Establishes the Respiratory Care Interstate Compact

SECOND REGULAR SESSION
SENATE BILL NO. 1519
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR LEWIS.
5905S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 334, RSMo, by adding thereto one new section relating to respiratory therapists.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 334, RSMo, is amended by adding thereto 1
one new section, to be known as section 334.935, to read as 2
follows:3
334.935. SECTION 1. TITLE AND PURPOSE 1
A. The purpose of this Compact is to facilitate the 2
interstate Practice of Respiratory Therapy with the goal of 3
improving public access to Respiratory Therapy services by 4
providing Respiratory Therapists licensed in a Member State 5
the ability to practice in other Member States. The Compact 6
preserves the regulatory authority of states to protect 7
public health and safety through the current system of State 8
licensure. 9
B. This Compact is designed to achieve the following 10
objectives: 11
1. Increase public access to Respiratory Therapy 12
services by creating a responsible, streamlined pathway for 13
Licensees to practice in Member States with the goal of 14
improving outcomes for patients; 15
2. Enhance States' ability to protect the public's 16
health and safety; 17
SB 1519 2
3. Promote the cooperation of Member States in 18
regulating the Practice of Respiratory Therapy within those 19
Member States; 20
4. Ease administrative burdens on States by 21
encouraging the cooperation of Member States in regulating 22
multi-state Respiratory Therapy practice; 23
5. Support relocating Active Military Members and 24
their spouses; and 25
6. Promote mobility and address workforce shortages. 26
SECTION 2. DEFINITIONS 27
As used in this Compact, unless the context requires 28
otherwise, the following definitions shall apply: 29
A. "Active Military Member" means any person with a 30
full-time duty status in the armed forces of the United 31
States, including members of the National Guard and Reserve. 32
B. "Adverse Action" means any administrative, civil, 33
equitable, or criminal action permitted by a State's laws 34
which is imposed by any State authority with regulatory 35
authority over Respiratory Therapists, such as license 36
denial, censure, revocation, suspension, probation, 37
monitoring of the Licensee, or restriction on the Licensee's 38
practice, not including participation in an Alternative 39
Program. 40
C. "Alternative Program" means a non-disciplinary 41
monitoring or practice remediation process applicable to a 42
Respiratory Therapist approved by any State authority with 43
regulatory authority over Respiratory Therapists. This 44
includes, but is not limited to, programs to which Licensees 45
with substance abuse or addiction issues are referred in 46
lieu of Adverse Action. 47
SB 1519 3
D. "Charter Member States" means those Member States 48
who were the first seven states to enact the Compact into 49
the laws of their State. 50
E. "Commission" or "Respiratory Care Interstate 51
Compact Commission" means the government instrumentality and 52
body politic whose membership consists of all Member States 53
that have enacted the Compact. 54
F. "Commissioner" means the individual appointed by a 55
Member State to serve as the member of the Commission for 56
that Member State. 57
G. "Compact" means the Respiratory Care Interstate 58
Compact. 59
H. "Compact Privilege" means the authorization granted 60
by a Remote State to allow a Licensee from another Member 61
State to practice as a Respiratory Therapist in the Remote 62
State under the Remote State's laws and Rules. The Practice 63
of Respiratory Therapy occurs in the Member State where the 64
patient is located at the time of the patient encounter. 65
I. "Criminal Background Check" means the submission by 66
the Member State of fingerprints or other biometric-based 67
information on license applicants at the time of initial 68
licensing for the purpose of obtaining that applicant's 69
criminal history record information, as defined in 28 C.F.R. 70
§ 20.3(d) or successor provision, from the Federal Bureau of 71
Investigation and the States criminal history record 72
repository, as defined in 28 C.F.R. § 20.3(f) or successor 73
provision. 74
J. "Data System" means the Commission's repository of 75
information about Licensees as further set forth in Section 76
8. 77
K. "Domicile" means the jurisdiction which is the 78
Licensee's principal home for legal purposes. 79
SB 1519 4
L. "Encumbered License" means a license that a State's 80
Respiratory Therapy Licensing Authority has limited in any 81
way. 82
M. "Executive Committee" means a group of directors 83
elected or appointed to act on behalf of, and within the 84
powers granted to them by the Commission. 85
N. "Home State" except as set forth in Section 5, 86
means the Member State that is the Licensee's primary 87
Domicile. 88
O. "Home State License" means an active license to 89
practice Respiratory Therapy in a Home State that is not an 90
Encumbered License. 91
P. "Jurisprudence Requirement" means an assessment of 92
an individual's knowledge of the State laws and regulations 93
governing the Practice of Respiratory Therapy in such State. 94
Q. "Licensee" means an individual who currently holds 95
an authorization from the State to practice as a Respiratory 96
Therapist. 97
R. "Member State" means a State that has enacted the 98
Compact and been admitted to the Commission in accordance 99
with the provisions herein and Commission Rules. 100
S. "Model Compact" means the model for the Respiratory 101
Care Interstate Compact on file with The Council of State 102
Governments or other entity as designated by the Commission. 103
T. "Remote State" means a Member State where a 104
Licensee is exercising or seeking to exercise the Compact 105
Privilege. 106
U. "Respiratory Therapist" or "Respiratory Care 107
Practitioner" means an individual who holds a credential 108
issued by the National Board for Respiratory Care (or its 109
successor) and holds a license in a State to practice 110
Respiratory Therapy. For purposes of this Compact, any 111
SB 1519 5
other title or status adopted by a State to replace the term 112
"Respiratory Therapist" or "Respiratory Care Practitioner" 113
shall be deemed synonymous with "Respiratory Therapist" and 114
shall confer the same rights and responsibilities to the 115
Licensee under the provisions of this Compact at the time of 116
its enactment. 117
V. "Respiratory Therapy," "Respiratory Therapy 118
Practice," "Respiratory Care," "the Practice of Respiratory 119
Care," and "the Practice of Respiratory Therapy" means the 120
care and services provided by or under the direction and 121
supervision of a Respiratory Therapist or Respiratory Care 122
Practitioner. 123
W. "Respiratory Therapy Licensing Authority" means the 124
agency, board, or other body of a State that is responsible 125
for licensing and regulation of Respiratory Therapists. 126
X. "Rule" means a regulation promulgated by an entity 127
that has the force and effect of law. 128
Y. "Scope of Practice" means the procedures, actions, 129
and processes a Respiratory Therapist licensed in a State or 130
practicing under a Compact Privilege in a State is permitted 131
to undertake in that State and the circumstances under which 132
the Respiratory Therapist is permitted to undertake those 133
procedures, actions, and processes. Such procedures, 134
actions, and processes, and the circumstances under which 135
they may be undertaken may be established through means, 136
including, but not limited to, statute, regulations, case 137
law, and other processes available to the State Respiratory 138
Therapy Licensing Authority or other government agency. 139
Z. "Significant Investigative Information" means 140
information, records, and documents received or generated by 141
a State Respiratory Therapy Licensing Authority pursuant to 142
an investigation for which a determination has been made 143
SB 1519 6
that there is probable cause to believe that the Licensee 144
has violated a statute or regulation that is considered more 145
than a minor infraction for which the State Respiratory 146
Therapy Licensing Authority could pursue Adverse Action 147
against the Licensee. 148
AA. "State" means any state, commonwealth, district, 149
or territory of the United States. 150
SECTION 3. STATE PARTICIPATION IN THIS COMPACT 151
A. In order to participate in this Compact and 152
thereafter continue as a Member State, a Member State shall: 153
1. Enact a Compact that is not materially different 154
from the Model Compact; 155
2. License Respiratory Therapists; 156
3. Participate in the Commission's Data System; 157
4. Have a mechanism in place for receiving and 158
investigating complaints against Licensees and Compact 159
Privilege holders; 160
5. Notify the Commission, in compliance with the terms 161
of this Compact and Commission Rules, of any Adverse Action 162
against a Licensee, a Compact Privilege holder, or a license 163
applicant; 164
6. Notify the Commission, in compliance with the terms 165
of this Compact and Commission Rules, of the existence of 166
Significant Investigative Information; 167
7. Comply with the Rules of the Commission; 168
8. Grant the Compact Privilege to a holder of an 169
active Home State License and otherwise meet the applicable 170
requirements of Section 4 in a Member State; and 171
9. Complete a Criminal Background Check for each new 172
Licensee at the time of initial licensure. 173
a. Where expressly authorized or permitted by federal 174
law, whether such federal law is in effect prior to, at, or 175
SB 1519 7
after the time of a Member State's enactment of this 176
Compact, a Member State's enactment of this Compact shall 177
hereby authorize the Member State's Respiratory Therapy 178
Licensing Authority to perform Criminal Background Checks as 179
defined herein. The absence of such a federal law as 180
described in this subsection shall not prevent or preclude 181
such authorization where it may be derived or granted 182
through means other than the enactment of this Compact. 183
B. Nothing in this Compact prohibits a Member State 184
from charging a fee for granting and renewing the Compact 185
Privilege. 186
SECTION 4. COMPACT PRIVILEGE 187
A. To exercise the Compact Privilege under the terms 188
and provisions of the Compact, the Licensee shall: 189
1. Hold and maintain an active Home State License as a 190
Respiratory Therapist; 191
2. Hold and maintain an active credential from the 192
National Board for Respiratory Care (or its successor) that 193
would qualify them for licensure in the Remote State in 194
which they are seeking the privilege; 195
3. Have not had any Adverse Action against a license 196
within the previous two (2) years; 197
4. Notify the Commission that the Licensee is seeking 198
the Compact Privilege within a Remote State(s); 199
5. Pay any applicable fees, including any State and 200
Commission fees and renewal fees, for the Compact Privilege; 201
6. Meet any Jurisprudence Requirements established by 202
the Remote State in which the Licensee is seeking a Compact 203
Privilege; 204
7. Report to the Commission Adverse Action taken by 205
any non-Member State within thirty (30) days from the date 206
the Adverse Action is taken; 207
SB 1519 8
8. Report to the Commission, when applying for a 208
Compact Privilege, the address of the Licensee's Domicile 209
and thereafter promptly report to the Commission any change 210
in the address of the Licensee's Domicile within thirty (30) 211
days of the effective date of the change in address; and 212
9. Consent to accept service of process by mail at the 213
Licensee's Domicile on record with the Commission with 214
respect to any action brought against the Licensee by the 215
Commission or a Member State, and consent to accept service 216
of a subpoena by mail at the Licensee's Domicile on record 217
with the Commission with respect to any action brought or 218
investigation conducted by the Commission or a Member State. 219
B. The Compact Privilege is valid until the expiration 220
date or revocation of the Home State License unless 221
terminated pursuant to Adverse Action. The Licensee must 222
comply with all of the requirements of subsection 4.A, 223
above, to maintain the Compact Privilege in a Remote State. 224
If those requirements are met, no Adverse Actions are taken, 225
and the Licensee has paid any applicable Compact Privilege 226
renewal fees, then the Licensee will maintain the Licensee's 227
Compact Privilege. 228
C. A Licensee providing Respiratory Therapy in a 229
Remote State under the Compact Privilege shall function 230
within the Scope of Practice authorized by the Remote State 231
for the type of Respiratory Therapist license the Licensee 232
holds. Such procedures, actions, processes, and the 233
circumstances under which they may be undertaken may be 234
established through means, including, but not limited to, 235
statute, regulations, case law, and other processes 236
available to the State Respiratory Therapy Licensing 237
Authority or other government agency. 238
SB 1519 9
D. If a Licensee's Compact Privilege in a Remote State 239
is removed by the Remote State, the individual shall lose or 240
be ineligible for the Compact privilege in that Remote State 241
until the Compact Privilege is no longer limited or 242
restricted by that State. 243
E. If a Home State License is encumbered, the Licensee 244
shall lose the Compact Privilege in all Remote States until 245
the following occur: 246
1. The Home State License is no longer encumbered; and 247
2. Two (2) years have elapsed from the date on which 248
the license is no longer encumbered due to the Adverse 249
Action. 250
F. Once a Licensee with a restricted or limited 251
license meets the requirements of subsection 7.E.1 and 2, 252
the Licensee must also meet the requirements of subsection 253
7.A to obtain a Compact Privilege in a Remote State. 254
SECTION 5. ACTIVE MILITARY MEMBER OR THEIR SPOUSE 255
A. An Active Military Member, or their spouse, shall 256
designate a Home State where the individual has a current 257
license in good standing. The individual may retain the 258
Home State designation during the period the service member 259
is on active duty. 260
B. An Active Military Member and their spouse shall 261
not be required to pay to the Commission for a Compact 262
Privilege any fee that may otherwise be charged by the 263
Commission. If a Remote State chooses to charge a fee for a 264
Compact Privilege, it may choose to charge a reduced fee or 265
no fee to an Active Military Member and their spouse for a 266
Compact Privilege. 267
SECTION 6. ADVERSE ACTIONS 268
SB 1519 10
A. A Member State in which a Licensee is licensed 269
shall have authority to impose Adverse Action against the 270
license issued by that Member State. 271
B. A Member State may take Adverse Action based on 272
Significant Investigative Information of a Remote State or 273
the Home State, so long as the Member State follows its own 274
procedures for imposing Adverse Action. 275
C. Nothing in this Compact shall override a Member 276
State's decision that participation in an Alternative 277
Program may be used in lieu of Adverse Action and that such 278
participation shall remain non-public if required by the 279
Member State's laws. 280
D. A Remote State shall have the authority to: 281
1. Take Adverse Actions as set forth herein against a 282
Licensee's Compact Privilege in that State; 283
2. Issue subpoenas for both hearings and 284
investigations that require the attendance and testimony of 285
witnesses, and the production of evidence. 286
a. Subpoenas may be issued by a Respiratory Therapy 287
Licensing Authority in a Member State for the attendance and 288
testimony of witnesses and the production of evidence. 289
b. Subpoenas issued by a Respiratory Therapy Licensing 290
Authority in a Member State for the attendance and testimony 291
of witnesses shall be enforced in the latter State by any 292
court of competent jurisdiction in the latter State, 293
according to the practice and procedure of that court 294
applicable to subpoenas issued in proceedings pending before 295
it. 296
c. Subpoenas issued by a Respiratory Therapy Licensing 297
Authority in a Member State for production of evidence from 298
another Member State shall be enforced in the latter State, 299
according to the practice and procedure of that court 300
SB 1519 11
applicable to subpoenas issued in the proceedings pending 301
before it. 302
d. The issuing authority shall pay any witness fees, 303
travel expenses, mileage, and other fees required by the 304
service statutes of the State where the witnesses or 305
evidence are located; 306
3. Unless otherwise prohibited by State law, recover 307
from the Licensee the costs of investigations and 308
disposition of cases resulting from any Adverse Action taken 309
against that Licensee; 310
4. Notwithstanding subsection 6.D.2., a Member State 311
may not issue a subpoena to gather evidence of conduct in 312
another Member State that is lawful in such other Member 313
State for the purpose of taking Adverse Action against a 314
Licensee's Compact Privilege or application for a Compact 315
Privilege in that Member State; and 316
5. Nothing in this Compact authorizes a Member State 317
to impose discipline against a Respiratory Therapist's 318
Compact Privilege in that Member State for the individual's 319
otherwise lawful practice in another State. 320
E. Joint Investigations 321
1. In addition to the authority granted to a Member 322
State by its respective Respiratory Therapy Practice act or 323
other applicable state law, a Member State may participate 324
with other Member States in joint investigations of 325
Licensees, provided, however, that a Member State receiving 326
such a request has no obligation to respond to any subpoena 327
issued regarding an investigation of conduct or practice 328
that was lawful in a Member State at the time it was 329
undertaken. 330
2. Member States shall share any Significant 331
Investigative Information, litigation, or compliance 332
SB 1519 12
materials in furtherance of any joint or individual 333
investigation initiated under the Compact. In sharing such 334
information between Member State Respiratory Therapy 335
Licensing Authorities, all information obtained shall be 336
kept confidential, except as otherwise mutually agreed upon 337
by the sharing and receiving Member State(s). 338
F. Nothing in this Compact may permit a Member State 339
to take any Adverse Action against a Licensee or holder of a 340
Compact Privilege for conduct or practice that was legal in 341
the Member State at the time it was undertaken. 342
G. Nothing in this Compact may permit a Member State 343
to take disciplinary action against a Licensee or holder of 344
a Compact Privilege for conduct or practice that was legal 345
in the Member State at the time it was undertaken. 346
SECTION 7. ESTABLISHMENT OF THE RESPIRATORY CARE 347
INTERSTATE COMPACT COMMISSION 348
A. The Compact Member States hereby create and 349
establish a joint government agency whose membership 350
consists of all Member States that have enacted the Compact 351
known as the Respiratory Care Interstate Compact 352
Commission. The Commission is an instrumentality of the 353
Compact Member States acting jointly and not an 354
instrumentality of any one State. The Commission shall come 355
into existence on or after the effective date of the 356
Compact, as set forth in Section 11. 357
B. Membership, Voting, and Meetings 358
1. Each Member State shall have and be limited to one 359
(1) Commissioner selected by that Member State's Respiratory 360
Therapy Licensing Authority. 361
2. The Commissioner shall be an administrator or their 362
designated staff member of the Member State's Respiratory 363
Therapy Licensing Authority. 364
SB 1519 13
3. The Commission shall by Rule or bylaw establish a 365
term of office for Commissioners and may by Rule or bylaw 366
establish term limits. 367
4. The Commission may recommend to a Member State the 368
removal or suspension of any Commissioner from office. 369
5. A Member State's Respiratory Therapy Licensing 370
Authority shall fill any vacancy of its Commissioner 371
occurring on the Commission within sixty (60) days of the 372
vacancy. 373
6. Each Commissioner shall be entitled to one vote on 374
all matters before the Commission requiring a vote by 375
Commissioners. 376
7. A Commissioner shall vote in person or by such 377
other means as provided in the bylaws. The bylaws may 378
provide for Commissioners to meet by telecommunication, 379
videoconference, or other means of communication. 380
8. The Commission shall meet at least once during each 381
calendar year. Additional meetings may be held as set forth 382
in the bylaws. 383
C. The Commission shall have the following powers: 384
1. Establish and amend the fiscal year of the 385
Commission; 386
2. Establish and amend bylaws and policies, including 387
but not limited to, a code of conduct and conflict of 388
interest; 389
3. Establish and amend Rules, which shall be binding 390
in all Member States; 391
4. Maintain its financial records in accordance with 392
the bylaws; 393
5. Meet and take such actions as are consistent with 394
the provisions of this Compact, the Commission's Rules, and 395
the bylaws; 396
SB 1519 14
6. Initiate and conduct legal proceedings or actions 397
in the name of the Commission, provided that the standing of 398
any Respiratory Therapy Licensing Authority to sue or be 399
sued under applicable law shall not be affected; 400
7. Maintain and certify records and information 401
provided to a Member State as the authenticated business 402
records of the Commission, and designate an agent to do so 403
on the Commission's behalf; 404
8. Purchase and maintain insurance and bonds; 405
9. Accept or contract for services of personnel, 406
including, but not limited to, employees of a Member State; 407
10. Conduct an annual financial review; 408
11. Hire employees, elect or appoint officers, fix 409
compensation, define duties, grant such individuals 410
appropriate authority to carry out the purposes of the 411
Compact, and establish the Commission's personnel policies 412
and programs relating to conflicts of interest, 413
qualifications of personnel, and other related personnel 414
matters; 415
12. Assess and collect fees; 416
13. Accept any and all appropriate gifts, donations, 417
grants of money, other sources of revenue, equipment, 418
supplies, materials, and services, and receive, utilize, and 419
dispose of the same, provided that at all times: 420
a. The Commission shall avoid any appearance of 421
impropriety; and 422
b. The Commission shall avoid any appearance of 423
conflict of interest; 424
14. Lease, purchase, retain, own, hold, improve, or 425
use any property, real, personal, or mixed, or any undivided 426
interest therein; 427
SB 1519 15
15. Sell, convey, mortgage, pledge, lease, exchange, 428
abandon, or otherwise dispose of any property real, 429
personal, or mixed; 430
16. Establish a budget and make expenditures; 431
17. Borrow money in a fiscally responsible manner; 432
18. Appoint committees, including standing committees, 433
composed of Commissioners State regulators, State 434
legislators or their representatives, and consumer 435
representatives, and such other interested persons as may be 436
designated in this Compact and the bylaws; 437
19. Provide and receive information from, and 438
cooperate with, law enforcement agencies; 439
20. Establish and elect an Executive Committee, 440
including a chair, vice-chair, secretary, treasurer, and 441
such other offices as the Commission shall establish by Rule 442
or bylaw; 443
21. Enter into contracts or arrangements for the 444
management of the affairs of the Commission; 445
22. Determine whether a State's adopted language is 446
materially different from the Model Compact language such 447
that the State would not qualify for participation in the 448
Compact; and 449
23. Perform such other functions as may be necessary 450
or appropriate to achieve the purposes of this Compact. 451
D. The Executive Committee 452
1. The Executive Committee shall have the power to act 453
on behalf of the Commission according to the terms of this 454
Compact. The powers, duties, and responsibilities of the 455
Executive Committee shall include: 456
a. Overseeing the day-to-day activities of the 457
administration of the Compact, including enforcement and 458
SB 1519 16
compliance with the provisions of the Compact, its Rules and 459
bylaws, and other such duties as deemed necessary; 460
b. Recommending to the Commission changes to the Rules 461
or bylaws, changes to this Compact legislation, fees charged 462
to Compact Member States, fees charged to Licensees, and 463
other fees; 464
c. Ensuring Compact administration services are 465
appropriately provided, including by contract; 466
d. Preparing and recommending the budget; 467
e. Maintaining financial records on behalf of the 468
Commission; 469
f. Monitoring Compact compliance of Member States and 470
providing compliance reports to the Commission; 471
g. Establishing additional committees as necessary; 472
h. Exercising the powers and duties of the Commission 473
during the interim between Commission meetings, except for 474
adopting or amending Rules, adopting or amending bylaws, and 475
exercising any other powers and duties expressly reserved to 476
the Commission by Rule or bylaw; and 477
i. Performing other duties as provided in the Rules or 478
bylaws of the Commission. 479
2. The Executive Committee shall be composed of up to 480
nine (9) members, as further set forth in the bylaws of the 481
Commission: 482
a. Seven (7) voting members who are elected by the 483
Commission from the current membership of the Commission; and 484
b. Two (2) ex-officio, non-voting members. 485
3. The Commission may remove any member of the 486
Executive Committee as provided in the Commission's bylaws. 487
4. The Executive Committee shall meet at least 488
annually. 489
SB 1519 17
a. Executive Committee meetings shall be open to the 490
public, except that the Executive Committee may meet in a 491
closed, non-public meeting as provided in subsection 7.F.4 492
below; 493
b. The Executive Committee shall give advance notice 494
of its meetings, posted on its website and as determined to 495
provide notice to persons with an interest in the business 496
of the Commission; and 497
c. The Executive Committee may hold a special meeting 498
in accordance with subsection 7.F.2 below. 499
E. The Commission shall adopt and provide to the 500
Member States an annual report. 501
F. Meetings of the Commission 502
1. All meetings of the Commission that are not closed 503
pursuant to subsection 7.F.4 shall be open to the public. 504
Notice of public meetings shall be posted on the 505
Commission's website at least thirty (30) days prior to the 506
public meeting. 507
2. Notwithstanding subsection 7.F.1, the Commission 508
may convene an emergency public meeting by providing at 509
least twenty-four (24) hours prior notice on the 510
Commission's website, and any other means as provided in the 511
Commission's Rules, for any of the reasons it may dispense 512
with notice of proposed rulemaking under subsection 9.G. 513
The Commission's legal counsel shall certify that one of the 514
reasons justifying an emergency public meeting has been met. 515
3. Notice of all Commission meetings shall provide the 516
time, date, and location of the meeting, and if the meeting 517
is to be held or accessible via telecommunication, video 518
conference, or other electronic means, the notice shall 519
include the mechanism for access to the meeting. 520
SB 1519 18
4. The Commission or the Executive Committee may 521
convene in a closed, non-public meeting for the Commission 522
or Executive Committee to receive or solicit legal advice or 523
to discuss: 524
a. Non-compliance of a Member State with its 525
obligations under the Compact; 526
b. The employment, compensation, discipline or other 527
matters, practices or procedures related to specific 528
employees; 529
c. Current or threatened discipline of a Licensee or 530
Compact Privilege holder by the Commission or by a Member 531
State's Respiratory Therapy Licensing Authority; 532
d. Current, threatened, or reasonably anticipated 533
litigation; 534
e. Negotiation of contracts for the purchase, lease, 535
or sale of goods, services, or real estate; 536
f. Accusing any person of a crime or formally 537
censuring any person; 538
g. Trade secrets or commercial or financial 539
information that is privileged or confidential; 540
h. Information of a personal nature where disclosure 541
would constitute a clearly unwarranted invasion of personal 542
privacy; 543
i. Investigative records compiled for law enforcement 544
purposes; 545
j. Information related to any investigative reports 546
prepared by or on behalf of or for use of the Commission or 547
other committee charged with responsibility of investigation 548
or determination of compliance issues pursuant to the 549
Compact; 550
k. Legal advice; 551
SB 1519 19
l. Matters specifically exempted from disclosure by 552
federal or Member State law; or 553
m. Other matters as promulgated by the Commission by 554
Rule. 555
5. If a meeting, or portion of a meeting, is closed, 556
the presiding officer shall state that the meeting will be 557
closed and reference each relevant exempting provision, and 558
such reference shall be recorded in the minutes. 559
6. The Commission shall keep minutes in accordance 560
with Commission Rules and bylaws. All documents considered 561
in connection with an action shall be identified in such 562
minutes. All minutes and documents of a closed meeting 563
shall remain under seal, subject to release only by a 564
majority vote of the Commission or order of a court of 565
competent jurisdiction. 566
G. Financing of the Commission 567
1. The Commission shall pay, or provide for the 568
payment of, the reasonable expenses of its establishment, 569
organization, and ongoing activities. 570
2. The Commission may accept any and all appropriate 571
revenue sources as provided herein. 572
3. The Commission may levy on and collect an annual 573
assessment from each Member State and impose fees on 574
Licensees of Member States to whom it grants a Compact 575
Privilege to cover the cost of the operations and activities 576
of the Commission and its staff. The aggregate annual 577
assessment amount for Member States, if any, shall be 578
allocated based upon a formula that the Commission shall 579
promulgate by Rule. 580
4. The Commission shall not incur obligations of any 581
kind prior to securing the funds or a loan adequate to meet 582
the same; nor shall the Commission pledge the credit of any 583
SB 1519 20
of the Member States, except by and with the authority of 584
the Member State. 585
5. The Commission shall keep accurate accounts of all 586
receipts and disbursements. The receipts and disbursements 587
of the Commission shall be subject to the financial review 588
and accounting procedures established under its bylaws. 589
However, all receipts and disbursements of funds handled by 590
the Commission shall be subject to an annual financial 591
review by a certified or licensed public accountant, and the 592
report of the financial review shall be included in and 593
become part of the annual report of the Commission. 594
H. Qualified Immunity, Defense, and Indemnification 595
1. Nothing herein shall be construed as a limitation 596
on the liability of any Licensee for professional 597
malpractice or misconduct, which shall be governed solely by 598
any other applicable state laws. 599
2. The Member States, Commissioners, officers, 600
executive directors, employees, and agents of the Commission 601
shall be immune from suit and liability, both personally and 602
in their official capacity, for any claim for damage to or 603
loss of property or personal injury or other civil liability 604
caused by or arising out of any actual or alleged act, 605
error, or omission that occurred, or that the person against 606
whom the claim is made had a reasonable basis for believing 607
occurred within the scope of Commission employment, duties 608
or responsibilities; provided that nothing in this 609
subsection shall be construed to protect any such person 610
from suit or liability for any damage, loss, injury, or 611
liability caused by the intentional or willful or wanton 612
misconduct of that person. The procurement of insurance of 613
any type by the Commission shall not in any way compromise 614
or limit the immunity granted hereunder. 615
SB 1519 21
3. The Commission shall defend any Commissioner, 616
officer, executive director, employee, and agent of the 617
Commission in any civil action seeking to impose liability 618
arising out of any actual or alleged act, error, or omission 619
that occurred within the scope of Commission employment, 620
duties, or responsibilities, or as determined by the 621
Commission that the person against whom the claim is made 622
had a reasonable basis for believing occurred within the 623
scope of Commission employment, duties, or responsibilities; 624
provided that nothing herein shall be construed to prohibit 625
that person from retaining their own counsel at their own 626
expense; and provided further, that the actual or alleged 627
act, error, or omission did not result from that person's 628
intentional or willful or wanton misconduct. 629
4. The Commission shall indemnify and hold harmless 630
any Commissioner, member, officer, executive director, 631
employee, and agent of the Commission for the amount of any 632
settlement or judgment obtained against that person arising 633
out of any actual or alleged act, error, or omission that 634
occurred within the scope of Commission employment, duties, 635
or responsibilities, or that such person had a reasonable 636
basis for believing occurred within the scope of Commission 637
employment, duties, or responsibilities, provided that the 638
actual or alleged act, error, or omission did not result 639
from the intentional or willful or wanton misconduct of that 640
person. 641
5. Nothing in this Compact shall be interpreted to 642
waive or otherwise abrogate a Member State's state action 643
immunity or state action affirmative defense with respect to 644
antitrust claims under the Sherman Act, Clayton Act, or any 645
other State or federal antitrust or anticompetitive law or 646
regulation. 647
SB 1519 22
6. Nothing in this Compact shall be construed to be a 648
waiver of sovereign immunity by the Member States or by the 649
Commission. 650
SECTION 8. DATA SYSTEM 651
A. The Commission shall provide for the development, 652
maintenance, operation, and utilization of a coordinated 653
database and reporting system containing licensure, Adverse 654
Action, and the presence of Significant Investigative 655
Information. 656
B. Notwithstanding any other provision of State law to 657
the contrary, a Member State shall submit a uniform data set 658
to the Data System as required by the Rules of the 659
Commission, including but not limited to: 660
1. Identifying information; 661
2. Licensure data; 662
3. Adverse Actions against a Licensee, license 663
applicant, or Compact Privilege holder and information 664
related thereto; 665
4. Non-confidential information related to Alternative 666
Program participation, the beginning and ending dates of 667
such participation, and other information related to such 668
participation not made confidential under Member State law; 669
5. Any denial of application for licensure, and the 670
reason(s) for such denial; 671
6. The presence of current Significant Investigative 672
Information; and 673
7. Other information that may facilitate the 674
administration of this Compact or the protection of the 675
public, as determined by the Rules of the Commission. 676
C. No Member State shall submit any information which 677
constitutes criminal history record information, as defined 678
SB 1519 23
by applicable federal law, to the Data System established 679
hereunder. 680
D. The records and information provided to a Member 681
State pursuant to this Compact or through the Data System, 682
when certified by the Commission or an agent thereof, shall 683
constitute the authenticated business records of the 684
Commission, and shall be entitled to any associated hearsay 685
exception in any relevant judicial, quasi-judicial or 686
administrative proceedings in a Member State. 687
E. Significant Investigative Information pertaining to 688
a Licensee in any Member State will only be available to 689
other Member States. 690
F. It is the responsibility of the Member States to 691
report any Adverse Action against a Licensee and to monitor 692
the database to determine whether Adverse Action has been 693
taken against a Licensee. Adverse Action information 694
pertaining to a Licensee in any Member State will be 695
available to any other Member State. 696
G. Member States contributing information to the Data 697
System may designate information that may not be shared with 698
the public without the express permission of the 699
contributing State. 700
H. Any information submitted to the Data System that 701
is subsequently expunged pursuant to federal law or the laws 702
of the Member State contributing the information shall be 703
removed from the Data System. 704
SECTION 9. RULEMAKING 705
A. The Commission shall promulgate reasonable Rules in 706
order to effectively and efficiently implement and 707
administer the purposes and provisions of the Compact. A 708
Rule shall be invalid and have no force or effect only if a 709
court of competent jurisdiction holds that the Rule is 710
SB 1519 24
invalid because the Commission exercised its rulemaking 711
authority in a manner that is beyond the scope and purposes 712
of the Compact, or the powers granted hereunder, or based 713
upon another applicable standard of review. 714
B. For purposes of the Compact, the Rules of the 715
Commission shall have the force of law in each Member State. 716
C. The Commission shall exercise its rulemaking powers 717
pursuant to the criteria set forth in this section and the 718
Rules adopted thereunder. Rules shall become binding as of 719
the date specified in each Rule. 720
D. If a majority of the legislatures of the Member 721
States rejects a Rule or portion of a Rule, by enactment of 722
a statute or resolution in the same manner used to adopt the 723
Compact within four (4) years of the date of adoption of the 724
Rule, then such Rule shall have no further force and effect 725
in any Member State. 726
E. Rules shall be adopted at a regular or special 727
meeting of the Commission. 728
F. Prior to adoption of a proposed Rule, the 729
Commission shall hold a public hearing and allow persons to 730
provide oral and written comments, data, facts, opinions, 731
and arguments. 732
G. Prior to adoption of a proposed Rule by the 733
Commission, and at least thirty (30) days in advance of the 734
meeting at which the Commission will hold a public hearing 735
on the proposed Rule, the Commission shall provide a notice 736
of proposed rulemaking: 737
1. On the website of the Commission or other publicly 738
accessible platform; 739
2. To persons who have requested notice of the 740
Commission's notices of proposed rulemaking, and 741
SB 1519 25
3. In such other way(s) as the Commission may by Rule 742
specify. 743
H. The notice of proposed rulemaking shall include: 744
1. The time, date, and location of the public hearing 745
at which the Commission will hear public comments on the 746
proposed Rule and, if different, the time, date, and 747
location of the meeting where the Commission will consider 748
and vote on the proposed Rule; 749
2. If the hearing is held via telecommunication, video 750
conference, or other electronic means, the Commission shall 751
include the mechanism for access to the hearing in the 752
notice of proposed rulemaking; 753
3. The text of the proposed Rule and the reason 754
therefor; 755
4. A request for comments on the proposed Rule from 756
any interested person; and 757
5. The manner in which interested persons may submit 758
written comments. 759
I. All hearings will be recorded. A copy of the 760
recording and all written comments and documents received by 761
the Commission in response to the proposed Rule shall be 762
available to the public. 763
J. Nothing in this section shall be construed as 764
requiring a separate hearing on each Rule. Rules may be 765
grouped for the convenience of the Commission at hearings 766
required by this section. 767
K. The Commission shall, by majority vote of all 768
Commissioners, take final action on the proposed Rule based 769
on the rulemaking record and the full text of the Rule. 770
1. The Commission may adopt changes to the proposed 771
Rule provided the changes are consistent with the original 772
purpose of the proposed Rule. 773
SB 1519 26
2. The Commission shall provide an explanation of the 774
reasons for substantive changes made to the proposed Rule as 775
well as reasons for substantive changes not made that were 776
recommended by commenters. 777
3. The Commission shall determine a reasonable 778
effective date for the Rule. Except for an emergency as 779
provided in subsection 9.L, the effective date of the Rule 780
shall be no sooner than thirty (30) days after issuing the 781
notice that it adopted or amended the Rule. 782
L. Upon determination that an emergency exists, the 783
Commission may consider and adopt an emergency Rule with 784
twenty-four (24) hours' notice, and with opportunity to 785
comment, provided that the usual rulemaking procedures 786
provided in the Compact and in this section shall be 787
retroactively applied to the Rule as soon as reasonably 788
possible, in no event later than ninety (90) days after the 789
effective date of the Rule. For the purposes of this 790
provision, an emergency Rule is one that must be adopted 791
immediately in order to: 792
1. Meet an imminent threat to public health, safety, 793
or welfare; 794
2. Prevent a loss of Commission or Member State funds; 795
3. Meet a deadline for the promulgation of a Rule that 796
is established by federal law or Rule; or 797
4. Protect public health and safety. 798
M. The Commission or an authorized committee of the 799
Commission may direct revisions to a previously adopted Rule 800
for purposes of correcting typographical errors, errors in 801
format, errors in consistency, or grammatical errors. 802
Public notice of any revisions shall be posted on the 803
website of the Commission. The revision shall be subject to 804
challenge by any person for a period of thirty (30) days 805
SB 1519 27
after posting. The revision may be challenged only on 806
grounds that the revision results in a material change to a 807
Rule. A challenge shall be made in writing and delivered to 808
the Commission prior to the end of the notice period. If no 809
challenge is made, the revision will take effect without 810
further action. If the revision is challenged, the revision 811
may not take effect without the approval of the Commission. 812
N. No Member State's rulemaking process or procedural 813
requirements shall apply to the Commission. 814
1. The Commission shall have no authority over any 815
Member State's rulemaking process or procedural requirements 816
that do not pertain to the Compact. 817
O. Nothing in this Compact, nor any Rule or regulation 818
of the Commission, shall be construed to limit, restrict, or 819
in any way reduce the ability of a Member State to enact and 820
enforce laws, regulations, or other Rules related to the 821
Practice of Respiratory Therapy in that State, where those 822
laws, regulations, or other Rules are not inconsistent with 823
the provisions of this Compact. 824
SECTION 10. OVERSIGHT, DISPUTE RESOLUTION, AND 825
ENFORCEMENT 826
A. Oversight 827
1. The executive and judicial branches of State 828
government in each Member State shall enforce this Compact 829
and take all actions necessary and appropriate to implement 830
the Compact. 831
2. Venue is proper and judicial proceedings by or 832
against the Commission shall be brought solely and 833
exclusively in a court of competent jurisdiction where the 834
principal office of the Commission is located. The 835
Commission may waive venue and jurisdictional defenses to 836
the extent it adopts or consents to participate in 837
SB 1519 28
alternative dispute resolution proceedings. Nothing herein 838
shall affect or limit the selection or propriety of venue in 839
any action against a Licensee for professional malpractice, 840
misconduct or any such similar matter. 841
3. The Commission shall be entitled to receive service 842
of process in any proceeding regarding the enforcement or 843
interpretation of the Compact and shall have standing to 844
intervene in such a proceeding for all purposes. Failure to 845
provide the Commission service of process shall render a 846
judgment or order void as to the Commission, this Compact, 847
or promulgated Rules. 848
B. Default, Technical Assistance, and Termination 849
1. If the Commission determines that a Member State 850
has defaulted in the performance of its obligations or 851
responsibilities under this Compact or the promulgated 852
Rules, the Commission shall provide written notice to the 853
defaulting State. The notice of default shall describe the 854
default, the proposed means of curing the default, and any 855
other action that the Commission may take, and shall offer 856
training and specific technical assistance regarding the 857
default. 858
2. The Commission shall provide a copy of the notice 859
of default to the other Member States. 860
C. If a State in default fails to cure the default, 861
the defaulting State may be terminated from the Compact upon 862
an affirmative vote of a majority of the Commissioners of 863
the Member States, and all rights, privileges and benefits 864
conferred on that State by this Compact may be terminated on 865
the effective date of termination. A cure of the default 866
does not relieve the offending State of obligations or 867
liabilities incurred during the period of default. 868
SB 1519 29
D. Termination of membership in the Compact shall be 869
imposed only after all other means of securing compliance 870
have been exhausted. Notice of intent to suspend or 871
terminate shall be given by the Commission to the governor, 872
the majority and minority leaders of the defaulting State's 873
legislature, the defaulting State's Respiratory Therapy 874
Licensing Authority and each of the Member States' 875
Respiratory Therapy Licensing Authorities. 876
E. A State that has been terminated is responsible for 877
all assessments, obligations, and liabilities incurred 878
through the effective date of termination, including 879
obligations that extend beyond the effective date of 880
termination, if necessary. 881
F. Upon the termination of a State's membership from 882
this Compact, that State shall immediately provide notice to 883
all Licensees and Compact Privilege holders (of which the 884
Commission has a record) within that State of such 885
termination. The terminated State shall continue to 886
recognize all licenses granted pursuant to this Compact for 887
a minimum of one hundred eighty (180) days after the date of 888
said notice of termination. 889
G. The Commission shall not bear any costs related to 890
a State that is found to be in default or that has been 891
terminated from the Compact, unless agreed upon in writing 892
between the Commission and the defaulting State. 893
H. The defaulting State may appeal the action of the 894
Commission by petitioning the U.S. District Court for the 895
District of Columbia or the federal district where the 896
Commission has its principal offices. The prevailing party 897
shall be awarded all costs of such litigation, including 898
reasonable attorney's fees. 899
I. Dispute Resolution 900
SB 1519 30
1. Upon request by a Member State, the Commission 901
shall attempt to resolve disputes related to the Compact 902
that arise among Member States and between Member and non- 903
Member States. 904
2. The Commission shall promulgate a Rule providing 905
for both mediation and binding dispute resolution for 906
disputes, as appropriate. 907
J. Enforcement 908
1. By majority vote, as may be further provided by 909
Rule, the Commission may initiate legal action against a 910
Member State in default in the United States District Court 911
for the District of Columbia or the federal district where 912
the Commission has its principal offices to enforce 913
compliance with the provisions of the Compact and its 914
promulgated Rules. A Member State by enactment of this 915
Compact consents to venue and jurisdiction in such court for 916
the purposes set forth herein. The relief sought may 917
include both injunctive relief and damages. In the event 918
judicial enforcement is necessary, the prevailing party 919
shall be awarded all costs of such litigation, including 920
reasonable attorney's fees. The remedies herein shall not 921
be the exclusive remedies of the Commission. The Commission 922
may pursue any other remedies available under federal or the 923
defaulting Member State's law. 924
2. A Member State may initiate legal action against 925
the Commission in the U.S. District Court for the District 926
of Columbia or the federal district where the Commission has 927
its principal offices to enforce compliance with the 928
provisions of the Compact and its promulgated Rules. The 929
relief sought may include both injunctive relief and 930
damages. In the event judicial enforcement is necessary, 931
SB 1519 31
the prevailing party shall be awarded all costs of such 932
litigation, including reasonable attorney's fees. 933
3. No person other than a Member State shall enforce 934
this Compact against the Commission. 935
SECTION 11. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT 936
A. The Compact shall come into effect on the date on 937
which the Compact statute is enacted into law in the seventh 938
Member State ("Effective Date"). 939
1. On or after the Effective Date of the Compact, the 940
Commission shall convene and review the enactment of each of 941
the first seven Member States ("Charter Member States") to 942
determine if the statute enacted by each such Charter Member 943
State is materially different than the Model Compact. 944
a. A Charter Member State whose enactment is found to 945
be materially different from the Model Compact shall be 946
entitled to the default process set forth in Section 10. 947
b. If any Member State is later found to be in 948
default, or is terminated or withdraws from the Compact, the 949
Commission shall remain in existence and the Compact shall 950
remain in effect even if the number of Member States should 951
be less than seven. 952
2. Member States enacting the Compact subsequent to 953
the seven initial Charter Member States shall be subject to 954
the process set forth herein and Commission Rule to 955
determine if their enactments are materially different from 956
the Model Compact and whether they qualify for participation 957
in the Compact. 958
3. All actions taken for the benefit of the Commission 959
or in furtherance of the purposes of the administration of 960
the Compact prior to the effective date of the Compact or 961
the Commission coming into existence shall be considered to 962
be actions of the Commission unless specifically repudiated 963
SB 1519 32
by the Commission. The Commission shall own and have all 964
rights to any intellectual property developed on behalf or 965
in furtherance of the Commission by individuals or entities 966
involved in organizing or establishing the Commission, as 967
may be further set forth in Rules of the Commission. 968
4. Any State that joins the Compact subsequent to the 969
Commission's initial adoption of the Rules and bylaws shall 970
be subject to the Rules and bylaws as they exist on the date 971
on which the Compact becomes law in that State. Any Rule 972
that has been previously adopted by the Commission shall 973
have the full force and effect of law on the date the 974
Compact becomes law in that State. 975
B. Any Member State may withdraw from this Compact by 976
enacting a statute repealing the same. 977
1. A Member State's withdrawal shall not take effect 978
until one hundred eighty (180) days after enactment of the 979
repealing statute. 980
2. Withdrawal shall not affect the continuing 981
requirement of the withdrawing State's Respiratory Therapy 982
Licensing Authority to comply with the investigative and 983
Adverse Action reporting requirements of this Compact prior 984
to the effective date of withdrawal. 985
3. Upon the enactment of a statute withdrawing from 986
this Compact, a State shall immediately provide notice of 987
such withdrawal to all Licensees and Compact Privilege 988
holders (of which the Commission has a record) within that 989
State. Notwithstanding any subsequent statutory enactment 990
to the contrary, such withdrawing State shall continue to 991
recognize all licenses granted pursuant to this Compact for 992
a minimum of one hundred eighty (180) days after the date of 993
such notice of withdrawal. 994
SB 1519 33
C. Nothing contained in this Compact shall be 995
construed to invalidate or prevent any licensure agreement 996
or other cooperative arrangement between a Member State and 997
a non-Member State that does not conflict with the 998
provisions of this Compact. 999
D. This Compact may be amended by the Member States. 1000
No amendment to this Compact shall become effective and 1001
binding upon any Member State until it is enacted into the 1002
laws of all Member States. 1003
SECTION 12. CONSTRUCTION AND SEVERABILITY 1004
A. This Compact and the Commission's rulemaking 1005
authority shall be liberally construed so as to effectuate 1006
the purposes and the implementation and administration of 1007
the Compact. Provisions of the Compact expressly 1008
authorizing or requiring the promulgation of Rules shall not 1009
be construed to limit the Commission's rulemaking authority 1010
solely for those purposes. 1011
B. The provisions of this Compact shall be severable, 1012
and if any phrase, clause, sentence or provision of this 1013
Compact is held by a court of competent jurisdiction to be 1014
contrary to the constitution of any Member State, a State 1015
seeking participation in the Compact, or of the United 1016
States, or the applicability thereof to any government, 1017
agency, person or circumstance is held to be 1018
unconstitutional by a court of competent jurisdiction, the 1019
validity of the remainder of this Compact and the 1020
applicability thereof to any other government, agency, 1021
person or circumstance shall not be affected hereby. 1022
C. Notwithstanding subsection 12.B of this section, 1023
the Commission may deny a State's participation in the 1024
Compact or, in accordance with the requirements of Section 1025
10, terminate a Member State's participation in the Compact, 1026
SB 1519 34
if it determines that a constitutional requirement of a 1027
Member State is a material departure from the Compact. 1028
Otherwise, if this Compact shall be held to be contrary to 1029
the constitution of any Member State, the Compact shall 1030
remain in full force and effect as to the remaining Member 1031
States and in full force and effect as to the Member State 1032
affected as to all severable matters. 1033
SECTION 13. CONSISTENT EFFECT AND CONFLICT WITH OTHER 1034
STATE LAWS 1035
A. Nothing herein shall prevent or inhibit the 1036
enforcement of any other law of a Member State that is not 1037
inconsistent with the Compact. 1038
B. Any laws, statutes, regulations, or other legal 1039
requirements in a Member State in conflict with the Compact 1040
are superseded to the extent of the conflict, including any 1041
subsequently enacted State laws. 1042
C. All permissible agreements between the Commission 1043
and the Member States are binding in accordance with their 1044
terms. 1045
D. Other than as expressly set forth herein, nothing 1046
in this Compact will impact initial licensure. 1047
✓