, str eamlined pathway for Licensees to practice in Participating
20 States;
21 (4) Enhances the ability of Participating States to protect the public's health and
22 safety;
23 (5) Does not interfer e with licensur e requ irem ents established by a Participating
24 State;
25 (6) Facilitates the sharing of licensur e and disciplinary information among
26 Participating States;
27 (7) Require s Dentists and Dental Hygienists who practice in a Participating State
28 pursuant to a Compact Privilege to practice within the Scope of Practice authorized in
29 that State;
30 (8) Extends the authority of a Participating State to regu late the practice of
31 dentistry and dental hygiene within its borders to Dentists and Dental Hygienists who
32 practice in the State thr ough a Compact Privilege;
33 (9) Pr omotes the cooperation of Participating States in regu lating the practice of
34 dentistry and dental hygiene within those States;
35 (10) Facilitates the reloc ation of military members and their spouses who are
36 licensed to practice dentistry or dental hygiene.
332.705. As used in this Compact, unless the context req uires otherwise, the
2 following definitions shall apply:
3 (1) "Active Military Member" means any person with 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 disciplinary action or encumbrance imposed on a
7 License or Compact Privilege by a State Licensing Authority .
8 (3) "Alternative Pr ogram" means a non-disciplinary monitoring or practice
9 r emediation pr ocess applicable to a Dentist or Dental Hygienist appr oved by a State
10 Licensing Authority of a Participating State in which the Dentist or Dental Hygienist is
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11 licensed. This includes, but is not limited to, progr ams to which Licensees with
12 substance abuse or addiction issues are ref erred in lieu of Adverse Action.
13 (4) "Clinical Assessment" means examination or process , r equir ed for licensur e
14 as a Dentist or Dental Hygienist as applicable, that prov ides evidence of clinical
15 competence in dentistry or dental hygiene.
16 (5) "Commissioner" means the individual appointed by a Participating State to
17 serve as the member of the Commission for that Participating State.
18 (6) "Compact" means this Dentist and Dental Hygienist Compact.
19 (7) "Compact Privilege" means the authorization granted by a Remote State to
20 allow a Licensee fr om a Participating State to practice as a Dentist or Dental Hygienist
21 in a Remote State.
22 (8) "Continuing Pr ofessional Development" means a req uirement, as a condition
23 of License ren ewal to prov ide evidence of successful participation in educational or
24 pr ofessional activities releva nt to practice or ar ea of work.
25 (9) "Criminal Backgr ound Check" means the submission of fingerprints or
26 other biometric-based information for a License applicant for the purpose of obtaining
27 that applicant's criminal history reco rd information, as defined in 28 C.F .R. § 20.3(d)
28 fr om the Federal Burea u of Investigation and the State's criminal history rec ord
29 r epository as defined in 28 C.F .R. § 20.3(f).
30 (10) "Data System" means the Commission's r epository of information about
31 Licensees, including but not limited to examination, licensur e, investigative, Compact
32 Privilege, Adverse Action, and Alternative Pro gram.
33 (1 1) "Dental Hygienist" means an individual who is licensed by a State Licensing
34 Authority to practice dental hygiene.
35 (12) "Dentist" means an individual who is licensed by a State Licensing
36 Authority to practice dentistry .
37 (13) "Dentist and Dental Hygienist Compact Commission" or "Commission"
38 means a joint government agency established by this Compact comprised of each State
39 that has enacted the Compact and a national administrative body comprised of a
40 Commissioner fr om each State that has enacted the Compact.
41 (14) "Encumber ed License" means a License that a State Licensing Authority
42 has limited in any way other than thr ough an Alternative Pr ogram.
43 (15) "Executive Board" means the Chair , V ice Chair , Secr etary and T re asurer
44 and any other Commissioners as may be determined by Commission Rule or bylaw .
45 (16) "Jurisprudence Requireme nt" means the assessment of an individual's
46 knowledge of the laws and Rules governing the practice of dentistry or dental hygiene,
47 as applicable, in a State.
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48 (17) "License" means curren t authorization by a State, other than authorization
49 pursuant to a Compact Privilege, or other privilege, for an individual to practice as a
50 Dentist or Dental Hygienist in that State.
51 (18) "Licensee" means an individual who holds an unr estricted License fr om a
52 Participating State to practice as a Dentist or Dental Hygienist in that State.
53 (19) "Model Compact" means the model for the Dentist and Dental Hygienist
54 Compact on file with the Council of State Governments or other entity as designated by
55 the Commission.
56 (20) "Participating State" means a State that has enacted the Compact and been
57 admitted to the Commission in accordance with the pr ovisions her ein and Commission
58 Rules.
59 (21) "Qualifying License" means a License that is not an Encumbered License
60 issued by a Participating State to practice dentistry or dental hygiene.
61 (22) "Remote State" means a Participating State wher e a Licensee who is not
62 licensed as a Dentist or Dental Hygienist is exerc ising or seeking to exer cise the Compact
63 Privilege.
64 (23) "Rule" means a r egulation pr omulgated by an entity that has the for ce of
65 law .
66 (24) "Scope of Practice" means the proce dures, actions, and process es a Dentist
67 or Dental Hygienist licensed in a State is permitted to undertake in that State and the
68 cir cumstances under which the Licensee is permitted to undertake those proced ures,
69 actions and process es. Such proc edures, actions and pr ocesses and the cir cumstances
70 under which they may be undertaken may be established thr ough means, including, but
71 not limited to, statute, r egulations, case law , and other pr ocesses available to the State
72 Licensing Authority or other government agency .
73 (25) "Significant Investigative Information" means information, record s, and
74 documents r eceived or generated by a State Licensing Authority pursuant to an
75 investigation for which a determination has been made that ther e is pr obable cause to
76 believe that the Licensee has violated a statute or regul ation that is consider ed mor e
77 than a minor infraction for which the State Licensing Authority could pursue Adverse
78 Action against the Licensee.
79 (26) "State" means any state, commonwealth, district, or territory of the United
80 States of America that regu lates the practices of dentistry and dental hygiene.
81 (27) "State Licensing Authority" means an agency or other entity of a State that
82 is res ponsible for the licensing and r egulation of Dentists or Dental Hygienists.
332.710. 1. In order to join the Compact and ther eafter continue as a
2 Participating State, a State must:
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3 (1) Enact a compact that is not materially differ ent fro m the Model Compact as
4 determined in accordance with Commission Rules;
5 (2) Participate fully in the Commission's Data System;
6 (3) Have a mechanism in place for receivi ng and investigating complaints about
7 its Licensees and License applicants;
8 (4) Notify the Commission, in compliance with the terms of the Compact and
9 Commission Rules, of any Adverse Action or the availability of Significant Investigative
10 Information regard ing a Licensee and License applicant;
11 (5) Fully implement a Criminal Backgr ound Check req uire ment, within a time
12 frame established by Commission Rule, by receiv ing the r esults of a qualifying Criminal
13 Backgr ound Check;
14 (6) Comply with the Commission Rules applicable to a Participating State;
15 (7) Accept the National Board Examinations of the Joint Commission on
16 National Dental Examinations or another examination accepted by Commission Rule as
17 a licensur e examination;
18 (8) Accept for licensur e that applicants for a Dentist License graduate fro m a
19 pr edoctoral dental education pr ogram accred ited by the Commission on Dental
20 Accr editation, or another accr editing agency reco gnized by the United States
2 1 Department of Education for the accreditati on of dentistry and dental hygiene
22 education pro grams, leading to the Doctor of Dental Surgery (D.D.S.) or Doctor of
23 Dental Medicine (D.M.D.) degr ee;
24 (9) Accept for licensur e that applicants for a Dental Hygienist License graduate
25 fr om a dental hygiene education prog ram accredi ted by the Commission on Dental
26 Accr editation or another accr editing agency r ecognized by the United States
2 7 Department of Education for the accreditati on of dentistry and dental hygiene
28 education pro grams;
29 (10) Require for licensur e that applicants successfully complete a Clinical
30 Assessment;
31 (1 1) Have Continuing Pro fessional Development re quir ements as a condition for
32 License ren ewal; and
33 (12) Pay a participation fee to the Commission as established by Commission
34 Rule.
35 2. Pr oviding alternative pathways for an individual to obtain an unr estricted
36 License does not disqualify a State fr om participating in the Compact.
37 3. When conducting a Criminal Backgr ound Check the State Licensing
38 Authority shall:
39 (1) Consider that information in making a licensur e decision;
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40 (2) Maintain documentation of completion of the Criminal Backgr ound Check
41 and backgroun d check information to the extent allowed by State and federal law; and
42 (3) Report to the Commission whether it has completed the Criminal
43 Backgr ound Check and whether the individual was granted or denied a License.
44 4. A Licensee of a Participating State who has a Qualifying License in that State
45 and does not hold an Encumbered License in any other Participating State, shall be
46 issued a Compact Privilege in a Remote State in accordance with the terms of the
47 Compact and Commission Rules. If a Remote State has a Jurisprudence Requirem ent a
48 Compact Privilege will not be issued to the Licensee unless the Licensee has satisfied the
49 Jurisprudence Requirem ent.
332.715. 1. T o obtain and exer cise the Compact Privilege under the terms and
2 pr ovisions of the Compact, the Licensee shall:
3 (1) Have a Qualifying License as a Dentist or Dental Hygienist in a Participating
4 State;
5 (2) Be eligible for a Compact Privilege in any Remote State in accordance with
6 subsections 4, 7, and 8 of this section;
7 (3) Submit to an application pro cess whenever the Licensee is seeking a Compact
8 Privilege;
9 (4) Pay any applicable Commission and Remote State fees for a Compact
10 Privilege in the Remote State;
11 (5) Meet any Jurisprudence Requirem ent established by a Remote State in
12 which the Licensee is seeking a Compact Privilege;
13 (6) Have passed a National Board Examination of the Joint Commission on
14 National Dental Examinations or another examination accepted by Commission Rule;
15 (7) For a Dentist, have graduated fr om a pr edoctoral dental education pr ogram
16 accr edited by the Commission on Dental Accredi tation, or another accr editing agency
17 r ecognized by the United States Department of Education for the accre ditation of
18 dentistry and dental hygiene education pro grams, leading to the Doctor of Dental
19 Surgery (D.D.S.) or Doctor of Dental Medicine (D.M.D.) degre e;
20 (8) For a Dental Hygienist, have graduated fr om a dental hygiene education
21 pr ogram accr edited by the Commission on Dental Accr editation or another accred iting
22 agency recogni zed by the United States Department of Education for the accr editation
23 of dentistry and dental hygiene education pr ograms;
24 (9) Have successfully completed a Clinical Assessment for licensur e;
25 (10) Report to the Commission Adverse Action taken by any non-Participating
26 State when applying for a Compact Privilege and, otherwise, within thirty (30) days
27 fr om the date the Adverse Action is taken;
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28 (1 1) Report to the Commission when applying for a Compact Privilege the
29 addr ess of the Licensee's primary r esidence and ther eafter immediately r eport to the
30 Commission any change in the addr ess of the Licensee's primary res idence; and
31 (12) Consent to accept service of proc ess by mail at the Licensee's primary
32 r esidence on record with the Commission with respect to any action br ought against the
33 Licensee by the Commission or a Participating State, and consent to accept service of a
34 subpoena by mail at the Licensee's primary res idence on r ecord with the Commission
35 with respect to any action brou ght or investigation conducted by the Commission or a
36 Participating State.
37 2. The Licensee must comply with the r equir ements of subsection 1 of this
38 section to maintain the Compact Privilege in the Remote State. If those r equir ements
39 ar e met, the Compact Privilege will continue as long as the Licensee maintains a
40 Qualifying License in the State thr ough which the Licensee applied for the Compact
41 Privilege and pays any applicable Compact Privilege renewa l fees.
42 3. A Licensee pr oviding dentistry or dental hygiene in a Remote State under the
43 Compact Privilege shall function within the Scope of Practice authorized by the Remote
44 State for a Dentist or Dental Hygienist licensed in that State.
45 4. A Licensee pr oviding dentistry or dental hygiene pursuant to a Compact
46 Privilege in a Remote State is subject to that State's regula tory authority . A Remote
47 State may , in accordance with due pro cess and that State's laws, by Adverse Action
48 r evoke or r emove a Licensee's Compact Privilege in the Remote State for a specific
49 period of time and impose fines or take any other necessary actions to pro tect the health
50 and safety of its citizens. If a Remote State imposes an Adverse Action against a
51 Compact Privilege that limits the Compact Privilege, that Adverse Action applies to all
52 Compact Privileges in all Remote States. A Licensee whose Compact Privilege in a
53 Remote State is r emoved for a specified period of time is not eligible for a Compact
54 Privilege in any other Remote State until the specific time for rem oval of the Compact
55 Privilege has passed and all encumbrance requ irem ents are satisfied.
56 5. If a License in a Participating State is an Encumber ed License, the Licensee
57 shall lose the Compact Privilege in a Remote State and shall not be eligible for a
58 Compact Privilege in any Remote State until the License is no longer encumber ed.
59 6. Once an Encumbered License in a Participating State is r estored to good
60 standing, the Licensee must meet the requ irem ents of subsection 1 of this section to
61 obtain a Compact Privilege in a Remote State.
62 7. If a Licensee's Compact Privilege in a Remote State is rem oved by the Remote
63 State, the individual shall lose or be ineligible for the Compact Privilege in any Remote
64 State until the following occur:
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65 (1) The specific period of time for which the Compact Privilege was rem oved has
66 ended; and
67 (2) All conditions for rem oval of the Compact Privilege have been satisfied.
68 8. Once the req uirements of subsection 7 of this section have been met, the
69 Licensee must meet the r equir ements in subsection 1 of this section to obtain a Compact
70 Privilege in a Remote State.
332.720. An Active Military Member and their spouse shall not be requi red to
2 pay to the Commission for a Compact Privilege the fee otherwise charged by the
3 Commission. If a Remote State chooses to charge a fee for a Compact Privilege, it may
4 choose to charge a red uced fee or no fee to an Active Military Member and their spouse
5 for a Compact Privilege.
332.725. 1. A Participating State in which a Licensee is licensed shall have
2 exclusive authority to impose Adverse Action against the Qualifying License issued by
3 that Participating State.
4 2. A Participating State may take Adverse Action based on the Significant
5 Investigative Information of a Remote State, so long as the Participating State follows its
6 own proced ures for imposing Adverse Action.
7 3. Nothing in this Compact shall override a Participating State's decision that
8 participation in an Alternative Pr ogram may be used in lieu of Adverse Action and that
9 such participation shall rem ain non-public if req uire d by the Participating State's laws.
10 Participating States must r equir e Licensees who enter any Alternative Pr ogram in lieu
11 of discipline to agr ee not to practice pursuant to a Compact Privilege in any other
12 Participating State during the term of the Alternative Pr ogram without prior
13 authorization fr om such other Participating State.
14 4. Any Participating State in which a Licensee is applying to practice or is
15 practicing pursuant to a Compact Privilege may investigate actual or alleged violations
16 of the statutes and regul ations authorizing the practice of dentistry or dental hygiene in
17 any other Participating State in which the Dentist or Dental Hygienist holds a License or
18 Compact Privilege.
19 5. A Remote State shall have the authority to:
20 (1) T ake Adverse Actions as set forth in subsection 4 of section 332.715 against a
21 Licensee's Compact Privilege in the State;
22 (2) In furtherance of its rights and res ponsibilities under the Compact and the
23 Commission's Rules issue subpoenas for both hearings and investigations that requ ire
24 the attendance and testimony of witnesses, and the pr oduction of evidence. Subpoenas
25 issued by a State Licensing Authority in a Participating State for the attendance and
26 testimony of witnesses, or the pr oduction of evidence fro m another Participating State,
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27 shall be enforced in the latter State by any court of competent jurisdiction, according to
28 the practice and proc edure of that court applicable to subpoenas issued in proceed ings
29 pending before it. The issuing authority shall pay any witness fees, travel expenses,
30 mileage, and other fees requ ired by the service statutes of the State wher e the witnesses
31 or evidence are located; and
32 (3) If otherwise permitted by State law , recover fr om the Licensee the costs of
33 investigations and disposition of cases r esulting fr om any Adverse Action taken against
34 that Licensee.
35 6. (1) In addition to the authority granted to a Participating State by its Dentist
36 or Dental Hygienist licensur e act or other applicable State law , a Participating State
37 may jointly investigate Licensees with other Participating States.
38 (2) Participating States shall share any Significant Investigative Information,
39 litigation, or compliance materials in furtherance of any joint or individual investigation
40 initiated under the Compact.
41 7. (1) After a Licensee's Compact Privilege in a Remote State is terminated, the
42 Remote State may continue an investigation of the Licensee that began when the
43 Licensee had a Compact Privilege in that Remote State.
44 (2) If the investigation yields what would be Significant Investigative
4 5 Information had the Licensee continued to have a Compact Privilege in that Remote
46 State, the Remote State shall r eport the pr esence of such information to the Data System
47 as requ ired by subdivision (6) of subsection 2 of section 332.735 as if it was Significant
48 Investigative Information.
332.730. 1. The Compact Participating States hereb y cr eate and establish a joint
2 government agency whose membership consists of all Participating States that have
3 enacted the Compact. The Commission is an instrumentality of the Participating States
4 acting jointly and not an instrumentality of any one State. The Commission shall come
5 into existence on or after the effective date of the Compact as set forth in subsection 1 of
6 section 332.750.
7 2. (1) Each Participating State shall have and be limited to one (1)
8 Commissioner selected by that Participating State's State Licensing Authority or , if
9 the State has mor e than one State Licensing Authority , selected collectively by the State
10 Licensing Authorities.
11 (2) The Commissioner shall be a member or designee of such Authority or
12 Authorities.
13 (3) The Commission may by Rule or bylaw establish a term of office for
14 Commissioners and may by Rule or bylaw establish term limits.
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15 (4) The Commission may recomme nd to a State Licensing Authority or
16 Authorities, as applicable, rem oval or suspension of an individual as the State's
17 Commissioner .
18 (5) A Participating State's State Licensing Authority , or Authorities, as
19 applicable, shall fill any vacancy of its Commissioner on the Commission within sixty
20 (60) days of the vacancy .
21 (6) Each Commissioner shall be entitled to one vote on all matters that are voted
22 upon by the Commission.
23 (7) The Commission shall meet at least once during each calendar year .
24 Additional meetings may be held as set forth in the bylaws. The Commission may meet
25 by telecommunication, video conferenc e or other similar electr onic means.
26 3. The Commission shall have the following powers:
27 (1) Establish the fiscal year of the Commission;
28 (2) Establish a code of conduct and conflict of inter est policies;
29 (3) Adopt Rules and bylaws;
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 conclude legal pr oceedings or actions in the name of the
34 Commission, pr ovided that the standing of any State Licensing Authority to sue or be
35 sued under applicable law shall not be affected;
36 (7) Maintain and certify rec ords and information pr ovided to a Participating
37 State as the authenticated business records of the Commission, and designate a person
38 to do so on the Commission's behalf;
39 (8) Purchase and maintain insurance and bonds;
40 (9) Borrow , accept, or contract for services of personnel, including, but not
41 limited to, employees of a Participating 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) As set forth in the Commission Rules, charge a fee to a Licensee for the
48 grant of a Compact Privilege in a Remote State and ther eafter , as may be established by
49 Commission Rule, charge the Licensee a Compact Privilege renewa l fee for each
50 r enewal period in which that Licensee exer cises or intends to exer cise the Compact
51 Privilege in that Remote State. Nothing her ein shall be construed to pr event a Remote
HCS SB 1092 41
52 State fr om charging a Licensee a fee for a Compact Privilege or ren ewals of a Compact
53 Privilege, or a fee for the Jurisprudence Requir ement if the Remote State imposes such
54 a req uire ment for the grant of a Compact Privilege;
55 (13) Accept any and all appr opriate gifts, donations, grants of money , other
56 sour ces of r evenue, equipment, supplies, materials, and services, and receive, utilize, and
57 dispose of the same; pr ovided that at all times the Commission shall avoid any
58 appearance of improp riety and/or conflict of inter est;
59 (14) Lease, pur chase, ret ain, own, hold, impr ove, or use any pr operty , r eal,
60 personal, or mixed, or any undivided interes t ther ein;
61 (15) Sell, convey , mortgage, pledge, lease, exchange, abandon, or otherwise
62 dispose of any pr operty real, personal, or mixed;
63 (16) Establish a budget and make expenditur es;
64 (17) Borrow money;
65 (18) Appoint committees, including standing committees, which may be
66 composed of members, State regu lators, State legislators or their repr esentatives, and
67 consumer r epresent atives, and such other interes ted persons as may be designated in
68 this Compact and the bylaws;
69 (19) Pr ovide and r eceive information fr om, and cooperate with, law enforcem ent
70 agencies;
71 (20) Elect a Chair , V ice Chair , Secr etary and T rea sur er and such other officers
72 of the Commission as pr ovided in the Commission's bylaws;
73 (21) Establish and elect an Executive Board;
74 (22) Adopt and prov ide to the Participating States an annual r eport;
75 (23) Determine whether a State's enacted compact is materially differ ent fr om
76 the Model Compact language such that the State would not qualify for participation in
77 the Compact; and
78 (24) Perform such other functions as may be necessary or appr opriate to achieve
79 the purposes of this Compact.
80 4. (1) All meetings of the Commission that are not closed pursuant to this
81 subsection shall be open to the public. Notice of public meetings shall be posted on the
82 Commission's website at least thirty (30) days prior to the public meeting.
83 (2) Notwithstanding subdivision (1) of this subsection, the Commission may
84 convene an emergency public meeting by pr oviding at least twenty-four (24) hours prior
85 notice on the Commission's website, and any other means as pr ovided in the
86 Commission's Rules, for any of the re asons it may dispense with notice of pro posed
87 rulemaking under subsection 13 of section 332.740. The Commission's legal counsel
HCS SB 1092 42
88 shall certify that one of the rea sons justifying an emergency public meeting has been
89 met.
90 (3) Notice of all Commission meetings shall prov ide the time, date, and location
91 of the meeting, and if the meeting is to be held or accessible via telecommunication,
92 video conference , or other electr onic means, the notice shall include the mechanism for
93 access to the meeting thr ough such means.
94 (4) The Commission may convene in a closed, non-public meeting for the
95 Commission to receiv e legal advice or to discuss:
96 (a) Non-compliance of a Participating State with its obligations under the
97 Compact;
98 (b) The employment, compensation, discipline or other matters, practices or
99 pr ocedur es rel ated to specific employees or other matters rela ted to the Commission's
100 internal personnel practices and proc edures;
101 (c) Curr ent or thr eatened discipline of a Licensee or Compact Privilege holder
102 by the Commission or by a Participating State's Licensing Authority;
103 (d) Curre nt, thr eatened, or reas onably anticipated litigation;
104 (e) Negotiation of contracts for the pur chase, lease, or sale of goods, services, or
105 r eal estate;
106 (f) Accusing any person of a crime or formally censuring any person;
107 (g) T rade secr ets or commer cial or financial information that is privileged or
108 confidential;
109 (h) Information of a personal natur e wher e disclosure would constitute a clearly
110 unwarranted invasion of personal privacy;
111 (i) Investigative record s compiled for law enfor cement purposes;
112 (j) Information r elated to any investigative repo rts prepa red by or on behalf of
113 or for use of the Commission or other committee charged with r esponsibility of
114 investigation or determination of compliance issues pursuant to the Compact;
115 (k) Legal advice;
116 (l) Matters specifically exempted fr om disclosur e to the public by federal or
117 Participating State law; and
118 (m) Other matters as pr omulgated by the Commission by Rule.
119 (5) If a meeting, or portion of a meeting, is closed, the pr esiding officer shall state
120 that the meeting will be closed and ref eren ce each relev ant exempting provi sion, and
121 such re feren ce shall be recor ded in the minutes.
122 (6) The Commission shall keep minutes that fully and clearly describe all
123 matters discussed in a meeting and shall pr ovide a full and accurate summary of actions
124 taken, and the reas ons ther efor , including a description of the views expr essed. All
HCS SB 1092 43
125 documents consider ed in connection with an action shall be identified in such minutes.
126 All minutes and documents of a closed meeting shall r emain under seal, subject to
127 r elease only by a majority vote of the Commission or order of a court of competent
128 jurisdiction.
129 5. (1) The Commission shall pay , or pr ovide for the payment of, the reas onable
130 expenses of its establishment, organization, and ongoing activities.
131 (2) The Commission may accept any and all appr opriate sources of reven ue,
132 donations, and grants of money , equipment, supplies, materials, and services.
133 (3) The Commission may levy on and collect an annual assessment fr om each
134 Participating State and impose fees on Licensees of Participating States when a
135 Compact Privilege is granted, to cover the cost of the operations and activities of the
136 Commission and its staff, which must be in a total amount sufficient to cover its annual
137 budget as appr oved each fiscal year for which sufficient revenu e is not pr ovided by
138 other source s. The aggr egate annual assessment amount for Participating States shall
139 be allocated based upon a formula that the Commission shall pr omulgate by Rule.
140 (4) The Commission shall not incur obligations of any kind prior to securing the
141 funds adequate to meet the same; nor shall the Commission pledge the credi t of any
142 Participating State, except by and with the authority of the Participating State.
143 (5) The Commission shall keep accurate accounts of all re ceipts and
1 4 4 disbursements. The r eceipts and disbursements of the Commission shall be subject
145 to the financial r eview and accounting pr ocedur es established under its bylaws. All
146 r eceipts and disbursements of funds handled by the Commission shall be subject to an
147 annual financial r eview by a certified or licensed public accountant, and the r eport of
148 the financial rev iew shall be included in and become part of the annual r eport of the
149 Commission.
150 6. (1) The Executive Board shall have the power to act on behalf of the
151 Commission according to the terms of this Compact. The powers, duties, and
152 r esponsibilities of the Executive Board shall include:
153 (a) Overseeing the day-to-day activities of the administration of the Compact
154 including compliance with the pr ovisions of the Compact and the Commission's Rules
155 and bylaws;
156 (b) Recommending to the Commission changes to the Rules or bylaws, changes
157 to this Compact legislation, fees charged to Compact Participating States, fees charged
158 to Licensees, and other fees;
159 (c) Ensuring Compact administration services ar e appr opriately pr ovided,
160 including by contract;
161 (d) Pr eparing and recommending the budget;
HCS SB 1092 44
162 (e) Maintaining financial reco rds on behalf of the Commission;
163 (f) Monitoring Compact compliance of Participating States and pr oviding
164 compliance rep orts to the Commission;
165 (g) Establishing additional committees as necessary;
166 (h) Exer cising the powers and duties of the Commission during the interim
167 between Commission meetings, except for adopting or amending Rules, adopting or
168 amending bylaws, and exer cising any other powers and duties expr essly res erved to the
169 Commission by Rule or bylaw; and
170 (i) Other duties as pr ovided in the Rules or bylaws of the Commission.
171 (2) The Executive Board shall be composed of up to seven (7) members:
172 (a) The Chair , V ice Chair , Secr etary and T rea sur er of the Commission and any
173 other members of the Commission who serve on the Executive Board shall be voting
174 members of the Executive Board; and
175 (b) Other than the Chair , V ice Chair , Secr etary , and T r easurer , the Commission
176 may elect up to thr ee (3) voting members fr om the curren t membership of the
177 Commission.
178 (3) The Commission may rem ove any member of the Executive Board as
179 pr ovided in the Commission's bylaws.
180 (4) The Executive Board shall meet at least annually .
181 (a) An Executive Board meeting at which it takes or intends to take formal
182 action on a matter shall be open to the public, except that the Executive Board may meet
183 in a closed, non-public session of a public meeting when dealing with any of the matters
184 cover ed under subdivision (4) of subsection 4 of this section.
185 (b) The Executive Board shall give five (5) business days' notice of its public
186 meetings, posted on its website and as it may otherwise determine to prov ide notice to
187 persons with an inter est in the public matters the Executive Board intends to addr ess at
188 those meetings.
189 (5) The Executive Board may hold an emergency meeting when acting for the
190 Commission to:
191 (a) Meet an imminent thr eat to public health, safety , or welfare;
192 (b) Pr event a loss of Commission or Participating State funds; or
193 (c) Pr otect public health and safety .
194 7. (1) The members, officers, executive director , employees and repr esentatives
195 of the Commission shall be immune fr om suit and liability , both personally and in their
196 official capacity , for any claim for damage to or loss of prop erty or personal injury or
197 other civil liability caused by or arising out of any actual or alleged act, error , or
198 omission that occurr ed, or that the person against whom the claim is made had a
HCS SB 1092 45
199 r easonable basis for believing occurr ed within the scope of Commission employment,
200 duties or r esponsibilities; prov ided that nothing in this subdivision shall be construed to
201 pr otect any such person fro m suit or liability for any damage, loss, injury , or liability
202 caused by the intentional or willful or wanton misconduct of that person. The
203 pr ocur ement of insurance of any type by the Commission shall not in any way
204 compr omise or limit the immunity granted hereu nder .
205 (2) The Commission shall defend any member , officer , executive direc tor ,
206 employee, and re present ative of the Commission in any civil action seeking to impose
207 liability arising out of any actual or alleged act, err or , or omission that occurred within
208 the scope of Commission employment, duties, or re sponsibilities, or as determined by
209 the Commission that the person against whom the claim is made had a rea sonable basis
210 for believing occurr ed within the scope of Commission employment, duties, or
211 r esponsibilities; pr ovided that nothing her ein shall be construed to pr ohibit that
212 person fro m ret aining their own counsel at their own expense; and pr ovided further ,
213 that the actual or alleged act, error , or omission did not res ult fr om that person's
214 intentional or willful or wanton misconduct.
215 (3) Notwithstanding subdivision (1) of this subsection, should any member ,
216 officer , executive dir ector , employee, or repr esentative of the Commission be held liable
217 for the amount of any settlement or judgment arising out of any actual or alleged act,
218 err or , or omission that occurr ed within the scope of that individual's employment,
219 duties, or responsibi lities for the Commission, or that the person to whom that
220 individual is liable had a r easonable basis for believing occurr ed within the scope of the
221 individual's employment, duties, or respon sibilities for the Commission, the
2 2 2 Commission shall indemnify and hold harmless such individual, prov ided that the
223 actual or alleged act, erro r , or omission did not result fr om the intentional or willful or
224 wanton misconduct of the individual.
225 (4) Nothing herei n shall be construed as a limitation on the liability of any
226 Licensee for profes sional malpractice or misconduct, which shall be governed solely by
227 any other applicable State laws.
228 (5) Nothing in this Compact shall be interpr eted to waive or otherwise abr ogate
229 a Participating State's state action immunity or state action affirmative defense with
230 r espect to antitrust claims under the Sherman Act, Clayton Act, or any other State or
231 federal antitrust or anticompetitive law or regul ation.
232 (6) Nothing in this Compact shall be construed to be a waiver of soverei gn
233 immunity by the Participating States or by the Commission.
332.735. 1. The Commission shall pr ovide for the development, maintenance,
2 operation, and utilization of a coordinated database and r eporting system containing
HCS SB 1092 46
3 licensur e, Adverse Action, and the pr esence of Significant Investigative Information on
4 all Licensees and applicants for a License in Participating States.
5 2. Notwithstanding any other pr ovision of State law to the contrary , a
6 Participating State shall submit a uniform data set to the Data System on all individuals
7 to whom this Compact is applicable as requi red by the Rules of the Commission,
8 including:
9 (1) Identifying information;
10 (2) Licensure data;
11 (3) Adverse Actions against a Licensee, License applicant or Compact Privilege
12 and information r elated ther eto;
13 (4) Non-confidential information rel ated to Alternative Pr ogram participation,
14 the beginning and ending dates of such participation, and other information rel ated to
15 such participation;
16 (5) Any denial of an application for licensur e, and the r eason or r easons for such
17 denial (excluding the re porting of any criminal history r ecord information wher e
18 pr ohibited by law);
19 (6) The pr esence of Significant Investigative Information; and
20 (7) Other information that may facilitate the administration of this Compact or
21 the pro tection of the public, as determined by the Rules of the Commission.
22 3. The rec ords and information pro vided to a Participating State pursuant to
23 this Compact or thr ough the Data System, when certified by the Commission or an
24 agent ther eof, shall constitute the authenticated business rec ords of the Commission,
25 and shall be entitled to any associated hearsay exception in any re levant judicial, quasi-
26 judicial or administrative pr oceedings in a Participating State.
27 4. Significant Investigative Information pertaining to a Licensee in any
28 Participating State will only be available to other Participating States.
29 5. It is the res ponsibility of the Participating States to monitor the database to
30 determine whether Adverse Action has been taken against a Licensee or License
31 applicant. Adverse Action information pertaining to a Licensee or License applicant in
32 any Participating State will be available to any other Participating State.
33 6. Participating States contributing information to the Data System may
34 designate information that may not be shar ed with the public without the expr ess
35 permission of the contributing State.
36 7. Any information submitted to the Data System that is subsequently expunged
37 pursuant to federal law or the laws of the Participating State contributing the
38 information shall be rem oved fr om the Data System.
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332.740. 1. The Commission shall promul gate r easonable Rules in order to
2 effectively and efficiently implement and administer the purposes and pro visions of the
3 Compact. A Commission Rule shall be invalid and have no for ce or effect only if a court
4 of competent jurisdiction holds that the Rule is invalid because the Commission
5 exer cised its rulemaking authority in a manner that is beyond the scope and purposes of
6 the Compact, or the powers granted her eunder , or based upon another applicable
7 standard of r eview .
8 2. The Commission shall pr omulgate Rules in accordance with the authority
9 granted under this Compact. All Commission Rules shall be consistent with the
10 Constitution of the United States and, to the extent applicable, the constitutions of
11 Participating States, and shall further the purposes and intent of this Compact. Any
12 Rule adopted by the Commission that exceeds the scope of the Commission's authority
13 or is otherwise inconsistent with this Compact or applicable constitutional r equir ements
14 shall be subject to challenge and determination in accordance with the dispute
15 r esolution and enforcem ent pr ovisions under section 332.745 of this Compact.
16 3. The Rules of the Commission shall have the for ce of law in each Participating
17 State, pro vided however that wher e the Rules of the Commission conflict with the laws
18 of the Participating State that establish the Participating State's Scope of Practice as
19 held by a court of competent jurisdiction, the Rules of the Commission shall be
20 ineffective in that State to the extent of the conflict.
21 4. The Commission shall exerci se its Rulemaking powers pursuant to the criteria
22 set forth in this section and the Rules adopted ther eunder . Rules shall become binding
23 as of the date specified by the Commission for each Rule.
24 5. If a majority of the legislatur es of the Participating States rej ects a
25 Commission Rule or portion of a Commission Rule, by enactment of a statute or
26 r esolution in the same manner used to adopt the Compact, within four (4) years of the
27 date of adoption of the Rule, then such Rule shall have no further for ce and effect in any
28 Participating State or to any State applying to participate in the Compact.
29 6. Rules shall be adopted at a reg ular or special meeting of the Commission.
30 7. Prior to adoption of a pr oposed Rule, the Commission shall hold a public
31 hearing and allow persons to pro vide oral and written comments, data, facts, opinions,
32 and arguments.
33 8. Prior to adoption of a pr oposed Rule by the Commission, and at least thirty
34 (30) days in advance of the meeting at which the Commission will hold a public hearing
35 on the pr oposed Rule, the Commission shall pr ovide a Notice of Pr oposed Rulemaking:
36 (1) On the website of the Commission or other publicly accessible platform;
HCS SB 1092 48
37 (2) T o persons who have requ ested notice of the Commission's notices of
38 pr oposed rulemaking; and
39 (3) In such other way or ways as the Commission may by Rule specify .
40 9. The Notice of Pr oposed Rulemaking shall include:
41 (1) The time, date, and location of the public hearing at which the Commission
42 will hear public comments on the pro posed Rule and, if differ ent, the time, date, and
43 location of the meeting wher e the Commission will consider and vote on the pro posed
44 Rule;
45 (2) If the hearing is held via telecommunication, video conference, or other
46 electr onic means, the Commission shall include the mechanism for access to the hearing
47 in the Notice of Pr oposed Rulemaking;
48 (3) The text of the pr oposed Rule and the reas on ther efor;
49 (4) A requ est for comments on the pr oposed Rule fr om any interes ted person;
50 and
51 (5) The manner in which interes ted persons may submit written comments.
52 10. All hearings will be record ed. A copy of the record ing and all written
53 comments and documents receiv ed by the Commission in res ponse to the prop osed Rule
54 shall be available to the public.
55 1 1. Nothing in this section shall be construed as requ iring a separate hearing on
56 each Commission Rule. Rules may be grou ped for the convenience of the Commission
57 at hearings req uired by this section.
58 12. The Commission shall, by majority vote of all Commissioners, take final
59 action on the prop osed Rule based on the rulemaking reco rd.
60 (1) The Commission may adopt changes to the pro posed Rule pro vided the
61 changes do not enlarge the original purpose of the pr oposed Rule.
62 (2) The Commission shall pro vide an explanation of the r easons for substantive
63 changes made to the pr oposed Rule as well as r easons for substantive changes not made
64 that wer e r ecommended by commenters.
65 (3) The Commission shall determine a reas onable effective date for the Rule.
66 Except for an emergency as pr ovided in subsection 13 of this section, the effective date
67 of the Rule shall be no sooner than thirty (30) days after the Commission issuing the
68 notice that it adopted or amended the Rule.
69 13. Upon determination that an emergency exists, the Commission may consider
70 and adopt an emergency Rule with 24 hours' notice, with opportunity to comment,
71 pr ovided that the usual rulemaking proced ures pr ovided in the Compact and in this
72 section shall be r etro actively applied to the Rule as soon as rea sonably possible, in no
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73 event later than ninety (90) days after the effective date of the Rule. For the purposes of
74 this prov ision, an emergency Rule is one that must be adopted immediately in order to:
75 (1) Meet an imminent thr eat to public health, safety , or welfare;
76 (2) Pr event a loss of Commission or Participating State funds;
77 (3) Meet a deadline for the pr omulgation of a Rule that is established by federal
78 law or rule; or
79 (4) Pr otect public health and safety .
80 14. The Commission or an authorized committee of the Commission may direct
81 r evisions to a pr eviously adopted Rule for purposes of corr ecting typographical errors,
82 err ors in format, err ors in consistency , or grammatical err ors. Public notice of any
83 r evisions shall be posted on the website of the Commission. The r evision shall be subject
84 to challenge by any person for a period of thirty (30) days after posting. The revi sion
85 may be challenged only on gr ounds that the r evision res ults in a material change to a
86 Rule. A challenge shall be made in writing and deliver ed to the Commission prior to the
87 end of the notice period. If no challenge is made, the r evision will take effect without
88 further action. If the r evision is challenged, the revi sion may not take effect without the
89 appr oval of the Commission.
90 15. No Participating State's rulemaking req uirements shall apply under this
91 Compact.
332.745. 1. (1) The executive and judicial branches of State government in each
2 Participating State shall enfor ce 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
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 regard ing the enfor cement or interpr etation of the Compact or Commission
13 Rule and shall have standing to intervene in such a pr oceeding for all purposes. Failur e
14 to pro vide the Commission service of pro cess shall rend er a judgment or order void as
15 to the Commission, this Compact, or promulg ated Rules.
16 2. (1) If the Commission determines that a Participating State has defaulted in
17 the performance of its obligations or res ponsibilities under this Compact or the
18 pr omulgated Rules, the Commission shall pro vide written notice to the defaulting State.
HCS SB 1092 50
19 The notice of default shall describe the default, the prop osed 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 Participating 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, and all rights, privileges and benefits conferred on that State by this
27 Compact may be terminated on the effective date of termination. A cur e of the default
28 does not reli eve the offending State of obligations or liabilities incurr ed during the
29 period of default.
30 4. T ermination of participation 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 legislatur e, the defaulting State's State Licensing
34 Authority or Authorities, as applicable, and each of the Participating States' State
35 Licensing Authority or Authorities, as applicable.
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.
39 6. Upon the termination of a State's participation in this Compact, that State
40 shall immediately pr ovide notice to all Licensees of the State, including Licensees of
41 other Participating States issued a Compact Privilege to practice within that State, of
42 such termination. The terminated State shall continue to rec ognize all Compact
43 Privileges then in effect in that State for a minimum of one hundred eighty (180) days
44 after the date of said notice of 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 United States District Court for the District of Columbia or the federal district
50 wher e the Commission has its principal offices. The pr evailing party shall be awarded
51 all costs of such litigation, including r easonable attorney's fees.
52 9. (1) Upon req uest by a Participating State, the Commission shall attempt to
53 r esolve disputes r elated to the Compact that arise among Participating States and
54 between Participating States and non-Participating States.
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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) The Commission, in the reas onable exer cise of its discr etion, shall enforce
58 the pro visions of this Compact and the Commission's Rules.
59 (2) By majority vote, the Commission may initiate legal action against a
60 Participating State in default in the United States District Court for the District of
61 Columbia or the federal district where the Commission has its principal offices to
62 enfor ce compliance with the pr ovisions of the Compact and its pro mulgated Rules. The
63 r elief sought may include both injunctive relief and damages. In the event judicial
64 enfor cement is necessary , the pr evailing party shall be awarded all costs of such
65 litigation, including r easonable attorney's fees. The r emedies herei n shall not be the
66 exclusive r emedies of the Commission. The Commission may pursue any other
67 r emedies available under federal or the defaulting Participating State's law .
68 (3) A Participating State may initiate legal action against the Commission in the
69 United States District Court for the District of Columbia or the federal district wher e
70 the Commission has its principal offices to enforce compliance with the pr ovisions of the
71 Compact and its pr omulgated Rules. The reli ef sought may include both injunctive
72 r elief and damages. In the event judicial enforcem ent is necessary , the pr evailing party
73 shall be awarded all costs of such litigation, including reas onable attorney's fees.
74 (4) No individual or entity other than a Participating State may enfor ce this
75 Compact against the Commission.
332.750. 1. The Compact shall come into effect on the date on which the
2 Compact statute is enacted into law in the seventh Participating State.
3 (1) On or after the effective date of the Compact, the Commission shall convene
4 and rev iew the enactment of each of the States that enacted the Compact prior to the
5 Commission convening ("Charter Participating States") to determine if the statute
6 enacted by each such Charter Participating State is materially differe nt than the Model
7 Compact.
8 (a) A Charter Participating State whose enactment is found to be materially
9 differ ent fr om the Model Compact shall be entitled to the default pr ocess set forth in
10 section 332.745.
11 (b) If any Participating State is later found to be in default, or is terminated or
12 withdraws fr om the Compact, the Commission shall rem ain in existence and the
13 Compact shall rem ain in effect even if the number of Participating States should be less
14 than seven (7).
15 (2) Participating States enacting the Compact subsequent to the Charter
16 Participating States shall be subject to the pr ocess set forth in subdivision (23) of
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17 subsection 3 of section 332.730 to determine if their enactments ar e materially differ ent
18 fr om the Model Compact and whether they qualify for participation in the Compact.
19 (3) All actions taken for the benefit of the Commission or in furtherance of the
20 purposes of the administration of the Compact prior to the effective date of the Compact
21 or the Commission coming into existence shall be considere d to be actions of the
22 Commission unless specifically r epudiated by the Commission.
23 (4) Any State that joins the Compact subsequent to the Commission's initial
24 adoption of the Rules and bylaws shall be subject to the Commission's Rules and bylaws
25 as they exist on the date on which the Compact becomes law in that State. Any Rule
26 that has been pr eviously adopted by the Commission shall have the full for ce and effect
27 of law on the day the Compact becomes law in that State.
28 2. Any Participating State may withdraw fr om this Compact by enacting a
29 statute repeal ing that State's enactment of the Compact.
30 (1) A Participating State's withdrawal shall not take effect until one hundr ed
31 eighty (180) days after enactment of the r epealing statute.
32 (2) Withdra wal shall not affect the continuing r equir ement of the withdrawing
33 State's Licensing Authority or Authorities to comply with the investigative and Adverse
34 Action reporting r equir ements of this Compact prior to the effective date of withdrawal.
35 (3) Upon the enactment of a statute withdrawing fr om this Compact, the State
36 shall immediately provi de notice of such withdrawal to all Licensees within that State.
37 Notwithstanding any subsequent statutory enactment to the contrary , such withdrawing
38 State shall continue to recogn ize all Compact Privileges to practice within that State
39 granted pursuant to this Compact for a minimum of one hundred eighty (180) days after
40 the date of such notice of withdrawal.
41 3. Nothing contained in this Compact shall be construed to invalidate or pr event
42 any licensur e agr eement or other cooperative arrangement between a Participating
43 State and a non-Participating State that does not conflict with the prov isions of this
44 Compact.
45 4. This Compact may be amended by the Participating States. No amendment to
46 this Compact shall become effective and binding upon any Participating State until it is
47 enacted into the laws of all Participating States.
332.755. 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.
HCS SB 1092 53
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 Participating State, a State seeking participation in
9 the 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 r equir ements of
15 subsection 2 of section 332.745, terminate a Participating State's participation in the
16 Compact, if it determines that a constitutional req uire ment of a Participating State is a
17 material departure fro m the Compact. Otherwise, if this Compact shall be held to be
18 contrary to the constitution of any Participating State, the Compact shall rem ain in full
19 for ce and effect as to the r emaining Participating States and in full for ce and effect as to
20 the Participating State affected as to all severable matters.
332.760. 1. Nothing herei n shall preven t or inhibit the enforcem ent of any other
2 law of a Participating State that is not inconsistent with the Compact.
3 2. Except as explicitly permitted her ein, nothing in this Compact, nor any Rule
4 of the Commission, shall be construed to limit, restrict, or in any way red uce the ability
5 of a Participating State to enact and enforce laws, regu lations, or other rules relat ed to
6 the practice of dentistry and dental hygiene within such Participating State, including
7 but not limited to standards of practice, Scope of Practice, office safety r equir ements,
8 patient care standards, and all other aspects of pr ofessional practice occurring within
9 such Participating State's borders.
10 3. Any laws, statutes, reg ulations, or other legal req uirements in a Participating
11 State in conflict with the Compact ar e superseded to the extent of the conflict.
12 4. All permissible agr eements between the Commission and the Participating
13 States ar e binding in accordance with their terms.
334.1800. 1. Sections 334.1800 to 334.1860 shall be known and may be cited as
2 the "Physician Assistant Licensure Compact".
3 2. In order to str engthen access to Medical Services, and in r ecognition of the
4 advances in the delivery of Medical Services, the Participating States of the P A
5 Licensur e Compact have allied in common purpose to develop a compr ehensive pro cess
6 that complements the existing authority of State Licensing Boards to license and
7 discipline physician assistants and seeks to enhance the portability of a License to
8 practice as a physician assistant while safeguarding the safety of patients. This
9 Compact allows Medical Services to be prov ided by physician assistants, via the mutual
HCS SB 1092 54
10 r ecognition of the Licensee's Qualifying License by other Compact Participating States.
11 This Compact also adopts the prevai ling standard for physician assistant licensur e and
12 affirms that the practice and delivery of Medical Services by the physician assistant
13 occurs wher e the patient is located at the time of the patient encounter , and ther efor e
14 r equir es the physician assistant to be under the jurisdiction of the State Licensing Board
15 wher e the patient is located. State Licensing Boards that participate in this Compact
16 r etain the jurisdiction to impose Adverse Action against a Compact Privilege in that
17 State issued to a physician assistant thr ough the pro cedur es of this Compact. The P A
18 Licensur e Compact will alleviate burdens for military families by allowing active duty
19 military personnel and their spouses to obtain a Compact Privilege based on having an
20 unr estricted License in good standing fr om a Participating State.
334.1805. In this Compact:
2 (1) "Adverse Action" means any administrative, civil, equitable, or criminal
3 action permitted by a State's laws which is imposed by a Licensing Board or other
4 authority against a physician assistant License or License application or Compact
5 Privilege such as License denial, censure, revo cation, suspension, pr obation, monitoring
6 of the Licensee, or r estriction on the Licensee's practice.
7 (2) "Compact Privilege" means the authorization granted by a Remote State to
8 allow a Licensee from another Participating State to practice as a physician assistant to
9 pr ovide Medical Services and other licensed activity to a patient located in the Remote
10 State under the Remote State's laws and regu lations.
11 (3) "Conviction" means a finding by a court that an individual is guilty of a
12 felony or misdemeanor offense thr ough adjudication or entry of a plea of guilt or no
13 contest to the charge by the offender .
14 (4) "Criminal Backgr ound Check" means the submission of fingerprints or
15 other biometric-based information for a License applicant for the purpose of obtaining
16 that applicant's criminal history record information, as defined in 28 C.F .R. § 20.3(d),
17 fr om the State's criminal history r ecord repo sitory as defined in 28 C.F .R. § 20.3(f).
18 (5) "Data System" means the r epository of information about Licensees,
19 including but not limited to License status and Adverse Actions, which is creat ed and
20 administer ed under the terms of this Compact.
21 (6) "Executive Committee" means a group of dir ectors and ex-officio individuals
22 elected or appointed pursuant to subdivision (2) of subsection 6 of section 334.1830.
23 (7) "Impair ed Practitioner" means a physician assistant whose practice is
24 adversely affected by health-re lated condition(s) that impact their ability to practice.
25 (8) "Investigative Information" means information, r ecords, or documents
26 r eceived or generated by a Licensing Board pursuant to an investigation.
HCS SB 1092 55
27 (9) "Jurisprudence Requirem ent" means the assessment of an individual's
28 knowledge of the laws and Rules governing the practice of a physician assistant in a
29 State.
30 (10) "License" means curren t authorization by a State, other than authorization
31 pursuant to a Compact Privilege, for a physician assistant to prov ide Medical Services,
32 which would be unlawful without curr ent authorization.
33 (1 1) "Licensee" means an individual who holds a License fr om a State to provi de
34 Medical Services as a physician assistant.
35 (12) "Licensing Board" means any State entity authorized to license and
36 otherwise reg ulate physician assistants.
37 (13) "Medical Services" means health care services pr ovided for the diagnosis,
38 pr evention, tr eatment, cur e or relief of a health condition, injury , or disease, as defined
39 by a State's laws and regu lations. The medical services pro vided by a physician
40 assistant to a patient located in Missouri are defined by Missouri's state laws and
41 r egulations.
42 (14) "Model Compact" means the model for the P A Licensure Compact on file
43 with The Council of State Governments or other entity as designated by the
44 Commission.
45 (15) "Participating State" means a State that has enacted this Compact.
46 (16) "P A" or "Physician Assistant" means an individual who is licensed as a
47 physician assistant in a State. For purposes of this Compact, any other title or status
48 adopted by a State to re place the term "physician assistant" shall be deemed
49 synonymous with "physician assistant" and shall confer the same rights and
5 0 r esponsibilities to the Licensee under the pr ovisions of this Compact at the time of its
51 enactment.
52 (17) "P A Licensur e Compact Commission," "Compact Commission," or
53 "Commission" mean the national administrative body cr eated pursuant to subsection
54 1 of section 334.1830 of this Compact.
55 (18) "Qualifying License" means an unrest ricted License issued by a
5 6 Participating State to provi de Medical Services as a physician assistant.
57 (19) "Remote State" means a Participating State wher e a Licensee who is not
58 licensed as a physician assistant is exercising or seeking to exerci se the Compact
59 Privilege.
60 (20) "Rule" means a r egulation pr omulgated by an entity that has the for ce and
61 effect of law .
62 (21) "Significant Investigative Information" means Investigative Information
63 that a Licensing Board, after an inquiry or investigation that includes notification and
HCS SB 1092 56
64 an opportunity for the physician assistant to r espond if requ ired by State law , has
65 r eason to believe is not groun dless and, if proven true, would indicate mor e than a
66 minor infraction.
67 (22) "State" means any state, commonwealth, district, or territory of the United
68 States.
334.1810. 1. T o participate in this Compact, a Participating State shall:
2 (1) License physician assistants.
3 (2) Participate in the Compact Commission's Data System.
4 (3) Have a mechanism in place for receivi ng and investigating complaints
5 against Licensees and License applicants.
6 (4) Notify the Commission, in compliance with the terms of this Compact and
7 Commission Rules, of any Adverse Action against a Licensee or License applicant and
8 the existence of Significant Investigative Information regard ing a Licensee or License
9 applicant.
10 (5) Fully implement a Criminal Backgr ound Check req uire ment, within a time
11 frame established by Commission Rule, by its Licensing Board r eceiving the results of a
12 Criminal Backgr ound Check and reporting to the Commission whether the License
13 applicant has been granted a License.
14 (6) Comply with the Rules of the Compact Commission.
15 (7) Utilize passage of a recog nized national exam such as the NCCP A P ANCE as
16 a req uire ment for physician assistant licensur e.
17 (8) Grant the Compact Privilege to a holder of a Qualifying License in a
18 Participating State.
19 2. Nothing in this Compact pr ohibits a Participating State fr om charging a fee
20 for granting the Compact Privilege.
334.1815. 1. T o exer cise the Compact Privilege, a Licensee must:
2 (1) Have graduated fr om a physician assistant progra m accr edited by the
3 Accr editation Review Commission on Education for the Physician Assistant, Inc. or
4 other pr ograms authorized by Commission Rule.
5 (2) Hold curr ent NCCP A certification.
6 (3) Have no felony or misdemeanor Conviction.
7 (4) Have never had a controlled substance license, permit, or regi stration
8 suspended or r evoked by a State or by the United States Drug Enfor cement
9 Administration.
10 (5) Have a unique identifier as determined by Commission Rule.
11 (6) Hold a Qualifying License.
HCS SB 1092 57
12 (7) Have had no rev ocation of a License or limitation or res triction on any
13 License curr ently held due to an adverse action.
14 (8) If a Licensee has had a limitation or res triction on a License or Compact
15 Privilege due to an Adverse Action, two years must have elapsed fr om the date on which
16 the License or Compact Privilege is no longer limited or res tricted due to the Adverse
17 Action.
18 (9) If a Compact Privilege has been r evoked or is limited or restricted in a
19 Participating State for conduct that would not be a basis for disciplinary action in a
20 Participating State in which the Licensee is practicing or applying to practice under a
21 Compact Privilege, that Participating State shall have the discret ion not to consider
22 such action as an Adverse Action req uiring the denial or rem oval of a Compact
23 Privilege in that State.
24 (10) Notify the Compact Commission that the Licensee is seeking the Compact
25 Privilege in a Remote State.
26 (1 1) Meet any Jurisprudence Requirem ent of a Remote State in which the
27 Licensee is seeking to practice under the Compact Privilege and pay any fees applicable
28 to satisfying the Jurisprudence Requirem ent.
29 (12) Report to the Commission any Adverse Action taken by a non-participating
30 State within thirty (30) days after the action is taken.
31 2. The Compact Privilege is valid until the expiration or r evocation of the
32 Qualifying License unless terminated pursuant to an Adverse Action. The Licensee
33 must also comply with all of the re quir ements of subsection 1 of this section to maintain
34 the Compact Privilege in a Remote State. If the Participating State takes Adverse
35 Action against a Qualifying License, the Licensee shall lose the Compact Privilege in any
36 Remote State in which the Licensee has a Compact Privilege until all of the following
37 occur:
38 (1) The License is no longer limited or restricted; and
39 (2) T wo (2) years have elapsed fr om the date on which the License is no longer
40 limited or res tricted due to the Adverse Action.
41 3. Once a res tricted or limited License satisfies the requ irem ents of subdivisions
42 (1) and (2) of subsection 2 of this section, the Licensee must meet the requ irem ents of
43 subsection 1 of this section to obtain a Compact Privilege in any Remote State.
44 4. For each Remote State in which a physician assistant seeks authority to
45 pr escribe control led substances, the physician assistant shall satisfy all r equir ements
46 imposed by such State in granting or renewi ng such authority .
334.1820. Upon a Licensee's application for a Compact Privilege, the Licensee
2 shall identify to the Commission the Participating State fr om which the Licensee is
HCS SB 1092 58
3 applying, in accordance with applicable Rules adopted by the Commission, and subject
4 to the following r equir ements:
5 (1) When applying for a Compact Privilege, the Licensee shall pr ovide the
6 Commission with the addr ess of the Licensee's primary res idence and ther eafter shall
7 immediately r eport to the Commission any change in the addr ess of the Licensee's
8 primary resi dence.
9 (2) When applying for a Compact Privilege, the Licensee is req uired to consent
10 to accept service of proc ess by mail at the Licensee's primary res idence on file with the
11 Commission with res pect to any action br ought against the Licensee by the Commission
12 or a Participating State, including a subpoena, with res pect to any action brou ght or
13 investigation conducted by the Commission or a Participating State.
334.1825. 1. A Participating State in which a Licensee is licensed shall have
2 exclusive power to impose Adverse Action against the Qualifying License issued by that
3 Participating State.
4 2. In addition to the other powers conferr ed by State law , a Remote State shall
5 have the authority , in accordance with existing State due process law , to do all of the
6 following:
7 (1) T ake Adverse Action against a physician assistant's Compact Privilege within
8 that State to rem ove a Licensee's Compact Privilege or take other action necessary
9 under applicable law to pr otect the health and safety of its citizens.
10 (2) Issue subpoenas for both hearings and investigations that requ ire the
11 attendance and testimony of witnesses as well as the prod uction of evidence. Subpoenas
12 issued by a Licensing Board in a Participating State for the attendance and testimony of
13 witnesses or the prod uction of evidence fro m another Participating State shall be
14 enfor ced in the latter State by any court of competent jurisdiction, according to the
15 practice and pr ocedur e of that court applicable to subpoenas issued in proceed ings
16 pending before it. The issuing authority shall pay any witness fees, travel expenses,
17 mileage and other fees req uired by the service statutes of the State in which the
18 witnesses or evidence are located.
19 (3) Notwithstanding subdivision (2) of this subsection, subpoenas may not be
20 issued by a Participating State to gather evidence of conduct in another State that is
21 lawful in that other State for the purpose of taking Adverse Action against a Licensee's
22 Compact Privilege or application for a Compact Privilege in that Participating State.
23 (4) Nothing in this Compact authorizes a Participating State to impose discipline
24 against a physician assistant's Compact Privilege or to deny an application for a
25 Compact Privilege in that Participating State for the individual's otherwise lawful
26 practice in another State.
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27 3. For purposes of taking Adverse Action, the Participating State which issued
28 the Qualifying License shall give the same priority and effect to repo rted conduct
29 r eceived fr om any other Participating State as it would if the conduct had occurr ed
30 within the Participating State which issued the Qualifying License. In so doing, that
31 Participating State shall apply its own State laws to determine appr opriate action.
32 4. A Participating State, if otherwise permitted by State law , may recover fr om
33 the affected physician assistant the costs of investigations and disposition of cases
34 r esulting from any Adverse Action taken against that physician assistant.
35 5. A Participating State may take Adverse Action based on the factual findings
36 of a Remote State, pr ovided that the Participating State follows its own pr ocedur es for
37 taking the Adverse Action.
38 6. (1) In addition to the authority granted to a Participating State by its
39 r espective State physician assistant laws and reg ulations or other applicable State law ,
40 any Participating State may participate with other Participating States in joint
41 investigations of Licensees.
42 (2) Participating States shall share any investigative, litigation, or compliance
43 materials in furtherance of any joint or individual investigation initiated under this
44 Compact.
45 7. If an Adverse Action is taken against a physician assistant's Qualifying
46 License, the physician assistant's Compact Privilege in all Remote States shall be
47 deactivated until two (2) years have elapsed after all res trictions have been r emoved
48 fr om the State License. All disciplinary orders by the Participating State which issued
49 the Qualifying License that impose Adverse Action against a physician assistant's
50 License shall include a Statement that the physician assistant's Compact Privilege is
51 deactivated in all Participating States during the pendency of the order .
52 8. If any Participating State takes Adverse Action, it pr omptly shall notify the
53 administrator of the Data System.
334.1830. 1. The Participating States her eby creat e and establish a joint
2 government agency and national administrative body known as the P A Licensur e
3 Compact Commission. The Commission is an instrumentality of the Compact States
4 acting jointly and not an instrumentality of any one State. The Commission shall come
5 into existence on or after the effective date of the Compact as set forth in subsection 1 of
6 section 334.1850.
7 2. (1) Each Participating State shall have and be limited to one (1) delegate
8 selected by that Participating State's Licensing Board or , if the State has mor e than one
9 Licensing Board, selected collectively by the Participating State's Licensing Boards.
10 (2) The delegate shall be either:
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11 (a) A curr ent physician assistant, physician or public member of a Licensing
12 Board or physician assistant Council/Committee; or
13 (b) An administrator of a Licensing Board.
14 (3) Any delegate may be rem oved or suspended fr om office as pro vided by the
15 laws of the State from which the delegate is appointed.
16 (4) The Participating State Licensing Board shall fill any vacancy occurring in
17 the Commission within sixty (60) days.
18 (5) Each delegate shall be entitled to one (1) vote on all matters voted on by the
19 Commission and shall otherwise have an opportunity to participate in the business and
20 affairs of the Commission. A delegate shall vote in person or by such other means as
21 pr ovided in the bylaws. The bylaws may prov ide for delegates' participation in
22 meetings by telecommunications, video confer ence, or other means of communication.
23 (6) The Commission shall meet at least once during each calendar year .
24 Additional meetings shall be held as set forth in this Compact and the bylaws.
25 (7) The Commission shall establish by Rule a term of office for delegates.
26 3. The Commission shall have the following powers and duties:
27 (1) Establish a code of ethics for the Commission;
28 (2) Establish the fiscal year of the Commission;
29 (3) Establish fees;
30 (4) Establish bylaws;
31 (5) Maintain its financial r ecords in accordance with the bylaws;
32 (6) Meet and take such actions as ar e consistent with the pr ovisions of this
33 Compact and the bylaws;
34 (7) Pr omulgate Rules limited to the Commission's authority to facilitate and
35 coordinate implementation and administration of this Compact. The Rules authorized
36 by the Compact shall have the forc e and effect of law and shall be binding in all
37 Participating States;
38 (8) Bring and prosecute legal pr oceedings or actions in the name of the
39 Commission, pr ovided that the standing of any State Licensing Board to sue or be sued
40 under applicable law shall not be affected;
41 (9) Purchase and maintain insurance and bonds;
42 (10) Borrow , accept, or contract for services of personnel, including, but not
43 limited to, employees of a Participating State;
44 (1 1) Hir e employees and engage contractors, elect or appoint officers, fix
45 compensation, define duties, grant such individuals appr opriate authority to carry out
46 the purposes of this Compact, and establish the Commission's personnel policies and
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47 pr ograms relat ing to conflicts of intere st, qualifications of personnel, and other r elated
48 personnel matters;
49 (12) Accept any and all appr opriate donations and grants of money , equipment,
50 supplies, materials and services, and receiv e, utilize and dispose of the same; pr ovided
51 that at all times the Commission shall avoid any appearance of impropri ety or conflict
52 of interes t;
53 (13) Lease, pur chase, accept appr opriate gifts or donations of, or otherwise own,
54 hold, improv e or use, any pro perty , rea l, personal or mixed; pr ovided that at all times
55 the Commission shall avoid any appearance of impropri ety;
56 (14) Sell, convey , mortgage, pledge, lease, exchange, abandon, or otherwise
57 dispose of any pr operty real, personal, or mixed;
58 (15) Establish a budget and make expenditur es;
59 (16) Borrow money;
60 (17) Appoint committees, including standing committees composed of members,
61 State r egulators, State legislators or their re pr esentatives, and consumer
6 2 r epresent atives, and such other interes ted persons as may be designated in this
63 Compact and the bylaws;
64 (18) Pr ovide and r eceive information fr om, and cooperate with, law enforcem ent
65 agencies;
66 (19) Elect a Chair , V ice Chair , Secr etary and T rea sur er and such other officers
67 of the Commission as pr ovided in the Commission's bylaws;
68 (20) Reserve for itself, in addition to those rese rved exclusively to the
69 Commission under the Compact, powers that the Executive Committee may not
70 exer cise;
71 (21) Appr ove or disappr ove a State's participation in the Compact based upon
72 its determination as to whether the State's Compact legislation departs in a material
73 manner fr om the Model Compact language;
74 (22) Pr epare and pr ovide to the Participating States an annual repo rt; and
75 (23) Perform such other functions as may be necessary or appr opriate to achieve
76 the purposes of this Compact consistent with the State regu lation of physician assistant
77 licensur e and practice.
78 4. (1) All meetings of the Commission that are not closed pursuant to this
79 subsection shall be open to the public. Notice of public meetings shall be posted on the
80 Commission's website at least thirty (30) days prior to the public meeting.
81 (2) Notwithstanding subdivision (1) of this subsection, the Commission may
82 convene a public meeting by pr oviding at least twenty-four (24) hours prior notice on
83 the Commission's website, and any other means as pr ovided in the Commission's Rules,
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84 for any of the reas ons it may dispense with notice of pro posed rulemaking under
85 subsection 12 of section 334.1840.
86 (3) The Commission may convene in a closed, non-public meeting or non-public
87 part of a public meeting to recei ve legal advice or to discuss:
88 (a) Non-compliance of a Participating State with its obligations under this
89 Compact;
90 (b) The employment, compensation, discipline or other matters, practices or
91 pr ocedur es rel ated to specific employees or other matters rela ted to the Commission's
92 internal personnel practices and proc edures;
93 (c) Curr ent, thr eatened, or r easonably anticipated litigation;
94 (d) Negotiation of contracts for the purch ase, lease, or sale of goods, services, or
95 r eal estate;
96 (e) Accusing any person of a crime or formally censuring any person;
97 (f) Disclosure of trade secr ets or commer cial or financial information that is
98 privileged or confidential;
99 (g) Disclosur e of information of a personal natur e wher e disclosur e would
100 constitute a clearly unwarranted invasion of personal privacy;
101 (h) Disclosur e of investigative r ecords compiled for law enfor cement purposes;
102 (i) Disclosur e of information re lated to any investigative rep orts pr epar ed by or
103 on behalf of or for use of the Commission or other committee charged with
104 r esponsibility of investigation or determination of compliance issues pursuant to this
105 Compact;
106 (j) Legal advice; or
107 (k) Matters specifically exempted fr om disclosure by federal or Participating
108 States' statutes.
109 (4) If a meeting, or portion of a meeting, is closed pursuant to this pr ovision, the
110 chair of the meeting or the chair's designee shall certify that the meeting or portion of
111 the meeting may be closed and shall r efer ence each r elevant exempting pr ovision.
112 (5) The Commission shall keep minutes that fully and clearly describe all
113 matters discussed in a meeting and shall pr ovide a full and accurate summary of actions
114 taken, including a description of the views expr essed. All documents consider ed in
115 connection with an action shall be identified in such minutes. All minutes and
116 documents of a closed meeting shall r emain under seal, subject to relea se by a majority
117 vote of the Commission or order of a court of competent jurisdiction.
118 5. (1) The Commission shall pay , or pr ovide for the payment of, the reas onable
119 expenses of its establishment, organization, and ongoing activities.
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120 (2) The Commission may accept any and all appr opriate reven ue sources ,
121 donations, and grants of money , equipment, supplies, materials, and services.
122 (3) The Commission may levy on and collect an annual assessment fr om each
123 Participating State and may impose Compact Privilege fees on Licensees of
1 2 4 Participating States to whom a Compact Privilege is granted to cover the cost of the
125 operations and activities of the Commission and its staff, which must be in a total
126 amount sufficient to cover its annual budget as appr oved by the Commission each year
127 for which rev enue is not pr ovided by other sour ces. The aggreg ate annual assessment
128 amount levied on Participating States shall be allocated based upon a formula to be
129 determined by Commission Rule.
130 (a) A Compact Privilege expir es when the Licensee's Qualifying License in the
131 Participating State fr om which the Licensee applied for the Compact Privilege expir es.
132 (b) If the Licensee terminates the Qualifying License thr ough which the Licensee
133 applied for the Compact Privilege before its scheduled expiration, and the Licensee has
134 a Qualifying License in another Participating State, the Licensee shall inform the
135 Commission that it is changing to that Participating State the Participating State
136 thr ough which it applies for a Compact Privilege and pay to the Commission any
137 Compact Privilege fee r equir ed by Commission Rule.
138 (4) The Commission shall not incur obligations of any kind prior to securing the
139 funds adequate to meet the same; nor shall the Commission pledge the cred it of any of
140 the Participating States, except by and with the authority of the Participating State.
141 (5) The Commission shall keep accurate accounts of all re ceipts and
1 4 2 disbursements. The r eceipts and disbursements of the Commission shall be subject
143 to the financial r eview and accounting pr ocedur es established under its bylaws. All
144 r eceipts and disbursements of funds handled by the Commission shall be subject to an
145 annual financial r eview by a certified or licensed public accountant, and the r eport of
146 the financial rev iew shall be included in and become part of the annual r eport of the
147 Commission.
148 6. (1) The Executive Committee shall have the power to act on behalf of the
149 Commission according to the terms of this Compact and Commission Rules.
150 (2) The Executive Committee shall be composed of nine (9) members:
151 (a) Seven voting members who ar e elected by the Commission fr om the curr ent
152 membership of the Commission;
153 (b) One ex-officio, nonvoting member fr om a reco gnized national physician
154 assistant profes sional association; and
155 (c) One ex-officio, nonvoting member fr om a recogn ized national physician
156 assistant certification organization.
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157 (3) The ex-officio members will be selected by their res pective organizations.
158 (4) The Commission may rem ove any member of the Executive Committee as
159 pr ovided in its bylaws.
160 (5) The Executive Committee shall meet at least annually .
161 (6) The Executive Committee shall have the following duties and res ponsibilities:
162 (a) Recommend to the Commission changes to the Commission's Rules or
163 bylaws, changes to this Compact legislation, fees to be paid by Compact Participating
164 States such as annual dues, and any Commission Compact fee charged to Licensees for
165 the Compact Privilege;
166 (b) Ensur e Compact administration services are appr opriately provi ded,
167 contractual or otherwise;
168 (c) Pr epar e and recomm end the budget;
169 (d) Maintain financial record s on behalf of the Commission;
170 (e) Monitor Compact compliance of Participating States and pr ovide compliance
171 r eports to the Commission;
172 (f) Establish additional committees as necessary;
173 (g) Exercis e the powers and duties of the Commission during the interim
174 between Commission meetings, except for issuing pr oposed rulemaking or adopting
175 Commission Rules or bylaws, or exer cising any other powers and duties exclusively
176 r eserved to the Commission by the Commission's Rules; and
177 (h) Perform other duties as provi ded in the Commission's Rules or bylaws.
178 (7) All meetings of the Executive Committee at which it votes or plans to vote on
179 matters in exer cising the powers and duties of the Commission shall be open to the
180 public and public notice of such meetings shall be given as public meetings of the
181 Commission are given.
182 (8) The Executive Committee may convene in a closed, non-public meeting for
183 the same r easons that the Commission may convene in a non-public meeting as set forth
184 in subdivision (3) of subsection 4 of this section and shall announce the closed meeting as
185 the Commission is req uired to under subdivision (4) of subsection 4 of this section and
186 keep minutes of the closed meeting as the Commission is requi red to under subdivision
187 (5) of subsection 4 of this section.
188 7. (1) The members, officers, executive director , employees and repr esentatives
189 of the Commission shall be immune fr om suit and liability , both personally and in their
190 official capacity , for any claim for damage to or loss of prop erty or personal injury or
191 other civil liability caused by or arising out of any actual or alleged act, error , or
192 omission that occurr ed, or that the person against whom the claim is made had a
193 r easonable basis for believing occurr ed within the scope of Commission employment,
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194 duties or r esponsibilities; prov ided that nothing in this subdivision shall be construed to
195 pr otect any such person fro m suit or liability for any damage, loss, injury , or liability
196 caused by the intentional or willful or wanton misconduct of that person. The
197 pr ocur ement of insurance of any type by the Commission shall not in any way
198 compr omise or limit the immunity granted hereu nder .
199 (2) The Commission shall defend any member , officer , executive direc tor ,
200 employee, and re present ative of the Commission in any civil action seeking to impose
201 liability arising out of any actual or alleged act, err or , or omission that occurred within
202 the scope of Commission employment, duties, or re sponsibilities, or as determined by
203 the commission that the person against whom the claim is made had a r easonable basis
204 for believing occurr ed within the scope of Commission employment, duties, or
205 r esponsibilities; pr ovided that nothing her ein shall be construed to pr ohibit that
206 person fro m ret aining their own counsel at their own expense; and pr ovided further ,
207 that the actual or alleged act, error , or omission did not res ult fr om that person's
208 intentional or willful or wanton misconduct.
209 (3) The Commission shall indemnify and hold harmless any member , officer ,
210 executive dir ector , employee, and repr esentative of the Commission for the amount of
211 any settlement or judgment obtained against that person arising out of any actual or
212 alleged act, err or , or omission that occurre d within the scope of Commission
21 3 employment, duties, or res ponsibilities, or that such person had a r easonable basis
214 for believing occurr ed within the scope of Commission employment, duties, or
215 r esponsibilities, prov ided that the actual or alleged act, erro r , or omission did not
216 r esult fr om the intentional or willful or wanton misconduct of that person.
217 (4) V enue is prop er and judicial proc eedings by or against the Commission shall
218 be bro ught solely and exclusively in a court of competent jurisdiction wher e the
219 principal office of the Commission is located. The Commission may waive venue and
220 jurisdictional defenses in any proceed ings as authorized by Commission Rules.
221 (5) Nothing herei n shall be construed as a limitation on the liability of any
222 Licensee for profes sional malpractice or misconduct, which shall be governed solely by
223 any other applicable State laws.
224 (6) Nothing her ein shall be construed to designate the venue or jurisdiction to
225 bring actions for alleged acts of malpractice, pr ofessional misconduct, negligence, or
226 other such civil action pertaining to the practice of a physician assistant. All such
227 matters shall be determined exclusively by State law other than this Compact.
228 (7) Nothing in this Compact shall be interpr eted to waive or otherwise abr ogate
229 a Participating State's state action immunity or state action affirmative defense with
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230 r espect to antitrust claims under the Sherman Act, Clayton Act, or any other State or
231 federal antitrust or anticompetitive law or regul ation.
232 (8) Nothing in this Compact shall be construed to be a waiver of soverei gn
233 immunity by the Participating States or by the Commission.
334.1835. 1. The Commission shall prov ide for the development, maintenance,
2 operation, and utilization of a coordinated data and r eporting system containing
3 licensur e, Adverse Action, and the rep orting of the existence of Significant Investigative
4 Information on all licensed physician assistants and applicants denied a License in
5 Participating States.
6 2. Notwithstanding any other State law to the contrary , a Participating State
7 shall submit a uniform data set to the Data System on all physician assistants to whom
8 this Compact is applicable (utilizing a unique identifier) as requ ired by the Rules of the
9 Commission, including:
10 (1) Identifying information;
11 (2) Licensure data;
12 (3) Adverse Actions against a License or Compact Privilege;
13 (4) Any denial of application for licensur e, and the reas on or rea sons for such
14 denial (excluding the repo rting of any Criminal history record information wher e
15 pr ohibited by law);
16 (5) The existence of Significant Investigative Information; and
17 (6) Other information that may facilitate the administration of this Compact, as
18 determined by the Rules of the Commission.
19 3. Significant Investigative Information pertaining to a Licensee in any
20 Participating State shall only be available to other Participating States.
21 4. The Commission shall pr omptly notify all Participating States of any Adverse
22 Action taken against a Licensee or an individual applying for a License that has been
23 r eported to it. This Adverse Action information shall be available to any other
24 Participating State.
25 5. Participating States contributing information to the Data System may , in
26 accordance with State or federal law , designate information that may not be shar ed with
27 the public without the expr ess permission of the contributing State. Notwithstanding
28 any such designation, such information shall be rep orted to the Commission thr ough the
29 Data System.
30 6. Any information submitted to the Data System that is subsequently expunged
31 pursuant to federal law or the laws of the Participating State contributing the
32 information shall be r emoved fr om the Data System upon reporting of such by the
33 Participating State to the Commission.
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34 7. The rec ords and information pro vided to a Participating State pursuant to
35 this Compact or thr ough the Data System, when certified by the Commission or an
36 agent ther eof, shall constitute the authenticated business rec ords of the Commission,
37 and shall be entitled to any associated hearsay exception in any re levant judicial, quasi-
38 judicial or administrative pr oceedings in a Participating State.
334.1840. 1. The Commission shall exer cise its Rulemaking powers pursuant to
2 the criteria set forth in this Section and the Rules adopted ther eunder . Commission
3 Rules shall become binding as of the date specified by the Commission for each Rule.
4 2. The Commission shall promul gate reas onable Rules in order to effectively and
5 efficiently implement and administer this Compact and achieve its purposes. A
6 Commission Rule shall be invalid and have no for ce or effect only if a court of
7 competent jurisdiction holds that the Rule is invalid because the Commission exer cised
8 its rulemaking authority in a manner that is beyond the scope of the purposes of this
9 Compact, or the powers granted hereunder , or based upon another applicable standard
10 of review .
11 3. The Rules of the Commission shall have the for ce of law in each Participating
12 State, pro vided however that wher e the Rules of the Commission conflict with the laws
13 of the Participating State that establish the medical services a physician assistant may
14 perform in the Participating State, as held by a court of competent jurisdiction, the
15 Rules of the Commission shall be ineffective in that State to the extent of the conflict.
16 4. If a majority of the legislatur es of the Participating States rej ects a
17 Commission Rule, by enactment of a statute or res olution in the same manner used to
18 adopt this Compact within four (4) years of the date of adoption of the Rule, then such
19 Rule shall have no further for ce and effect in any Participating State or to any State
20 applying to participate in the Compact.
21 5. Commission Rules shall be adopted at a regu lar or special meeting of the
22 Commission.
23 6. Prior to pr omulgation and adoption of a final Rule or Rules by the
24 Commission, and at least thirty (30) days in advance of the meeting at which the Rule
25 will be consider ed and voted upon, the Commission shall file a Notice of Pr oposed
26 Rulemaking:
27 (1) On the website of the Commission or other publicly accessible platform; and
28 (2) T o persons who have requ ested notice of the Commission's notices of
29 pr oposed rulemaking; and
30 (3) In such other way(s) as the Commission may by Rule specify .
31 7. The Notice of Pr oposed Rulemaking shall include:
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32 (1) The time, date, and location of the public hearing on the prop osed Rule and
33 the pro posed time, date and location of the meeting in which the pr oposed Rule will be
34 consider ed and voted upon;
35 (2) The text of the pr oposed Rule and the reas on for the pr oposed Rule;
36 (3) A r equest for comments on the prop osed Rule fr om any interes ted person
37 and the date by which written comments must be receiv ed; and
38 (4) The manner in which interes ted persons may submit notice to the
39 Commission of their intention to attend the public hearing or pr ovide any written
40 comments.
41 8. Prior to adoption of a pro posed Rule, the Commission shall allow persons to
42 submit written data, facts, opinions, and arguments, which shall be made available to
43 the public.
44 9. If the hearing is to be held via electr onic means, the Commission shall publish
45 the mechanism for access to the electr onic hearing.
46 (1) All persons wishing to be heard at the hearing shall as direc ted in the Notice
47 of Pr oposed Rulemaking, not less than five (5) business days befor e the scheduled date
48 of the hearing, notify the Commission of their desire to appear and testify at the hearing.
49 (2) Hearings shall be conducted in a manner provi ding each person who wishes
50 to comment a fair and reas onable opportunity to comment orally or in writing.
51 (3) All hearings shall be r ecorded. A copy of the r ecording and the written
52 comments, data, facts, opinions, and arguments recei ved in res ponse to the pro posed
53 rulemaking shall be made available to a person upon requ est.
54 (4) Nothing in this section shall be construed as requi ring a separate hearing on
55 each pr oposed Rule. Pr oposed Rules may be gro uped for the convenience of the
56 Commission at hearings req uire d by this section.
57 10. Following the public hearing the Commission shall consider all written and
58 oral comments timely r eceived.
59 1 1. The Commission shall, by majority vote of all delegates, take final action on
60 the prop osed Rule and shall determine the effective date of the Rule, if adopted, based
61 on the Rulemaking record and the full text of the Rule.
62 (1) If adopted, the Rule shall be posted on the Commission's website.
63 (2) The Commission may adopt changes to the pro posed Rule pro vided the
64 changes do not enlarge the original purpose of the pr oposed Rule.
65 (3) The Commission shall prov ide on its website an explanation of the reas ons
66 for substantive changes made to the pr oposed Rule as well as reas ons for substantive
67 changes not made that were recommended by commenters.
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68 (4) The Commission shall determine a reas onable effective date for the Rule.
69 Except for an emergency as pr ovided in subsection 12 of this section, the effective date
70 of the Rule shall be no sooner than thirty (30) days after the Commission issued the
71 notice that it adopted the Rule.
72 12. Upon determination that an emergency exists, the Commission may consider
73 and adopt an emergency Rule with twenty-four (24) hours prior notice, without the
74 opportunity for comment, or hearing, provi ded that the usual rulemaking proce dures
75 pr ovided in this Compact and in this section shall be r etr oactively applied to the Rule as
76 soon as rea sonably possible, in no event later than ninety (90) days after the effective
77 date of the Rule. For the purposes of this pr ovision, an emergency Rule is one that must
78 be adopted immediately by the Commission in order to:
79 (1) Meet an imminent thr eat to public health, safety , or welfare;
80 (2) Pr event a loss of Commission or Participating State funds;
81 (3) Meet a deadline for the pro mulgation of a Commission Rule that is
82 established by federal law or Rule; or
83 (4) Pr otect public health and safety .
84 13. The Commission or an authorized committee of the Commission may direct
85 r evisions to a pr eviously adopted Commission Rule for purposes of corr ecting
86 typographical erro rs, err ors in format, erro rs in consistency , or grammatical errors.
87 Public notice of any revision s shall be posted on the website of the Commission. The
88 r evision shall be subject to challenge by any person for a period of thirty (30) days after
89 posting. The revision may be challenged only on gr ounds that the re vision r esults in a
90 material change to a Rule. A challenge shall be made as set forth in the notice of
91 r evisions and deliver ed to the Commission prior to the end of the notice period. If no
92 challenge is made, the revision will take effect without further action. If the r evision is
93 challenged, the rev ision may not take effect without the appr oval of the Commission.
94 14. No Participating State's rulemaking req uirements shall apply under this
95 Compact.
334.1845. 1. (1) The executive and judicial branches of State government in
2 each Participating State shall enfor ce 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
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
HCS SB 1092 70
9 pr opriety of venue in any action against a licensee for pr ofessional 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 or the
13 Commission's Rules and shall have standing to intervene in such a pr oceeding for all
14 purposes. Failur e to pr ovide the Commission with service of pr ocess shall rend er a
15 judgment or order in such proceed ing void as to the Commission, this Compact, or
16 Commission Rules.
17 2. (1) If the Commission determines that a Participating State has defaulted in
18 the performance of its obligations or res ponsibilities under this Compact or the
19 Commission Rules, the Commission shall pr ovide written notice to the defaulting State
20 and other Participating States. The notice shall describe the default, the pro posed
21 means of curing the default and any other action that the Commission may take and
22 shall offer rem edial training and specific technical assistance r egarding the default.
23 (2) If a State in default fails to cur e the default, the defaulting State may be
24 terminated fr om this Compact upon an affirmative vote of a majority of the delegates of
25 the Participating States, and all rights, privileges and benefits conferred by this
26 Compact upon such State may be terminated on the effective date of termination. A
27 cur e of the default does not reli eve the offending State of obligations or liabilities
28 incurr ed during the period of default.
29 (3) T ermination of participation in this Compact shall be imposed only after all
30 other means of securing compliance have been exhausted. Notice of intent to suspend or
31 terminate shall be given by the Commission to the governor , the majority and minority
32 leaders of the defaulting State's legislature, and to the Licensing Board(s) of each of the
33 Participating States.
34 (4) A State that has been terminated is res ponsible for all assessments,
35 obligations, and liabilities incurr ed thr ough the effective date of termination, including
36 obligations that extend beyond the effective date of termination.
37 (5) The Commission shall not bear any costs rela ted to a State that is found to be
38 in default or that has been terminated fr om this Compact, unless agre ed upon in writing
39 between the Commission and the defaulting State.
40 (6) The defaulting State may appeal its termination fro m the Compact by the
41 Commission by petitioning the United States District Court for the District of Columbia
42 or the federal district where the Commission has its principal offices. The pr evailing
43 member shall be awarded all costs of such litigation, including rea sonable attorney's
44 fees.
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45 (7) Upon the termination of a State's participation in the Compact, the State
46 shall immediately pr ovide notice to all Licensees within that State of such termination:
47 (a) Licensees who have been granted a Compact Privilege in that State shall
48 r etain the Compact Privilege for one hundred eighty (180) days following the effective
49 date of such termination.
50 (b) Licensees who are licensed in that State who have been granted a Compact
51 Privilege in a Participating State shall reta in the Compact Privilege for one hundr ed
52 eighty (180) days unless the Licensee also has a Qualifying License in a Participating
53 State or obtains a Qualifying License in a Participating State before the one hundr ed
54 eighty (180)-day period ends, in which case the Compact Privilege shall continue.
55 3. (1) Upon req uest by a Participating State, the Commission shall attempt to
56 r esolve disputes rela ted to this Compact that arise among Participating States and
57 between participating and non-Participating States.
58 (2) The Commission shall pr omulgate a Rule prov iding for both mediation and
59 binding dispute r esolution for disputes as appr opriate.
60 4. (1) The Commission, in the rea sonable exerc ise of its discr etion, shall enforce
61 the pro visions of this Compact and Rules of the Commission.
62 (2) If compliance is not secure d after all means to secure compliance have been
63 exhausted, by majority vote, the Commission may initiate legal action in the United
64 States District Court for the District of Columbia or the federal district wher e the
65 Commission has its principal offices, against a Participating State in default to enforce
66 compliance with the prov isions of this Compact and the Commission's pr omulgated
67 Rules and bylaws. The r elief sought may include both injunctive reli ef and damages. In
68 the event judicial enforcem ent is necessary , the prevai ling party shall be awarded all
69 costs of such litigation, including r easonable attorney's fees.
70 (3) The r emedies her ein shall not be the exclusive rem edies of the Commission.
71 The Commission may pursue any other rem edies available under federal or State law .
72 5. (1) A Participating State may initiate legal action against the Commission in
73 the United States District Court for the District of Columbia or the federal district
74 wher e the Commission has its principal offices to enforce compliance with the pr ovisions
75 of the Compact and its Rules. The r elief sought may include both injunctive r elief and
76 damages. In the event judicial enfor cement is necessary , the pr evailing party shall be
77 awarded all costs of such litigation, including reas onable attorney's fees.
78 (2) No person other than a Participating State shall enforce this Compact against
79 the Commission.
334.1850. 1. This Compact shall come into effect on the date on which this
2 Compact statute is enacted into law in the seventh Participating State.
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3 (1) On or after the effective date of the Compact, the Commission shall convene
4 and rev iew the enactment of each of the States that enacted the Compact prior to the
5 Commission convening ("Charter Participating States") to determine if the statute
6 enacted by each such Charter Participating State is materially differe nt than the Model
7 Compact.
8 (a) A Charter Participating State whose enactment is found to be materially
9 differ ent fr om the Model Compact shall be entitled to the default pr ocess set forth in
10 subsection 2 of section 334.1845.
11 (b) If any Participating State later withdraws fr om the Compact or its
12 participation is terminated, the Commission shall r emain in existence and the Compact
13 shall rem ain in effect even if the number of Participating States should be less than
14 seven. Participating States enacting the Compact subsequent to the Commission
15 convening shall be subject to the pr ocess set forth in subdivision (21) of subsection 3 of
16 section 334.1830 to determine if their enactments are materially differ ent from the
17 Model Compact and whether they qualify for participation in the Compact.
18 (2) Participating States enacting the Compact subsequent to the seven initial
19 Charter Participating States shall be subject to the pr ocess set forth in subdivision (21)
20 of subsection 3 of section 334.1830 to determine if their enactments ar e materially
21 differ ent fr om the Model Compact and whether they qualify for participation in the
22 Compact.
23 (3) All actions taken for the benefit of the Commission or in furtherance of the
24 purposes of the administration of the Compact prior to the effective date of the Compact
25 or the Commission coming into existence shall be considere d to be actions of the
26 Commission unless specifically r epudiated by the Commission.
27 2. Any State that joins this Compact shall be subject to the Commission's Rules
28 and bylaws as they exist on the date on which this Compact becomes law in that State.
29 Any Rule that has been pr eviously adopted by the Commission shall have the full for ce
30 and effect of law on the day this Compact becomes law in that State.
31 3. Any Participating State may withdraw fr om this Compact by enacting a
32 statute repeal ing the same.
33 (1) A Participating State's withdrawal shall not take effect until one hundr ed
34 eighty (180) days after enactment of the r epealing statute. During this one hundr ed
35 eighty (180) day-period, all Compact Privileges that wer e in effect in the withdrawing
36 State and wer e granted to Licensees licensed in the withdrawing State shall rem ain in
37 effect. If any Licensee licensed in the withdrawing State is also licensed in another
38 Participating State or obtains a license in another Participating State within the one
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39 hundr ed eighty (180) days, the Licensee's Compact Privileges in other Participating
40 States shall not be affected by the passage of the one hundred eighty (180) days.
41 (2) W ithdrawal shall not affect the continuing r equir ement of the State
42 Licensing Board(s) of the withdrawing State to comply with the investigative, and
43 Adverse Action rep orting req uirements of this Compact prior to the effective date of
44 withdrawal.
45 (3) Upon the enactment of a statute withdrawing a State fro m this Compact, the
46 State shall immediately provi de notice of such withdrawal to all Licensees within that
47 State. Such withdrawing State shall continue to reco gnize all licenses granted pursuant
48 to this Compact for a minimum of one hundr ed eighty (180) days after the date of such
49 notice of withdrawal.
50 4. Nothing contained in this Compact shall be construed to invalidate or pr event
51 any physician assistant licensur e agreement or other cooperative arrangement between
52 Participating States and between a Participating State and non-Participating State that
53 does not conflict with the pro visions of this Compact.
54 5. This Compact may be amended by the Participating States. No amendment to
55 this Compact shall become effective and binding upon any Participating State until it is
56 enacted materially in the same manner into the laws of all Participating States as
57 determined by the Commission.
334.1855. 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 Participating State, a State seeking participation in
9 the 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 r equir ements of
15 subsection 2 of section 334.1845, terminate a Participating State's participation in the
16 Compact, if it determines that a constitutional re quir ement of a Participating State is, or
17 would be with res pect to a State seeking to participate in the Compact, a material
18 departur e from the Compact. Otherwise, if this Compact shall be held to be contrary to
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19 the constitution of any Participating State, the Compact shall r emain in full for ce and
20 effect as to the rem aining Participating States and in full for ce and effect as to the
21 Participating State affected as to all severable matters.
334.1860. 1. Nothing her ein pr events the enfor cement of any other law of a
2 Participating State that is not inconsistent with this Compact.
3 2. Any laws in a Participating State in conflict with this Compact are superseded
4 to the extent of the conflict.
5 3. All agreements between the Commission and the Participating States are
6 binding in accordance with their terms.
337.600. As used in sections 337.600 to 337.689, the following terms mean:
2 (1) "Advanced macro social worker", the applications of social work theory ,
3 knowledge, methods, principles, values, and ethics; and the professional use of self to
4 community and or ganizational systems, systemic and macrocosm issues, and other indirect
5 nonclinical services; specialized knowledge and advanced practice skills in case management,
6 information and referral, nonclinical assessments, counseling, outcome evaluation, mediation,
7 nonclinical supervision, nonclinical consultation, expert testimony , education, outcome
8 evaluation, research, advocacy , social planning and policy development, community
9 or ganization, and the development, implementation and administration of policies,
1 0 programs, and activities. A licensed advanced macro social worker may not treat mental
11 or emotional disorders or provide psychotherapy without the direct supervision of a licensed
12 clinical social worker , or diagnose a mental disorder;
13 (2) "Clinical social work", the application of social work theory , knowledge, values,
14 methods, principles, and techniques of case work, group work, client-centered advocacy ,
15 community or ganization, administration, planning, evaluation, consultation, research,
16 psychotherapy and counseling methods and techniques to persons, families and groups in
17 assessment, diagnosis, treatment, prevention and amelioration of mental and emotional
18 conditions;
19 (3) "Committee", the state committee for social workers established in section
20 337.622;
21 (4) "Department", the Missouri department of commerce and insurance;
22 (5) "Director", the director of the division of professional registration;
23 (6) "Division", the division of professional registration;
24 (7) "Independent practice", any practice of social workers outside of an or ganized
25 setting such as a social, medical, or governmental agency in which a social worker assumes
26 responsibility and accountability for services required;
27 (8) "Licensed advanced macro social worker", any person who of fers to render
28 services to individuals, groups, families, couples, or ganizations, institutions, communities,
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29 government agencies, corporations, or the general public for a fee, monetary or otherwise,
30 implying that the person is trained, experienced, and licensed as an advanced macro social
31 worker , and who holds a current valid license to practice as an advanced macro social worker;
32 (9) "Licensed baccalaureate social worker", any person who of fers to render services
33 to individuals, groups, or ganizations, institutions, corporations, government agencies, or the
34 general public for a fee, monetary or otherwise, implying that the person is trained,
35 experienced, and licensed as a baccalaureate social worker , and who holds a current valid
36 license to practice as a baccalaureate social worker;
37 (10) "Licensed clinical social worker", any person who of fers to render services to
38 individuals, groups, or ganizations, institutions, corporations, government agencies, or the
39 general public for a fee, monetary or otherwise, implying that the person is trained,
40 experienced, and licensed as a clinical social worker , and who holds a current, valid license to
41 practice as a clinical social worker;
42 (1 1) "Licensed master social worker", any person who of fers to render services to
43 individuals, groups, families, couples, or ganizations, institutions, communities, government
44 agencies, corporations, or the general public for a fee, monetary or otherwise, implying that
45 the person is trained, experienced, and licensed as a master social worker , and who holds a
46 current valid license to practice as a master social worker . A licensed master social worker
47 may not treat mental or emotional disorders, provide psychotherapy without the direct
48 supervision of a licensed clinical social worker , or diagnose a mental disorder;
49 (12) "Master social work", the application of social work theory , knowledge,
50 methods, and ethics and the professional use of self to restore or enhance social, psychosocial,
51 or biopsychosocial functioning of individuals, couples, families, groups, or ganizations,
52 communities, institutions, government agencies, or corporations. The practice includes the
53 applications of specialized knowledge and advanced practice skills in the areas of assessment,
54 treatment planning, implementation and evaluation, case management, mediation,
5 5 information and referral, counseling, client education, supervision, consultation, education,
56 research, advocacy , community or ganization and development, planning, evaluation,
57 implementation and administration of policies, programs, and activities. Under supervision
58 as provided in this section, the practice of master social work may include the practices
59 reserved to clinical social workers or advanced macro social workers for no more than forty-
60 eight consecutive calendar months for the purpose of obtaining licensure under section
61 337.615 or 337.645;
62 (13) "Practice of advanced macro social work", rendering, of fering to render , or
63 supervising those who render to individuals, couples, families, groups, or ganizations,
64 institutions, corporations, government agencies, communities, or the general public any
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65 service involving the application of methods, principles, and techniques of advanced practice
66 macro social work;
67 (14) "Practice of baccalaureate social work", rendering, of fering to render , or
68 supervising those who render to individuals, families, groups, or ganizations, institutions,
69 corporations, or the general public any service involving the application of methods,
70 principles, and techniques of baccalaureate social work;
71 (15) "Practice of clinical social work", rendering, of fering to render , or supervising
72 those who render to individuals, couples, groups, or ganizations, institutions, corporations, or
73 the general public any service involving the application of methods, principles, and
74 techniques of clinical social work;
75 (16) "Practice of master social work", rendering, of fering to render , or supervising
76 those who render to individuals, couples, families, groups, or ganizations, institutions,
77 corporations, government agencies, communities, or the general public any service involving
78 the application of methods, principles, and techniques of master social work;
79 (17) "Qualified advanced macro supervisor", any licensed social worker who meets
80 the qualifications of a qualified clinical supervisor or a licensed advanced macro social
81 worker who has:
82 (a) Practiced in the field of social work as a licensed social worker for which he or
83 she is supervising the applicant for a minimum of [ five ] thr ee years;
84 (b) Successfully completed a minimum of sixteen hours of supervisory training from
85 the Association of Social W ork Boards, the National Association of Social W orkers, an
86 accredited university , or a program approved by the state committee for social workers. All
87 or ganizations providing the supervisory training shall adhere to the basic content and quality
88 standards outlined by the state committee on social work; and
89 (c) Met all the requirements of sections 337.600 to 337.689, and as defined by rule by
90 the state committee for social workers;
91 (18) "Qualified baccalaureate supervisor", any licensed social worker who meets the
92 qualifications of a qualified clinical supervisor , qualified master supervisor , qualified
93 advanced macro supervisor , or a licensed baccalaureate social worker who has:
94 (a) Practiced in the field of social work as a licensed social worker for which he or
95 she is supervising the applicant for a minimum of [ five ] thr ee years;
96 (b) Successfully completed a minimum of sixteen hours of supervisory training from
97 the Association of Social W ork Boards, the National Association of Social W orkers, an
98 accredited university , or a program approved by the state committee for social workers. All
99 or ganizations providing the supervisory training shall adhere to the basic content and quality
100 standards outlined by the state committee on social workers; and
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101 (c) Met all the requirements of sections 337.600 to 337.689, and as defined by rule by
102 the state committee for social workers;
103 (19) "Qualified clinical supervisor", any licensed clinical social worker who has:
104 (a) Practiced in the field of social work as a licensed social worker for which he or
105 she is supervising the applicant for a minimum of [ five ] thr ee years;
106 (b) Successfully completed a minimum of sixteen hours of supervisory training from
107 the Association of Social W ork Boards, the National Association of Social W orkers, an
108 accredited university , or a program approved by the state committee for social workers. All
109 or ganizations providing the supervisory training shall adhere to the basic content and quality
110 standards outlined by the state committee on social work; and
111 (c) Met all the requirements of sections 337.600 to 337.689, and as defined by rule by
112 the state committee for social workers;
113 (20) "Social worker", any individual that has:
114 (a) Received a baccalaureate degree in social work from an accredited social work
115 program approved by the Council on Social W ork Education;
116 (b) Received a master's degree in social work from a social work program:
117 a. Accredited by the Council on Social W ork Education; or
118 b. Recognized and approved by the committee in accordance with rules adopted by
119 the committee under section 337.627 and in accordance with the procedure set forth in section
120 337.628;
121 (c) Received a doctorate or Ph.D. in social work; or
122 (d) A current social worker license as set forth in sections 337.600 to 337.689.
345.050. T o be eligible for licensure by the board by examination, each applicant
2 shall submit the application fee and shall furnish evidence of such person's current
3 competence and shall:
4 (1) Hold a master's or a doctoral degree from a program that was awarded
5 "accreditation candidate" status or is accredited by the Council on Academic Accreditation of
6 the American Speech-Language-Hearing Association or other accrediting agency approved
7 by the board in the area in which licensure is sought;
8 (2) Submit official transcripts from one or more accredited colleges or universities
9 presenting evidence of the completion of course work and clinical practicum requirements
10 equivalent to that required by the Council on Academic Accreditation of the American
11 Speech-Language-Hearing Association or other accrediting agency approved by the board;
12 (3) Present written evidence of completion of a clinical fellowship from supervisors.
13 The experience required by this subdivision shall follow the completion of the requirements
14 of subdivisions (1) and (2) of this section. This period of employment shall be under the
15 direct supervision of a [ person who is ] licensed [ by the state of Missouri in the profession in
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16 which the applicant seeks to be licensed ] speech-language pathologist in good standing in
17 any state . Persons applying with an audiology clinical doctoral degree are exempt from this
18 provision; and
19 (4) Pass an examination promulgated or approved by the board. The board shall
20 determine the subject and scope of the examinations.
✔
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