The official site of the Nebraska Unicameral Legislature

LEGISLATIVE BILL 912
Approved by the Governor April 14, 2026

Introduced by Hardin, 48.

A BILL FOR AN ACT relating to public health and welfare; to amend sections
38-1915, 38-2315, 38-2850, 38-2871, 71-1918, 71-2444, 71-2445, and
71-2447, Reissue Revised Statutes of Nebraska, sections 38-404, 38-409,
38-1716, 38-2101, 38-2123, 38-2801, 38-2852, 38-3208, and 52-401, Revised
Statutes Cumulative Supplement, 2024, and sections 38-131, 38-2866.01,
71-1908, and 71-1912, Revised Statutes Supplement, 2025; to adopt the
Community Health Worker Training Endorsement Act, the Athletic Trainer
Compact, and the Respiratory Care Interstate Compact; to change provisions
relating to the practice of athletic training, respiratory care, massage
therapy, medical radiography, mental health practitioners, nurse
practitioners, pharmacy, and pharmacists; to change provisions relating to
child care licensing; to provide for liens for physical therapy services;
to provide for automated pickup kiosks for certain prescription
medication; to eliminate provisions relating to physician liability for a
physician assistant; to harmonize provisions; to provide operative dates;
to repeal the original sections; to outright repeal section 38-2053,
Revised Statutes Cumulative Supplement, 2024; and to declare an emergency.
Be it enacted by the people of the State of Nebraska,
Section 1. Sections 1 to 5 of this act shall be known and may be cited as
the Community Health Worker Training Endorsement Act.
Sec. 2. (1) The Legislature finds that establishing certification of
training programs for community health workers will strengthen Nebraska's
public health and health care workforce, promote consistent standards of
practice, and support improved access to preventive and primary care services.
(2) The purpose of the Community Health Worker Training Endorsement Act is
to establish a consistent statewide process for recognizing community health
worker training programs that meet minimum standards of quality and content and
ensure that community health worker services are eligible for reimbursement by
medicaid and private insurers.
Sec. 3. For purposes of the Community Health Worker Training Endorsement
Act:
(1) Community health worker means an individual who has successfully
completed an endorsed community health worker training program and has a close
understanding of the community served and who acts as a liaison between health,
behavioral health, and social service systems and the community to facilitate
access, promote understanding, and improve health outcomes;
(2) Community health worker services means preventive, outreach,
education, navigation, advocacy, and social support services provided by a
community health worker;
(3) Core competencies means the knowledge, skills, and abilities a
certified community health worker is required to demonstrate as determined by
the department;
(4) Department means the Department of Health and Human Services; and
(5) Endorsed community health worker training program means an education
or training program that the department has determined meets minimum standards,
including core competencies as defined by the department, for the purpose of
qualifying for reimbursement by medicaid and private insurers.
Sec. 4. On or before July 1, 2027, the department may adopt and
promulgate rules and regulations that:
(1) Identify and maintain the core competencies required for community
health worker training programs using the department's expertise in public
health, behavioral health, workforce development, and medical assistance
program alignment. The department shall periodically review and update the core
competencies to ensure they reflect national best practices and community
health needs;
(2) Define the application, approval, and renewal process for training
endorsement;
(3) Set reasonable application and renewal fees;
(4) Establish procedures for denial, suspension, and revocation of a
training endorsement;
(5) Approve training programs and training providers that meet established
core competencies; and
(6) Provide that an individual who is aggrieved by a denial, suspension,
or revocation of approval of a training endorsement may request a hearing in
accordance with the Administrative Procedure Act.
Sec. 5. (1) Nothing in the Community Health Worker Training Endorsement
Act shall be construed to: (a) Create a licensure or certification requirement
for a community health worker; (b) authorize a community health worker to
perform tasks that require professional licensure; or (c) limit the scope of
practice of a licensed health care professional.
(2) Completion of a recognized community health worker training program
shall not constitute licensure, certification, or credentialing under the
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Uniform Credentialing Act.
Sec. 6. The State of Nebraska adopts the Respiratory Care Interstate
Compact in the form provided in this section.
SECTION 1. TITLE AND PURPOSE
A. The purpose of this Compact is to facilitate the interstate Practice of
Respiratory Therapy with the goal of improving public access to Respiratory
Therapy services by providing Respiratory Therapists licensed in a Member State
the ability to practice in other Member States. The Compact preserves the
regulatory authority of states to protect public health and safety through the
current system of State licensure.
B. This Compact is designed to achieve the following objectives:
1. Increase public access to Respiratory Therapy services by creating a
responsible, streamlined pathway for Licensees to practice in Member States
with the goal of improving outcomes for patients;
2. Enhance States' ability to protect the public's health and safety;
3. Promote the cooperation of Member States in regulating the Practice of
Respiratory Therapy within those Member States;
4. Ease administrative burdens on States by encouraging the cooperation of
Member States in regulating multistate Respiratory Therapy practice;
5. Support relocating Active Military Members and their spouses; and
6. Promote mobility and address workforce shortages.
SECTION 2. DEFINITIONS
As used in this Compact, unless the context requires otherwise, the
following definitions shall apply:
A. Active Military Member means any person with a full-time duty status in
the armed forces of the United States, including members of the National Guard
and Reserve.
B. Adverse Action means any administrative, civil, equitable, or criminal
action permitted by a State's laws which is imposed by any State authority with
regulatory authority over Respiratory Therapists, such as license denial,
censure, revocation, suspension, probation, monitoring of the Licensee, or
restriction on the Licensee's practice, not including participation in an
Alternative Program.
C. Alternative Program means a nondisciplinary monitoring or practice
remediation process applicable to a Respiratory Therapist approved by any State
authority with regulatory authority over Respiratory Therapists. 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. Charter Member States means those Member States who were the first
seven states to enact the Compact into the laws of their State.
E. Commission or Respiratory Care Interstate Compact Commission means the
government instrumentality and body politic whose membership consists of all
Member States that have enacted the Compact.
F. Commissioner means the individual appointed by a Member State to serve
as the member of the Commission for that Member State.
G. Compact means the Respiratory Care Interstate Compact.
H. Compact Privilege means the authorization granted by a Remote State to
allow a Licensee from another Member State to practice as a Respiratory
Therapist in the Remote State under the Remote State's laws and Rules. The
Practice of Respiratory Therapy occurs in the Member State where the patient is
located at the time of the patient encounter.
I. Criminal Background Check means the submission by the Member State of
fingerprints or other biometric-based information on license applicants at the
time of initial licensing for the purpose of obtaining that applicant's
criminal history record information, as defined in 28 C.F.R. 20.3(d) or
successor provision, from the Federal Bureau of Investigation and the State's
criminal history record repository, as defined in 28 C.F.R. 20.3(f) or
successor provision.
J. Data System means the Commission's repository of information about
Licensees as further set forth in Section 8.
K. Domicile means the jurisdiction which is the Licensee's principal home
for legal purposes.
L. Encumbered License means a license that a State's Respiratory Therapy
Licensing Authority has limited in any way.
M. Executive Committee means a group of directors elected or appointed to
act on behalf of, and within the powers granted to them by the Commission.
N. Home State except as set forth in Section 5, means the Member State
that is the Licensee's primary Domicile.
O. Home State License means an active license to practice Respiratory
Therapy in a Home State that is not an Encumbered License.
P. Jurisprudence Requirement means an assessment of an individual's
knowledge of the State laws and regulations governing the Practice of
Respiratory Therapy in such State.
Q. Licensee means an individual who currently holds an authorization from
the State to practice as a Respiratory Therapist.
R. Member State means a State that has enacted the Compact and been
admitted to the Commission in accordance with the provisions herein and
Commission Rules.
S. Model Compact means the model for the Respiratory Care Interstate
Compact on file with The Council of State Governments or other entity as
designated by the Commission.
T. Remote State means a Member State where a Licensee is exercising or
seeking to exercise the Compact Privilege.
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U. Respiratory Therapist or Respiratory Care Practitioner means an
individual who holds a credential issued by the National Board for Respiratory
Care (or its successor) and holds a license in a State to practice Respiratory
Therapy. For purposes of this Compact, any other title or status adopted by a
State to replace the term Respiratory Therapist or Respiratory Care
Practitioner shall be deemed synonymous with Respiratory Therapist and shall
confer the same rights and responsibilities to the Licensee under the
provisions of this Compact at the time of its enactment.
V. Respiratory Therapy, Respiratory Therapy Practice, Respiratory Care,
the Practice of Respiratory Care, and the Practice of Respiratory Therapy means
the care and services provided by or under the direction and supervision of a
Respiratory Therapist or Respiratory Care Practitioner.
W. Respiratory Therapy Licensing Authority means the agency, board, or
other body of a State that is responsible for licensing and regulation of
Respiratory Therapists.
X. Rule means a regulation promulgated by an entity that has the force and
effect of law.
Y. Scope of Practice means the procedures, actions, and processes a
Respiratory Therapist licensed in a State or practicing under a Compact
Privilege in a State is permitted to undertake in that State and the
circumstances under which the Respiratory Therapist 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 Respiratory Therapy
Licensing Authority or other government agency.
Z. Significant Investigative Information means information, records, and
documents received or generated by a State Respiratory Therapy 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 regulation that is considered more than a minor infraction for which
the State Respiratory Therapy Licensing Authority could pursue Adverse Action
against the Licensee.
AA. State means any state, commonwealth, district, or territory of the
United States.
SECTION 3. STATE PARTICIPATION IN THIS COMPACT
A. In order to participate in this Compact and thereafter continue as a
Member State, a Member State shall:
1. Enact a Compact that is not materially different from the Model
Compact;
2. License Respiratory Therapists;
3. Participate in the Commission's Data System;
4. Have a mechanism in place for receiving and investigating complaints
against Licensees and Compact Privilege holders;
5. Notify the Commission, in compliance with the terms of this Compact and
Commission Rules, of any Adverse Action against a Licensee, a Compact Privilege
holder, or a license applicant;
6. Notify the Commission, in compliance with the terms of this Compact and
Commission Rules, of the existence of Significant Investigative Information;
7. Comply with the Rules of the Commission;
8. Grant the Compact Privilege to a holder of an active Home State License
who otherwise meets the applicable requirements of Section 4 in a Member State;
and
9. Complete a Criminal Background Check for each new Licensee at the time
of initial licensure.
a. Where expressly authorized or permitted by federal law, whether such
federal law is in effect prior to, at, or after the time of a Member State's
enactment of this Compact, a Member State's enactment of this Compact shall
hereby authorize the Member State's Respiratory Therapy Licensing Authority to
perform Criminal Background Checks as defined herein. The absence of such a
federal law as described in this subsection shall not prevent or preclude such
authorization where it may be derived or granted through means other than the
enactment of this Compact.
B. Nothing in this Compact prohibits a Member State from charging a fee
for granting and renewing the Compact Privilege.
SECTION 4. COMPACT PRIVILEGE
A. To exercise the Compact Privilege under the terms and provisions of the
Compact, the Licensee shall:
1. Hold and maintain an active Home State License as a Respiratory
Therapist;
2. Hold and maintain an active credential from the National Board for
Respiratory Care (or its successor) that would qualify them for licensure in
the Remote State in which they are seeking the privilege;
3. Have not had any Adverse Action against a license within the previous
two years;
4. Notify the Commission that the Licensee is seeking the Compact
Privilege within a Remote State;
5. Pay any applicable fees, including any State and Commission fees and
renewal fees, for the Compact Privilege;
6. Meet any Jurisprudence Requirements established by the Remote State in
which the Licensee is seeking a Compact Privilege;
7. Report to the Commission Adverse Action taken by any non-Member State
within thirty days from the date the Adverse Action is taken;
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8. Report to the Commission, when applying for a Compact Privilege, the
address of the Licensee's Domicile and thereafter promptly report to the
Commission any change in the address of the Licensee's Domicile within thirty
days of the effective date of the change in address; and
9. Consent to accept service of process by mail at the Licensee's Domicile
on record with the Commission with respect to any action brought against the
Licensee by the Commission or a Member State, and consent to accept service of
a subpoena by mail at the Licensee's Domicile on record with the Commission
with respect to any action brought or investigation conducted by the Commission
or a Member State.
B. The Compact Privilege is valid until the expiration date or revocation
of the Home State License unless terminated pursuant to Adverse Action. The
Licensee must comply with all of the requirements of Subsection A, above, to
maintain the Compact Privilege in a Remote State. If those requirements are
met, no Adverse Actions are taken, and the Licensee has paid any applicable
Compact Privilege renewal fees, then the Licensee will maintain the Licensee's
Compact Privilege.
C. A Licensee providing Respiratory Therapy in a Remote State under the
Compact Privilege shall function within the Scope of Practice authorized by the
Remote State for the type of Respiratory Therapist license the Licensee holds.
Such procedures, actions, 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
Respiratory Therapy Licensing Authority or other government agency.
D. 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 that Remote State until the Compact Privilege is no longer limited
or restricted by that State.
E. If a Home State License is encumbered, the Licensee shall lose the
Compact Privilege in all Remote States until the following occur:
1. The Home State License is no longer encumbered; and
2. Two years have elapsed from the date on which the license is no longer
encumbered due to the Adverse Action.
F. Once a Licensee with a restricted or limited license meets the
requirements of Subsection E.1 and 2, the Licensee must also meet the
requirements of Subsection A to obtain a Compact Privilege in a Remote State.
SECTION 5. ACTIVE MILITARY MEMBER OR THEIR SPOUSE
A. An Active Military Member, or their spouse, shall designate a Home
State where the individual has a current license in good standing. The
individual may retain the Home State designation during the period the service
member is on active duty.
B. An Active Military Member and their spouse shall not be required to pay
to the Commission for a Compact Privilege any fee that may otherwise be 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 Member State in which a Licensee is licensed shall have authority to
impose Adverse Action against the license issued by that Member State.
B. A Member State may take Adverse Action based on Significant
Investigative Information of a Remote State or the Home State, so long as the
Member State follows its own procedures for imposing Adverse Action.
C. Nothing in this Compact shall override a Member State's decision that
participation in an Alternative Program may be used in lieu of Adverse Action
and that such participation shall remain nonpublic if required by the Member
State's laws.
D. A Remote State shall have the authority to:
1. Take Adverse Actions as set forth herein against a Licensee's Compact
Privilege in that State;
2. Issue subpoenas for both hearings and investigations that require the
attendance and testimony of witnesses, and the production of evidence.
a. Subpoenas may be issued by a Respiratory Therapy Licensing Authority in
a Member State for the attendance and testimony of witnesses and the production
of evidence.
b. Subpoenas issued by a Respiratory Therapy Licensing Authority in a
Member State for the attendance and testimony of witnesses shall be enforced in
the latter State by any court of competent jurisdiction in the latter State,
according to the practice and procedure of that court applicable to subpoenas
issued in proceedings pending before it.
c. Subpoenas issued by a Respiratory Therapy Licensing Authority in a
Member State for production of evidence from another Member State shall be
enforced in the latter State, according to the practice and procedure of that
court applicable to subpoenas issued in the proceedings pending before it.
d. 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;
3. Unless otherwise prohibited by State law, recover from the Licensee the
costs of investigations and disposition of cases resulting from any Adverse
Action taken against that Licensee;
4. Notwithstanding subsection D.2., a Member State may not issue a
subpoena to gather evidence of conduct in another Member State that is lawful
in such other Member State for the purpose of taking Adverse Action against a
Licensee's Compact Privilege or application for a Compact Privilege in that
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Member State; and
5. Nothing in this Compact authorizes a Member State to impose discipline
against a Respiratory Therapist's Compact Privilege in that Member State for
the individual's otherwise lawful practice in another State.
E. Joint Investigations
1. In addition to the authority granted to a Member State by its
respective Respiratory Therapy Practice act or other applicable state law, a
Member State may participate with other Member States in joint investigations
of Licensees, provided, however, that a Member State receiving such a request
has no obligation to respond to any subpoena issued regarding an investigation
of conduct or practice that was lawful in a Member State at the time it was
undertaken.
2. Member States shall share any Significant Investigative Information,
litigation, or compliance materials in furtherance of any joint or individual
investigation initiated under the Compact. In sharing such information between
Member State Respiratory Therapy Licensing Authorities, all information
obtained shall be kept confidential, except as otherwise mutually agreed upon
by the sharing and receiving Member States.
F. Nothing in this Compact may permit a Member State to take any Adverse
Action against a Licensee or holder of a Compact Privilege for conduct or
practice that was legal in the Member State at the time it was undertaken.
G. Nothing in this Compact may permit a Member State to take disciplinary
action against a Licensee or holder of a Compact Privilege for conduct or
practice that was legal in the Member State at the time it was undertaken.
SECTION 7. ESTABLISHMENT OF THE RESPIRATORY CARE INTERSTATE COMPACT
COMMISSION
A. The Compact Member States hereby create and establish a joint
government agency whose membership consists of all Member States that have
enacted the Compact known as the Respiratory Care Interstate Compact
Commission. The Commission is an instrumentality of the Compact Member 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.
B. Membership, Voting, and Meetings
1. Each Member State shall have and be limited to one Commissioner
selected by that Member State's Respiratory Therapy Licensing Authority.
2. The Commissioner shall be an administrator or their designated staff
member of the Member State's Respiratory Therapy Licensing Authority.
3. The Commission shall 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 Member State the removal or
suspension of any Commissioner from office.
5. A Member State's Respiratory Therapy Licensing Authority shall fill any
vacancy of its Commissioner occurring on the Commission within sixty days of
the vacancy.
6. Each Commissioner shall be entitled to one vote on all matters before
the Commission requiring a vote by Commissioners.
7. A Commissioner shall vote in person or by such other means as provided
in the bylaws. The bylaws may provide for Commissioners to meet by
telecommunication, videoconference, or other means of communication.
8. The Commission shall meet at least once during each calendar year.
Additional meetings may be held as set forth in the bylaws.
C. The Commission shall have the following powers:
1. Establish and amend the fiscal year of the Commission;
2. Establish and amend bylaws and policies, including, but not limited to,
a code of conduct and conflict of interest;
3. Establish and amend Rules, which shall be binding in all Member States;
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 conduct legal proceedings or actions in the name of the
Commission, provided that the standing of any Respiratory Therapy Licensing
Authority to sue or be sued under applicable law shall not be affected;
7. Maintain and certify records and information provided to a Member State
as the authenticated business records of the Commission, and designate an agent
to do so on the Commission's behalf;
8. Purchase and maintain insurance and bonds;
9. Accept or contract for services of personnel, including, but not
limited to, employees of a Member 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. Assess and collect fees;
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:
a. The Commission shall avoid any appearance of impropriety; and
b. The Commission shall avoid any appearance of conflict of interest;
14. Lease, purchase, retain, own, hold, improve, or use any property,
real, personal, or mixed, or any undivided interest therein;
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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 in a fiscally responsible manner;
18. Appoint committees, including standing committees, composed of
Commissioners, 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. Establish and elect an Executive Committee, including a chair, vice-
chair, secretary, treasurer, and such other offices as the Commission shall
establish by Rule or bylaw;
21. Enter into contracts or arrangements for the management of the affairs
of the Commission;
22. Determine whether a State's adopted language is materially different
from the Model Compact language such that the State would not qualify for
participation in the Compact; and
23. Perform such other functions as may be necessary or appropriate to
achieve the purposes of this Compact.
D. The Executive Committee
1. The Executive Committee 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 Committee shall include:
a. Overseeing the day-to-day activities of the administration of the
Compact, including enforcement and compliance with the provisions of the
Compact, its Rules and bylaws, and other such duties as deemed necessary;
b. Recommending to the Commission changes to the Rules or bylaws, changes
to this Compact legislation, fees charged to Compact Member 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 Member 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. Performing other duties as provided in the Rules or bylaws of the
Commission.
2. The Executive Committee shall be composed of up to nine members, as
further set forth in the bylaws of the Commission:
a. Seven voting members who are elected by the Commission from the current
membership of the Commission; and
b. Two ex officio, nonvoting members.
3. The Commission may remove any member of the Executive Committee as
provided in the Commission's bylaws.
4. The Executive Committee shall meet at least annually.
a. Executive Committee meetings shall be open to the public, except that
the Executive Committee may meet in a closed, nonpublic meeting as provided in
subsection F.4 below;
b. The Executive Committee shall give advance notice of its meetings,
posted on its website and as determined to provide notice to persons with an
interest in the business of the Commission; and
c. The Executive Committee may hold a special meeting in accordance with
subsection F.2 below.
E. The Commission shall adopt and provide to the Member States an annual
report.
F. Meetings of the Commission
1. All meetings of the Commission that are not closed pursuant to
subsection 7.F.4 shall be open to the public. Notice of public meetings shall
be posted on the Commission's website at least thirty days prior to the public
meeting.
2. Notwithstanding subsection 7.F.1, the Commission may convene an
emergency public meeting by providing at least twenty-four 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 subsection 9.G. 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, videoconference, or other electronic means, the notice shall
include the mechanism for access to the meeting.
4. The Commission or the Executive Committee may convene in a closed,
nonpublic meeting for the Commission or Executive Committee to receive or
solicit legal advice or to discuss:
a. Noncompliance of a Member State with its obligations under the Compact;
b. The employment, compensation, discipline or other matters, practices or
procedures related to specific employees;
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c. Current or threatened discipline of a Licensee or Compact Privilege
holder by the Commission or by a Member State's Respiratory Therapy 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;
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 by federal or Member
State law; or
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 in accordance with Commission Rules
and bylaws. 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.
G. Financing of the Commission
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 revenue sources as
provided herein.
3. The Commission may levy on and collect an annual assessment from each
Member State and impose fees on Licensees of Member States to whom it grants a
Compact Privilege to cover the cost of the operations and activities of the
Commission and its staff. The aggregate annual assessment amount for Member
States, if any, 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 or a loan adequate to meet the same; nor shall the
Commission pledge the credit of any of the Member States, except by and with
the authority of the Member 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. However, 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.
H. Qualified Immunity, Defense, and Indemnification
1. 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.
2. The members, officers, executive director, employees, and agents of the
Commission shall have no greater liability than a state employee would have
under the same or similar circumstances, either personally or in their official
capacity, for any claim for damage to or loss of property, 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 responsibilities; provided that nothing in
this subsection 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.
3. The Commission shall defend any Commissioner, officer, executive
director, employee, and agent 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.
4. The Commission shall indemnify and hold harmless any Commissioner,
member, officer, executive director, employee, and agent of the Commission for
the amount of any settlement or judgment obtained against that person arising
out of any actual or alleged act, error, or omission that occurred within the
scope of Commission employment, duties, or responsibilities, or that such
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person had a reasonable basis for believing occurred within the scope of
Commission employment, duties, or responsibilities; provided that the actual or
alleged act, error, or omission did not result from the intentional or willful
or wanton misconduct of that person.
5. Nothing in this Compact shall be interpreted to waive or otherwise
abrogate a Member 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 Member 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.
B. Notwithstanding any other provision of State law to the contrary, a
Member State shall submit a uniform data set to the Data System as required by
the Rules of the Commission, including, but not limited to:
1. Identifying information;
2. Licensure data;
3. Adverse Actions against a Licensee, license applicant, or Compact
Privilege holder and information related thereto;
4. Nonconfidential information related to Alternative Program
participation, the beginning and ending dates of such participation, and other
information related to such participation not made confidential under Member
State law;
5. Any denial of application for licensure, and the reasons for such
denial;
6. The presence of current 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. No Member State shall submit any information which constitutes criminal
history record information, as defined by applicable federal law, to the Data
System established hereunder.
D. The records and information provided to a Member 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 Member
State.
E. Significant Investigative Information pertaining to a Licensee in any
Member State will only be available to other Member States.
F. It is the responsibility of the Member States to report any Adverse
Action against a Licensee and to monitor the database to determine whether
Adverse Action has been taken against a Licensee. Adverse Action information
pertaining to a Licensee in any Member State will be available to any other
Member State.
G. Member 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.
H. Any information submitted to the Data System that is subsequently
expunged pursuant to federal law or the laws of the Member 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 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. For purposes of the Compact, the Rules of the Commission shall have the
force of law in each Member State.
C. 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 in each Rule.
D. If a majority of the legislatures of the Member States rejects a Rule
or portion of a Rule, by enactment of a statute or resolution in the same
manner used to adopt the Compact within four years of the date of adoption of
the Rule, then such Rule shall have no further force and effect in any Member
State.
E. Rules shall be adopted at a regular or special meeting of the
Commission.
F. 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.
G. Prior to adoption of a proposed Rule by the Commission, and at least
thirty 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
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proposed rulemaking; and
3. In such other ways as the Commission may by Rule specify.
H. The notice of proposed rulemaking shall include:
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, videoconference, 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.
I. 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.
J. Nothing in this section shall be construed as requiring a separate
hearing on each Rule. Rules may be grouped for the convenience of the
Commission at hearings required by this section.
K. The Commission shall, by majority vote of all Commissioners, take final
action on the proposed Rule based on the rulemaking record and the full text of
the Rule.
1. The Commission may adopt changes to the proposed Rule provided the
changes are consistent with 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.
3. The Commission shall determine a reasonable effective date for the
Rule. Except for an emergency as provided in Section 9.L, the effective date of
the Rule shall be no sooner than thirty days after issuing the notice that it
adopted or amended the Rule.
L. Upon determination that an emergency exists, the Commission may
consider and adopt an emergency Rule with twenty-four hours' notice, and 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 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 Member 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.
M. 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
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 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.
N. No Member State's rulemaking process or procedural requirements shall
apply to the Commission.
1. The Commission shall have no authority over any Member State's
rulemaking process or procedural requirements that do not pertain to the
Compact.
O. Nothing in this Compact, nor any Rule or regulation of the Commission,
shall be construed to limit, restrict, or in any way reduce the ability of a
Member State to enact and enforce laws, regulations, or other Rules related to
the Practice of Respiratory Therapy in that State, where those laws,
regulations, or other Rules are not inconsistent with the provisions of this
Compact.
SECTION 10. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
A. Oversight
1. The executive and judicial branches of State government in each Member
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 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.
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B. Default, Technical Assistance, and Termination
1. If the Commission determines that a Member 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
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 Member 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 of the Member States, 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 membership 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 Respiratory Therapy Licensing Authority and each of the
Member States' Respiratory Therapy Licensing Authorities.
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, if necessary.
F. Upon the termination of a State's membership from this Compact, that
State shall immediately provide notice to all Licensees and Compact Privilege
holders (of which the Commission has a record) within that State of such
termination. The terminated State shall continue to recognize all licenses
granted pursuant to this Compact for a minimum of one hundred eighty 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 Member State, the Commission shall attempt to resolve
disputes related to the Compact that arise among Member States and between
Member and non-Member States.
2. The Commission shall promulgate a Rule providing for both mediation and
binding dispute resolution for disputes, as appropriate.
J. Enforcement
1. By majority vote, as may be further provided by Rule, the Commission
may initiate legal action against a Member 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. A Member State by
enactment of this Compact consents to venue and jurisdiction in such court for
the purposes set forth herein. 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. 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 Member State's law.
2. A Member 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.
3. No person other than a Member State shall 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 Member State ("Effective Date").
1. On or after the Effective Date of the Compact, the Commission shall
convene and review the enactment of each of the first seven Member States
("Charter Member States") to determine if the statute enacted by each such
Charter Member State is materially different than the Model Compact.
a. A Charter Member 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.
b. If any Member 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 Member States should be
less than seven.
2. Member States enacting the Compact subsequent to the seven initial
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Charter Member States shall be subject to the process set forth herein and
Commission Rule 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. The Commission shall own and have all rights to any intellectual
property developed on behalf or in furtherance of the Commission by individuals
or entities involved in organizing or establishing the Commission, as may be
further set forth in Rules of 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 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 date the Compact becomes law in that State.
B. Any Member State may withdraw from this Compact by enacting a statute
repealing the same.
1. A Member State's withdrawal shall not take effect until one hundred
eighty days after enactment of the repealing statute.
2. Withdrawal shall not affect the continuing requirement of the
withdrawing State's Respiratory Therapy Licensing Authority to comply with the
investigative and Adverse Action reporting requirements of this Compact prior
to the effective date of withdrawal.
3. Upon the enactment of a statute withdrawing from this Compact, a State
shall immediately provide notice of such withdrawal to all Licensees and
Compact Privilege holders (of which the Commission has a record) within that
State. Notwithstanding any subsequent statutory enactment to the contrary, such
withdrawing State shall continue to recognize all licenses granted pursuant to
this Compact for a minimum of one hundred eighty 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
Member State and a non-Member State that does not conflict with the provisions
of this Compact.
D. This Compact may be amended by the Member States. No amendment to this
Compact shall become effective and binding upon any Member State until it is
enacted into the laws of all Member 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 Member State, a State
seeking participation in the Compact, or of the United States, or the
applicability thereof to any government, 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, terminate a Member State's participation in the Compact, if it
determines that a constitutional requirement of a Member State is a material
departure from the Compact. Otherwise, if this Compact shall be held to be
contrary to the constitution of any Member State, the Compact shall remain in
full force and effect as to the remaining Member States and in full force and
effect as to the Member 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 Member State that is not inconsistent with the Compact.
B. Any laws, statutes, regulations, or other legal requirements in a
Member State in conflict with the Compact are superseded to the extent of the
conflict, including any subsequently enacted State laws.
C. All permissible agreements between the Commission and the Member States
are binding in accordance with their terms.
D. Other than as expressly set forth herein, nothing in this Compact will
impact initial licensure.
Sec. 7. The State of Nebraska adopts the Athletic Trainer Compact in the
form substantially as follows:
SECTION 1. TITLE AND PURPOSE
This statute shall be known and cited as the Athletic Trainer Compact. The
purposes of this compact are to expand mobility of Athletic Training practice
and improve public access to services by providing qualified Licensed Athletic
Trainers the ability to practice in other Member States. This compact preserves
the regulatory authority of States to protect public health and safety through
the current system of State licensure.
This compact is designed to achieve the following objectives:
A. Increase public access to Athletic Training and enhance continuity of
care by providing for the mutual recognition of other Licenses issued by Member
States;
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B. Provide an additional streamlined opportunity for interstate practice
by Licensed Athletic Trainers who meet compact uniform requirements;
C. Promote mobility and workforce development by eliminating the necessity
for Licenses in multiple States by providing for the mutual recognition of
other Licenses issued by Member States;
D. Reduce administrative burdens on Licensed Athletic Trainers and Member
States;
E. Enhance the States' ability to protect the public's health and safety;
F. Encourage the cooperation of Member States in regulating interstate
practice of Licensed Athletic Trainers;
G. Support relocating Active Military Members and their spouses;
H. Enhance the exchange of licensure, investigative, and disciplinary
information among Member States;
I. Allow for the use of telehealth to facilitate increased access to
Athletic Training services;
J. Support the uniformity of Licensed Athletic Trainer licensure
requirements throughout the States;
K. Affirm the authority of all Member States to hold a Licensed Athletic
Trainer accountable for abiding by the Scope of Practice in the State in which
the patient is located at the time of care; and
L. Require adherence to the Model Compact Language in order to promote
uniformity and ensure that all Member States have accepted and are mutually
obligated to the same terms.
SECTION 2. DEFINITIONS
As used in this compact, unless the context requires otherwise, the
following definitions shall apply:
A. "Active Military Member" means any individual with full-time duty
status in the active armed forces of the United States, including members of
the National Guard and Reserve;
B. "Adverse Action" means any administrative, civil, equitable, or
criminal action permitted by a State's laws which is imposed by a Licensing
Authority or other authority against a Licensee, including actions against an
individual's License or Compact Privilege such as revocation, suspension,
probation, monitoring of the Licensee, limitation on the Licensee's practice,
or any other Encumbrance on licensure affecting a Licensee's authorization to
practice;
C. "Alternative Program" means a nondisciplinary monitoring or practice
remediation process applicable to an Athletic Trainer approved by a State
Licensing Authority of a Member State in which the Athletic Trainer is
licensed. This includes, but is not limited to, programs to which Licensees
with substance use, addiction, or mental health conditions are referred in lieu
of Adverse Action;
D. "Athletic Training" means the prevention, examination, assessment,
treatment, and rehabilitation of emergent, acute, or chronic injuries and
medical conditions as defined by applicable Member State laws and regulations;
E. "Athletic Trainer Compact Commission" or "Compact Commission" means the
government agency whose membership consists of all States that have enacted
this compact, as described herein and which shall operate as an instrumentality
of the Member States to administer and implement the compact according to its
terms;
F. "BOC" means the Board of Certification, Inc. or any successor
organization thereto;
G. "CAATE" means the Commission on Accreditation of Athletic Training
Education or any successor organization thereto;
H. "Charter Member State" means any Member State which enacted and made
effective this compact by law before the compact effective date specified
herein;
I. "Commissioner" means the individual appointed by a Member State to
serve as the member of the Commission for that Member State;
J. "Compact Privilege" means the legal authorization granted by a Remote
State, equivalent to a License, allowing a Licensee from another Member State
to provide Athletic Training services in a Remote State;
K. "Compact Qualifying License" means a License that is not an Encumbered
License issued by a Member State to practice Athletic Training which qualifies
the Licensee to exercise a Compact Privilege pursuant to Section 4 of this
compact;
L. "Continuing Competence" means a requirement, as a condition of License
renewal, to provide evidence of successful participation, and completion of,
educational and professional activities relevant to practice or area of work.
For purposes of this compact, evidence of active BOC certification may satisfy
the meaning of Continuing Competence as set forth herein;
M. "Current Significant Investigative Information" means the existence of:
1. Investigative Information that a Licensing Authority, after a
preliminary inquiry that includes notification and an opportunity for the
subject Licensee to respond, if required by State law, has reason to believe is
not groundless and, if proven true, would indicate more than a minor
infraction; or
2. Investigative Information that indicates that the subject Licensee
represents an immediate threat to public health and safety regardless of
whether the subject Licensee has been notified and had an opportunity to
respond;
N. "Criminal Background Check" means the submission of fingerprints or
other biometric-based information for a License applicant for the purpose of
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obtaining that 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);
O. "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;
P. "Encumbrance" or "Encumbered" means a revocation or suspension of, or
any limitation or condition on, the full and unrestricted practice of Athletic
Training;
Q. "Executive Committee" means a group of Commissioners elected or
appointed to act on behalf of, and within the powers granted to them by, the
compact and Commission;
R. "Investigative Information" means information, records, and documents
received or generated by a Licensing Authority pursuant to an investigation;
S. "Jurisprudence Requirement" means the assessment of an individual's
knowledge of the laws and Rules governing the practice of Athletic Training, as
applicable, in a State;
T. "License" means current authorization by a Member State to engage in
the practice of Athletic Training;
U. "Licensee" or "Licensed Athletic Trainer" means an individual who
currently holds an active, unrestricted License and who meets all of the
requirements outlined in Section 4 of this compact;
V. "Licensing Authority" means the board or agency of a State, or
equivalent, that is responsible for the licensing and regulation of Athletic
Trainers;
W. "Model Compact Language" means the model language for the Athletic
Trainer Compact on file with The Council of State Governments or other entity
as designated by the Commission to which all Member States must substantively
adhere and adopt;
X. "Member State" means a State that has enacted the compact;
Y. "Remote State" means a Member State other than the State of Qualifying
Licensure;
Z. "Rule" means a regulation promulgated by an authorized entity that has
the force of law;
AA. "Scope of Practice" means the procedures, actions, and processes an
Athletic Trainer 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. Scope of Practice shall include any State requirements regarding
supervision or direction, if required by such State and as further defined by
such State's statutes and regulations;
BB. "Single-State License" means a License issued by any State that
authorizes practice only within the issuing State;
CC. "State" means any state, commonwealth, district, or territory of the
United States of America;
DD. "State of Qualifying Licensure" means the Member State that has issued
a Compact Qualifying License to a Licensee pursuant to this compact; and
EE. "Unencumbered License" means a License that authorizes a Licensee to
engage in the full and unrestricted practice of Athletic Training.
SECTION 3. STATE PARTICIPATION IN THE COMPACT
A. To be eligible to join this compact and to maintain eligibility as a
Member State, a State must:
1. Enact and maintain a statute that is not materially different from the
Model Compact Language;
2. License and regulate the practice of Athletic Training;
3. Require that Licensees in that State maintain Continuing Competence
standards as part of their State practice act or Rules;
4. Have a mechanism in place for receiving and investigating complaints
about Licensees;
5. Grant the Compact Privilege to a Licensee who meets all the
requirements outlined in Section 4 of this compact in accordance with the terms
of the compact and any Rules promulgated thereunder;
6. Participate fully in the Compact Commission's Data System, including
using the unique identifier as defined in Rules;
7. Notify the Compact Commission, in compliance with the terms of the
compact and Rules, of any Adverse Action or the availability of Current
Significant Investigative Information regarding a Licensee;
8. Within a timeframe established by Rule, implement or utilize procedures
for considering the criminal history records of applicants for a Compact
Qualifying License which includes receiving the results of the Federal Bureau
of Investigation record search and shall use those results in making licensure
decisions. These procedures shall include the submission of fingerprints or
other biometric-based information by applicants for the purpose of obtaining an
applicant's criminal history record information from the Federal Bureau of
Investigation and the agency responsible for retaining that State's criminal
records;
a. A Member State must fully implement a Criminal Background Check
requirement in order to participate in the issuance and acceptance of Compact
Privileges; and
b. Communication between a Member State and the Compact Commission or
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among Member States regarding the verification of eligibility for licensure
through the compact shall not include any information received from the Federal
Bureau of Investigation relating to a federal criminal records check performed
by a Member State; and
9. Comply with and enforce the Rules of the Compact Commission.
B. Member States may set and collect a fee for issuance and renewal of a
Compact Privilege to applicants.
C. Individuals without a Compact Qualifying License shall continue to be
able to apply for a Member State's Single-State License as provided under the
laws of each Member State.
D. Nothing in this compact shall affect the requirements established by a
Member State for the issuance of a Single-State License.
E. A Compact Qualifying License shall be recognized by each Remote State
as authorizing that Licensee to engage in the practice of Athletic Training,
under a Compact Privilege, in another Member State in accordance with the
requirements in Section 4 of this compact.
SECTION 4. COMPACT PRIVILEGE
A. To be eligible for a Compact Privilege under the terms and provisions
of the compact, the Licensee shall complete a Criminal Background Check
performed by the Licensing Authority in the State of Qualifying Licensure prior
to entry in the compact and shall:
1. Satisfy one of the following two pathways:
a. Hold a valid current active certification through the BOC, or its
successor organization; or
b. If a Licensee does not meet the requirements of subsection 4.A.1.a.,
the following must be completed:
i. An education program which is one of the following:
1. At least a bachelor's degree with a major course of study in Athletic
Training, or an equivalent course of study from a college or university
accredited at the time of graduation by CAATE, or its successor organization;
2. An academic degree from a college or university in a foreign country
equivalent to the degree described in subparagraph 1 of this subsection with a
major course of study as described in subparagraph 1 of this subsection that is
accredited by CAATE, or its successor organization; or
3. The substantial equivalent of the foregoing which the Commission may
determine by Rule; and
ii. Successful completion of the exam administered by the BOC, or its
successor organization, preceding the date of the Licensee's application for
licensure in their State of Qualifying Licensure or the substantial equivalent
of the foregoing requirement which the Commission may determine by Rule.
2. Hold a Compact Qualifying License;
3. Have not had any Encumbrance against any License or Compact Privilege
to practice Athletic Training within the previous two years;
4. Be eligible for a Compact Privilege in any Member State in accordance
with Section 4 of this compact;
5. Notify the Compact Commission that the Licensee is seeking the Compact
Privilege within a Remote State;
6. Pay any applicable fees, including any State fee, for the Compact
Privilege;
7. Meet only the Continuing Competence requirements established by the
State of Qualifying Licensure;
8. Comply with any requirements of the State of Qualifying Licensure as
set forth in Section 3 of this compact;
9. Meet any Jurisprudence Requirements established by the Remote State in
which the Licensee is seeking a Compact Privilege; and
10. Report to the Compact Commission any Adverse Action, Encumbrance, or
restriction on a License taken by any non-Member State within thirty days from
the date the action is taken.
B. The Compact Privilege is valid until the expiration date of the Compact
Qualifying License. To maintain a Compact Privilege, renewal of the Compact
Privilege shall be congruent with the renewal of the Compact Qualifying License
as the Compact Commission may define by Rule. The Licensee must comply with the
requirements of this section to maintain the Compact Privilege in the Remote
State. A Licensee may apply for and hold Compact Privileges in multiple Member
States.
C. A Licensed Athletic Trainer must follow the Scope of Practice of the
Member State where the patient is located. A Licensee engaging in the practice
of Athletic Training in a Remote State under the Compact Privilege shall adhere
to the Scope of Practice laws and regulations of the Remote State. Licensees
shall be responsible for educating themselves on, and complying with, any and
all Scope of Practice laws and regulations and State laws relating to the
remote practice of Athletic Training, as applicable.
D. A Licensee engaging in the practice of Athletic Training 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, remove a Licensee's Compact
Privilege in the Remote State for a specific period of time, impose fines, or
take any other necessary actions to protect the health and safety of its
citizens. Any Member State which undertakes such an action shall promptly
notify the Member State and the Commission as specified in the Rules. The
Licensee may be deemed to be ineligible to exercise the Compact Privilege by
any Member State until the specific time for removal has passed and all fines
are paid.
E. All Member State disciplinary orders that impose Adverse Action against
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a Compact Qualifying License shall result in deactivation of the Licensee's
Compact Privilege in all Member States during the pendency of the order. If a
Compact Qualifying License is Encumbered, the Licensee shall lose the Compact
Privilege in any Remote State until the following occur:
1. The Compact Qualifying License is no longer Encumbered; and
2. The Licensee has not had any Encumbrance or restriction against any
License, Compact Qualifying License, or Compact Privilege within the previous
two years.
F. Once an Encumbered License is restored to good standing as a Compact
Qualifying License (as certified by the Licensing Authority) the Licensee must
meet the requirements of this section to obtain a Compact Privilege in any
Remote State.
G. If a Licensee's Compact Privilege in any Remote State is removed, that
Licensee may also lose the Compact Privilege in other Remote States, as each
Member State shall determine in its sole authority, until the following occur:
1. The specific period of time for which the Compact Privilege was removed
has ended;
2. All fines have been paid; and
3. Have not had any Encumbrance or restriction against any License or
Compact Privilege within the previous two years.
H. Once the requirements of Section 4.G have been met, the Licensee must
meet the requirements in Section 4.A to obtain a Compact Privilege in a Remote
State.
SECTION 5. COMPACT QUALIFYING LICENSE
A. A Licensee may only designate one License as their Compact Qualifying
License at a time. The procedures for such designation may be further defined
by Compact Commission Rule.
B. Nothing in this Section shall require that the State of Qualifying
Licensure be the State of primary residence or State of primary practice for
the Licensee.
C. Nothing in this compact shall interfere with a Licensee's ability to
hold a Single-State License in multiple States.
D. Nothing in this compact shall affect the requirements established by a
Member State for the issuance of a Single-State License.
SECTION 6. ACTIVE MILITARY MEMBER OR THEIR SPOUSES
An Active Military Member or their spouse shall not be required to pay a
fee to the Commission for a Compact Privilege. If a Member State chooses to
charge a Member State fee, it may choose to charge a reduced fee or no fee to
an Active Military Member or their spouse for a Compact Privilege.
SECTION 7. ADVERSE ACTIONS
A. A Member State in which a Licensee is issued a Compact Qualifying
License shall have the exclusive authority to impose Adverse Action against the
Compact Qualifying License issued by that Member State.
B. A Member State may take Adverse Action based on Current Significant
Investigative Information of a Remote State, so long as the Member State
follows its own procedures for imposing Adverse Action.
C. Nothing in this compact shall override a Member State's decision that
participation in an Alternative Program may be used in lieu of Adverse Action
and that such participation shall remain nonpublic if required by the Member
State's laws or Rules.
D. A Remote State shall have the authority to:
1. Take Adverse Actions as set forth herein against a Licensee's Compact
Privilege in that State; and
2. Issue subpoenas for both hearings and investigations that require the
attendance and testimony of witnesses as well as the production of evidence.
a. Subpoenas may be issued by a Member State Athletic Training Licensing
Authority for the attendance and testimony of witnesses and the production of
evidence.
b. A Member State which issues a subpoena may request service of that
subpoena by another Member State. The Member State receiving the request to
serve a subpoena shall serve the subpoena if it is deemed enforceable by a
court of competent jurisdiction according to the practice and procedure in the
receiving Member State.
c. 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.
E. For purposes of taking Adverse Action, a Member State shall give the
same priority and effect to reported conduct received from another Member State
as it would if the conduct had occurred within that State. In so doing, the
investigating Member State shall apply its own State laws to determine
appropriate action.
F. A Member State, if otherwise permitted by State law, may recover from
the affected Licensee the costs of investigations and dispositions of cases
resulting from any Adverse Action taken against that Licensee.
G. Joint Investigations:
1. In addition to the authority granted to a Member State by its
respective State law, any Member State may participate with other Member States
in joint investigations of Licensees.
2. Member States shall share any Current Significant Investigative
Information, litigation, or compliance materials in furtherance of any joint or
individual investigation initiated under the compact. In sharing such
information between Member State Athletic Trainer Licensing Authorities, all
information obtained shall be kept confidential, except as otherwise mutually
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agreed upon by the sharing and receiving Member States.
3. A Remote State may issue subpoenas on behalf of a Member State for both
hearings and investigations that require the attendance and testimony of
witnesses as well as the production of evidence.
H. If a Member State takes Adverse Action, it shall promptly notify the
administrator of the Data System. The administrator of the Data System shall
promptly notify all Member States of any Adverse Actions by Remote States.
I. Nothing in this compact may permit a Member State to take any Adverse
Action against a Licensee or holder of a Compact Privilege for conduct or
practice occurring in another Member State that was legal in the Member State
at the time it was undertaken.
SECTION 8. ESTABLISHMENT AND OPERATION OF THE COMMISSION
A. The compact Member States hereby create and establish a joint
government agency whose membership consists of all Member States that have
enacted the compact known as the Athletic Trainer Licensure Compact Commission.
The Compact Commission is an instrumentality of the Member States acting
jointly and not an instrumentality of any one State. The Compact Commission
shall come into existence on or after the effective date of the compact as set
forth in Section 12 of this compact.
B. Membership, Voting, and Meetings
1. Each Member State shall have and be limited to one Commissioner
selected by that Member State's Licensing Authority within sixty days of the
Member State's effective date.
2. The Commissioner shall be an administrator or their designated staff or
current board member of the Licensing Authority.
3. The Compact Commission may recommend removal or suspension of any
Commissioner from office.
4. A Member State's Licensing Authority shall fill any vacancy of its
Commissioner occurring on the Compact Commission within sixty days of the
vacancy.
5. Each Commissioner shall be entitled to one vote on all matters before
the Compact Commission requiring a vote by the Commissioners.
6. The Compact Commission shall meet at least once during each calendar
year. Additional meetings may be held as set forth in the Commission bylaws. A
Commissioner shall vote in person or by such other means as provided in the
bylaws. The bylaws may provide for Commissioners to meet by telecommunication,
videoconference, or other means of communication.
C. The Compact Commission shall have the following powers:
1. Promulgate, adopt, and amend Rules and bylaws;
2. Establish code of conduct, confidentiality, and conflict of interest
policies for Commissioners;
3. Establish the fiscal year of the Compact Commission;
4. Maintain its financial records in accordance with the bylaws;
5. Purchase and maintain insurance and insurance bonds;
6. Accept, or contract for services of personnel, including, but not
limited to, employees of a Member State;
7. Conduct a financial review or audit;
8. 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 Compact Commission's personnel policies and
programs relating to conflicts of interest, qualifications of personnel, and
other related personnel matters;
9. Enter into contracts or arrangements for the management of the affairs
of the Commission;
10. Assess and collect fees;
11. 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
Compact Commission shall avoid any appearance of impropriety or conflict of
interest;
12. Lease, purchase, retain, own, hold, improve, invest, or use any
property, real, personal, or mixed, or any undivided interest therein;
13. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise
dispose of any property real, personal, or mixed;
14. Establish a budget and make expenditures;
15. Borrow and invest money;
16. Meet and take such actions as are consistent with the provisions of
this compact, the Compact Commission's Rules, and the bylaws;
17. Initiate and conclude legal proceedings or actions in the name of the
Compact Commission, provided that the standing of any Licensing Authority to
sue or be sued under applicable law shall not be affected;
18. Maintain and certify records and information provided to a Member
State as the authenticated business records of the Compact Commission, and
designate an agent to do so on the Compact Commission's behalf;
19. Provide and receive information from, and cooperate with, law
enforcement agencies;
20. Determine whether a State's adopted language is materially different
from the Model Compact Language such that the State would not qualify for
participation in the compact;
21. Establish and elect an Executive Committee, including a chair and a
vice-chair, secretary, treasurer, and such other offices as the Commission
shall establish by Rule or bylaw;
22. Appoint committees, including standing committees, composed of Member
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State Commissioners, 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; and
23. Perform such other functions as may be necessary or appropriate to
achieve the purposes of this compact.
D. The Executive Committee
1. The Executive Committee shall have the power to act on behalf of the
Compact Commission according to the terms of this compact. The powers, duties,
and responsibilities of the Executive Committee shall include:
a. Exercise the powers and duties of the Compact Commission during the
interim between Compact Commission meetings, except for adopting or amending
Rules, adopting or amending bylaws, and exercising any other powers and duties
expressly reserved to the Compact Commission by Rule or bylaw;
b. Oversee the day-to-day activities of the administration of the compact
including enforcement and compliance with the provisions of the compact, its
Rules and bylaws, and other such duties as deemed necessary;
c. Recommend to the Compact Commission changes to the Rules or bylaws,
changes to this compact legislation, fees charged to compact Member States,
fees charged to Licensees, and other fees;
d. Ensure compact administration services are appropriately provided,
including by contract;
e. Prepare and recommend the budget;
f. Maintain financial records on behalf of the Compact Commission;
g. Monitor compact compliance of Member States and provide compliance
reports to the Compact Commission;
h. Establish additional committees as necessary; and
i. Other duties as provided in the Rules or bylaws of the Compact
Commission.
2. The Executive Committee shall be composed of five voting members,
elected by the Compact Commission:
a. The chair and vice-chair of the Compact Commission shall be voting
members of the Executive Committee;
b. The Compact Commission shall elect up to three additional voting
members from the current membership of the Compact Commission to include the
offices of treasurer, secretary, and one member-at-large; and
c. Up to four ex officio, nonvoting members from recognized national
athletic trainer organizations.
3. The Compact Commission may remove any member of the Executive Committee
as provided in the Compact Commission's bylaws.
4. The Executive Committee shall meet at least annually:
a. Executive Committee meetings shall be open to the public, except that
the Executive Committee may meet in a closed, nonpublic meeting as provided in
this Section.
b. The Executive Committee shall give advance notice of its meetings,
posted on its website and as determined by Rule or bylaw to provide notice to
persons with an interest in the business of the Compact Commission.
c. The Executive Committee may hold a special meeting in accordance with
this section.
E. The Compact Commission shall adopt and provide to the Member States an
annual report.
F. Meetings of the Compact Commission:
1. All meetings shall be open to the public, except that the Compact
Commission may meet in a closed, nonpublic meeting as provided in this section.
2. Public notice for all meetings of the full Compact Commission shall be
given in the same manner as required under the rulemaking provisions in this
compact, except that the Compact Commission may hold a special meeting as
provided in this section.
3. The Compact Commission may hold a special meeting when it must meet to
conduct emergency business by giving twenty-four hours' notice to all
Commissioners, on the Compact Commission's website, and by other means as
provided in the Compact Commission's Rules. The Compact Commission's legal
counsel shall certify that the Compact Commission's need to meet qualifies as
an emergency.
4. The Compact Commission or the Executive Committee or other committees
of the Compact Commission may convene in a closed, nonpublic meeting for the
Compact Commission or Executive Committee or other committees of the Compact
Commission to receive legal advice or to discuss:
a. Noncompliance of a Member State with its obligations under the compact;
b. The employment, compensation, discipline, or other matters, practices,
or procedures related to specific employees;
c. Current or threatened discipline of a Licensee by a Member 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;
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 Compact Commission or other committee charged with
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responsibility of investigation or determination of compliance issues pursuant
to the compact;
k. Matters specifically exempted from disclosure by federal or Member
State law; or
l. Other matters as specified in Rules of the Compact Commission.
5. If a meeting, or portion of a meeting, is closed, the Compact
Commission's legal counsel or designee shall certify that the meeting will be
closed and reference each relevant exempting provision, and such reference
shall be recorded in the minutes. All minutes and documents of a closed meeting
shall remain under seal, subject to release only by a majority vote of the
Compact Commission or order of a court of competent jurisdiction.
G. Financing of the Compact Commission:
1. The Compact Commission shall pay, or provide for the payment of, the
reasonable expenses of its establishment, organization, and ongoing activities.
2. The Compact Commission may accept any and all appropriate revenue
sources as provided in this section.
3. The Compact Commission may levy on and collect an annual assessment
from each Member State and impose fees on Licensees of Member States to whom it
grants a Compact Privilege to cover the cost of the operations and activities
of the Compact Commission and its staff, which must be in a total amount
sufficient to cover its annual budget as approved each year for which revenue
is not provided by other sources. The aggregate annual assessment amount for
Member States shall be allocated based upon a formula that the Compact
Commission shall promulgate by Rule.
4. The Compact Commission shall not incur obligations of any kind prior to
securing the funds or a loan adequate to meet the same; nor shall the Compact
Commission pledge the credit of any of the Member States, except by and with
the authority of the Member State.
5. The Compact Commission shall keep accurate accounts of all receipts and
disbursements. The receipts and disbursements of the Compact Commission shall
be subject to the financial review or audit and accounting procedures
established under its bylaws. However, all receipts and disbursements of funds
handled by the Compact Commission shall be subject to an annual financial
review or audit by a certified or licensed public accountant, and the report of
the financial review or audit shall be included in and become part of the
annual report of the Compact Commission.
H. Qualified Immunity, Defense, and Indemnification:
1. The members, officers, executive director, employees, and
representatives of the Compact Commission shall have no greater liability than
a state employee would have under the same or similar circumstances, 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 Compact Commission employment, duties, or
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 Compact Commission
shall not in any way compromise or limit the immunity granted hereunder.
2. The Compact Commission shall defend any member, officer, executive
director, employee, and representative of the Compact 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 Compact Commission
employment, duties, or responsibilities, or as determined by the Compact
Commission that the person against whom the claim is made had a reasonable
basis for believing occurred within the scope of Compact 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. The Compact Commission shall indemnify and hold harmless any member,
officer, executive director, employee, and representative of the Compact
Commission for the amount of any settlement or judgment obtained against that
person arising out of any actual or alleged act, error, or omission that
occurred within the scope of Compact Commission employment, duties, or
responsibilities, or that such person had a reasonable basis for believing
occurred within the scope of Compact Commission employment, duties, or
responsibilities, provided that the actual or alleged act, error, or omission
did not result from the intentional or willful or wanton misconduct of that
person.
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 Member 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 Member States or by the Compact Commission.
SECTION 9. DATA SYSTEM
A. The Commission shall provide for the development, maintenance,
operation, and utilization of a coordinated Data System and reporting system
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containing licensure, Compact Privileges, Adverse Action, and the presence of
Current Significant Investigative Information on all Licensees and applicants
for a License in Member States.
B. Notwithstanding any other provision of State law to the contrary, a
Member State shall submit a uniform data set to the Data System on all
Licensees, applicants, and others to whom this compact is applicable as
required by the Rules of the Compact Commission, including:
1. Personally identifying information;
2. Licensure data;
3. Adverse Actions against a Licensee, License applicant, or Compact
Privilege and information related thereto;
4. Nonconfidential 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 for such
denial, excluding the reporting of any criminal history record information
where prohibited by law;
6. A binary determination regarding the presence of Current 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 Member 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 Member
State.
D. Current Significant Investigative Information pertaining to a Licensee
in any Member State will only be available to other Member States.
E. It is the responsibility of the Member States to monitor the Data
System 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 Member State will be available to any other Member
State.
F. Member 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.
G. Any information submitted to the Data System that is subsequently
expunged pursuant to federal law or the laws of the Member State contributing
the information shall be removed from the Data System.
SECTION 10. RULEMAKING
A. The Compact Commission shall promulgate reasonable Rules in order to
effectively and efficiently implement and administer the purposes and
provisions of the compact. A 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 Compact 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 Rules of the Compact Commission shall have the force of law in each
Member State, provided however that where the Rules conflict with the laws or
regulations of a Member State that relate to the Scope of Practice a Licensed
Athletic Trainer is permitted to undertake in that State and the circumstances
under which they may do so, as held by a court of competent jurisdiction, the
Rules of the Compact Commission shall be ineffective in that State to the
extent of the conflict.
C. The Compact Commission shall exercise its rulemaking powers pursuant to
the criteria set forth in this section and the Rules adopted thereunder. Rules
of this compact shall become binding on the day following adoption or as of the
date specified in the Rule or amendment, whichever is later.
D. If a majority of the legislatures of the Member States rejects a Rule
or portion of a Rule, by enactment of a statute or resolution in the same
manner used to adopt the compact within four years of the date of adoption of
the Rule, then such Rule shall have no further force and effect in any Member
State.
E. Rules shall be adopted at a regular or special meeting of the Compact
Commission.
F. Prior to adoption of a proposed Rule, the Compact Commission shall hold
a public hearing and allow persons to provide oral and written comments, data,
facts, opinions, and arguments. At least thirty days in advance of the public
hearing on the proposed Rule, the Compact Commission shall provide a notice of
proposed rulemaking:
1. On the website of the Compact Commission or other publicly accessible
platform;
2. To persons who have requested notice of the Compact Commission's
notices of proposed rulemaking; and
3. In such other ways as the Compact Commission may by Rule specify.
G. The notice of proposed rulemaking shall include:
1. The time, date, and location of the public hearing at which the Compact
Commission will hear public comments on the proposed Rule and, if different,
the time, date, and location of the meeting where the Compact Commission will
consider and vote on the proposed Rule;
2. If the hearing is held via telecommunication, videoconference, or other
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electronic means, the Compact 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.
H. All hearings will be recorded. A copy of the recording and all written
comments and documents received by the Compact Commission in response to the
proposed Rule shall be available to the public.
I. Nothing in this section shall be construed as requiring a separate
hearing on each Rule. Rules may be grouped for the convenience of the Compact
Commission at hearings required by this section.
J. The Compact Commission shall, by majority vote of all members, take
final action on the proposed Rule based on the rulemaking record and the full
text of the Rule.
1. The Compact Commission may adopt changes to the proposed Rule provided
the changes do not enlarge the original purpose of the proposed Rule.
2. The Compact 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.
3. The Compact Commission shall determine a reasonable effective date for
the Rule. Except for an emergency as provided in this section, the effective
date of the Rule shall be no sooner than thirty days after issuing the notice
that it adopted or amended the Rule.
K. Upon determination that an emergency exists, the Compact Commission may
consider and adopt an emergency Rule with twenty-four 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 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 Compact Commission or Member 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.
L. The Compact Commission or an authorized committee of the Compact
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 Compact Commission. The revisions shall be subject to challenge
by any person for a period of thirty days after posting. A 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 Compact
Commission prior to the end of the notice period. If no 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
Compact Commission.
M. No Member State's rulemaking requirements shall apply under this
compact.
SECTION 11. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
A. Oversight:
1. The executive and judicial branches of State government in each Member
State shall enforce this compact and take all actions necessary and appropriate
to implement the compact.
2. Except as otherwise provided in this compact, venue is proper and
judicial proceedings by or against the Compact Commission shall be brought
solely and exclusively in a court of competent jurisdiction where the principal
office of the Compact Commission is located. The Compact 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 Compact Commission shall be entitled to receive service of process
in any proceeding regarding the enforcement or interpretation of the compact
and shall have standing to intervene in such a proceeding for all purposes.
Failure to provide the Compact Commission service of process shall render a
judgment or order void as to the Compact Commission, this compact, or
promulgated Rules.
B. Default, Technical Assistance, and Termination:
1. If the Compact Commission determines that a Member 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
defaulting State. The notice of default shall describe the default, the
proposed means of curing the default, and any other action that the Compact
Commission may take, and shall offer training and specific technical assistance
regarding the default.
2. The Compact Commission shall provide a copy of the notice of default to
the other Member 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 of the Member States, and all rights, privileges and benefits
conferred on that State by this compact may be terminated on the effective date
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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 membership 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 Compact Commission to the Governor,
the majority and minority leaders of the defaulting State's legislature, the
defaulting State's Licensing Authority and each of the Member States' Licensing
Authority.
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 membership from this compact, that
State shall immediately provide notice to all Licensees within that State of
such termination. The terminated State shall continue to recognize all Licenses
and Compact Privileges granted pursuant to this compact for a minimum of one
hundred eighty days after the date of said notice of termination.
G. The Compact 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 Compact Commission and the defaulting State.
H. The defaulting State may appeal the action of the Compact Commission by
petitioning the United States District Court for the District of Columbia or
the federal district where the Compact 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 Member State, the Compact Commission shall attempt to
resolve disputes related to the compact that arise among Member States and
between Member and non-Member States.
2. The Compact Commission shall promulgate a Rule providing for both
mediation and binding dispute resolution for disputes as appropriate.
J. Enforcement:
1. By two-thirds majority vote, the Compact Commission may initiate legal
action against a Member State in default in the United States District Court
for the District of Columbia or the federal district where the Compact
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. The remedies herein shall not be the exclusive
remedies of the Compact Commission. The Compact Commission may pursue any other
remedies available under federal or the defaulting Member State's law.
2. A Member State may initiate legal action against the Compact Commission
in the United States District Court for the District of Columbia or the federal
district where the Compact 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.
3. No person other than a Member State shall enforce this compact against
the Compact Commission.
SECTION 12. 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 Member State.
1. On or after the effective date of the compact, the Compact Commission
shall convene and review the enactment of each of the first seven Member States
(Charter Member States) to determine if the statute enacted and made effective
by each such Charter Member State is materially different than the Model
Compact Language.
a. A Charter Member State whose enactment is found to be materially
different from the Model Compact Language shall be entitled to the default
process set forth in Section 11 of this compact.
b. If any Member State is later found to be in default, or is terminated
or withdraws from the compact, the Compact Commission shall remain in existence
and the compact shall remain in effect even if the number of Member States
should be less than seven.
2. Member States enacting the compact subsequent to the seven initial
Charter Member States shall be subject to the process set forth in this section
to determine if their enactments are materially different from the Model
Compact Language and whether they qualify for participation in the compact.
3. All actions taken for the benefit of the Compact Commission or in
furtherance of the purposes of the administration of the compact prior to the
effective date of the compact or the Compact Commission coming into existence
shall be considered to be actions of the Compact Commission unless specifically
repudiated by the Compact Commission.
4. Any State that joins the compact subsequent to the Compact Commission's
initial adoption of the Rules and bylaws shall be subject to the 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 Compact Commission
shall have the full force and effect of law on the day the compact becomes law
in that State.
B. Any Member State may withdraw from this compact by enacting a statute
repealing the same.
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1. A Member State's withdrawal shall not take effect until one hundred
eighty days after enactment of the repealing statute.
2. Withdrawal shall not affect the continuing requirement of the
withdrawing State's Licensing Authority to comply with the investigative and
Adverse Action reporting requirements of this compact prior to the effective
date of withdrawal.
3. Upon the enactment of a statute withdrawing from this compact, a State
shall immediately provide notice of such withdrawal to all Licensees and
privilege holders within that State. Notwithstanding any subsequent statutory
enactment to the contrary, such withdrawing State shall continue to recognize
all Compact Privileges granted pursuant to this compact for a minimum of one
hundred eighty days after the date of such notice of withdrawal.
4. Nothing contained in this compact shall be construed to invalidate or
prevent any licensure agreement or other cooperative arrangement between a
Member State and a non-Member State that does not conflict with the provisions
of this compact.
5. This compact may be amended by the Member States. No amendment to this
compact shall become effective and binding upon any Member State until it is
enacted into the laws of all Member States.
SECTION 13. CONSTRUCTION AND SEVERABILITY
A. This compact and the Compact 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 Compact 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 Member State, a State
seeking participation in the compact, or of the United States, or the
applicability thereof to any government, 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 the foregoing, the Compact Commission may deny a
State's participation in the compact or terminate a Member State's
participation in the compact if it determines that a constitutional requirement
of a Member State is a material departure from the compact. Otherwise, if this
compact shall be held to be contrary to the constitution of any Member State,
the compact shall remain in full force and effect as to the remaining Member
States and in full force and effect as to the Member State affected as to all
severable matters.
SECTION 14. CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS
A. Nothing herein shall prevent or inhibit the enforcement of any other
law of a Member State that is not inconsistent with the compact.
B. Any laws, statutes, regulations, or other legal requirements in a
Member State in conflict with the compact are superseded to the extent of the
conflict.
C. All permissible agreements between the Compact Commission and the
Member States are binding in accordance with their terms.
Sec. 8. Section 38-131, Revised Statutes Supplement, 2025, is amended to
read:
38-131 (1) An applicant for an initial license to practice as a registered
nurse, a licensed practical nurse, a physical therapist, a physical therapy
assistant, an athletic trainer, a psychologist, a respiratory care
practitioner, an advanced emergency medical technician, an emergency medical
technician, an audiologist, a speech-language pathologist, a licensed
independent mental health practitioner, an occupational therapist, an
occupational therapy assistant, a dietitian, a certified social worker, a
certified master social worker, a licensed clinical social worker, a paramedic,
a physician, an osteopathic physician, a physician or osteopathic physician who
is an applicant for a temporary educational permit, a physician or osteopathic
physician who is an applicant for a temporary visiting faculty permit, a
physician assistant, a dentist, a dental hygienist, an optometrist, a
podiatrist, a veterinarian, an advanced practice registered nurse-nurse
practitioner, an advanced practice registered nurse-certified nurse midwife, or
an advanced practice registered nurse-certified registered nurse anesthetist
shall be subject to a criminal background check. Except as provided in
subsection (4) of this section, such an applicant for an initial license shall
submit a full set of fingerprints to the Nebraska State Patrol for a criminal
history record information check. The applicant shall authorize release of the
results of the national criminal history record information check by the
Federal Bureau of Investigation to the department. The applicant shall pay the
actual cost of the fingerprinting and criminal background check.
(2) The Nebraska State Patrol is authorized to submit the fingerprints of
such applicants to the Federal Bureau of Investigation and to issue a report to
the department that includes the criminal history record information concerning
the applicant. The Nebraska State Patrol shall forward submitted fingerprints
to the Federal Bureau of Investigation for a national criminal history record
information check. The Nebraska State Patrol shall issue a report to the
department that includes the criminal history record information concerning the
applicant.
(3) This section shall not apply to a dentist who is an applicant for a
dental locum tenens under section 38-1122, to a physician or osteopathic
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physician who is an applicant for a physician locum tenens under section
38-2036, or to a veterinarian who is an applicant for a veterinarian locum
tenens under section 38-3335.
(4) A physician or osteopathic physician who is an applicant for a
temporary educational permit shall have ninety days from the issuance of the
permit to comply with subsection (1) of this section and shall have such permit
suspended after such ninety-day period if the criminal background check is not
complete or revoked if the criminal background check reveals that the applicant
was not qualified for the permit.
(5) The department and the Nebraska State Patrol may adopt and promulgate
rules and regulations concerning costs associated with the fingerprinting and
the national criminal history record information check.
(6) For purposes of interpretation by the Federal Bureau of Investigation,
the term department in this section means the Division of Public Health of the
Department of Health and Human Services.
Sec. 9. Section 38-404, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-404 Athletic trainer means a health care professional who is licensed
to practice athletic training under the Athletic Training Practice Act or the
Athletic Trainer Compact and who, under guidelines established with a licensed
physician, performs the functions outlined in section 38-408 except as
otherwise provided in subsection (5) of section 38-408.
Sec. 10. Section 38-409, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-409 No person shall be authorized to perform the functions outlined in
section 38-408 unless the person first obtains a license as an athletic trainer
or unless such person is licensed as a physician, osteopathic physician,
chiropractor, nurse, physical therapist, or podiatrist. No person shall hold
himself or herself out as an athletic trainer in this state unless such person
is licensed under the Athletic Training Practice Act or the Athletic Trainer
Compact.
Sec. 11. Section 38-1716, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-1716 No person shall operate or profess or attempt to operate a massage
therapy establishment unless such establishment is licensed by the department
under the Massage Therapy Practice Act. The department shall not issue or renew
a license for a massage therapy establishment until all requirements of the act
have been complied with. No person shall engage in any of the practices of
massage therapy in any location or premises other than a licensed massage
therapy establishment except as specifically permitted in the act or in the
rules and regulations adopted and promulgated by the department.
Sec. 12. Section 38-1915, Reissue Revised Statutes of Nebraska, is amended
to read:
38-1915 (1)(a) (1) A person licensed by the department, with the
recommendation of the board, as a medical radiographer may practice medical
radiography on any part of the human anatomy for interpretation by , and under
the direction of , a licensed practitioner, including computed tomography but
excluding interpretative fluoroscopic procedures, and may use fluoroscopy in
collaboration conjunction with a certified registered nurse anesthetist as
authorized in section 38-711.
(b) A medical radiographer may also utilize fluoroscopy under the
direction of, or in collaboration with, a nurse practitioner pursuant to
section 38-2315.
(2) An applicant for a license as a medical radiographer shall:
(a) Complete an educational program in radiography approved by the board
pursuant to subsection (1) of section 38-1918;
(b) Complete an application in accordance with the Uniform Credentialing
Act; and
(c) Successfully complete an examination approved by the board.
(3) Presentation of proof of registration in radiography with the American
Registry of Radiologic Technologists is proof of meeting the requirements of
subdivisions (2)(a) and (c) of this section.
Sec. 13. Section 38-2101, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-2101 Sections 38-2101 to 38-2147 and section 14 of this act shall be
known and may be cited as the Mental Health Practice Act.
Sec. 14. (1) Every two years, a minimum of two hours of continuing
education in domestic abuse counseling shall be required for all licensed
mental health practitioners and licensed independent mental health
practitioners under the Mental Health Practice Act.
(2) Such training shall be conducted by an individual who has (a) received
the domestic abuse training required in section 38-2123, (b) a minimum of three
years' experience working with victims of domestic abuse or offenders, and (c)
completed an additional forty hours in domestic abuse-related training.
(3) For purposes of the section, domestic abuse means abuse as defined in
section 42-903.
Sec. 15. Section 38-2123, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-2123 (1) A person who needs to obtain the required three thousand hours
of supervised experience in mental health practice as specified in section
38-2122 to qualify for a mental health practitioner license shall obtain a
provisional mental health practitioner license. To qualify for a provisional
mental health practitioner license, such person shall:
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(a) Have a master's degree, a doctoral degree, or the equivalent of a
master's degree, as determined by the board, that consists of course work and
training which was primarily therapeutic mental health in content and included
a practicum or internship and was from a mental health program as specified in
section 38-2122;
(b) Apply prior to earning the three thousand hours of supervised
experience; and
(c) Pay the provisional mental health practitioner license fee; and .
(d) Beginning September 1, 2027, obtain three hours of training relating
to domestic abuse, which shall include: (i) Appropriate screening tools for
victims of domestic abuse; (ii) indicators of high lethality or risk; (iii)
documentation standards; (iv) appropriate referrals to domestic abuse specific
services, advocacy, and systems navigation professionals; (v) impact on
children; (vi) ethical practice and boundaries; and (vii) trauma-informed,
victim-centered care and safety planning. For purposes of this subdivision (1)
(d), domestic abuse means abuse as defined in section 42-903.
(2) An individual or organization providing the training described in
subdivision (1)(d) of this section shall submit all training materials to the
board for approval.
(3) (2) The rules and regulations approved by the board and adopted and
promulgated by the department shall not require that the applicant have a
supervisor in place at the time of application for a provisional mental health
practitioner license.
(4) (3) A provisional mental health practitioner license shall expire upon
receipt of licensure as a mental health practitioner or five years after the
date of issuance, whichever comes first.
(5) (4) A person who holds a provisional mental health practitioner
license shall inform all clients that he or she holds a provisional license and
is practicing mental health under supervision and shall identify the
supervisor. Failure to make such disclosure is a ground for discipline as set
forth in section 38-2139.
Sec. 16. Section 38-2315, Reissue Revised Statutes of Nebraska, is amended
to read:
38-2315 (1) A nurse practitioner may provide health care services within
specialty areas. A nurse practitioner shall function by establishing
collaborative, consultative, and referral networks as appropriate with other
health care professionals. Patients who require care beyond the scope of
practice of a nurse practitioner shall be referred to an appropriate health
care provider.
(2) Nurse practitioner practice means health promotion, health
supervision, illness prevention and diagnosis, treatment, and management of
common health problems and acute and chronic conditions, including:
(a) Assessing patients, ordering diagnostic tests and therapeutic
treatments, synthesizing and analyzing data, and applying advanced nursing
principles;
(b) Dispensing, incident to practice only, sample medications which are
provided by the manufacturer and are provided at no charge to the patient; and
(c) Prescribing therapeutic measures and medications relating to health
conditions within the scope of practice.
(3) A nurse practitioner who has proof of a current certification from an
approved certification program in a psychiatric or mental health specialty may
manage the care of patients committed under the Nebraska Mental Health
Commitment Act. Patients who require care beyond the scope of practice of a
nurse practitioner, who has proof of a current certification from an approved
certification program in a psychiatric or mental health specialty , shall be
referred to an appropriate health care provider.
(4) A nurse practitioner may pronounce death and may complete and sign
death certificates and any other forms if such acts are within the scope of
practice of the nurse practitioner and are not otherwise prohibited by law.
(5) A nurse practitioner may perform and utilize fluoroscopy for
procedural guidance and for the performance of authorized duties upon the nurse
practitioner's successful completion of appropriate education and training as
approved jointly by the department and the board. Such education and training
shall be in accordance with rules and regulations adopted and promulgated
pursuant to section 71-3508. A nurse practitioner may also direct fluoroscopy
in collaboration with a licensed medical radiographer.
Sec. 17. Section 38-2801, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-2801 Sections 38-2801 to 38-28,117 and section 18 of this act and the
Nebraska Drug Product Selection Act shall be known and may be cited as the
Pharmacy Practice Act.
Sec. 18. (1) Individuals employed by a facility where dispensed drugs and
devices are delivered from a pharmacy to be picked up by a patient or
caregiver, as requested by the patient, shall not be considered to be engaging
in the practice of pharmacy if:
(a) The drug or device has been prepaid by the patient or caregiver;
(b) The dispensing pharmacist has offered patient counseling either prior
to, or at the time of, dispensing;
(c) The drug or device is (i) maintained in the packaging as received from
the dispensing pharmacy and stored in accordance with the manufacturer's
recommendations and (ii) kept in a separate area from other drugs or devices
held by the facility;
(d) The drug or device being delivered is not a controlled substance;
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(e) A drug or device that is not picked up within thirty days after
delivery is donated or destroyed by the facility or returned to the pharmacy
and is not eligible for a refund of any amount paid;
(f) The facility has implemented a written policy relating to the donation
or destruction of a drug or device that is not picked up by a patient or
caregiver within thirty days after delivery to the facility; and
(g) The facility maintains documentation of the delivery of a drug or
device under this subsection, including the date received, the name of the
pharmacy, the name of the patient, the signature and printed name of the
individual picking up the drug or device, the date it was picked up, and the
date of donation, destruction, or return to a pharmacy.
(2) A facility other than a pharmacy, acting in accordance with subsection
(1) of this section, shall not be liable for the contents of a drug or device
delivered to a patient.
(3) The decision to accept a drug or device for delivery to a patient
rests solely with the receiving facility.
(4) The department, with the recommendation of the board, may adopt and
promulgate rules and regulations for the administration of this section.
Sec. 19. Section 38-2850, Reissue Revised Statutes of Nebraska, is amended
to read:
38-2850 As authorized by the Uniform Credentialing Act, the practice of
pharmacy may be engaged in by a pharmacist, a pharmacist intern, or a
practitioner with a pharmacy license. The practice of pharmacy shall not be
construed to include:
(1) Practitioners, other than veterinarians, certified nurse midwives,
certified registered nurse anesthetists, nurse practitioners, and physician
assistants, who dispense drugs or devices as an incident to the practice of
their profession, except that if such practitioner engages in dispensing such
drugs or devices to his or her patients for which such patients are charged,
such practitioner shall obtain a pharmacy license;
(2) Persons who sell, offer, or expose for sale nonprescription drugs or
proprietary medicines, the sale of which is not in itself a violation of the
Nebraska Liquor Control Act;
(3) Medical representatives, detail persons, or persons known by some name
of like import, but only to the extent of permitting the relating of
pharmaceutical information to health care professionals;
(4) Licensed veterinarians practicing within the scope of their
profession;
(5) Certified nurse midwives, certified registered nurse anesthetists,
nurse practitioners, and physician assistants who dispense sample medications
which are provided by the manufacturer and are dispensed at no charge to the
patient;
(6) Optometrists who prescribe or dispense eyeglasses or contact lenses to
their own patients, including contact lenses that contain and deliver ocular
pharmaceutical agents as authorized under the Optometry Practice Act, and
ophthalmologists who prescribe or dispense eyeglasses or contact lenses to
their own patients, including contact lenses that contain and deliver ocular
pharmaceutical agents;
(7) Registered nurses or licensed practical nurses employed by a hospital
who administer pursuant to a chart order, or procure for such purpose, single
doses of drugs or devices from original drug or device containers or properly
labeled repackaged or prepackaged drug or device containers to persons
registered as patients and within the confines of the hospital;
(8) Persons employed by a facility where dispensed drugs and devices are
delivered from a pharmacy for pickup by a patient or caregiver and no
dispensing or storage of drugs or devices occurs;
(9) Persons who sell or purchase medical products, compounds, vaccines, or
serums used in the prevention or cure of animal diseases and maintenance of
animal health if such medical products, compounds, vaccines, or serums are not
sold or purchased under a direct, specific, written medical order of a licensed
veterinarian;
(10) A person accredited by an accrediting body who, pursuant to a medical
order, (a) administers, dispenses, or distributes medical gas or medical gas
devices to patients or ultimate users or (b) purchases or receives medical gas
or medical gas devices for administration, dispensing, or distribution to
patients or ultimate users; and
(11) A person accredited by an accrediting body who, pursuant to a medical
order, (a) sells, delivers, or distributes devices described in subsection (2)
of section 38-2841 to patients or ultimate users or (b) purchases or receives
such devices with intent to sell, deliver, or distribute to patients or
ultimate users; and .
(12) Individuals described in section 18 of this act.
Sec. 20. Section 38-2852, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-2852 Every applicant for licensure as a pharmacist shall be required to
attain a passing grade to be determined by the board in an examination in
pharmacy and in an examination in jurisprudence of pharmacy. The jurisprudence
examination may occur at a time, before or after graduation, as determined by
the accredited pharmacy program attended by the applicant.
Sec. 21. Section 38-2866.01, Revised Statutes Supplement, 2025, is amended
to read:
38-2866.01 (1) A pharmacist may supervise any combination of pharmacy
technicians and pharmacist interns at any time up to a total of four people.
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(2) A pharmacist intern shall be supervised at all times while performing
the functions of a pharmacist intern which may include all aspects of the
practice of pharmacy unless otherwise restricted. This subsection does not
apply to a pharmacist intern who is receiving experiential training directed by
the accredited pharmacy program in which he or she is enrolled.
(3) For any pharmacist supervising four pharmacy technicians or pharmacist
interns, at least one individual person shall be a certified pharmacy
technician pursuant to section 38-2890.
Sec. 22. Section 38-2871, Reissue Revised Statutes of Nebraska, is amended
to read:
38-2871 (1) Original prescription information for any controlled
substances listed in Schedule III, IV, or V of section 28-405 and other
prescription drugs or devices not listed in section 28-405 may be transferred
between pharmacies for the purpose of refill dispensing as set forth in this
section on a one-time basis, except that pharmacies electronically sharing a
real-time, online database may transfer up to the maximum refills permitted by
law and as authorized by the prescribing practitioner on the prescription.
Transfers are subject to the following:
(a) The transfer is communicated directly between two pharmacists or
pharmacist interns except when the pharmacies can use a real-time, online
database;
(b) The transferring pharmacist or pharmacist intern indicates void on the
record of the prescription;
(c) The transferring pharmacist or pharmacist intern indicates on the
record of the prescription the name, the address, and, if a controlled
substance, the Drug Enforcement Administration number of the pharmacy to which
the information was transferred, the name of the pharmacist or pharmacist
intern receiving the information, the date of transfer, and the name of the
transferring pharmacist or pharmacist intern;
(d) The receiving pharmacist or pharmacist intern indicates on the record
of the transferred prescription that the prescription is transferred;
(e) The transferred prescription includes the following information:
(i) The date of issuance of the original prescription;
(ii) The original number of refills authorized;
(iii) The date of original dispensing;
(iv) The number of valid refills remaining;
(v) The date and location of last refill; and
(vi) The name, the address, and, if a controlled substance, the Drug
Enforcement Administration number of the pharmacy from which the transfer was
made, the name of the pharmacist or pharmacist intern transferring the
information, the original prescription number, and the date of transfer; and
(f) Both the original and transferred prescriptions must be maintained by
the transferring and receiving pharmacy for a period of five years from the
date of transfer.
(2) Prescriptions for drugs or devices not listed in section 28-405 may be
transferred between pharmacies for the purpose of refill dispensing if (a) the
number of transfers does not exceed the number of originally authorized refills
and (b) the original prescription is still valid.
(3) (2) Nothing in this section shall prevent a pharmacist from forwarding
an original prescription for a noncontrolled substance to another pharmacy at
the request of the patient or the patient’s caregiver. An original prescription
for a controlled substance shall not be forwarded to another pharmacy unless
permitted under 21 C.F.R. 1306.25.
(4) A prescription for a controlled substance may be transferred or
forwarded as permitted by federal law.
Sec. 23. Section 38-3208, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
38-3208 (1) Except as provided in subsection (2) of this section, a person
shall not engage in the practice of respiratory care unless such person is
licensed pursuant to the Respiratory Care Practice Act or holds a compact
privilege under the Respiratory Care Interstate Compact.
(2) Subsection (1) of this section The Respiratory Care Practice Act shall
not prohibit:
(a) (1) The practice of respiratory care which is an integral part of the
program of study by students enrolled in approved respiratory care education
programs;
(b) (2) The gratuitous care, including the practice of respiratory care,
of the ill by a friend or member of the family or by a person who is not
licensed to practice respiratory care if such person does not represent himself
or herself as a respiratory care practitioner;
(c) (3) The practice of respiratory care by nurses, physicians, physician
assistants, physical therapists, or any other professional required to be
licensed under the Uniform Credentialing Act when such practice is within the
scope of practice for which that person is licensed to practice in this state;
(d) (4) The practice of any respiratory care practitioner of this state or
any other state or territory while employed by the federal government or any
bureau or division thereof while in the discharge of his or her official
duties;
(e) (5) Techniques defined as pulmonary function testing and the
administration of aerosol and inhalant medications to the cardiorespiratory
system as it relates to pulmonary function technology administered by a
registered pulmonary function technologist credentialed by the National Board
for Respiratory Care or a certified pulmonary function technologist
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credentialed by the National Board for Respiratory Care; or
(f) (6) The performance of oxygen therapy or the initiation of noninvasive
positive pressure ventilation by a registered polysomnographic technologist
relating to the study of sleep disorders if such procedures are performed or
initiated under the supervision of a licensed physician at a facility
accredited by the American Academy of Sleep Medicine.
Sec. 24. Section 52-401, Revised Statutes Cumulative Supplement, 2024, is
amended to read:
52-401 (1) Whenever any person employs a physician, nurse, chiropractor,
physical therapist, hospital, or provider of emergency medical service to
perform professional services of any nature, in the treatment of or in
connection with an injury, and such injured person claims damages from the
party causing the injury, such physician, nurse, chiropractor, physical
therapist, hospital, or provider of emergency medical service , shall have a
lien upon any sum awarded the injured person in judgment or obtained by
settlement or compromise on the amount due for the usual and customary charges
of such physician, nurse, chiropractor, physical therapist, hospital, or
provider of emergency medical service applicable at the time services are
performed, except that no such lien shall be valid against anyone covered under
the Nebraska Workers' Compensation Act. For persons covered under private
medical insurance or another private health benefit plan, the amount of the
lien shall be reduced by the contracted discount or other limitation which
would have been applied had the claim been submitted for reimbursement to the
medical insurer or administrator of such other health benefit plan. The measure
of damages for medical expenses in personal injury claims shall be the private
party rate, not the discounted amount.
(2) In order to prosecute such lien, it shall be necessary for such
physician, nurse, chiropractor, physical therapist, hospital, or provider of
emergency medical service to serve a written notice upon the person or
corporation from whom damages are claimed that such physician, nurse,
chiropractor, physical therapist, hospital, or provider of emergency medical
service claims a lien for such services and stating the amount due and the
nature of such services, except that whenever an action is pending in court for
the recovery of such damages, it shall be sufficient to file the notice of such
lien in the pending action.
(3) A physician, nurse, chiropractor, physical therapist, hospital, or
provider of emergency medical service claiming a lien under this section shall
not be liable for attorney's fees and costs incurred by the injured person in
securing the judgment, settlement, or compromise, but the lien of the injured
person's attorney shall have precedence over the lien created by this section.
(4) Upon a written request and with the injured person's consent, a
lienholder shall provide medical records, answers to interrogatories,
depositions, or any expert medical testimony related to the recovery of damages
within its custody and control at a reasonable charge to the injured person.
(5) For purposes of this section, provider of emergency medical service
means a public entity that provides emergency medical service as defined in
section 38-1207.
Sec. 25. Section 71-1908, Revised Statutes Supplement, 2025, is amended to
read:
71-1908 (1) Sections 71-1908 to 71-1923.03 and sections 28 and 29 of this
act shall be known and may be cited as the Child Care Licensing Act.
(2) The Legislature finds that there is a present and growing need for
quality child care programs and facilities. There is a need to establish and
maintain licensure of persons providing such programs to ensure that such
persons are competent and are using safe and adequate facilities. The
Legislature further finds and declares that the development and supervision of
programs are a matter of statewide concern and should be dealt with uniformly
on the state and local levels. There is a need for cooperation among the
various state and local agencies which impose standards on licensees, and there
should be one agency which coordinates the enforcement of such standards and
informs the Legislature about cooperation among the various agencies.
Sec. 26. Section 71-1912, Revised Statutes Supplement, 2025, is amended to
read:
71-1912 (1) Before issuance of a license, the department shall investigate
or cause an investigation to be made, when it deems necessary, to determine if
the applicant or person in charge of the program meets or is capable of meeting
the physical well-being, safety, and protection standards and the other rules
and regulations of the department adopted and promulgated under the Child Care
Licensing Act. The department may investigate the character of applicants and
licensees, any member of the applicant's or licensee's household, and the staff
and employees of programs. The department may at any time inspect or cause an
inspection to be made of any place where a program is operating to determine if
such program is being properly conducted.
(2) All inspections by the department shall be unannounced except for
initial licensure visits and consultation visits. Initial licensure visits are
announced visits necessary for a provisional license to be issued to a family
child care home I, family child care home II, child care center, or school-age-
only or preschool program. Consultation visits are announced visits made at the
request of a licensee for the purpose of consulting with a department
specialist on ways of improving the program.
(3) An unannounced inspection of any place where a program is operating
shall be conducted by the department or the city, village, or county pursuant
to subsection (2) of section 71-1914 at least annually for a program licensed
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to provide child care for fewer than thirty children and at least twice every
year for a program licensed to provide child care for thirty or more children.
At each unannounced inspection, the inspector shall request from the licensee,
and verify, current proof of required liability insurance. If the licensee is
unable to provide current proof of liability insurance or has let the required
coverage lapse, the department shall notify the licensee that proof of
insurance shall be provided to the department within three business days. If
such proof of insurance is not provided to the department within three business
days, the licensee's license shall be suspended. Licensure shall be restored
upon the department's receipt and verification of current proof of the required
liability insurance as provided in section 71-1911.03.
(4) Whenever an inspection is made, the findings shall be recorded in a
report designated by the department. The public shall have access to the
results of these inspections upon a written or oral request to the department.
The request must include the name and address of the program. Additional
unannounced inspections shall be performed as often as is necessary for the
efficient and effective enforcement of the Child Care Licensing Act.
(5)(a) A person applying for a license as a child care provider or a
licensed child care provider under the Child Care Licensing Act shall submit a
request for a national criminal history record information check for each child
care staff member, including a prospective child care staff member of the child
care provider, at the applicant's or licensee's expense, as set forth in this
section.
(b)(i) (b) A prospective child care staff member shall submit to a
national criminal history record information check (A) (i) prior to employment,
except as otherwise permitted under 45 C.F.R. 98.43, as such regulation existed
on January 1, 2019, or (B) (ii) prior to residing in a family child care home.
(ii) Pursuant to 45 C.F.R. 98.43(d)(4), the department shall authorize a
prospective child care staff member to begin work for a child care provider for
purposes of employment in child care, or for a staffing agency or substitute
child care staff pool operator, for the purposes of employment in child care as
a substitute child care staff member, after receiving qualifying results for
either (A) a Federal Bureau of Investigation fingerprint check or (B) a state
criminal registry or repository check with the use of fingerprints, for the
state where the staff member resides. Pending completion of all background
check components, the staff member shall be supervised at all times by an
individual who received a qualifying result on a background check described in
this subsection (5) within the past five years.
(c)(i) (c) The department shall provide documentation of national criminal
history record information checks which proves eligibility for employment. Such
documentation shall be made available to each child care staff member or
prospective child care staff member by the applicant or licensee for at least
one hundred eighty days after the last day of employment or date the
documentation was provided by the department, whichever is later.
(ii) Pursuant to 45 C.F.R. 98.43(d)(3), a child care provider, staffing
agency, or substitute child care staff pool operator shall not be required to
submit a request for a national criminal history record information check for a
child care staff member or prospective child care staff member if:
(A) The child care staff member or prospective child care staff member
received qualifying results from a background check described in subdivisions
(5)(d) and (5)(e) of this section:
(I) Within five years before the latest date on which such a submission
may be made; and
(II) While employed, or seeking employment, in child care within the
state;
(B) The department provided to the first child care provider, staffing
agency, or substitute child care staffing pool operator a qualifying background
check result for the child care staff member or prospective child care staff
member; and
(C) The child care staff member or prospective child care staff member is
employed in child care within the state, or has been separated from employment
in child care within the state, for a period of not more than one hundred
eighty consecutive days.
(d) A child care staff member shall be required to undergo a national
criminal history record information check not less than once during each five-
year period. A child care staff member shall submit a complete set of his or
her fingerprints to the Nebraska State Patrol. The Nebraska State Patrol shall
transmit a copy of the child care staff member's fingerprints to the Federal
Bureau of Investigation for a national criminal history record information
check. The national criminal history record information check shall include
information concerning child care staff members from federal repositories of
such information and repositories of such information in other states, if
authorized by federal law for use by the Nebraska State Patrol. The Nebraska
State Patrol shall issue a report to the department that includes the
information collected from the national criminal history record information
check concerning child care staff members. The department shall seek federal
funds, if available, to assist child care providers and child care staff
members with the costs of the fingerprinting and national criminal history
record information check. If the department does not receive sufficient federal
funds to assist child care providers and staff members with such costs, then
the child care staff member being screened, applicant for a license, or
licensee shall pay the actual cost of the fingerprinting and national criminal
history record information check, except that the department may pay all or
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part of the cost if funding becomes available. The department and the Nebraska
State Patrol may adopt and promulgate rules and regulations concerning the
costs associated with the fingerprinting and the national criminal history
record information check. The department may adopt and promulgate rules and
regulations implementing national criminal history record information check
requirements for child care providers and child care staff members.
(e) A child care staff member shall also submit to the following
background checks at his or her expense not less than once during each five-
year period:
(i) A search of the National Crime Information Center's National Sex
Offender Registry; and
(ii) A search of the following registries, repositories, or databases in
the state where the child care provider is located or where the child care
staff member resides and each state where the child care provider was located
or where the child care staff member resided during the preceding five years:
(A) State criminal registries or repositories;
(B) State sex offender registries or repositories; and
(C) State-based child abuse and neglect registries and databases.
(f) Documentation of eligibility for employment in child care from a
national criminal history record information check Background checks shall be
portable between child care providers , child care staff members, prospective
child care staff members, staffing agencies, and substitute child care staff
pool operators.
(g) Any individual shall be ineligible for employment by a child care
provider if such individual:
(i) Refuses to consent to the national criminal history record information
check or a background check described in this subsection;
(ii) Knowingly makes a materially false statement in connection with the
national criminal history record information check or a background check
described in this subsection;
(iii) Is registered, or required to be registered, on a state sex offender
registry or repository or the National Sex Offender Registry; or
(iv) Has been convicted of a crime of violence, a crime of moral
turpitude, or a crime of dishonesty.
(h) The department may adopt and promulgate rules and regulations for
purposes of this section.
(i) A child care provider shall be ineligible for a license under the
Child Care Licensing Act and shall be ineligible to participate in the child
care subsidy program if the provider employs a child care staff member who is
ineligible for employment under subdivisions (g) or (h) of this subsection.
(j) National criminal history record information and information from
background checks described in this subsection subject to state or federal
confidentiality requirements may only be used for purposes of granting a child
care license or approving a child care provider for participation in the child
care subsidy program.
(k) For purposes of this subsection:
(i) Child care provider means a child care program required to be licensed
under the Child Care Licensing Act; and
(ii) Child care staff member means an individual who is not related to all
of the children for whom child care services are provided and:
(A) Who is employed by a child care provider for compensation, including
contract employees or self-employed individuals;
(B) Whose activities involve the care or supervision of children for a
child care provider or unsupervised access to children who are cared for or
supervised by a child care provider; or
(C) Who is residing in a family child care home and who is eighteen years
of age or older.
Sec. 27. Section 71-1918, Reissue Revised Statutes of Nebraska, is amended
to read:
71-1918 The department shall maintain a complaint tracking system which
shall identify licensing violations discovered from a complaint investigation,
an unannounced inspection, or a self-report investigation for licensees under
the Child Care Licensing Act.
Sec. 28. (1) No child care program licensed under the Child Care
Licensing Act shall be prohibited from including a volunteer in the supervised
staff-to-child ratio if the volunteer (a) receives qualifying results for
either (i) a Federal Bureau of Investigation fingerprint check or (ii) a state
criminal registry or repository check with the use of fingerprints, for the
state where the staff member resides, and submits to all other background
checks as required in section 71-1912 and (b) is supervised at all times by an
individual who received a qualifying result on a background check.
(2) No child care program licensed under the Child Care Licensing Act
shall be prohibited from including a volunteer in the unsupervised staff-to-
child ratio if the volunteer (a) receives qualifying results for either (i) a
Federal Bureau of Investigation fingerprint check or (ii) a state criminal
registry or repository check with the use of fingerprints, for the state where
the staff member resides, (b) submits to all other background checks as
required by section 71-1912, and (c) meets staff qualifications and training
requirements.
(3) No volunteer shall be included in the staff-to-child ratio for more
than ten hours per week.
(4) The department shall adopt and promulgate rules and regulations to
include volunteer staff who provide direct care to children and any other
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individual who counts in the staff-to-child ratio in the definition of staff in
all licensed settings under the Child Care Licensing Act.
(5) This section terminates on December 31, 2028.
Sec. 29. No political subdivision shall institute residency requirements
for a family child care home II. This section shall not be construed to
prohibit a political subdivision from regulating business use relating to
outside appearance, nuisances, or public health and safety.
Sec. 30. Section 71-2444, Reissue Revised Statutes of Nebraska, is amended
to read:
71-2444 Sections 71-2444 to 71-2452 and section 33 of this act shall be
known and may be cited as the Automated Medication Systems Act.
Sec. 31. Section 71-2445, Reissue Revised Statutes of Nebraska, is amended
to read:
71-2445 For purposes of the Automated Medication Systems Act:
(1) Automated medication distribution machine means a type of automated
medication system that stores medication to be administered to a patient by a
person credentialed under the Uniform Credentialing Act;
(2) Automated medication system means a mechanical system that performs
operations or activities, other than compounding, administration, or other
technologies, relative to storage and packaging for dispensing or distribution
of medications and that collects, controls, and maintains all transaction
information and includes, but is not limited to, a prescription medication
distribution machine or an automated medication distribution machine. An
automated medication system may only be used in conjunction with the provision
of pharmacist care . Automated medication system does not include an automated
pickup kiosk;
(3) Automated pickup kiosk means a secure, automated storage and retrieval
device operated by a licensed pharmacy for the purpose of releasing
prescription medication, other than controlled substances, to a patient or a
caregiver and does not include an automated medication system;
(4) (3) Chart order means an order for a drug or device issued by a
practitioner for a patient who is in the hospital where the chart is stored,
for a patient receiving detoxification treatment or maintenance treatment
pursuant to section 28-412, or for a resident in a long-term care facility in
which a long-term care automated pharmacy is located from which drugs will be
dispensed. Chart order does not include a prescription;
(5) (4) Hospital has the definition found in section 71-419;
(6) (5) Long-term care automated pharmacy means a designated area in a
long-term care facility where an automated medication system is located, that
stores medications for dispensing pursuant to a medical order to residents in
such long-term care facility, that is installed and operated by a pharmacy
licensed under the Health Care Facility Licensure Act, and that is licensed
under section 71-2451;
(7) (6) Long-term care facility means an intermediate care facility, an
intermediate care facility for persons with developmental disabilities, a long-
term care hospital, a mental health substance use treatment center, a nursing
facility, or a skilled nursing facility, as such terms are defined in the
Health Care Facility Licensure Act;
(8) (7) Medical order means a prescription, a chart order, or an order for
pharmaceutical care issued by a practitioner;
(9) (8) Pharmacist means any person who is licensed by the State of
Nebraska to practice pharmacy;
(10) (9) Pharmacist care means the provision by a pharmacist of medication
therapy management, with or without the dispensing of drugs or devices,
intended to achieve outcomes related to the cure or prevention of a disease,
elimination or reduction of a patient's symptoms, or arresting or slowing of a
disease process;
(11) (10) Pharmacist remote order entry means entering an order into a
computer system or drug utilization review by a pharmacist licensed to practice
pharmacy in the State of Nebraska and located within the United States,
pursuant to medical orders in a hospital, long-term care facility, or pharmacy
licensed under the Health Care Facility Licensure Act;
(12) Pharmacy has the same meaning as defined in section 71-425;
(13) (11) Practice of pharmacy has the definition found in section
38-2837;
(14) (12) Practitioner means a certified registered nurse anesthetist, a
certified nurse midwife, a dentist, an optometrist, a nurse practitioner, a
physician assistant, a physician, a podiatrist, or a veterinarian;
(15) (13) Prescription means an order for a drug or device issued by a
practitioner for a specific patient, for emergency use, or for use in
immunizations. Prescription does not include a chart order;
(16) (14) Prescription medication distribution machine means a type of
automated medication system that packages, labels, or counts medication in
preparation for dispensing of medications by a pharmacist pursuant to a
prescription; and
(17) (15) Telepharmacy means the provision of pharmacist care, by a
pharmacist located within the United States, using telecommunications, remote
order entry, or other automations and technologies to deliver care to patients
or their agents who are located at sites other than where the pharmacist is
located.
Sec. 32. Section 71-2447, Reissue Revised Statutes of Nebraska, is amended
to read:
71-2447 Any health care facility authorized to use hospital, long-term
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care facility, or pharmacy that uses an automated medication system or an
automated pickup kiosk shall develop, maintain, and comply with policies and
procedures developed in consultation with the pharmacist responsible for
pharmacist care for that hospital, long-term care facility , or pharmacy. At a
minimum, the policies and procedures shall address the following:
(1) The description and location within or at the hospital, long-term care
facility , or pharmacy of the automated medication system or automated pickup
kiosk or the equipment being used;
(2) The name of the pharmacist responsible for implementation of , and
compliance with, the policies and procedures;
(3) Medication access and information access procedures;
(4) Security of inventory and confidentiality of records in compliance
with state and federal laws, rules, and regulations;
(5) A description of the process used by a pharmacist or pharmacy
technician for filling an automated medication system or an automated pickup
kiosk;
(6) A description of how , and by whom , the automated medication system or
automated pickup kiosk is being utilized, including processes for verifying,
dispensing, and distributing medications;
(7) Staff education and training;
(8) Quality assurance and quality improvement programs and processes;
(9) Inoperability or emergency downtime procedures;
(10) Periodic system maintenance; and
(11) Medication security and controls.
Sec. 33. (1) In order for an automated pickup kiosk to be operated by, or
under the authority of, a pharmacy located in Nebraska and licensed under the
Health Care Facility Licensure Act, the pharmacist in charge of the licensed
pharmacy shall annually license the automated pickup kiosk. An automated pickup
kiosk may be operated in connection with a licensed pharmacy if it is located
on property owned or leased by the pharmacy or a hospital, a facility operated
by a hospital, a health clinic as defined in section 71-416, a health care
practitioner facility as defined in section 71-414, or a rural emergency
hospital as defined in section 71-428.01 within which the licensed pharmacy
operates, whether placed within the interior of the building or affixed to, or
situated on, the exterior of the building or property.
(2) The pharmacist in charge of a licensed pharmacy shall submit an
application for licensure or renewal of licensure to the Division of Public
Health of the Department of Health and Human Services with a fee in an amount
determined by the Board of Pharmacy, not to exceed two hundred dollars for
initial licensure or fifty dollars for a renewal of licensure. The application
shall include:
(a) The name and location of the licensed pharmacy;
(b) The physical location of the automated pickup kiosk; and
(c) The name of the pharmacist in charge of the licensed pharmacy.
(3) As part of the application process, the division shall conduct an
inspection of the automated pickup kiosk by a pharmacy inspector as provided in
section 38-28,101. The division shall also conduct inspections of the operation
of the automated pickup kiosk as necessary.
(4) The division shall license an automated pickup kiosk which meets the
licensure requirements of this section.
(5) A pharmacist in charge of a licensed pharmacy shall apply for a
separate license for each location at which it operates one or more automated
pickup kiosks. The licensed pharmacy shall be the provider pharmacy for the
automated pickup kiosk.
(6) The pharmacist in charge of the licensed pharmacy operating an
automated pickup kiosk shall:
(a) Identify a pharmacist responsible for the operation, supervision, and
development of policies and procedures for the automated pickup kiosk.
Compliance with this subdivision shall be sufficient if the pharmacist monitors
the automated pickup kiosk electronically and keeps records of compliance with
this requirement for a period of five years;
(b) Implement the policies and procedures developed to comply with section
71-2447;
(c) Assure compliance with the prescription drug storage and record-
keeping requirements of the Pharmacy Practice Act;
(d) Assure compliance with the labeling requirements described in
subsection (7) of this section;
(e) Develop and implement policies for the verification of a prescription
drug by a pharmacist prior to being loaded into an automated pickup kiosk or
for the verification of a prescription drug by a pharmacist prior to being
released to a patient or caregiver; and
(f) Assure that each prescription drug is reviewed by a pharmacist prior
to the release of a drug by an automated pickup kiosk.
(7) Each prescription drug dispensed from an automated pickup kiosk shall
meet the labeling requirements applicable to prescription drugs dispensed by a
licensed pharmacist pursuant to section 71-2479.
(8) An automated pickup kiosk shall not dispense or make available
prescription medication to a patient or caregiver unless pharmacist care has
been offered and made available in a manner consistent with section 38-2869.
(9) An automated pickup kiosk that is located outside a fully enclosed
building shall not be placed in a manner that exposes medications to adverse
environmental conditions or to security risks, unless the Board of Pharmacy
determines, through rule or case-specific approval, that the automated pickup
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kiosk employs environmental controls and physical security measures sufficient
to protect medication integrity and prevent diversion.
(10) An automated pickup kiosk operated in accordance with this section
shall not store, dispense, or otherwise make available a controlled substance
as defined in section 28-401 or federal law except an automated pickup kiosk
operated by, or under the authority of, a hospital pharmacy as defined in
section 71-419.01 and that is located in the hospital or facility operated by a
hospital.
(11) This section does not apply to a long-term care automated pharmacy or
an automated medication system operated in a long-term care facility under
section 71-2451.
Sec. 34. Sections 6, 7, 8, 9, 10, 13, 14, 15, 23, and 35 of this act
become operative on January 1, 2027. Sections 30, 31, 32, 33, and 36 of this
act become operative on May 1, 2027. Sections 1, 2, 3, 4, 5, 11, 12, 16, 17,
18, 19, 24, 25, 26, 27, 28, 29, 37, and 39 of this act become operative three
calendar months after the adjournment of this legislative session. The other
sections of this act become operative on their effective date.
Sec. 35. Original sections 38-404, 38-409, 38-2101, 38-2123, and 38-3208,
Revised Statutes Cumulative Supplement, 2024, and section 38-131, Revised
Statutes Supplement, 2025, are repealed.
Sec. 36. Original sections 71-2444, 71-2445, and 71-2447, Reissue Revised
Statutes of Nebraska, are repealed.
Sec. 37. Original sections 38-1915, 38-2315, 38-2850, and 71-1918,
Reissue Revised Statutes of Nebraska, sections 38-1716, 38-2801, and 52-401,
Revised Statutes Cumulative Supplement, 2024, and sections 71-1908 and 71-1912,
Revised Statutes Supplement, 2025, are repealed.
Sec. 38. Original section 38-2871, Reissue Revised Statutes of Nebraska,
section 38-2852, Revised Statutes Cumulative Supplement, 2024, and section
38-2866.01, Revised Statutes Supplement, 2025, are repealed.
Sec. 39. The following section is outright repealed: Section 38-2053,
Revised Statutes Cumulative Supplement, 2024.
Sec. 40. Since an emergency exists, this act takes effect when passed and
approved according to law.
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