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4727S.02C
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SENATE COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 988
AN ACT
To amend chapter 332, RSMo, by adding thereto one new
section relating to licensure of dentists and dental
hygienists.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 332, RSMo, is amended by adding thereto
one new section, to be known as section 332.700, to read as
follows:
332.700. SECTION 1. TITLE AND PURPOSE
This statute shall be known and cited as the Dentist
and Dental Hygienist Compact. The purposes of this Compact
are to facilitate the interstate practice of dentistry and
dental hygiene and improve public access to dentistry and
dental hygiene services by providing Dentists and Dental
Hygienists licensed in a Participating State the ability to
practice in Participating States in which they are not
licensed. The Compact does this by establishing a pathway
for Dentists and Dental Hygienists licensed in a
Participating State to obtain a Compact Privilege that
authorizes them to practice in another Participating State
in which they are not licensed. The Compact enables
Participating States to protect the public health and safety
with respect to the practice of such Dentists and Dental
Hygienists, through the State's authority to regulate the
practice of dentistry and dental hygiene in the State. The
Compact:
A. Enables Dentists and Dental Hygienists who qualify
for a Compact Privilege to practice in other Participating
States without satisfying burdensome and duplicative
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requirements associated with securing a License to practice
in those States;
B. Promotes mobility and addresses workforce shortages
through each Participating State's acceptance of a Compact
Privilege to practice in that State;
C. Increases public access to qualified, licensed
Dentists and Dental Hygienists by creating a responsible,
streamlined pathway for Licensees to practice in
Participating States;
D. Enhances the ability of Participating States to
protect the public's health and safety;
E. Does not interfere with licensure requirements
established by a Participating State;
F. Facilitates the sharing of licensure and
disciplinary information among Participating States;
G. Requires Dentists and Dental Hygienists who
practice in a Participating State pursuant to a Compact
Privilege to practice within the Scope of Practice
authorized in that State;
H. Extends the authority of a Participating State to
regulate the practice of dentistry and dental hygiene within
its borders to Dentists and Dental Hygienists who practice
in the State through a Compact Privilege;
I. Promotes the cooperation of Participating States in
regulating the practice of dentistry and dental hygiene
within those States;
J. Facilitates the relocation of military members and
their spouses who are licensed to practice dentistry or
dental hygiene.
SECTION 2. DEFINITIONS
As used in this Compact, unless the context requires
otherwise, the following definitions shall apply:
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A. "Active Military Member" means any person with full-
time duty status in the armed forces of the United States,
including members of the National Guard and Reserve.
B. "Adverse Action" means disciplinary action or
encumbrance imposed on a License or Compact Privilege by a
State Licensing Authority.
C. "Alternative Program" means a non-disciplinary
monitoring or practice remediation process applicable to a
Dentist or Dental Hygienist approved by a State Licensing
Authority of a Participating State in which the Dentist or
Dental Hygienist is licensed. This includes, but is not
limited to, programs to which Licensees with substance abuse
or addiction issues are referred in lieu of Adverse Action.
D. "Clinical Assessment" means examination or process,
required for licensure as a Dentist or Dental Hygienist as
applicable, that provides evidence of clinical competence in
dentistry or dental hygiene.
E. "Commissioner" means the individual appointed by a
Participating State to serve as the member of the Commission
for that Participating State.
F. "Compact" means this Dentist and Dental Hygienist
Compact.
G. "Compact Privilege" means the authorization granted
by a Remote State to allow a Licensee from a Participating
State to practice as a Dentist or Dental Hygienist in a
Remote State.
H. "Continuing Professional Development" means a
requirement, as a condition of License renewal to provide
evidence of successful participation in educational or
professional activities relevant to practice or area of work.
I. "Criminal Background Check" means the submission of
fingerprints or other biometric-based information for a
License applicant for the purpose of obtaining that
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applicant's criminal history record information, as defined
in 28 C.F.R. § 20.3(d) from the Federal Bureau of
Investigation and the State's criminal history record
repository as defined in 28 C.F.R. § 20.3(f).
J. "Data System" means the Commission's repository of
information about Licensees, including but not limited to
examination, licensure, investigative, Compact Privilege,
Adverse Action, and Alternative Program.
K. "Dental Hygienist" means an individual who is
licensed by a State Licensing Authority to practice dental
hygiene.
L. "Dentist" means an individual who is licensed by a
State Licensing Authority to practice dentistry.
M. "Dentist and Dental Hygienist Compact Commission"
or "Commission" means a joint government agency established
by this Compact comprised of each State that has enacted the
Compact and a national administrative body comprised of a
Commissioner from each State that has enacted the Compact.
N. "Encumbered License" means a License that a State
Licensing Authority has limited in any way other than
through an Alternative Program.
O. "Executive Board" means the Chair, Vice Chair,
Secretary and Treasurer and any other Commissioners as may
be determined by Commission Rule or bylaw.
P. "Jurisprudence Requirement" means the assessment of
an individual's knowledge of the laws and Rules governing
the practice of dentistry or dental hygiene, as applicable,
in a State.
Q. "License" means current authorization by a State,
other than authorization pursuant to a Compact Privilege, or
other privilege, for an individual to practice as a Dentist
or Dental Hygienist in that State.
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R. "Licensee" means an individual who holds an
unrestricted License from a Participating State to practice
as a Dentist or Dental Hygienist in that State.
S. "Model Compact" means the model for the Dentist and
Dental Hygienist Compact on file with the Council of State
Governments or other entity as designated by the Commission.
T. "Participating State" means a State that has
enacted the Compact and been admitted to the Commission in
accordance with the provisions herein and Commission Rules.
U. "Qualifying License" means a License that is not an
Encumbered License issued by a Participating State to
practice dentistry or dental hygiene.
V. "Remote State" means a Participating State where a
Licensee who is not licensed as a Dentist or Dental
Hygienist is exercising or seeking to exercise the Compact
Privilege.
W. "Rule" means a regulation promulgated by an entity
that has the force of law.
X. "Scope of Practice" means the procedures, actions,
and processes a Dentist or Dental Hygienist licensed in a
State is permitted to undertake in that State and the
circumstances under which the Licensee is permitted to
undertake those procedures, actions and processes. Such
procedures, actions and processes and the circumstances
under which they may be undertaken may be established
through means, including, but not limited to, statute,
regulations, case law, and other processes available to the
State Licensing Authority or other government agency.
Y. "Significant Investigative Information" means
information, records, and documents received or generated by
a State Licensing Authority pursuant to an investigation for
which a determination has been made that there is probable
cause to believe that the Licensee has violated a statute or
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regulation that is considered more than a minor infraction
for which the State Licensing Authority could pursue Adverse
Action against the Licensee.
Z. "State" means any state, commonwealth, district, or
territory of the United States of America that regulates the
practices of dentistry and dental hygiene.
AA. "State Licensing Authority" means an agency or
other entity of a State that is responsible for the
licensing and regulation of Dentists or Dental Hygienists.
SECTION 3. STATE PARTICIPATION IN THE COMPACT
A. In order to join the Compact and thereafter
continue as a Participating State, a State must:
1. Enact a compact that is not materially different
from the Model Compact as determined in accordance with
Commission Rules;
2. Participate fully in the Commission's Data System;
3. Have a mechanism in place for receiving and
investigating complaints about its Licensees and License
applicants;
4. Notify the Commission, in compliance with the terms
of the Compact and Commission Rules, of any Adverse Action
or the availability of Significant Investigative Information
regarding a Licensee and License applicant;
5. Fully implement a Criminal Background Check
requirement, within a time frame established by Commission
Rule, by receiving the results of a qualifying Criminal
Background Check;
6. Comply with the Commission Rules applicable to a
Participating State;
7. Accept the National Board Examinations of the Joint
Commission on National Dental Examinations or another
examination accepted by Commission Rule as a licensure
examination;
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8. Accept for licensure that applicants for a Dentist
License graduate from a predoctoral dental education program
accredited by the Commission on Dental Accreditation, or
another accrediting agency recognized by the United States
Department of Education for the accreditation of dentistry
and dental hygiene education programs, leading to the Doctor
of Dental Surgery (D.D.S.) or Doctor of Dental Medicine
(D.M.D.) degree;
9. Accept for licensure that applicants for a Dental
Hygienist License graduate from a dental hygiene education
program accredited by the Commission on Dental Accreditation
or another accrediting agency recognized by the United
States Department of Education for the accreditation of
dentistry and dental hygiene education programs;
10. Require for licensure that applicants successfully
complete a Clinical Assessment;
11. Have Continuing Professional Development
requirements as a condition for License renewal; and
12. Pay a participation fee to the Commission as
established by Commission Rule.
B. Providing alternative pathways for an individual to
obtain an unrestricted License does not disqualify a State
from participating in the Compact.
C. When conducting a Criminal Background Check the
State Licensing Authority shall:
1. Consider that information in making a licensure
decision;
2. Maintain documentation of completion of the
Criminal Background Check and background check information
to the extent allowed by State and federal law; and
3. Report to the Commission whether it has completed
the Criminal Background Check and whether the individual was
granted or denied a License.
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D. A Licensee of a Participating State who has a
Qualifying License in that State and does not hold an
Encumbered License in any other Participating State, shall
be issued a Compact Privilege in a Remote State in
accordance with the terms of the Compact and Commission
Rules. If a Remote State has a Jurisprudence Requirement a
Compact Privilege will not be issued to the Licensee unless
the Licensee has satisfied the Jurisprudence Requirement.
SECTION 4. COMPACT PRIVILEGE
A. To obtain and exercise the Compact Privilege under
the terms and provisions of the Compact, the Licensee shall:
1. Have a Qualifying License as a Dentist or Dental
Hygienist in a Participating State;
2. Be eligible for a Compact Privilege in any Remote
State in accordance with subsections D, G, and H of this
section;
3. Submit to an application process whenever the
Licensee is seeking a Compact Privilege;
4. Pay any applicable Commission and Remote State fees
for a Compact Privilege in the Remote State;
5. Meet any Jurisprudence Requirement established by a
Remote State in which the Licensee is seeking a Compact
Privilege;
6. Have passed a National Board Examination of the
Joint Commission on National Dental Examinations or another
examination accepted by Commission Rule;
7. For a Dentist, have graduated from a predoctoral
dental education program accredited by the Commission on
Dental Accreditation, or another accrediting agency
recognized by the United States Department of Education for
the accreditation of dentistry and dental hygiene education
programs, leading to the Doctor of Dental Surgery (D.D.S.)
or Doctor of Dental Medicine (D.M.D.) degree;
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8. For a Dental Hygienist, have graduated from a
dental hygiene education program accredited by the
Commission on Dental Accreditation or another accrediting
agency recognized by the United States Department of
Education for the accreditation of dentistry and dental
hygiene education programs;
9. Have successfully completed a Clinical Assessment
for licensure;
10. Report to the Commission Adverse Action taken by
any non-Participating State when applying for a Compact
Privilege and, otherwise, within thirty (30) days from the
date the Adverse Action is taken;
11. Report to the Commission when applying for a
Compact Privilege the address of the Licensee's primary
residence and thereafter immediately report to the
Commission any change in the address of the Licensee's
primary residence; and
12. Consent to accept service of process by mail at
the Licensee's primary residence on record with the
Commission with respect to any action brought against the
Licensee by the Commission or a Participating State, and
consent to accept service of a subpoena by mail at the
Licensee's primary residence on record with the Commission
with respect to any action brought or investigation
conducted by the Commission or a Participating State.
B. The Licensee must comply with the requirements of
subsection A of this section to maintain the Compact
Privilege in the Remote State. If those requirements are
met, the Compact Privilege will continue as long as the
Licensee maintains a Qualifying License in the State through
which the Licensee applied for the Compact Privilege and
pays any applicable Compact Privilege renewal fees.
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C. A Licensee providing dentistry or dental hygiene in
a Remote State under the Compact Privilege shall function
within the Scope of Practice authorized by the Remote State
for a Dentist or Dental Hygienist licensed in that State.
D. A Licensee providing dentistry or dental hygiene
pursuant to a Compact Privilege in a Remote State is subject
to that State's regulatory authority. A Remote State may,
in accordance with due process and that State's laws, by
Adverse Action revoke or remove a Licensee's Compact
Privilege in the Remote State for a specific period of time
and impose fines or take any other necessary actions to
protect the health and safety of its citizens. If a Remote
State imposes an Adverse Action against a Compact Privilege
that limits the Compact Privilege, that Adverse Action
applies to all Compact Privileges in all Remote States. A
Licensee whose Compact Privilege in a Remote State is
removed for a specified period of time is not eligible for a
Compact Privilege in any other Remote State until the
specific time for removal of the Compact Privilege has
passed and all encumbrance requirements are satisfied.
E. If a License in a Participating State is an
Encumbered License, the Licensee shall lose the Compact
Privilege in a Remote State and shall not be eligible for a
Compact Privilege in any Remote State until the License is
no longer encumbered.
F. Once an Encumbered License in a Participating State
is restored to good standing, the Licensee must meet the
requirements of subsection A of this section to obtain a
Compact Privilege in a Remote State.
G. If a Licensee's Compact Privilege in a Remote State
is removed by the Remote State, the individual shall lose or
be ineligible for the Compact Privilege in any Remote State
until the following occur:
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1. The specific period of time for which the Compact
Privilege was removed has ended; and
2. All conditions for removal of the Compact Privilege
have been satisfied.
H. Once the requirements of subsection G of this
section have been met, the Licensee must meet the
requirements in subsection A of this section to obtain a
Compact Privilege in a Remote State.
SECTION 5. ACTIVE MILITARY MEMBER OR THEIR SPOUSES
An Active Military Member and their spouse shall not be
required to pay to the Commission for a Compact Privilege
the fee otherwise charged by the Commission. If a Remote
State chooses to charge a fee for a Compact Privilege, it
may choose to charge a reduced fee or no fee to an Active
Military Member and their spouse for a Compact Privilege.
SECTION 6. ADVERSE ACTIONS
A. A Participating State in which a Licensee is
licensed shall have exclusive authority to impose Adverse
Action against the Qualifying License issued by that
Participating State.
B. A Participating State may take Adverse Action based
on the Significant Investigative Information of a Remote
State, so long as the Participating State follows its own
procedures for imposing Adverse Action.
C. Nothing in this Compact shall override a
Participating State's decision that participation in an
Alternative Program may be used in lieu of Adverse Action
and that such participation shall remain non-public if
required by the Participating State's laws. Participating
States must require Licensees who enter any Alternative
Program in lieu of discipline to agree not to practice
pursuant to a Compact Privilege in any other Participating
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State during the term of the Alternative Program without
prior authorization from such other Participating State.
D. Any Participating State in which a Licensee is
applying to practice or is practicing pursuant to a Compact
Privilege may investigate actual or alleged violations of
the statutes and regulations authorizing the practice of
dentistry or dental hygiene in any other Participating State
in which the Dentist or Dental Hygienist holds a License or
Compact Privilege.
E. A Remote State shall have the authority to:
1. Take Adverse Actions as set forth in Section 4.D
against a Licensee's Compact Privilege in the State;
2. In furtherance of its rights and responsibilities
under the Compact and the Commission's Rules issue subpoenas
for both hearings and investigations that require the
attendance and testimony of witnesses, and the production of
evidence. Subpoenas issued by a State Licensing Authority
in a Participating State for the attendance and testimony of
witnesses, or the production of evidence from another
Participating State, shall be enforced in the latter State
by any court of competent jurisdiction, according to the
practice and procedure of that court applicable to subpoenas
issued in proceedings pending before it. The issuing
authority shall pay any witness fees, travel expenses,
mileage, and other fees required by the service statutes of
the State where the witnesses or evidence are located; and
3. If otherwise permitted by State law, recover from
the Licensee the costs of investigations and disposition of
cases resulting from any Adverse Action taken against that
Licensee.
F. Joint Investigations
1. In addition to the authority granted to a
Participating State by its Dentist or Dental Hygienist
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licensure act or other applicable State law, a Participating
State may jointly investigate Licensees with other
Participating States.
2. Participating States shall share any Significant
Investigative Information, litigation, or compliance
materials in furtherance of any joint or individual
investigation initiated under the Compact.
G. Authority to Continue Investigation
1. After a Licensee's Compact Privilege in a Remote
State is terminated, the Remote State may continue an
investigation of the Licensee that began when the Licensee
had a Compact Privilege in that Remote State.
2. If the investigation yields what would be
Significant Investigative Information had the Licensee
continued to have a Compact Privilege in that Remote State,
the Remote State shall report the presence of such
information to the Data System as required by Section 8.B.6
as if it was Significant Investigative Information.
SECTION 7. ESTABLISHMENT AND OPERATION OF THE COMMISSION
A. The Compact Participating States hereby create and
establish a joint government agency whose membership
consists of all Participating States that have enacted the
Compact. The Commission is an instrumentality of the
Participating States acting jointly and not an
instrumentality of any one State. The Commission shall come
into existence on or after the effective date of the Compact
as set forth in Section 11.A.
B. Participation, Voting, and Meetings
1. Each Participating State shall have and be limited
to one (1) Commissioner selected by that Participating
State's State Licensing Authority or, if the State has more
than one State Licensing Authority, selected collectively by
the State Licensing Authorities.
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2. The Commissioner shall be a member or designee of
such Authority or Authorities.
3. The Commission may by Rule or bylaw establish a
term of office for Commissioners and may by Rule or bylaw
establish term limits.
4. The Commission may recommend to a State Licensing
Authority or Authorities, as applicable, removal or
suspension of an individual as the State's Commissioner.
5. A Participating State's State Licensing Authority,
or Authorities, as applicable, shall fill any vacancy of its
Commissioner on the Commission within sixty (60) days of the
vacancy.
6. Each Commissioner shall be entitled to one vote on
all matters that are voted upon by the Commission.
7. The Commission shall meet at least once during each
calendar year. Additional meetings may be held as set forth
in the bylaws. The Commission may meet by
telecommunication, video conference or other similar
electronic means.
C. The Commission shall have the following powers:
1. Establish the fiscal year of the Commission;
2. Establish a code of conduct and conflict of
interest policies;
3. Adopt Rules and bylaws;
4. Maintain its financial records in accordance with
the bylaws;
5. Meet and take such actions as are consistent with
the provisions of this Compact, the Commission's Rules, and
the bylaws;
6. Initiate and conclude legal proceedings or actions
in the name of the Commission, provided that the standing of
any State Licensing Authority to sue or be sued under
applicable law shall not be affected;
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7. Maintain and certify records and information
provided to a Participating State as the authenticated
business records of the Commission, and designate a person
to do so on the Commission's behalf;
8. Purchase and maintain insurance and bonds;
9. Borrow, accept, or contract for services of
personnel, including, but not limited to, employees of a
Participating State;
10. Conduct an annual financial review;
11. Hire employees, elect or appoint officers, fix
compensation, define duties, grant such individuals
appropriate authority to carry out the purposes of the
Compact, and establish the Commission's personnel policies
and programs relating to conflicts of interest,
qualifications of personnel, and other related personnel
matters;
12. As set forth in the Commission Rules, charge a fee
to a Licensee for the grant of a Compact Privilege in a
Remote State and thereafter, as may be established by
Commission Rule, charge the Licensee a Compact Privilege
renewal fee for each renewal period in which that Licensee
exercises or intends to exercise the Compact Privilege in
that Remote State. Nothing herein shall be construed to
prevent a Remote State from charging a Licensee a fee for a
Compact Privilege or renewals of a Compact Privilege, or a
fee for the Jurisprudence Requirement if the Remote State
imposes such a requirement for the grant of a Compact
Privilege;
13. Accept any and all appropriate gifts, donations,
grants of money, other sources of revenue, equipment,
supplies, materials, and services, and receive, utilize, and
dispose of the same; provided that at all times the
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Commission shall avoid any appearance of impropriety and/or
conflict of interest;
14. Lease, purchase, retain, own, hold, improve, or
use any property, real, personal, or mixed, or any undivided
interest therein;
15. Sell, convey, mortgage, pledge, lease, exchange,
abandon, or otherwise dispose of any property real,
personal, or mixed;
16. Establish a budget and make expenditures;
17. Borrow money;
18. Appoint committees, including standing committees,
which may be composed of members, State regulators, State
legislators or their representatives, and consumer
representatives, and such other interested persons as may be
designated in this Compact and the bylaws;
19. Provide and receive information from, and
cooperate with, law enforcement agencies;
20. Elect a Chair, Vice Chair, Secretary and Treasurer
and such other officers of the Commission as provided in the
Commission's bylaws;
21. Establish and elect an Executive Board;
22. Adopt and provide to the Participating States an
annual report;
23. Determine whether a State's enacted compact is
materially different from the Model Compact language such
that the State would not qualify for participation in the
Compact; and
24. Perform such other functions as may be necessary
or appropriate to achieve the purposes of this Compact.
D. Meetings of the Commission
1. All meetings of the Commission that are not closed
pursuant to this subsection shall be open to the public.
Notice of public meetings shall be posted on the
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Commission's website at least thirty (30) days prior to the
public meeting.
2. Notwithstanding subsection D.1 of this section, the
Commission may convene an emergency public meeting by
providing at least twenty-four (24) hours prior notice on
the Commission's website, and any other means as provided in
the Commission's Rules, for any of the reasons it may
dispense with notice of proposed rulemaking under Section
9.M. The Commission's legal counsel shall certify that one
of the reasons justifying an emergency public meeting has
been met.
3. Notice of all Commission meetings shall provide the
time, date, and location of the meeting, and if the meeting
is to be held or accessible via telecommunication, video
conference, or other electronic means, the notice shall
include the mechanism for access to the meeting through such
means.
4. The Commission may convene in a closed, non-public
meeting for the Commission to receive legal advice or to
discuss:
a. Non-compliance of a Participating State with its
obligations under the Compact;
b. The employment, compensation, discipline or other
matters, practices or procedures related to specific
employees or other matters related to the Commission's
internal personnel practices and procedures;
c. Current or threatened discipline of a Licensee or
Compact Privilege holder by the Commission or by a
Participating State's Licensing Authority;
d. Current, threatened, or reasonably anticipated
litigation;
e. Negotiation of contracts for the purchase, lease,
or sale of goods, services, or real estate;
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f. Accusing any person of a crime or formally
censuring any person;
g. Trade secrets or commercial or financial
information that is privileged or confidential;
h. Information of a personal nature where disclosure
would constitute a clearly unwarranted invasion of personal
privacy;
i. Investigative records compiled for law enforcement
purposes;
j. Information related to any investigative reports
prepared by or on behalf of or for use of the Commission or
other committee charged with responsibility of investigation
or determination of compliance issues pursuant to the
Compact;
k. Legal advice;
l. Matters specifically exempted from disclosure to
the public by federal or Participating State law; and
m. Other matters as promulgated by the Commission by
Rule.
5. If a meeting, or portion of a meeting, is closed,
the presiding officer shall state that the meeting will be
closed and reference each relevant exempting provision, and
such reference shall be recorded in the minutes.
6. The Commission shall keep minutes that fully and
clearly describe all matters discussed in a meeting and
shall provide a full and accurate summary of actions taken,
and the reasons therefore, including a description of the
views expressed. All documents considered in connection
with an action shall be identified in such minutes. All
minutes and documents of a closed meeting shall remain under
seal, subject to release only by a majority vote of the
Commission or order of a court of competent jurisdiction.
E. Financing of the Commission
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1. The Commission shall pay, or provide for the
payment of, the reasonable expenses of its establishment,
organization, and ongoing activities.
2. The Commission may accept any and all appropriate
sources of revenue, donations, and grants of money,
equipment, supplies, materials, and services.
3. The Commission may levy on and collect an annual
assessment from each Participating State and impose fees on
Licensees of Participating States when a Compact Privilege
is granted, to cover the cost of the operations and
activities of the Commission and its staff, which must be in
a total amount sufficient to cover its annual budget as
approved each fiscal year for which sufficient revenue is
not provided by other sources. The aggregate annual
assessment amount for Participating States shall be
allocated based upon a formula that the Commission shall
promulgate by Rule.
4. The Commission shall not incur obligations of any
kind prior to securing the funds adequate to meet the same;
nor shall the Commission pledge the credit of any
Participating State, except by and with the authority of the
Participating State.
5. The Commission shall keep accurate accounts of all
receipts and disbursements. The receipts and disbursements
of the Commission shall be subject to the financial review
and accounting procedures established under its bylaws. All
receipts and disbursements of funds handled by the
Commission shall be subject to an annual financial review by
a certified or licensed public accountant, and the report of
the financial review shall be included in and become part of
the annual report of the Commission.
F. The Executive Board
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1. The Executive Board shall have the power to act on
behalf of the Commission according to the terms of this
Compact. The powers, duties, and responsibilities of the
Executive Board shall include:
a. Overseeing the day-to-day activities of the
administration of the Compact including compliance with the
provisions of the Compact and the Commission's Rules and
bylaws;
b. Recommending to the Commission changes to the Rules
or bylaws, changes to this Compact legislation, fees charged
to Compact Participating States, fees charged to Licensees,
and other fees;
c. Ensuring Compact administration services are
appropriately provided, including by contract;
d. Preparing and recommending the budget;
e. Maintaining financial records on behalf of the
Commission;
f. Monitoring Compact compliance of Participating
States and providing compliance reports to the Commission;
g. Establishing additional committees as necessary;
h. Exercising the powers and duties of the Commission
during the interim between Commission meetings, except for
adopting or amending Rules, adopting or amending bylaws, and
exercising any other powers and duties expressly reserved to
the Commission by Rule or bylaw; and
i. Other duties as provided in the Rules or bylaws of
the Commission.
2. The Executive Board shall be composed of up to
seven (7) members:
a. The Chair, Vice Chair, Secretary and Treasurer of
the Commission and any other members of the Commission who
serve on the Executive Board shall be voting members of the
Executive Board; and
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b. Other than the Chair, Vice Chair, Secretary, and
Treasurer, the Commission may elect up to three (3) voting
members from the current membership of the Commission.
3. The Commission may remove any member of the
Executive Board as provided in the Commission's bylaws.
4. The Executive Board shall meet at least annually.
a. An Executive Board meeting at which it takes or
intends to take formal action on a matter shall be open to
the public, except that the Executive Board may meet in a
closed, non-public session of a public meeting when dealing
with any of the matters covered under subsection D.4.
b. The Executive Board shall give five (5) business
days' notice of its public meetings, posted on its website
and as it may otherwise determine to provide notice to
persons with an interest in the public matters the Executive
Board intends to address at those meetings.
5. The Executive Board may hold an emergency meeting
when acting for the Commission to:
a. Meet an imminent threat to public health, safety,
or welfare;
b. Prevent a loss of Commission or Participating State
funds; or
c. Protect public health and safety.
G. Qualified Immunity, Defense, and Indemnification
1. The members, officers, executive director,
employees and representatives of the Commission shall be
immune from suit and liability, both personally and in their
official capacity, for any claim for damage to or loss of
property or personal injury or other civil liability caused
by or arising out of any actual or alleged act, error, or
omission that occurred, or that the person against whom the
claim is made had a reasonable basis for believing occurred
within the scope of Commission employment, duties or
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responsibilities; provided that nothing in this paragraph
shall be construed to protect any such person from suit or
liability for any damage, loss, injury, or liability caused
by the intentional or willful or wanton misconduct of that
person. The procurement of insurance of any type by the
Commission shall not in any way compromise or limit the
immunity granted hereunder.
2. The Commission shall defend any member, officer,
executive director, employee, and representative of the
Commission in any civil action seeking to impose liability
arising out of any actual or alleged act, error, or omission
that occurred within the scope of Commission employment,
duties, or responsibilities, or as determined by the
Commission that the person against whom the claim is made
had a reasonable basis for believing occurred within the
scope of Commission employment, duties, or responsibilities;
provided that nothing herein shall be construed to prohibit
that person from retaining their own counsel at their own
expense; and provided further, that the actual or alleged
act, error, or omission did not result from that person's
intentional or willful or wanton misconduct.
3. Notwithstanding subsection G.1 of this section,
should any member, officer, executive director, employee, or
representative of the Commission be held liable for the
amount of any settlement or judgment arising out of any
actual or alleged act, error, or omission that occurred
within the scope of that individual's employment, duties, or
responsibilities for the Commission, or that the person to
whom that individual is liable had a reasonable basis for
believing occurred within the scope of the individual's
employment, duties, or responsibilities for the Commission,
the Commission shall indemnify and hold harmless such
individual, provided that the actual or alleged act, error,
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or omission did not result from the intentional or willful
or wanton misconduct of the individual.
4. Nothing herein shall be construed as a limitation
on the liability of any Licensee for professional
malpractice or misconduct, which shall be governed solely by
any other applicable State laws.
5. Nothing in this Compact shall be interpreted to
waive or otherwise abrogate a Participating State's state
action immunity or state action affirmative defense with
respect to antitrust claims under the Sherman Act, Clayton
Act, or any other State or federal antitrust or
anticompetitive law or regulation.
6. Nothing in this Compact shall be construed to be a
waiver of sovereign immunity by the Participating States or
by the Commission.
SECTION 8. DATA SYSTEM
A. The Commission shall provide for the development,
maintenance, operation, and utilization of a coordinated
database and reporting system containing licensure, Adverse
Action, and the presence of Significant Investigative
Information on all Licensees and applicants for a License in
Participating States.
B. Notwithstanding any other provision of State law to
the contrary, a Participating State shall submit a uniform
data set to the Data System on all individuals to whom this
Compact is applicable as required by the Rules of the
Commission, including:
1. Identifying information;
2. Licensure data;
3. Adverse Actions against a Licensee, License
applicant or Compact Privilege and information related
thereto;
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4. Non-confidential information related to Alternative
Program participation, the beginning and ending dates of
such participation, and other information related to such
participation;
5. Any denial of an application for licensure, and the
reason(s) for such denial (excluding the reporting of any
criminal history record information where prohibited by law);
6. The presence of Significant Investigative
Information; and
7. Other information that may facilitate the
administration of this Compact or the protection of the
public, as determined by the Rules of the Commission.
C. The records and information provided to a
Participating State pursuant to this Compact or through the
Data System, when certified by the Commission or an agent
thereof, shall constitute the authenticated business records
of the Commission, and shall be entitled to any associated
hearsay exception in any relevant judicial, quasi-judicial
or administrative proceedings in a Participating State.
D. Significant Investigative Information pertaining to
a Licensee in any Participating State will only be available
to other Participating States.
E. It is the responsibility of the Participating
States to monitor the database to determine whether Adverse
Action has been taken against a Licensee or License
applicant. Adverse Action information pertaining to a
Licensee or License applicant in any Participating State
will be available to any other Participating State.
F. Participating States contributing information to
the Data System may designate information that may not be
shared with the public without the express permission of the
contributing State.
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G. Any information submitted to the Data System that
is subsequently expunged pursuant to federal law or the laws
of the Participating State contributing the information
shall be removed from the Data System.
SECTION 9. RULEMAKING
A. The Commission shall promulgate reasonable Rules in
order to effectively and efficiently implement and
administer the purposes and provisions of the Compact. A
Commission Rule shall be invalid and have no force or effect
only if a court of competent jurisdiction holds that the
Rule is invalid because the Commission exercised its
rulemaking authority in a manner that is beyond the scope
and purposes of the Compact, or the powers granted
hereunder, or based upon another applicable standard of
review.
B. The Commission shall promulgate Rules in accordance
with the authority granted under this Compact. All
Commission Rules shall be consistent with the Constitution
of the United States and, to the extent applicable, the
constitutions of Participating States, and shall further the
purposes and intent of this Compact. Any Rule adopted by
the Commission that exceeds the scope of the Commission's
authority or is otherwise inconsistent with this Compact or
applicable constitutional requirements shall be subject to
challenge and determination in accordance with the dispute
resolution and enforcement provisions under Section 10 of
this Compact.
C. The Rules of the Commission shall have the force of
law in each Participating State, provided however that where
the Rules of the Commission conflict with the laws of the
Participating State that establish the Participating State's
Scope of Practice as held by a court of competent
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jurisdiction, the Rules of the Commission shall be
ineffective in that State to the extent of the conflict.
D. The Commission shall exercise its Rulemaking powers
pursuant to the criteria set forth in this section and the
Rules adopted thereunder. Rules shall become binding as of
the date specified by the Commission for each Rule.
E. If a majority of the legislatures of the
Participating States rejects a Commission Rule or portion of
a Commission Rule, by enactment of a statute or resolution
in the same manner used to adopt the Compact, within four
(4) years of the date of adoption of the Rule, then such
Rule shall have no further force and effect in any
Participating State or to any State applying to participate
in the Compact.
F. Rules shall be adopted at a regular or special
meeting of the Commission.
G. Prior to adoption of a proposed Rule, the
Commission shall hold a public hearing and allow persons to
provide oral and written comments, data, facts, opinions,
and arguments.
H. Prior to adoption of a proposed Rule by the
Commission, and at least thirty (30) days in advance of the
meeting at which the Commission will hold a public hearing
on the proposed Rule, the Commission shall provide a Notice
of Proposed Rulemaking:
1. On the website of the Commission or other publicly
accessible platform;
2. To persons who have requested notice of the
Commission's notices of proposed rulemaking; and
3. In such other way(s) as the Commission may by Rule
specify.
I. The Notice of Proposed Rulemaking shall include:
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1. The time, date, and location of the public hearing
at which the Commission will hear public comments on the
proposed Rule and, if different, the time, date, and
location of the meeting where the Commission will consider
and vote on the proposed Rule;
2. If the hearing is held via telecommunication, video
conference, or other electronic means, the Commission shall
include the mechanism for access to the hearing in the
Notice of Proposed Rulemaking;
3. The text of the proposed Rule and the reason
therefor;
4. A request for comments on the proposed Rule from
any interested person; and
5. The manner in which interested persons may submit
written comments.
J. All hearings will be recorded. A copy of the
recording and all written comments and documents received by
the Commission in response to the proposed Rule shall be
available to the public.
K. Nothing in this section shall be construed as
requiring a separate hearing on each Commission Rule. Rules
may be grouped for the convenience of the Commission at
hearings required by this section.
L. The Commission shall, by majority vote of all
Commissioners, take final action on the proposed Rule based
on the rulemaking record.
1. The Commission may adopt changes to the proposed
Rule provided the changes do not enlarge the original
purpose of the proposed Rule.
2. The Commission shall provide an explanation of the
reasons for substantive changes made to the proposed Rule as
well as reasons for substantive changes not made that were
recommended by commenters.
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3. The Commission shall determine a reasonable
effective date for the Rule. Except for an emergency as
provided in subsection M, the effective date of the Rule
shall be no sooner than thirty (30) days after the
Commission issuing the notice that it adopted or amended the
Rule.
M. Upon determination that an emergency exists, the
Commission may consider and adopt an emergency Rule with 24
hours' notice, with opportunity to comment, provided that
the usual rulemaking procedures provided in the Compact and
in this section shall be retroactively applied to the Rule
as soon as reasonably possible, in no event later than
ninety (90) days after the effective date of the Rule. For
the purposes of this provision, an emergency Rule is one
that must be adopted immediately in order to:
1. Meet an imminent threat to public health, safety,
or welfare;
2. Prevent a loss of Commission or Participating State
funds;
3. Meet a deadline for the promulgation of a Rule that
is established by federal law or rule; or
4. Protect public health and safety.
N. The Commission or an authorized committee of the
Commission may direct revisions to a previously adopted Rule
for purposes of correcting typographical errors, errors in
format, errors in consistency, or grammatical errors.
Public notice of any revisions shall be posted on the
website of the Commission. The revision shall be subject to
challenge by any person for a period of thirty (30) days
after posting. The revision may be challenged only on
grounds that the revision results in a material change to a
Rule. A challenge shall be made in writing and delivered to
the Commission prior to the end of the notice period. If no
29
challenge is made, the revision will take effect without
further action. If the revision is challenged, the revision
may not take effect without the approval of the Commission.
O. No Participating State's rulemaking requirements
shall apply under this Compact.
SECTION 10. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
A. Oversight
1. The executive and judicial branches of State
government in each Participating State shall enforce this
Compact and take all actions necessary and appropriate to
implement the Compact.
2. Venue is proper and judicial proceedings by or
against the Commission shall be brought solely and
exclusively in a court of competent jurisdiction where the
principal office of the Commission is located. The
Commission may waive venue and jurisdictional defenses to
the extent it adopts or consents to participate in
alternative dispute resolution proceedings. Nothing herein
shall affect or limit the selection or propriety of venue in
any action against a Licensee for professional malpractice,
misconduct or any such similar matter.
3. The Commission shall be entitled to receive service
of process in any proceeding regarding the enforcement or
interpretation of the Compact or Commission Rule and shall
have standing to intervene in such a proceeding for all
purposes. Failure to provide the Commission service of
process shall render a judgment or order void as to the
Commission, this Compact, or promulgated Rules.
B. Default, Technical Assistance, and Termination
1. If the Commission determines that a Participating
State has defaulted in the performance of its obligations or
responsibilities under this Compact or the promulgated
Rules, the Commission shall provide written notice to the
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defaulting State. The notice of default shall describe the
default, the proposed means of curing the default, and any
other action that the Commission may take, and shall offer
training and specific technical assistance regarding the
default.
2. The Commission shall provide a copy of the notice
of default to the other Participating States.
C. If a State in default fails to cure the default,
the defaulting State may be terminated from the Compact upon
an affirmative vote of a majority of the Commissioners, and
all rights, privileges and benefits conferred on that State
by this Compact may be terminated on the effective date of
termination. A cure of the default does not relieve the
offending State of obligations or liabilities incurred
during the period of default.
D. Termination of participation in the Compact shall
be imposed only after all other means of securing compliance
have been exhausted. Notice of intent to suspend or
terminate shall be given by the Commission to the governor,
the majority and minority leaders of the defaulting State's
legislature, the defaulting State's State Licensing
Authority or Authorities, as applicable, and each of the
Participating States' State Licensing Authority or
Authorities, as applicable.
E. A State that has been terminated is responsible for
all assessments, obligations, and liabilities incurred
through the effective date of termination, including
obligations that extend beyond the effective date of
termination.
F. Upon the termination of a State's participation in
this Compact, that State shall immediately provide notice to
all Licensees of the State, including Licensees of other
Participating States issued a Compact Privilege to practice
31
within that State, of such termination. The terminated
State shall continue to recognize all Compact Privileges
then in effect in that State for a minimum of one hundred
eighty (180) days after the date of said notice of
termination.
G. The Commission shall not bear any costs related to
a State that is found to be in default or that has been
terminated from the Compact, unless agreed upon in writing
between the Commission and the defaulting State.
H. The defaulting State may appeal the action of the
Commission by petitioning the United States District Court
for the District of Columbia or the federal district where
the Commission has its principal offices. The prevailing
party shall be awarded all costs of such litigation,
including reasonable attorney's fees.
I. Dispute Resolution
1. Upon request by a Participating State, the
Commission shall attempt to resolve disputes related to the
Compact that arise among Participating States and between
Participating States and non-Participating States.
2. The Commission shall promulgate a Rule providing
for both mediation and binding dispute resolution for
disputes as appropriate.
J. Enforcement
1. The Commission, in the reasonable exercise of its
discretion, shall enforce the provisions of this Compact and
the Commission's Rules.
2. By majority vote, the Commission may initiate legal
action against a Participating State in default in the
United States District Court for the District of Columbia or
the federal district where the Commission has its principal
offices to enforce compliance with the provisions of the
Compact and its promulgated Rules. The relief sought may
32
include both injunctive relief and damages. In the event
judicial enforcement is necessary, the prevailing party
shall be awarded all costs of such litigation, including
reasonable attorney's fees. The remedies herein shall not
be the exclusive remedies of the Commission. The Commission
may pursue any other remedies available under federal or the
defaulting Participating State's law.
3. A Participating State may initiate legal action
against the Commission in the United States District Court
for the District of Columbia or the federal district where
the Commission has its principal offices to enforce
compliance with the provisions of the Compact and its
promulgated Rules. The relief sought may include both
injunctive relief and damages. In the event judicial
enforcement is necessary, the prevailing party shall be
awarded all costs of such litigation, including reasonable
attorney's fees.
4. No individual or entity other than a Participating
State may enforce this Compact against the Commission.
SECTION 11. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT
A. The Compact shall come into effect on the date on
which the Compact statute is enacted into law in the seventh
Participating State.
1. On or after the effective date of the Compact, the
Commission shall convene and review the enactment of each of
the States that enacted the Compact prior to the Commission
convening ("Charter Participating States") to determine if
the statute enacted by each such Charter Participating State
is materially different than the Model Compact.
a. A Charter Participating State whose enactment is
found to be materially different from the Model Compact
shall be entitled to the default process set forth in
Section 10.
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b. If any Participating State is later found to be in
default, or is terminated or withdraws from the Compact, the
Commission shall remain in existence and the Compact shall
remain in effect even if the number of Participating States
should be less than seven (7).
2. Participating States enacting the Compact
subsequent to the Charter Participating States shall be
subject to the process set forth in Section 7.C.23 to
determine if their enactments are materially different from
the Model Compact and whether they qualify for participation
in the Compact.
3. All actions taken for the benefit of the Commission
or in furtherance of the purposes of the administration of
the Compact prior to the effective date of the Compact or
the Commission coming into existence shall be considered to
be actions of the Commission unless specifically repudiated
by the Commission.
4. Any State that joins the Compact subsequent to the
Commission's initial adoption of the Rules and bylaws shall
be subject to the Commission's Rules and bylaws as they
exist on the date on which the Compact becomes law in that
State. Any Rule that has been previously adopted by the
Commission shall have the full force and effect of law on
the day the Compact becomes law in that State.
B. Any Participating State may withdraw from this
Compact by enacting a statute repealing that State's
enactment of the Compact.
1. A Participating State's withdrawal shall not take
effect until one hundred eighty (180) days after enactment
of the repealing statute.
2. Withdrawal shall not affect the continuing
requirement of the withdrawing State's Licensing Authority
or Authorities to comply with the investigative and Adverse
34
Action reporting requirements of this Compact prior to the
effective date of withdrawal.
3. Upon the enactment of a statute withdrawing from
this Compact, the State shall immediately provide notice of
such withdrawal to all Licensees within that State.
Notwithstanding any subsequent statutory enactment to the
contrary, such withdrawing State shall continue to recognize
all Compact Privileges to practice within that State granted
pursuant to this Compact for a minimum of one hundred eighty
(180) days after the date of such notice of withdrawal.
C. Nothing contained in this Compact shall be
construed to invalidate or prevent any licensure agreement
or other cooperative arrangement between a Participating
State and a non-Participating State that does not conflict
with the provisions of this Compact.
D. This Compact may be amended by the Participating
States. No amendment to this Compact shall become effective
and binding upon any Participating State until it is enacted
into the laws of all Participating States.
SECTION 12. CONSTRUCTION AND SEVERABILITY
A. This Compact and the Commission's rulemaking
authority shall be liberally construed so as to effectuate
the purposes, and the implementation and administration of
the Compact. Provisions of the Compact expressly
authorizing or requiring the promulgation of Rules shall not
be construed to limit the Commission's rulemaking authority
solely for those purposes.
B. The provisions of this Compact shall be severable
and if any phrase, clause, sentence or provision of this
Compact is held by a court of competent jurisdiction to be
contrary to the constitution of any Participating State, a
State seeking participation in the Compact, or of the United
States, or the applicability thereof to any government,
35
agency, person or circumstance is held to be
unconstitutional by a court of competent jurisdiction, the
validity of the remainder of this Compact and the
applicability thereof to any other government, agency,
person or circumstance shall not be affected thereby.
C. Notwithstanding subsection B of this section, the
Commission may deny a State's participation in the Compact
or, in accordance with the requirements of Section 10.B,
terminate a Participating State's participation in the
Compact, if it determines that a constitutional requirement
of a Participating State is a material departure from the
Compact. Otherwise, if this Compact shall be held to be
contrary to the constitution of any Participating State, the
Compact shall remain in full force and effect as to the
remaining Participating States and in full force and effect
as to the Participating State affected as to all severable
matters.
SECTION 13. CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE
LAWS
A. Nothing herein shall prevent or inhibit the
enforcement of any other law of a Participating State that
is not inconsistent with the Compact.
B. Except as explicitly permitted herein, nothing in
this Compact, nor any Rule of the Commission, shall be
construed to limit, restrict, or in any way reduce the
ability of a Participating State to enact and enforce laws,
regulations, or other rules related to the practice of
dentistry and dental hygiene within such Participating
State, including but not limited to standards of practice,
Scope of Practice, office safety requirements, patient care
standards, and all other aspects of professional practice
occurring within such Participating State's borders.
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C. Any laws, statutes, regulations, or other legal
requirements in a Participating State in conflict with the
Compact are superseded to the extent of the conflict.
D. All permissible agreements between the Commission
and the Participating States are binding in accordance with
their terms.