Revises provisions relating to certain providers of health care. (BDR 54-449)

REQUIRES TWO-THIRDS MAJORITY VOTE
(§§ 1, 10, 21, 23, 26)

S.B. 34

- *SB34*

SENATE BILL NO. 34–COMMITTEE ON COMMERCE AND LABOR

(ON BEHALF OF THE PATIENT PROTECTION COMMISSION)

PREFILED NOVEMBER 15, 2024
____________

Referred to Committee on Commerce and Labor

SUMMARY—Revises provisions relating to certain providers of
health care. (BDR 54-449)

FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.

~

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

AN ACT relating to health care; entering into interstate compacts
that authorize the multistate practice of certain providers
of health care under certain conditions; providing
professionals practicing in this State u nder those
compacts with the same legal status as persons who are
licensed to practice the same professions in this State;
authorizing the sharing of certain information with data
systems created by those compacts; revising certain
terminology; providing f or a study of certain impacts of
entering into certain interstate compacts; and providing
other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law provides for the licensure and regulation of physician assistants in 1
this State b y the Board of Medical Examiners and the State Board of Osteopathic 2
Medicine. (NRS 630.271 -630.2755, 633.432-633.469) Section 1 of this bill enacts 3
the PA Li censure Compact, which allows a person who is licensed as a physician 4
assistant in a state that is a member of the Compact to practice as a physician 5
assistant in other states that are members of the Compact. In order to practice as a 6
physician assistant u nder the Compact, the Compact requires a physician assistant 7
to: (1) have graduated from certain programs for the education of physician 8
assistants; (2) hold current certification issued by the National Commission on 9
Certification of Physician Assistants; (3) have no felony or misdemeanor 10
convictions; (4) have never had a license, permit or registration relating to 11
controlled substances suspended or revoked; (5) have a unique identifier, as 12
prescribed by the PA Licensure Compact Commission, a joint public b ody 13

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established by the Compact; (6) hold an unrestricted license in his or her home 14
state; (7) currently have no limitations or restrictions on his or her license and have 15
had no adverse actions taken against any license or authority to practice under the 16
Compact within the previous 2 years, with certain exceptions; (8) notify the 17
Commission that he or she is seeking to practice under the Compact in another 18
state; (9) pay any applicable fees; (10) meet any requirement in the state in which 19
he or she seeks t o practice under the Compact to pass an assessment of his or her 20
knowledge of the applicable laws and rules of that state; and (11) report any 21
adverse action taken against him or her within 30 days after the date the adverse 22
action is taken. 23
Existing law provides for the licensure and regulation of nurses in this State. 24
(Chapter 632 of NRS) Section 10 of this bill enacts the Nurse Licensure Compact, 25
which allows a person who is licensed as a nurse in a state that is a party to the 26
Compact to obtain a multistate license to practice as a nurse in other states that are 27
parties to the Compact. The Compact regulates the licensure and discipline of 28
nurses who ho ld multistate licenses through the Compact. To obtain a multistate 29
license, the Compact requires a nurse to: (1) meet the qualifications of his or her 30
home state for licensure; (2) graduate from or be eligible to graduate from a 31
registered nurse or licensed practical/vocational nurse program; (3) pass an English 32
proficiency examination if the applicant is a graduate of a foreign prelicensure 33
education program not taught in English or if English is not the applicant’s native 34
language; (4) pass an NCLEX -RN or NCLEX-PN examination; (5) hold or be 35
eligible to hold an active license in his or her home state; (6) undergo a fingerprint 36
or other biometric -based criminal background check; (7) not have been convicted 37
or found guilty of a felony or a misdemeanor offens e related to nursing; (8) not be 38
currently enrolled in certain monitoring programs; (9) disclose to the licensing 39
authority in his or her home state whether he or she is participating in such a 40
program; and (10) have a valid social security number. 41
Existing law provides for the licensure and regulation of audiologists and 42
speech-language pathologists in this State. (Chapter 637B of NRS) Section 21 of 43
this bill enacts the Audiology and Speech -Language Pathology Interstate Compact, 44
which allows a person who is licensed as an audiologist or speech -language 45
pathologist in a state that is a member of the Compact to practice as an audiologist 46
or speech-language pathologist in other states that are members of the Compact. In 47
order to practice as an audiologist or speech -language pathologist under the 48
Compact, the Compact requires an audiologist or speec h-language pathologist to: 49
(1) hold a license in his or her home state; (2) have no encumbrances on his or her 50
license; (3) meet certain other requirements for eligibility; (4) have had no adverse 51
actions taken against any license or authority to practice under the Compact within 52
the previous 2 years; (5) notify the Audiology and Speech -Language Pathology 53
Compact Commission, a joint public body established by the Compact, that he or 54
she is seeking to practice under the Compact in another state; (6) pay any 55
applicable fees; and (7) report any adverse action taken against him or her within 56
30 days after the date the adverse action is taken. The Compact additionally 57
requires a member state to recognize the right of an audiologist or speech -language 58
pathologist who is licensed by any member state to practice audiology or speech -59
language pathology, as applicable, through telehealth in any member state under 60
conditions prescribed by the Commission. 61
Existing law provides for the licensure and regulation of physical therapists and 62
physical therapist assistants in this State. (Chapter 640 of NRS) Section 23 of this 63
bill enacts the Physical Therapy Licensure Compact, whi ch allows a person who is 64
licensed as a physical therapist or physical therapist assistant in a state that is a 65
member of the Compact to practice as a physical therapist or physical therapist 66
assistant in other states that are members of the Compact. In or der to practice as a 67
physical therapist or physical therapist assistant under the Compact, the Compact 68

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requires a physical therapist or physical therapist assistant to: (1) hold a license in 69
his or her home state; (2) have no encumbrances on his or her lic ense; (3) meet 70
certain other requirements for eligibility; (4) have had no adverse actions taken 71
against any license or authority to practice under the Compact within the previous 2 72
years; (5) notify the Physical Therapy Compact Commission, a joint public body 73
established by the Compact, that he or she is seeking to practice under the Compact 74
in another state; (6) pay any applicable fees; (7) meet any requirements in the state 75
in which he or she seeks to practice under the Compact; and (8) report any advers e 76
action taken against him or her within 30 days after the date the adverse action is 77
taken. 78
Existing law provides for the licensure and regulation of occupational therapists 79
and occupational therapy assistants in this State. (Chapter 640A of NRS) Section 80
26 of this bill enacts the Occupational Therapy Licensure Compact, which allows a 81
person who is licensed as an occupational therapist or occupational ther apy 82
assistant in a state that is a member of the Compact to practice as an occupational 83
therapist or occupational therapy assistant in other states that are members of the 84
Compact. In order to practice as an occupational therapist or occupational therapy 85
assistant under the Compact, the Compact requires an occupational therapist or 86
occupational therapy assistant to: (1) hold a license in his or her home state; (2) 87
have a valid social security number or National Practitioner Identification number; 88
(3) have no encumbrances on his or her license; (4) meet certain other requirements 89
for eligibility; (5) have had no adverse actions taken against any license or authority 90
to practice under the Compact within the previous 2 years; (6) notify the 91
Occupational Therapy Compact Commission, a joint public body established by the 92
Compact, that he or she is seeking to practice under the Compact in another state; 93
(7) pay any applicable fees; (8) complete a fingerprint or other biometric -based 94
criminal background check; (9) m eet any requirement in the state in which he or 95
she seeks to practice under the Compact to pass an assessment of his or her 96
knowledge of the applicable laws and rules of that state; and (10) report any 97
adverse action taken against him or her within 30 days after the date the adverse 98
action is taken. 99
Each interstate compact adopted by sections 1, 10, 21, 23 and 26 authorizes a 100
member state to take adverse action against a provider of health care who is 101
practicing in the member state under the Compact. Each such interstate compact 102
authorizes the commission created by the compact to levy and collect assessments 103
from party states to cover the cost of its operations. Each such compact also creates 104
a data system to facilitate the sharing of information among member states. 105
Sections 8, 9, 11, 12, 18, 20, 22, 24 and 27 of this bill generally authorize the 106
Board of Medical Examiners, the State Board of Nursing, the State Board of 107
Osteopathic Medicine, the Speech -Language Pathology, Audiology and Hearing 108
Aid Dispensing Board, the Nevada Physical Therapy Board and the Board of 109
Occupational Therapy to disclose information to those data systems when required 110
by those compacts. Sections 1, 10, 21, 23, 26 and 33 of this bill provide for the 111
confidentiality of certain information disclosed through a data system. 112
Section 2 of this bill makes a conforming change to reflect that the PA 113
Licensure Compact will be placed in the same chapter as the Interstate Medical 114
Licensure Compact, which relates to physicians. Sections 4 and 14 of this bill 115
define “PA Licensure Compact” t o refer to the PA Licensure Compact for the 116
purposes of provisions governing allopathic and osteopathic medicine. Sections 6 117
and 16 of this bill indicate the applicability of those definitions. Sections 5 and 15 118
of this bill prescribe the conditions under which the Board of Medical Examiners or 119
the State Board of Osteopathic Medicine will regulate a physician as sistant 120
practicing in this State under the PA Licensure Compact. 121
Section 28 of this bill deems practicing as a physician assistant, audiologist, 122
speech-language pathologist, physical therapist, physical therapist assistant, 123

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occupational therapist or occupational therapy assistant under the Compact to be 124
equivalent to practicing under a license issued by the applicable professional 125
licensing board, thereby providing such persons with the same authority, duties and 126
legal protections as a licensee. Because the Nurse Licensure Compact enacted by 127
section 10 requires a nurse practicing under the Nurse Licensure Compact to obtain 128
a multistate license, such a nurse would be licensed pursuant to provisions of law 129
governing nursing and would thus also have the same authority as any other nurse 130
who is licensed to practice in this State. Sections 7 and 17 of this bill further clarify 131
that a physician assistant practicing in this State under the PA Licensure Compact 132
has the same legal status as a physician assistant licensed by the Board of Medical 133
Examiners or the State Board of Osteopathic Medicine. Sections 19 and 25 of this 134
bill require an osteopathic physician assist ant or physical therapist practicing under 135
the Compact to display proof that he or she is authorized to practice under the 136
Compact in the same manner as a licensed osteopathic physician assistant or 137
licensed physical therapist, as applicable, is required t o display his or her license. 138
Sections 29-32, 34-36 and 39 of this bill replace the term “registered physical 139
therapist” with the term “licensed physical therapist” to reflect current terminology 140
used in existing law governing the practice of physical therapy and this bill. 141
Sections 37 and 38 of this bill make further revisions to clarify that physician 142
assistants licensed by the Board of Medical Examiners or the State Board of 143
Osteopathic Medicine and physician assistants practicing in this State under the PA 144
Licensure Compact have the same authority with regar d to prescribing, dispensing, 145
administering and possessing controlled substances and dangerous drugs. 146
Section 40 of this bill requires the Department of Health and Human Services 147
to: (1) study the potential impacts of the interstate compacts ratified and entered 148
into in sections 1, 10, 21, 23 and 26 on the availability of relevant health care 149
services in this State; and (2) report the results of the study to the Patient Protection 150
Commission and the Legislature. 151

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. Chapter 629A of NRS is hereby amended by 1
adding thereto a new section to read as follows: 2
The PA Licensure Compact is her eby ratified and entered into 3
with all other jurisdictions legally joining the Compact, in 4
substantially the form set forth in this section: 5
PA LICENSURE COMPACT 6
7
SECTION 1. PURPOSE 8
9
In order to strengthen access to Medical Services, and in 10
recognition of the advances in the delivery of Medical Services, 11
the Participating States of the PA Licensure Compact have allied 12
in common purpose to develop a comprehensive process that 13
complements the existing authority of State Licensing Boards to 14
license and discipline PAs and seeks to enhance the portability of 15
a License to practice as a PA while safeguarding the safety of 16
patients. This Compact allows Medical Services to be provided by 17

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PAs, via the mutual recognition of the Licensee’s Qualifying 1
License by other Compact Participating States. This Compact also 2
adopts the prevailing standard for PA licensure and affirms that 3
the practice and delivery of Medical Services by the PA occurs 4
where the patient is located at the time of the patient encounter, 5
and therefore requires the PA to be under the jurisdiction of the 6
State Licensing Board where the patient is located. State Licensing 7
Boards that participate in this Compact retain the jurisdiction to 8
impose Adverse Action against a Compact Privilege in that State 9
issued to a PA through the procedures of this Compact. The PA 10
Licensure Compact will alleviate burdens for military families by 11
allowing active duty military personnel and their spouses to obtain 12
a Compact Privilege based on having an unrestricted License in 13
good standing from a Participating State. 14
15
SECTION 2. DEFINITIONS 16
17
In this Compact: 18
A. “Adverse Action” means any administrative, civil, 19
equitable, or criminal action permitted by a State’s laws which is 20
imposed by a Licensing Board or other authority against a PA 21
License or License application or Compact Privilege such as 22
License denial, censure, revocation, suspension, probation, 23
monitoring of the Licensee, or restriction on the Licensee’s 24
practice. 25
B. “Compact Privilege” means the authorization granted by a 26
Remote State to allow a Licensee from another Participating State 27
to practice as a PA to provide Medical Services and other licensed 28
activity to a patient located in the Remote State under the Remote 29
State’s laws and regulations. 30
C. “Conviction” means a finding by a court that an 31
individual is guilty of a felony or misdemeanor offense through 32
adjudication or entry of a plea of guilt or no contest to the charge 33
by the offender. 34
D. “Criminal Background Check” means the submission of 35
fingerprints or other biometric -based information for a License 36
applicant for the purpose of obtaining that applicant’s criminal 37
history record information, as defined in 28 C.F.R. § 20.3(d), from 38
the State’s criminal history record repository as defined in 28 39
C.F.R. § 20.3(f). 40
E. “Data System” means the repository of information about 41
Licensees, including but not limited to License status and Adverse 42
Actions, which is created and administered under the terms of this 43
Compact. 44

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F. “Executive Committee” means a group of directors and 1
ex-officio individuals elected or appointed pursuant to 2
Section 7.F.2. 3
G. “Impaired Practitioner” means a PA whose practice is 4
adversely affected by health -related condition(s) that impact their 5
ability to practice. 6
H. “Investigative Information” means information, records, 7
or documents received or generated by a Licensing Board 8
pursuant to an investigation. 9
I. “Jurisprudence Requirement” means the assessment of an 10
individual’s knowledge of the laws and Rules governing the 11
practice of a PA in a State. 12
J. “License” means current authorization by a State, other 13
than authorization pursuant to a Compact Privilege, for a PA to 14
provide Medical Services, which would be unlawful without 15
current authorization. 16
K. “Licensee” means an individual who holds a License from 17
a State to provide Medical Services as a PA. 18
L. “Licensing Board” means any State entity authorized to 19
license and otherwise regulate PAs. 20
M. “Medical Services” means health care services provided 21
for the diagnosis, prevention, treatment, cure or relief of a health 22
condition, injury, or disease, as defined by a State’s laws and 23
regulations. 24
N. “Model Compact” means the model for the PA Licensure 25
Compact on file with The Council of State Governments or other 26
entity as designated by the Commission. 27
O. “Participating State” means a State that has enacted this 28
Compact. 29
P. “PA” means an individual who is licensed as a physician 30
assistant in a State. For purposes of this Compact, any other title 31
or status adopted by a State to replace the term “physician 32
assistant” shall be deemed synonymous with “physician assistant” 33
and shall confer the same rights and responsibilities to the 34
Licensee under the provisions of this Compact at the time of its 35
enactment. 36
Q. “PA Licensur e Compact Commission,” “Compact 37
Commission,” or “Commission” mean the national administrative 38
body created pursuant to Section 7.A of this Compact. 39
R. “Qualifying License” means an unrestricted License 40
issued by a Participating State to provide Medical S ervices as a 41
PA. 42
S. “Remote State” means a Participating State where a 43
Licensee who is not licensed as a PA is exercising or seeking to 44
exercise the Compact Privilege. 45

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T. “Rule” means a regulation promulgated by an entity that 1
has the force and effect of law. 2
U. “Significant Investigative Information” means 3
Investigative Information that a Licensing Board, after an inquiry 4
or investigation that includes notification and an opportunity for 5
the PA to respond if required by State law, has reason to belie ve is 6
not groundless and, if proven true, would indicate more than a 7
minor infraction. 8
V. “State” means any state, commonwealth, district, or 9
territory of the United States. 10
11
SECTION 3. STATE PARTICIPATION IN THIS COMPACT 12
13
A. To participate in this Compact, a Participating State shall: 14
1. License PAs. 15
2. Participate in the Compact Commission’s Data System. 16
3. Have a mechanism in place for receiving and 17
investigating complaints against Licensees and License applicants. 18
4. Notify the Commission, i n compliance with the terms of 19
this Compact and Commission Rules, of any Adverse Action 20
against a Licensee or License applicant and the existence of 21
Significant Investigative Information regarding a Licensee or 22
License applicant. 23
5. Fully implement a Cri minal Background Check 24
requirement, within a time frame established by Commission Rule, 25
by its Licensing Board receiving the results of a Criminal 26
Background Check and reporting to the Commission whether the 27
License applicant has been granted a License. 28
6. Comply with the Rules of the Compact Commission. 29
7. Utilize passage of a recognized national exam such as 30
the National Commission on Certification of Physician Assistants 31
(NCCPA) Physician Assistant National Certifying Examination 32
(PANCE) as a requirement for PA licensure. 33
8. Grant the Compact Privilege to a holder of a Qualifying 34
License in a Participating State. 35
B. Nothing in this Compact prohibits a Participating State 36
from charging a fee for granting the Compact Privilege. 37
38
SECTION 4. COMPACT PRIVILEGE 39
40
A. To exercise the Compact Privilege, a Licensee must: 41
1. Have graduated from a PA program accredited by the 42
Accreditation Review Commission on Education for the Physician 43
Assistant, Inc. or other programs authorized by Commission Rule. 44

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2. Hold current National Commission on Certification of 1
Physician Assistants (NCCPA) certification. 2
3. Have no felony or misdemeanor Conviction. 3
4. Have never had a controlled substance license, permit, or 4
registration suspended or revoked by a State or by the United 5
States Drug Enforcement Administration. 6
5. Have a unique identifier as determined by Commission 7
Rule. 8
6. Hold a Qualifying License. 9
7. Have had no revocation of a License or limitation or 10
restriction on any License currently held due to an adverse action. 11
8. If a Licensee has had a limitation or restriction on a 12
License or Compact Privilege due to an Adverse Action, two years 13
must have elapsed from the date on which the License or Compact 14
Privilege is no longer limited or res tricted due to the Adverse 15
Action. 16
9. If a Compact Privilege has been revoked or is limited or 17
restricted in a Participating State for conduct that would not be a 18
basis for disciplinary action in a Participating State in which the 19
Licensee is practicing or applying to practice under a Compact 20
Privilege, that Participating State shall have the discretion not to 21
consider such action as an Adverse Action requiring the denial or 22
removal of a Compact Privilege in that State. 23
10. Notify the Compact Commission that the Licensee is 24
seeking the Compact Privilege in a Remote State. 25
11. Meet any Jurisprudence Requirement of a Remote State 26
in which the Licensee is seeking to practice under the Compact 27
Privilege and pay any fees applicable to satisfying the 28
Jurisprudence Requirement. 29
12. Report to the Commission any Adverse Action taken by 30
a non-participating State within thirty (30) days after the action is 31
taken. 32
B. The Compact Privilege is valid until the expiration or 33
revocation of the Qualifying License unl ess terminated pursuant 34
to an Adverse Action. The Licensee must also comply with all of 35
the requirements of Subsection A above to maintain the Compact 36
Privilege in a Remote State. If the Participating State takes 37
Adverse Action against a Qualifying License , the Licensee shall 38
lose the Compact Privilege in any Remote State in which the 39
Licensee has a Compact Privilege until all of the following occur: 40
1. The License is no longer limited or restricted; and 41
2. Two (2) years have elapsed from the date on wh ich the 42
License is no longer limited or restricted due to the Adverse 43
Action. 44

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C. Once a restricted or limited License satisfies the 1
requirements of Subsection B.1 and 2, the Licensee must meet the 2
requirements of Subsection A to obtain a Compact Privilege in any 3
Remote State. 4
D. For each Remote State in which a PA seeks authority to 5
prescribe controlled substances, the PA shall satisfy all 6
requirements imposed by such State in granting or renewing such 7
authority. 8
9
SECTION 5. DESIGNATION OF THE STATE FROM WHICH 10
LICENSEE IS APPLYING FOR A COMPACT PRIVILEGE 11
12
A. Upon a Licensee’s application for a Compact Privilege, 13
the Licensee shall identify to the Commission the Participating 14
State from which the Licensee is applying, in accordance with 15
applicable R ules adopted by the Commission, and subject to the 16
following requirements: 17
1. When applying for a Compact Privilege, the Licensee 18
shall provide the Commission with the address of the Licensee’s 19
primary residence and thereafter shall immediately report to the 20
Commission any change in the address of the Licensee’s primary 21
residence. 22
2. When applying for a Compact Privilege, the Licensee is 23
required to consent to accept service of process by mail at the 24
Licensee’s primary residence on file with the Commiss ion with 25
respect to any action brought against the Licensee by the 26
Commission or a Participating State, including a subpoena, with 27
respect to any action brought or investigation conducted by the 28
Commission or a Participating State. 29
30
SECTION 6. ADVERSE ACTIONS 31
32
A. A Participating State in which a Licensee is licensed shall 33
have exclusive power to impose Adverse Action against the 34
Qualifying License issued by that Participating State. 35
B. In addition to the other powers conferred by State law, a 36
Remote State shall have the authority, in accordance with existing 37
State due process law, to do all of the following: 38
1. Take Adverse Action against a PA’s Compact Privilege 39
within that State to remove a Licensee’s Compact Privilege or take 40
other action necessa ry under applicable law to protect the health 41
and safety of its citizens. 42
2. Issue subpoenas for both hearings and investigations 43
that require the attendance and testimony of witnesses as well as 44
the production of evidence. Subpoenas issued by a Licensin g 45

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Board in a Participating State for the attendance and testimony of 1
witnesses or the production of evidence from another Participating 2
State shall be enforced in the latter State by any court of 3
competent jurisdiction, according to the practice and proced ure of 4
that court applicable to subpoenas issued in proceedings pending 5
before it. The issuing authority shall pay any witness fees, travel 6
expenses, mileage and other fees required by the service statutes of 7
the State in which the witnesses or evidence are located. 8
3. Notwithstanding paragraph 2, subpoenas may not be 9
issued by a Participating State to gather evidence of conduct in 10
another State that is lawful in that other State for the purpose of 11
taking Adverse Action against a Licensee’s Compact Privil ege or 12
application for a Compact Privilege in that Participating State. 13
4. Nothing in this Compact authorizes a Participating State 14
to impose discipline against a PA’s Compact Privilege or to deny 15
an application for a Compact Privilege in that Participat ing State 16
for the individual’s otherwise lawful practice in another State. 17
C. For purposes of taking Adverse Action, the Participating 18
State which issued the Qualifying License shall give the same 19
priority and effect to reported conduct received from any other 20
Participating State as it would if the conduct had occurred within 21
the Participating State which issued the Qualifying License. In so 22
doing, that Participating State shall apply its own State laws to 23
determine appropriate action. 24
D. A Participating State, if otherwise permitted by State law, 25
may recover from the affected PA the costs of investigations and 26
disposition of cases resulting from any Adverse Action taken 27
against that PA. 28
E. A Participating State may take Adverse Action based on 29
the fac tual findings of a Remote State, provided that the 30
Participating State follows its own procedures for taking the 31
Adverse Action. 32
F. Joint Investigations 33
1. In addition to the authority granted to a Participating 34
State by its respective State PA laws an d regulations or other 35
applicable State law, any Participating State may participate with 36
other Participating States in joint investigations of Licensees. 37
2. Participating States shall share any investigative, 38
litigation, or compliance materials in furth erance of any joint or 39
individual investigation initiated under this Compact. 40
G. If an Adverse Action is taken against a PA’s Qualifying 41
License, the PA’s Compact Privilege in all Remote States shall be 42
deactivated until two (2) years have elapsed after all restrictions 43
have been removed from the State License. All disciplinary orders 44
by the Participating State which issued the Qualifying License that 45

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impose Adverse Action against a PA’s License shall include a 1
Statement that the PA’s Compact Privilege is deactivated in all 2
Participating States during the pendency of the order. 3
H. If any Participating State takes Adverse Action, it 4
promptly shall notify the administrator of the Data System. 5
6
SECTION 7. ESTABLISHMENT OF THE PA 7
LICENSURE COMPACT COMMISSION 8
9
A. The Participating States hereby create and establish a joint 10
government agency and national administrative body known as 11
the PA Licensure Compact Commission. The Commission is an 12
instrumentality of the Compact States acting jointly and not an 13
instrumentality of any one State. The Commission shall come into 14
existence on or after the effective date of the Compact as set forth 15
in Section 11.A. 16
B. Membership, Voting, and Meetings 17
1. Each Participating State shall have and be limited to one 18
(1) delegate selected by that Participating State’s Licensing Board 19
or, if the State has more than one Licensing Board, selected 20
collectively by the Participating State’s Licensing Boards. 21
2. The delegate shall be either: 22
a. A current PA, physician or public member of a 23
Licensing Board or PA Council/Committee; or 24
b. An administrator of a Licensing Board. 25
3. Any delegate may be removed or suspended from office 26
as provided by the laws of the State from which the delegate is 27
appointed. 28
4. The Participating State Licensing Board shall fill any 29
vacancy occurring in the Commission within sixty (60) days. 30
5. Each delegate shall be entitled to one (1) vote on all 31
matters voted on by the Commission and shall otherwise have an 32
opportunity to participate in the b usiness and affairs of the 33
Commission. A delegate shall vote in person or by such other 34
means as provided in the bylaws. The bylaws may provide for 35
delegates’ participation in meetings by telecommunications, video 36
conference, or other means of communication. 37
6. The Commission shall meet at least once during each 38
calendar year. Additional meetings shall be held as set forth in this 39
Compact and the bylaws. 40
7. The Commission shall establish by Rule a term of office 41
for delegates. 42
C. The Commission shall have the following powers and 43
duties: 44
1. Establish a code of ethics for the Commission; 45

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2. Establish the fiscal year of the Commission; 1
3. Establish fees; 2
4. Establish bylaws; 3
5. Maintain its financial records in accordance with the 4
bylaws; 5
6. Meet and take such actions as are consistent with the 6
provisions of this Compact and the bylaws; 7
7. Promulgate Rules to facilitate and coordinate 8
implementation and administration of this Compact. The Rules 9
shall have the force and effect of law and shal l be binding in all 10
Participating States; 11
8. Bring and prosecute legal proceedings or actions in the 12
name of the Commission, provided that the standing of any State 13
Licensing Board to sue or be sued under applicable law shall not 14
be affected; 15
9. Purchase and maintain insurance and bonds; 16
10. Borrow, accept, or contract for services of personnel, 17
including, but not limited to, employees of a Participating State; 18
11. Hire employees and engage contractors, elect or 19
appoint officers, fix compensation, d efine duties, grant such 20
individuals appropriate authority to carry out the purposes of this 21
Compact, and establish the Commission’s personnel policies and 22
programs relating to conflicts of interest, qualifications of 23
personnel, and other related personnel matters; 24
12. Accept any and all appropriate donations and grants of 25
money, equipment, supplies, materials and services, and receive, 26
utilize and dispose of the same; provided that at all times the 27
Commission shall avoid any appearance of impropriety or conflict 28
of interest; 29
13. Lease, purchase, accept appropriate gifts or donations 30
of, or otherwise own, hold, improve or use, any property, real, 31
personal or mixed; provided that at all times the Commission shall 32
avoid any appearance of impropriety; 33
14. Sell, convey, mortgage, pledge, lease, exchange, 34
abandon, or otherwise dispose of any property real, personal, or 35
mixed; 36
15. Establish a budget and make expenditures; 37
16. Borrow money; 38
17. Appoint committees, including standing committees 39
composed of members, State regulators, State legislators or their 40
representatives, and consumer representatives, and such other 41
interested persons as may be designated in this Compact and the 42
bylaws; 43
18. Provide and receive information from, and cooperate 44
with, law enforcement agencies; 45

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19. Elect a Chair, Vice Chair, Secretary and Treasurer and 1
such other officers of the Commission as provided in the 2
Commission’s bylaws; 3
20. Reserve for itself, in addition to those reserved 4
exclusively to the Commission under the Compact, powers that the 5
Executive Committee may not exercise; 6
21. Approve or disapprove a State’s participation in 7
the Compact based upon its determination as to whether the 8
State’s Compact legislation departs in a material manner from the 9
Model Compact language; 10
22. Prepare and provide to the Participating States an 11
annual report; and 12
23. Perform such other functions as may be necessary or 13
appropriate to achieve the purposes of this Compact consistent 14
with the State regulation of PA licensure and practice. 15
D. Meetings of the Commission 16
1. All meetings of the Commission that are not closed 17
pursuant to this subsection shall be open to the public. Notice of 18
public meetings shall be posted on the Commission’s website at 19
least thirty (30) days prior to the public meeting. 20
2. Notwithstanding subsection D.1 of this section, the 21
Commission may convene a public meeting by providing at least 22
twenty-four (24) hours prior notice on the Commission’s website, 23
and any other means as provided in the Commiss ion’s Rules, for 24
any of the reasons it may dispense with notice of proposed 25
rulemaking under Section 9.L. 26
3. The Commission may convene in a closed, non -public 27
meeting or non -public part of a public meeting to receive legal 28
advice or to discuss: 29
a. Non-compliance of a Participating State with its 30
obligations under this Compact; 31
b. The employment, compensation, discipline or other 32
matters, practices or procedures related to specific employees or 33
other matters related to the Commission’s internal pe rsonnel 34
practices and procedures; 35
c. Current, threatened, or reasonably anticipated 36
litigation; 37
d. Negotiation of contracts for the purchase, lease, or 38
sale of goods, services, or real estate; 39
e. Accusing any person of a crime or formally censuring 40
any person; 41
f. Disclosure of trade secrets or commercial or financial 42
information that is privileged or confidential; 43

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g. Disclosure of information of a personal nature where 1
disclosure would constitute a clearly unwarranted invasion of 2
personal privacy; 3
h. Disclosure of investigative records compiled for law 4
enforcement purposes; 5
i. Disclosure of information related to any investigative 6
reports prepared by or on behalf of or for use of the Commission 7
or other committee charged with responsibil ity of investigation or 8
determination of compliance issues pursuant to this Compact; 9
j. Legal advice; or 10
k. Matters specifically exempted from disclosure by 11
federal or Participating States’ statutes. 12
4. If a meeting, or portion of a meeting, is clo sed pursuant 13
to this provision, the chair of the meeting or the chair’s designee 14
shall certify that the meeting or portion of the meeting may be 15
closed and shall reference each relevant exempting provision. 16
5. The Commission shall keep minutes that fully and 17
clearly describe all matters discussed in a meeting and shall 18
provide a full and accurate summary of actions taken, including a 19
description of the views expressed. All documents considered in 20
connection with an action shall be identified in such minut es. All 21
minutes and documents of a closed meeting shall remain under 22
seal, subject to release by a majority vote of the Commission or 23
order of a court of competent jurisdiction. 24
E. Financing of the Commission 25
1. The Commission shall pay, or provide for the payment 26
of, the reasonable expenses of its establishment, organization, and 27
ongoing activities. 28
2. The Commission may accept any and all appropriate 29
revenue sources, donations, and grants of money, equipment, 30
supplies, materials, and services. 31
3. The Commission may levy on and collect an annual 32
assessment from each Participating State and may impose 33
Compact Privilege fees on Licensees of Participating States to 34
whom a Compact Privilege is granted to cover the cost of the 35
operations and activities o f the Commission and its staff, which 36
must be in a total amount sufficient to cover its annual budget as 37
approved by the Commission each year for which revenue is not 38
provided by other sources. The aggregate annual assessment 39
amount levied on Participating States shall be allocated based 40
upon a formula to be determined by Commission Rule. 41
a. A Compact Privilege expires when the Licensee’s 42
Qualifying License in the Participating State from which the 43
Licensee applied for the Compact Privilege expires. 44

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b. If the Licensee terminates the Qualifying License 1
through which the Licensee applied for the Compact Privilege 2
before its scheduled expiration, and the Licensee has a Qualifying 3
License in another Participating State, the Licensee shall inform 4
the Commission that it is changing to that Participating State the 5
Participating State through which it applies for a Compact 6
Privilege and pay to the Commission any Compact Privilege fee 7
required by Commission Rule. 8
4. The Commission shall not incur obligations o f any kind 9
prior to securing the funds adequate to meet the same; nor shall 10
the Commission pledge the credit of any of the Participating 11
States, except by and with the authority of the Participating State. 12
5. The Commission shall keep accurate accounts o f all 13
receipts and disbursements. The receipts and disbursements of the 14
Commission shall be subject to the financial review and 15
accounting procedures established under its bylaws. All receipts 16
and disbursements of funds handled by the Commission shall be 17
subject to an annual financial review by a certified or licensed 18
public accountant, and the report of the financial review shall be 19
included in and become part of the annual report of the 20
Commission. 21
F. The Executive Committee 22
1. The Executive Committee shall have the power to act on 23
behalf of the Commission according to the terms of this Compact 24
and Commission Rules. 25
2. The Executive Committee shall be composed of nine (9) 26
members: 27
a. Seven voting members who are elected by the 28
Commission from the current membership of the Commission; 29
b. One ex-officio, nonvoting member from a recognized 30
national PA professional association; and 31
c. One ex-officio, nonvoting member from a recognized 32
national PA certification organization. 33
3. The ex -officio me mbers will be selected by their 34
respective organizations. 35
4. The Commission may remove any member of the 36
Executive Committee as provided in its bylaws. 37
5. The Executive Committee shall meet at least annually. 38
6. The Executive Committee shall have the following duties 39
and responsibilities: 40
a. Recommend to the Commission changes to the 41
Commission’s Rules or bylaws, changes to this Compact 42
legislation, fees to be paid by Compact Participating States such as 43
annual dues, and any Commission Compact fee charged to 44
Licensees for the Compact Privilege; 45

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b. Ensure Compact administration services are 1
appropriately provided, contractual or otherwise; 2
c. Prepare and recommend the budget; 3
d. Maintain financial records on behalf of the 4
Commission; 5
e. Monitor Compact compliance of Participating States 6
and provide compliance reports to the Commission; 7
f. Establish additional committees as necessary; 8
g. Exercise the powers and duties of the Commission 9
during the interim between Commission meetings, e xcept for 10
issuing proposed rulemaking or adopting Commission Rules or 11
bylaws, or exercising any other powers and duties exclusively 12
reserved to the Commission by the Commission’s Rules; and 13
h. Perform other duties as provided in the Commission’s 14
Rules or bylaws. 15
7. All meetings of the Executive Committee at which it votes 16
or plans to vote on matters in exercising the powers and duties of 17
the Commission shall be open to the public and public notice of 18
such meetings shall be given as public meetings of t he 19
Commission are given. 20
8. The Executive Committee may convene in a closed, non -21
public meeting for the same reasons that the Commission may 22
convene in a non-public meeting as set forth in Section 7.D 3 and 23
shall announce the closed meeting as the Commission is required 24
to under Section 7.D.4 and keep minutes of the closed meeting as 25
the Commission is required to under Section 7.D.5. 26
G. Qualified Immunity, Defense, and Indemnification 27
1. The members, officers, executive director, employees and 28
representatives of the Commission shall be immune from suit and 29
liability, both personally and in their official capacity, for any 30
claim for damage to or loss of property or personal injury or other 31
civil liability caused by or arising out of any actual or alleged act, 32
error, or omission that occurred, or that the person against whom 33
the claim is made had a reasonable basis for believing occurred 34
within the scope of Commission employment, duties or 35
responsibilities; provided that nothing in this paragraph sh all be 36
construed to protect any such person from suit or liability for any 37
damage, loss, injury, or liability caused by the intentional or 38
willful or wanton misconduct of that person. The procurement of 39
insurance of any type by the Commission shall not in any way 40
compromise or limit the immunity granted hereunder. 41
2. The Commission shall defend any member, officer, 42
executive director, employee, and representative of the 43
Commission in any civil action seeking to impose liability arising 44
out of any actual o r alleged act, error, or omission that occurred 45

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within the scope of Commission employment, duties, or 1
responsibilities, or as determined by the commission that the 2
person against whom the claim is made had a reasonable basis for 3
believing occurred within t he scope of Commission employment, 4
duties, or responsibilities; provided that nothing herein shall be 5
construed to prohibit that person from retaining their own counsel 6
at their own expense; and provided further, that the actual or 7
alleged act, error, or o mission did not result from that person’s 8
intentional or willful or wanton misconduct. 9
3. The Commission shall indemnify and hold harmless any 10
member, officer, executive director, employee, and representative 11
of the Commission for the amount of any settl ement or judgment 12
obtained against that person arising out of any actual or alleged 13
act, error, or omission that occurred within the scope of 14
Commission employment, duties, or responsibilities, or that such 15
person had a reasonable basis for believing occur red within the 16
scope of Commission employment, duties, or responsibilities, 17
provided that the actual or alleged act, error, or omission did not 18
result from the intentional or willful or wanton misconduct of that 19
person. 20
4. Venue is proper and judicial pr oceedings by or against 21
the Commission shall be brought solely and exclusively in a court 22
of competent jurisdiction where the principal office of the 23
Commission is located. The Commission may waive venue and 24
jurisdictional defenses in any proceedings as au thorized by 25
Commission Rules. 26
5. Nothing herein shall be construed as a limitation on the 27
liability of any Licensee for professional malpractice or 28
misconduct, which shall be governed solely by any other 29
applicable State laws. 30
6. Nothing herein shall be construed to designate the venue 31
or jurisdiction to bring actions for alleged acts of malpractice, 32
professional misconduct, negligence, or other such civil action 33
pertaining to the practice of a PA. All such matters shall be 34
determined exclusively by State law other than this Compact. 35
7. Nothing in this Compact shall be interpreted to waive or 36
otherwise abrogate a Participating State’s state action immunity or 37
state action affirmative defense with respect to antitrust claims 38
under the Sherman Act, Clayton Act, or any other State or federal 39
antitrust or anticompetitive law or regulation. 40
8. Nothing in this Compact shall be construed to be a 41
waiver of sovereign immunity by the Participating States or by the 42
Commission. 43

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SECTION 8. DATA SYSTEM 1
2
A. The Commission shall provide for the development, 3
maintenance, operation, and utilization of a coordinated data and 4
reporting system containing licensure, Adverse Action, and the 5
reporting of the existence of Significant Investigative Information 6
on all licens ed PAs and applicants denied a License in 7
Participating States. 8
B. Notwithstanding any other State law to the contrary, a 9
Participating State shall submit a uniform data set to the Data 10
System on all PAs to whom this Compact is applicable (utilizing a 11
unique identifier) as required by the Rules of the Commission, 12
including: 13
1. Identifying information; 14
2. Licensure data; 15
3. Adverse Actions against a License or Compact Privilege; 16
4. Any denial of application for licensure, and the reason(s) 17
for such denial (excluding the reporting of any Criminal history 18
record information where prohibited by law); 19
5. The existence of Significant Investigative Information; 20
and 21
6. Other information that may facilitate the administration 22
of this Compact, as determined by the Rules of the Commission. 23
C. Significant Investigative Information pertaining to a 24
Licensee in any Participating State shall only be available to other 25
Participating States. 26
D. The Commission shall promptly notify all Participating 27
States of any Adverse Action taken against a Licensee or an 28
individual applying for a License that has been reported to it. This 29
Adverse Action information shall be available to any other 30
Participating State. 31
E. Participating States contributing information to the Data 32
System may, in accordance with State or federal law, designate 33
information that may not be shared with the public without the 34
express permission of the contributing State. Notwithstanding any 35
such designation, such information shall be reported to th e 36
Commission through the Data System. 37
F. Any information submitted to the Data System that is 38
subsequently expunged pursuant to federal law or the laws of the 39
Participating State contributing the information shall be removed 40
from the Data System upon rep orting of such by the Participating 41
State to the Commission. 42
G. The records and information provided to a Participating 43
State pursuant to this Compact or through the Data System, when 44
certified by the Commission or an agent thereof, shall constitute 45

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- *SB34*
the authenticated business records of the Commission, and shall 1
be entitled to any associated hearsay exception in any relevant 2
judicial, quasi -judicial or administrative proceedings in a 3
Participating State. 4
5
SECTION 9. RULEMAKING 6
7
A. The Commission shall e xercise its Rulemaking powers 8
pursuant to the criteria set forth in this Section and the Rules 9
adopted thereunder. Commission Rules shall become binding as of 10
the date specified by the Commission for each Rule. 11
B. The Commission shall promulgate reasonab le Rules in 12
order to effectively and efficiently implement and administer this 13
Compact and achieve its purposes. A Commission Rule shall be 14
invalid and have not force or effect only if a court of competent 15
jurisdiction holds that the Rule is invalid becaus e the Commission 16
exercised its rulemaking authority in a manner that is beyond the 17
scope of the purposes of this Compact, or the powers granted 18
hereunder, or based upon another applicable standard of review. 19
C. The Rules of the Commission shall have the force of law 20
in each Participating State, provided however that where the Rules 21
of the Commission conflict with the laws of the Participating State 22
that establish the medical services a PA may perform in the 23
Participating State, as held by a court of compe tent jurisdiction, 24
the Rules of the Commission shall be ineffective in that State to 25
the extent of the conflict. 26
D. If a majority of the legislatures of the Participating States 27
rejects a Commission Rule, by enactment of a statute or resolution 28
in the sa me manner used to adopt this Compact within four (4) 29
years of the date of adoption of the Rule, then such Rule shall 30
have no further force and effect in any Participating State or to 31
any State applying to participate in the Compact. 32
E. Commission Rules shall be adopted at a regular or special 33
meeting of the Commission. 34
F. Prior to promulgation and adoption of a final Rule or 35
Rules by the Commission, and at least thirty (30) days in advance 36
of the meeting at which the Rule will be considered and voted 37
upon, the Commission shall file a Notice of Proposed 38
Rulemaking: 39
1. On the website of the Commission or other publicly 40
accessible platform; and 41
2. To persons who have requested notice of the 42
Commission’s notices of proposed rulemaking; and 43
3. In such o ther way(s) as the Commission may by Rule 44
specify. 45

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G. The Notice of Proposed Rulemaking shall include: 1
1. The time, date, and location of the public hearing on the 2
proposed Rule and the proposed time, date and location of the 3
meeting in which the propo sed Rule will be considered and voted 4
upon; 5
2. The text of the proposed Rule and the reason for the 6
proposed Rule; 7
3. A request for comments on the proposed Rule from any 8
interested person and the date by which written comments must be 9
received; and 10
4. The manner in which interested persons may submit 11
notice to the Commission of their intention to attend the public 12
hearing or provide any written comments. 13
H. Prior to adoption of a proposed Rule, the Commission 14
shall allow persons to submit written data, facts, opinions, and 15
arguments, which shall be made available to the public. 16
I. If the hearing is to be held via electronic means, the 17
Commission shall publish the mechanism for access to the 18
electronic hearing. 19
1. All persons wishing to be heard at the hearing shall as 20
directed in the Notice of Proposed Rulemaking, not less than five 21
(5) business days before the scheduled date of the hearing, notify 22
the Commission of their desire to appear and testify at the hearing. 23
2. Hearings shall be conducted in a manner providing each 24
person who wishes to comment a fair and reasonable opportunity 25
to comment orally or in writing. 26
3. All hearings shall be recorded. A copy of the recording 27
and the written comments, data, facts, opinions, and arguments 28
received in response to the proposed rulemaking shall be made 29
available to a person upon request. 30
4. Nothing in this section shall be construed as requiring a 31
separate hearing on each proposed Rule. Proposed Rules may be 32
grouped for the convenience of the Com mission at hearings 33
required by this section. 34
J. Following the public hearing the Commission shall 35
consider all written and oral comments timely received. 36
K. The Commission shall, by majority vote of all delegates, 37
take final action on the proposed Rule and shall determine the 38
effective date of the Rule, if adopted, based on the Rulemaking 39
record and the full text of the Rule. 40
1. If adopted, the Rule shall be posted on the Commission’s 41
website. 42
2. The Commission may adopt changes to the proposed 43
Rule provided the changes do not enlarge the original purpose of 44
the proposed Rule. 45

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3. The Commission shall provide on its website an 1
explanation of the reasons for substantive changes made to the 2
proposed Rule as well as reasons for substantive changes not 3
made that were recommended by commenters. 4
4. The Commission shall determine a reasonable effective 5
date for the Rule. Except for an emergency as provided in 6
subsection L, the effective date of the Rule shall be no sooner than 7
thirty (30) days after t he Commission issued the notice that it 8
adopted the Rule. 9
L. Upon determination that an emergency exists, the 10
Commission may consider and adopt an emergency Rule with 11
twenty-four (24) hours prior notice, without the opportunity for 12
comment, or hearing, p rovided that the usual rulemaking 13
procedures provided in this Compact and in this section shall be 14
retroactively applied to the Rule as soon as reasonably possible, in 15
no event later than ninety (90) days after the effective date of the 16
Rule. For the purposes of this provision, an emergency Rule is one 17
that must be adopted immediately by the Commission in order to: 18
1. Meet an imminent threat to public health, safety, or 19
welfare; 20
2. Prevent a loss of Commission or Participating State 21
funds; 22
3. Meet a d eadline for the promulgation of a Commission 23
Rule that is established by federal law or Rule; or 24
4. Protect public health and safety. 25
M. The Commission or an authorized committee of the 26
Commission may direct revisions to a previously adopted 27
Commission Rule for purposes of correcting typographical errors, 28
errors in format, errors in consistency, or grammatical errors. 29
Public notice of any revisions shall be posted on the website of the 30
Commission. The revision shall be subject to challenge by any 31
person for a period of thirty (30) days after posting. The revision 32
may be challenged only on grounds that the revision results in a 33
material change to a Rule. A challenge shall be made as set forth 34
in the notice of revisions and delivered to the Commission prio r to 35
the end of the notice period. If no challenge is made, the revision 36
will take effect without further action. If the revision is 37
challenged, the revision may not take effect without the approval 38
of the Commission. 39
N. No Participating State’s rulemaki ng requirements shall 40
apply under this Compact. 41

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SECTION 10. OVERSIGHT, DISPUTE RESOLUTION, 1
AND ENFORCEMENT 2
3
A. Oversight 4
1. The executive and judicial branches of State government 5
in each Participating State shall enforce this Compact and take all 6
actions necessary and appropriate to implement the Compact. 7
2. Venue is proper and judicial proceedings by or against 8
the Commission shall be brought solely and exclusively in a court 9
of competent jurisdiction where the principal office of the 10
Commission is located. The Commission may waive venue and 11
jurisdictional defenses to the extent it adopts or consents to 12
participate in alternative dispute resolution proceedings. Nothing 13
herein shall affect or limit the selection or propriety of venue in 14
any actio n against a licensee for professional malpractice, 15
misconduct or any such similar matter. 16
3. The Commission shall be entitled to receive service of 17
process in any proceeding regarding the enforcement or 18
interpretation of the Compact or the Commission’s Rules and 19
shall have standing to intervene in such a proceeding for all 20
purposes. Failure to provide the Commission with service of 21
process shall render a judgment or order in such proceeding void 22
as to the Commission, this Compact, or Commission Rules. 23
B. Default, Technical Assistance, and Termination 24
1. If the Commission determines that a Participating State 25
has defaulted in the performance of its obligations or 26
responsibilities under this Compact or the Commission Rules, the 27
Commission shall provide written notice to the defaulting State 28
and other Participating States. The notice shall describe the 29
default, the proposed means of curing the default and any other 30
action that the Commission may take and shall offer remedial 31
training and specific technical assistance regarding the default. 32
2. If a State in default fails to cure the default, the 33
defaulting State may be terminated from this Compact upon an 34
affirmative vote of a majority of the delegates of the Participating 35
States, and all rights, privileg es and benefits conferred by this 36
Compact upon such State may be terminated on the effective date 37
of termination. A cure of the default does not relieve the offending 38
State of obligations or liabilities incurred during the period of 39
default. 40
3. Termination of participation in this Compact shall be 41
imposed only after all other means of securing compliance have 42
been exhausted. Notice of intent to suspend or terminate shall be 43
given by the Commission to the governor, the majority and 44

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minority leaders of the defaulting State’s legislature, and to the 1
Licensing Board(s) of each of the Participating States. 2
4. A State that has been terminated is responsible for all 3
assessments, obligations, and liabilities incurred through the 4
effective date of termination, in cluding obligations that extend 5
beyond the effective date of termination. 6
5. The Commission shall not bear any costs related to a 7
State that is found to be in default or that has been terminated 8
from this Compact, unless agreed upon in writing between th e 9
Commission and the defaulting State. 10
6. The defaulting State may appeal its termination from the 11
Compact by the Commission by petitioning the U.S. District Court 12
for the District of Columbia or the federal district where the 13
Commission has its principal offices. The prevailing member shall 14
be awarded all costs of such litigation, including reasonable 15
attorney’s fees. 16
7. Upon the termination of a State’s participation in the 17
Compact, the State shall immediately provide notice to all 18
Licensees within that State of such termination: 19
a. Licensees who have been granted a Compact 20
Privilege in that State shall retain the Compact Privilege for one 21
hundred eighty (180) days following the effective date of such 22
termination. 23
b. Licensees who are licensed in that State who have 24
been granted a Compact Privilege in a Participating State shall 25
retain the Compact Privilege for one hundred eighty (180) days 26
unless the Licensee also has a Qualifying License in a 27
Participating State or obtains a Qualifying License i n a 28
Participating State before the one hundred eighty (180)-day period 29
ends, in which case the Compact Privilege shall continue. 30
C. Dispute Resolution 31
1. Upon request by a Participating State, the Commission 32
shall attempt to resolve disputes related to this Compact that arise 33
among Participating States and between participating and non -34
Participating States. 35
2. The Commission shall promulgate a Rule providing for 36
both mediation and binding dispute resolution for disputes as 37
appropriate. 38
D. Enforcement 39
1. The Commission, in the reasonable exercise of its 40
discretion, shall enforce the provisions of this Compact and Rules 41
of the Commission. 42
2. If compliance is not secured after all means to secure 43
compliance have been exhausted, by majority vote, the 44
Commission may initiate legal action in the United States District 45

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- *SB34*
Court for the District of Columbia or the federal district where the 1
Commission has its principal offices, against a Participating State 2
in default to enforce compliance with the provision s of this 3
Compact and the Commission’s promulgated Rules and bylaws. 4
The relief sought may include both injunctive relief and damages. 5
In the event judicial enforcement is necessary, the prevailing party 6
shall be awarded all costs of such litigation, inclu ding reasonable 7
attorney’s fees. 8
3. The remedies herein shall not be the exclusive remedies 9
of the Commission. The Commission may pursue any other 10
remedies available under federal or State law. 11
E. Legal Action Against the Commission 12
1. A Participating State may initiate legal action against the 13
Commission in the U.S. District Court for the District of Columbia 14
or the federal district where the Commission has its principal 15
offices to enforce compliance with the provisions of the Compact 16
and its Rules. The relief sought may include both injunctive relief 17
and damages. In the event judicial enforcement is necessary, the 18
prevailing party shall be awarded all costs of such litigation, 19
including reasonable attorney’s fees. 20
2. No person other than a Particip ating State shall enforce 21
this Compact against the Commission. 22
23
SECTION 11. DATE OF IMPLEMENTATION OF THE 24
PA LICENSURE COMPACT COMMISSION 25
26
A. This Compact shall come into effect on the date on which 27
this Compact statute is enacted into law in the sevent h 28
Participating State. 29
1. On or after the effective date of the Compact, the 30
Commission shall convene and review the enactment of each of 31
the States that enacted the Compact prior to the Commission 32
convening (“Charter Participating States”) to determine if the 33
statute enacted by each such Charter Participating State is 34
materially different than the Model Compact. 35
a. A Charter Participating State whose enactment is 36
found to be materially different from the Model Compact shall be 37
entitled to the default process set forth in Section 10.B. 38
b. If any Participating State later withdraws from the 39
Compact or its participation is terminated, the Commission shall 40
remain in existence and the Compact shall remain in effect even if 41
the number of Participating States should be less than seven. 42
Participating States enacting the Compact subsequent to the 43
Commission convening shall be subject to the process set forth in 44
Section 7.C.21 to determine if their enactments are materially 45

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different from the Model Compact and whether they qualify for 1
participation in the Compact. 2
2. Participating States enacting the Compact subsequent to 3
the seven initial Charter Participating States shall be subject to the 4
process set forth in Section 7.C.21 to determine if their enactments 5
are materially different from the Model Compact and whether they 6
qualify for participation in the Compact. 7
3. All actions taken for the benefit of the Commission or in 8
furtherance of the purposes of the administration of the Compact 9
prior to the effe ctive date of the Compact or the Commission 10
coming into existence shall be considered to be actions of the 11
Commission unless specifically repudiated by the Commission. 12
B. Any State that joins this Compact shall be subject to the 13
Commission’s Rules and bylaws as they exist on the date on which 14
this Compact becomes law in that State. Any Rule that has been 15
previously adopted by the Commission shall have the full force 16
and effect of law on the day this Compact becomes law in that 17
State. 18
C. Any Participating State may withdraw from this Compact 19
by enacting a statute repealing the same. 20
1. A Participating State’s withdrawal shall not take effect 21
until one hundred eighty (180) days after enactment of the 22
repealing statute. During this one hundred eighty (180 ) day -23
period, all Compact Privileges that were in effect in the 24
withdrawing State and were granted to Licensees licensed in the 25
withdrawing State shall remain in effect. If any Licensee licensed 26
in the withdrawing State is also licensed in another Particip ating 27
State or obtains a license in another Participating State within the 28
one hundred eighty (180) days, the Licensee’s Compact Privileges 29
in other Participating States shall not be affected by the passage of 30
the one hundred eighty (180) days. 31
2. Withdrawal shall not affect the continuing requirement 32
of the State Licensing Board(s) of the withdrawing State to comply 33
with the investigative, and Adverse Action reporting requirements 34
of this Compact prior to the effective date of withdrawal. 35
3. Upon the e nactment of a statute withdrawing a State 36
from this Compact, the State shall immediately provide notice of 37
such withdrawal to all Licensees within that State. Such 38
withdrawing State shall continue to recognize all licenses granted 39
pursuant to this Compact for a minimum of one hundred eighty 40
(180) days after the date of such notice of withdrawal. 41
D. Nothing contained in this Compact shall be construed to 42
invalidate or prevent any PA licensure agreement or other 43
cooperative arrangement between Participating States and 44

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between a Participating State and non -Participating State that 1
does not conflict with the provisions of this Compact. 2
E. This Compact may be amended by the Participating States. 3
No amendment to this Compact shall become effective and 4
binding upon any Participating State until it is enacted materially 5
in the same manner into the laws of all Participating States as 6
determined by the Commission. 7
8
SECTION 12. CONSTRUCTION AND SEVERABILITY 9
10
A. This Compact and the Commission’s rulemaking authority 11
shall be liberally construed so as to effectuate the purposes, and 12
the implementation and administration of the Compact. Provisions 13
of the Compact expressly authorizing or requiring the 14
promulgation of Rules shall not be construed to limit the 15
Commission’s rulemaking authority solely for those purposes. 16
B. The provisions of this Compact shall be severable and if 17
any phrase, clause, sentence or provision of this Compact is held 18
by a court of competent jurisdiction to be contrary to the 19
constitution of an y Participating State, a State seeking 20
participation in the Compact, or of the United States, or the 21
applicability thereof to any government, agency, person or 22
circumstance is held to be unconstitutional by a court of 23
competent jurisdiction, the validity o f the remainder of this 24
Compact and the applicability thereof to any other government, 25
agency, person or circumstance shall not be affected thereby. 26
C. Notwithstanding subsection B or this section, the 27
Commission may deny a State’s participation in the C ompact or, 28
in accordance with the requirements of Section 10.B, terminate a 29
Participating State’s participation in the Compact, if it determines 30
that a constitutional requirement of a Participating State is, or 31
would be with respect to a State seeking to p articipate in the 32
Compact, a material departure from the Compact. Otherwise, if 33
this Compact shall be held to be contrary to the constitution of any 34
Participating State, the Compact shall remain in full force and 35
effect as to the remaining Participating St ates and in full force 36
and effect as to the Participating State affected as to all severable 37
matters. 38
39
SECTION 13. BINDING EFFECT OF COMPACT 40
41
A. Nothing herein prevents the enforcement of any other law 42
of a Participating State that is not inconsistent with this Compact. 43
B. Any laws in a Participating State in conflict with this 44
Compact are superseded to the extent of the conflict. 45

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C. All agreements between the Commission and the 1
Participating States are binding in accordance with their terms. 2
Sec. 2. NRS 629A.100 is hereby amended to read as follows: 3
629A.100 The Interstate Medical Licensure Compact is hereby 4
ratified and entered into with all other jurisdictions legally joining 5
the Compact, in substantially the form set forth in this [chapter:] 6
section: 7
8
INTERSTATE MEDICAL LICENSURE COMPACT 9
10
ARTICLE 1. PURPOSE 11
12
In order to strengthen access to health care, and in recognition of 13
the advances in the delivery of health care, the member states of the 14
Interstate Medical Licensure Compact have allied in common 15
purpose to develop a comprehensive process th at complements the 16
existing licensing and regulatory authority of state medical boards 17
and provides a streamlined process which allows physicians to 18
become licensed in multiple states, thereby enhancing the portability 19
of a medical license and ensuring the safety of patients. The 20
Compact creates another pathway for licensure and does not 21
otherwise change a state’s existing Medical Practice Act. The 22
Compact also adopts the prevailing standard for licensure and 23
affirms that the practice of medicine occurs whe re the patient is 24
located at the time of the physician-patient encounter, and therefore, 25
requires the physician to be under the jurisdiction of the state 26
medical board where the patient is located. State medical boards that 27
participate in the Compact retai n the jurisdiction to impose an 28
adverse action against a license to practice medicine in that state 29
issued to a physician through the procedures in the Compact. 30
31
ARTICLE 2. DEFINITIONS 32
33
In this Compact: 34
(a) “Bylaws” means those bylaws established by the Interstate 35
Commission pursuant to Article 11 for its governance, or for 36
directing and controlling its actions and conduct. 37
(b) “Commissioner” means the voting representative appointed 38
by each member board pursuant to Article 11. 39
(c) “Conviction” means a finding by a court that an individual is 40
guilty of a criminal offense through adjudication, or entry of a plea 41
of guilt or no contest to the charge by the offender. Evidence of an 42
entry of a conviction of a criminal offense by the court shall be 43
considered final for purposes of disciplinary action by a member 44
board. 45

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(d) “Expedited license” means a full and unrestricted medical 1
license granted by a member state to an eligible physician through 2
the process set forth in the Compact. 3
(e) “Interstate Commissi on” means the Interstate Medical 4
Licensure Compact Commission created pursuant to Article 11. 5
(f) “License” means authorization by a state for a physician to 6
engage in the practice of medicine, which would be unlawful 7
without the authorization. 8
(g) “Medical Practice Act” means laws and regulations 9
governing the practice of allopathic and osteopathic medicine within 10
a member state. 11
(h) “Member board” means a state agency in a member state that 12
acts in the sovereign interests of the state by protecting the public 13
through licensure, regulation and education of physicians as directed 14
by the state government. 15
(i) “Member state” means a state that has enacted the Compact. 16
(j) “Practice of medicine” means the clinical prevention, 17
diagnosis or treatment of a hu man disease, injury or condition 18
requiring a physician to obtain and maintain a license in compliance 19
with the Medical Practice Act of a member state. 20
(k) “Physician” means any person who: 21
(1) Is a graduate of a medical school accredited by the 22
Liaison Committee on Medical Education, the Commission on 23
Osteopathic College Accreditation of the American Osteopathic 24
Association or a medical school listed in the International Medical 25
Education Directory or its equivalent; 26
(2) Has passed each component of th e United States Medical 27
Licensing Examination (USMLE) or the Comprehensive 28
Osteopathic Medical Licensing Examination (COMLEX -USA) 29
within three attempts, or any of its predecessor examinations 30
accepted by a state medical board as an equivalent examination f or 31
licensure purposes; 32
(3) Has successfully completed graduate medical education 33
approved by the Accreditation Council for Graduate Medical 34
Education or the American Osteopathic Association; 35
(4) Holds specialty certification or a time-unlimited specialty 36
certificate recognized by the American Board of Medical Specialties 37
or the American Osteopathic Association’s Bureau of Osteopathic 38
Specialists; 39
(5) Possesses a full and unrestricted license to engage in the 40
practice of medicine issued by a member board; 41
(6) Has never been convicted, received adjudication, deferred 42
adjudication, community supervision or deferred disposition for any 43
offense by a court of appropriate jurisdiction; 44

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(7) Has never held a license authorizing the practice of 1
medicine subjected to discipline by a licensing agency in any state, 2
federal or foreign jurisdiction, excluding any action related to 3
nonpayment of fees related to a license; 4
(8) Has never had a controlled substance license or permit 5
suspended or revoked by a state o r the United States Drug 6
Enforcement Administration; and 7
(9) Is not under active investigation by a licensing agency or 8
law enforcement authority in any state, federal or foreign 9
jurisdiction. 10
(l) “Offense” means a felony, gross misdemeanor or crime of 11
moral turpitude. 12
(m) “Rule” means a written statement by the Interstate 13
Commission promulgated pursuant to Article 12 of the Compact 14
that is of general applicability, implements, interprets or prescribes a 15
policy or provision of the Compact, or an organiz ational, procedural 16
or practice requirement of the Interstate Commission, and has the 17
force and effect of statutory law in a member state, and includes the 18
amendment, repeal or suspension of an existing rule. 19
(n) “State” means any state, commonwealth, dis trict or territory 20
of the United States. 21
(o) “State of principal license” means a member state where a 22
physician holds a license to practice medicine and which has been 23
designated as such by the physician for purposes of registration and 24
participation in the Compact. 25
26
ARTICLE 3. ELIGIBILITY 27
28
(a) A physician must meet the eligibility requirements as 29
defined in Article 2(k) to receive an expedited license under the 30
terms and provisions of the Compact. 31
(b) A physician who does not meet the requirements of Article 32
2(k) may obtain a license to practice medicine in a member state if 33
the physician complies with all laws and requirements, other than 34
the Compact, relating to the issuance of a license to practice 35
medicine in that state. 36
37
ARTICLE 4. DESIGNATION OF STATE 38
OF PRINCIPAL LICENSE 39
40
(a) A physician shall designate a member state as the state of 41
principal license for purposes of registration for expedited licensure 42
through the Compact if the physician possesses a full and 43
unrestricted license to practice medicine in the state, and the state is: 44
(1) The state of primary residence for the physician; 45

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(2) The state where at least 25 percent of the practice of 1
medicine occurs; 2
(3) The location of the physician’s employer; or 3
(4) If no state qualifies under paragraph (1), (2) or (3), the 4
state designated as the state of residence for the purpose of federal 5
income tax. 6
(b) A physician may redesignate a member state as the state of 7
principal license at any time, as long as the state meets the 8
requirements in subsection (a). 9
(c) The Interstate Commission is authorized to develop rules to 10
facilitate redesignation of another member state as the state of 11
principal license. 12
13
ARTICLE 5. APPLICATION AND ISSUANCE 14
OF EXPEDITED LICENSURE 15
16
(a) A physician seeking licensure through the Compact shall file 17
an application for an expedited license with the member board of the 18
state selected by the physician as the state of principal license. 19
(b) Upon receipt of an application for an expedited license, the 20
member boar d within the state selected as the state of principal 21
license shall evaluate whether the physician is eligible for expedited 22
licensure and issue a letter of qualification, verifying or denying the 23
physician’s eligibility, to the Interstate Commission. For purposes of 24
this subsection: 25
(1) Static qualifications, which include verification of 26
medical education, graduate medical education, results of any 27
medical or licensing examination and other qualifications as 28
determined by the Interstate Commission throu gh rule, shall not be 29
subject to additional primary source verification where the primary 30
source has already been verified by the state of principal license. 31
(2) The member board within the state selected as the state of 32
principal license shall, in the c ourse of verifying eligibility, perform 33
a criminal background check of an applicant, including the use of 34
the results of fingerprint or other biometric data checks compliant 35
with the requirements of the Federal Bureau of Investigation, with 36
the exception o f federal employees who have a suitability 37
determination in accordance with 5 C.F.R. § 731.202. 38
(3) Appeal on the determination of eligibility shall be made 39
to the member state where the application was filed and shall be 40
subject to the law of that state. 41
(c) Upon verification in subsection (b), physicians eligible for an 42
expedited license shall complete the registration process established 43
by the Interstate Commission to receive a license in a member state 44

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selected pursuant to subsection (a), inclu ding the payment of any 1
applicable fees. 2
(d) After receiving verification of eligibility under subsection 3
(b) and any fees under subsection (c), a member board shall issue an 4
expedited license to the physician. This license shall authorize the 5
physician t o practice medicine in the issuing state consistent with 6
the Medical Practice Act and all applicable laws and regulations of 7
the issuing member board and member state. 8
(e) An expedited license shall be valid for a period consistent 9
with the licensure peri od in the member state and in the same 10
manner as required for other physicians holding a full and 11
unrestricted license within the member state. 12
(f) An expedited license obtained through the Compact shall be 13
terminated if a physician fails to maintain a li cense in the state of 14
principal licensure for a nondisciplinary reason, without 15
redesignation of a new state of principal licensure. 16
(g) The Board of Medical Examiners and the State Board of 17
Osteopathic Medicine, in conjunction with the Interstate 18
Commission, are authorized to develop rules regarding the 19
application process, including payment of any applicable fees and 20
the issuance of an expedited license. 21
22
ARTICLE 6. FEES FOR EXPEDITED LICENSURE 23
24
(a) A member state issuing an expedited license authorizi ng the 25
practice of medicine in that state may impose a fee for a license 26
issued or renewed through the Compact. 27
(b) The Board of Medical Examiners and the State Board of 28
Osteopathic Medicine, in conjunction with the Interstate 29
Commission, are authorized t o develop rules regarding fees for 30
expedited licenses. 31
32
ARTICLE 7. RENEWAL AND CONTINUED 33
PARTICIPATION 34
35
(a) A physician seeking to renew an expedited license granted in 36
a member state shall complete a renewal process with the Board of 37
Medical Examiners or the State Board of Osteopathic Medicine, as 38
applicable, in conjunction with the Interstate Commission, if the 39
physician: 40
(1) Maintains a full and unrestricted license in a state of 41
principal license; 42
(2) Has not been convicted, received adjudication , deferred 43
adjudication, community supervision or deferred disposition for any 44
offense by a court of appropriate jurisdiction; 45

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- *SB34*
(3) Has not had a license authorizing the practice of medicine 1
subject to discipline by a licensing agency in any state, federa l or 2
foreign jurisdiction, excluding any action related to nonpayment of 3
fees related to a license; and 4
(4) Has not had a controlled substance license or permit 5
suspended or revoked by a state or the United States Drug 6
Enforcement Administration. 7
(b) Physicians shall comply with all continuing professional 8
development or continuing medical education requirements for 9
renewal of a license issued by a member state. 10
(c) The Board of Medical Examiners and the State Board of 11
Osteopathic Medicine, as applicabl e, shall collect any renewal fees 12
charged for the renewal of a license and distribute the fees to the 13
Interstate Commission. 14
(d) Subject to the renewal requirements in this Article and those 15
specific to license renewal by the Board of Medical Examiners or 16
the State Board of Osteopathic Medicine, as applicable, and upon 17
receipt of any renewal fees collected in subsection (c), a member 18
board shall renew the physician’s license. 19
(e) Physician information collected by the Interstate 20
Commission during the rene wal process will be distributed to all 21
member boards. 22
(f) The Board of Medical Examiners and the State Board of 23
Osteopathic Medicine, in conjunction with the Interstate 24
Commission, are authorized to develop rules to address renewal of 25
licenses obtained through the Compact. 26
27
ARTICLE 8. COORDINATED INFORMATION SYSTEM 28
29
(a) The Interstate Commission shall establish a database of all 30
physicians licensed, or who have applied for licensure, pursuant to 31
Article 5. 32
(b) Notwithstanding any other provision of law, member boards 33
shall report to the Interstate Commission any public action or 34
complaints against a licensed physician who has applied for or 35
received an expedited license through the Compact. 36
(c) Member boards shall report disciplinary or investigatory 37
information determined as necessary and proper by rule of the 38
Interstate Commission. 39
(d) Member boards may report any nonpublic complaint, 40
disciplinary or investigatory information not required by subsection 41
(c) to the Interstate Commission. 42
(e) Member boa rds shall share complaint or disciplinary 43
information about a physician upon request of another member 44
board. 45

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(f) All information provided to the Interstate Commission or 1
distributed by member boards shall be confidential, filed under seal 2
and used only for investigatory or disciplinary matters. 3
(g) The Interstate Commission is authorized to develop rules for 4
mandatory or discretionary sharing of information by member 5
boards. 6
7
ARTICLE 9. JOINT INVESTIGATIONS 8
9
(a) Licensure and disciplinary records of ph ysicians are deemed 10
investigative. 11
(b) In addition to the authority granted to a member board by its 12
respective Medical Practice Act or other applicable state law, a 13
member board may participate with other member boards in joint 14
investigations of physicians licensed by the member boards. 15
(c) A subpoena issued by a member state shall be enforceable in 16
other member states. 17
(d) Member boards may share any investigative, litigation or 18
compliance materials in furtherance of any joint or individual 19
investigation initiated under the Compact. 20
(e) Any member state may investigate actual or alleged 21
violations of the statutes authorizing the practice of medicine in any 22
other member state in which a physician holds a license to practice 23
medicine. 24
25
ARTICLE 10. DISCIPLINARY ACTIONS 26
27
(a) Any disciplinary action taken by any member board against a 28
physician licensed through the Compact shall be deemed 29
unprofessional conduct which may be subject to discipline by other 30
member boards, in addition to any violation of the Medical Practice 31
Act or regulations in that state. 32
(b) If a license granted to a physician by the member board in 33
the state of principal license is revoked, surrendered or relinquished 34
in lieu of discipline, or suspended, then all licenses issued t o the 35
physician by member boards shall automatically be placed, without 36
further action necessary by any member board, on the same status. If 37
the member board in the state of principal license subsequently 38
reinstates the physician’s license, a license issue d to the physician 39
by any other member board shall remain encumbered until that 40
respective member board takes action to reinstate the license in a 41
manner consistent with the Medical Practice Act of that state. 42
(c) If disciplinary action is taken against a physician by a 43
member board not in the state of principal license, any other 44

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- *SB34*
member board may deem the action conclusive as to matter of law 1
and fact decided, and: 2
(1) Impose the same or lesser sanctions against the physician 3
so long as such sanctions a re consistent with the Medical Practice 4
Act of that state; or 5
(2) Pursue separate disciplinary action against the physician 6
under its respective Medical Practice Act, regardless of the action 7
taken in other member states. 8
(d) If a license granted to a p hysician by a member board is 9
revoked, surrendered or relinquished in lieu of discipline, or 10
suspended, then any license issued to the physician by any other 11
member board shall be suspended, automatically and immediately 12
without further action necessary by the other member board, for 90 13
days upon entry of the order by the disciplining board, to permit the 14
member board to investigate the basis for the action under the 15
Medical Practice Act of that state. A member board may terminate 16
the automatic suspension o f the license it issued prior to the 17
completion of the 90 day suspension period in a manner consistent 18
with the Medical Practice Act of that state. 19
20
ARTICLE 11. INTERSTATE MEDICAL 21
LICENSURE COMPACT COMMISSION 22
23
(a) The member states hereby create the “In terstate Medical 24
Licensure Compact Commission.” 25
(b) The purpose of the Interstate Commission is the 26
administration of the Interstate Medical Licensure Compact, which 27
is a discretionary state function. 28
(c) The Interstate Commission shall be a body corporate and 29
joint agency of the member states and shall have all the 30
responsibilities, powers and duties set forth in the Compact, and 31
such additional powers as may be conferred upon it by a subsequent 32
concurrent action of the respective legislatures of the member states 33
in accordance with the terms of the Compact. 34
(d) The Interstate Commission shall consist of two voting 35
representatives appointed by each member state who shall serve as 36
Commissioners. In states where allopathic and osteopathic 37
physicians are regulated by separate member boards, or if the 38
licensing and disciplinary authority is split between multiple 39
member boards within a member state, the member state shall 40
appoint one representative from each member board. A 41
Commissioner shall be: 42
(1) An allopathic or osteopathic physician appointed to a 43
member board; 44

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(2) An executive director, executive secretary or similar 1
executive of a member board; or 2
(3) A member of the public appointed to a member board. 3
(e) The Interstate Commission shall meet at least once each 4
calendar year. A portion of this meeting shall be a business meeting 5
to address such matters as may properly come before the 6
Commission, including the election of officers. The Chairperson 7
may call additional meetings and shall call for a meeting upon the 8
request of a majority of the member states. 9
(f) The bylaws may provide for meetings of the Interstate 10
Commission to be conducted by telecommunication or electronic 11
communication. 12
(g) Each Commissioner participating at a meeting of the 13
Interstate Commission is entitled to one vote. A majority of 14
Commissioners shall constitute a quorum for the transaction of 15
business, unless a larger quorum is required by the bylaws of the 16
Interstate Commission. A Commissioner shall not delegate a vo te to 17
another Commissioner. In the absence of its Commissioner, a 18
member state may delegate voting authority for a specified meeting 19
to another person from that state who meets the requirements of 20
subsection (d). 21
(h) The Interstate Commission shall provid e public notice of all 22
meetings, and all meetings must be open to the public. The Interstate 23
Commission may close a meeting, in full or in portion, where it 24
determines by a two -thirds vote of the Commissioners present that 25
an open meeting would be likely to: 26
(1) Relate solely to the internal personnel practices and 27
procedures of the Interstate Commission; 28
(2) Discuss matters specifically exempted from disclosure by 29
a federal statute; 30
(3) Discuss trade secrets, commercial or financial 31
information that is privileged or confidential; 32
(4) Involve accusing a person of a crime or formally 33
censuring a person; 34
(5) Discuss information of a personal nature where 35
disclosure would constitute a clearly unwarranted invasion of 36
personal privacy; 37
(6) Discuss inv estigative records compiled for law 38
enforcement purposes; or 39
(7) Specifically relate to the participation in a civil action or 40
other legal proceeding. 41
(i) The Interstate Commission shall keep minutes which shall 42
fully describe all matters discussed in a meeting and shall provide a 43
full and accurate summary of actions taken, including a record of 44
any roll call votes. 45

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(j) The Interstate Commission shall make its information and 1
official records, to the extent not otherwise designated in the 2
Compact or by its rules, available to the public for inspection. 3
(k) The Interstate Commission shall establish an Executive 4
Committee, which must include officers, members and others as 5
determined by the bylaws. The Executive Committee shall have the 6
power to act on be half of the Interstate Commission, with the 7
exception of rulemaking, during periods when the Interstate 8
Commission is not in session. When acting on behalf of the 9
Interstate Commission, the Executive Committee shall oversee the 10
administration of the Compac t, including enforcement and 11
compliance with the provisions of the Compact, its bylaws and rules 12
and other such duties as necessary. 13
(l) The Interstate Commission may establish other committees 14
for governance and administration of the Compact. 15
16
ARTICLE 12. POWERS AND DUTIES 17
OF THE INTERSTATE COMMISSION 18
19
The Interstate Commission shall have the duty and power to: 20
(a) Oversee and maintain the administration of the Compact; 21
(b) Promulgate rules which shall be binding to the extent and in 22
the manner provided for in the Compact; 23
(c) Issue, upon the request of a member state or member board, 24
advisory opinions concerning the meaning or interpretation of the 25
Compact, its bylaws, rules and actions; 26
(d) Enforce compliance with Compact provisions, the rules 27
promulgated by the Interstate Commission and the bylaws, using all 28
necessary and proper means, including, but not limited to, the use of 29
judicial process; 30
(e) Establish and appoint committees, including, but not limited 31
to, an Executive Committee as required by Article 11, which shall 32
have the power to act on behalf of the Interstate Commission in 33
carrying out its powers and duties; 34
(f) Pay, or provide for the payment of, the expenses related to 35
the establishment, organization and ongoing activities of the 36
Interstate Commission; 37
(g) Establish and maintain one or more offices; 38
(h) Borrow, accept, hire or contract for services of personnel; 39
(i) Purchase and maintain insurance and bonds; 40
(j) Employ an Executive Director who shall have such powers to 41
employ, select or appoint employees, agents or consultants, and to 42
determine their qualifications, define their duties and fix their 43
compensation; 44

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(k) Establish personnel policies and programs relating to 1
conflicts of interest, rates of compensation and qualifica tions of 2
personnel; 3
(l) Accept donations and grants of money, equipment, supplies, 4
materials and services, and to receive, utilize and dispose of it in a 5
manner consistent with the conflict of interest policies established 6
by the Interstate Commission; 7
(m) Lease, purchase, accept contributions or donations of, or 8
otherwise to own, hold, improve or use, any property, real, personal 9
or mixed; 10
(n) Sell, convey, mortgage, pledge, lease, exchange, abandon or 11
otherwise dispose of any property, real, personal or mixed; 12
(o) Establish a budget and make expenditures; 13
(p) Adopt a seal and bylaws governing the management and 14
operation of the Interstate Commission; 15
(q) Report annually to the legislatures and governors of the 16
member states concerning the activities of the Interstate 17
Commission during the preceding year. Such reports shall also 18
include reports of financial audits and any recommendations that 19
may have been adopted by the Interstate Commission; 20
(r) Coordinate education, training and public awareness 21
regarding the Compact, its implementation and its operation; 22
(s) Maintain records in accordance with the bylaws; 23
(t) Seek and obtain trademarks, copyrights and patents; and 24
(u) Perform such functions as may be necessary or appropriate 25
to achieve the purposes of the Compact. 26
27
ARTICLE 13. FINANCE POWERS 28
29
(a) The Interstate Commission may levy on and collect an 30
annual assessment from each member state to cover the cost of the 31
operations and activities of the Interstate Commission and its staff. 32
The total as sessment must be sufficient to cover the annual budget 33
approved each year for which revenue is not provided by other 34
sources. The aggregate annual assessment amount shall be allocated 35
upon a formula to be determined by the Interstate Commission, 36
which shall promulgate a rule binding upon all member states. 37
(b) The Interstate Commission shall not incur obligations of any 38
kind prior to securing the funds adequate to meet the same. 39
(c) The Interstate Commission shall not pledge the credit of any 40
of the membe r states, except by, and with the authority of, the 41
member state. 42
(d) The Interstate Commission shall be subject to a yearly 43
financial audit conducted by a certified or licensed public 44

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- *SB34*
accountant and the report of the audit shall be included in the annual 1
report of the Interstate Commission. 2
3
ARTICLE 14. ORGANIZATION AND OPERATION 4
OF THE INTERSTATE COMMISSION 5
6
(a) The Interstate Commission shall, by a majority of 7
Commissioners present and voting, adopt bylaws to govern its 8
conduct as may be necessary or appropriate to carry out the 9
purposes of the Compact within 12 months of the first Interstate 10
Commission meeting. 11
(b) The Interstate Commission shall elect or appoint annually 12
from among its Commissioners a Chairperson, a Vice Chairperson 13
and a Treasurer, each of whom shall have such authority and duties 14
as may be specified in the bylaws. The Chairperson, or in the 15
Chairperson’s absence or disability, the Vice Chairperson, shall 16
preside at all meetings of the Interstate Commission. 17
(c) Officers selected in subsection (b) shall serve without 18
remuneration from the Interstate Commission. 19
(d) The officers and employees of the Interstate Commission 20
shall be immune from suit and liability, either personally or in their 21
official capacity, for a claim f or damage to or loss of property or 22
personal injury or other civil liability caused or arising out of, or 23
relating to, an actual or alleged act, error or omission that occurred, 24
or that such person had a reasonable basis for believing occurred, 25
within the scope of Interstate Commission employment, duties or 26
responsibilities, provided that such person shall not be protected 27
from suit or liability for damage, loss, injury or liability caused by 28
the intentional or willful and wanton misconduct of such person. For 29
purposes of this subsection: 30
(1) The liability of the Executive Director and employees of 31
the Interstate Commission or representatives of the Interstate 32
Commission, acting within the scope of such person’s employment 33
or duties for acts, errors or omissions occurring within such person’s 34
state, may not exceed the limits of liability set forth under the 35
constitution and laws of that state for state officials, employees and 36
agents. The Interstate Commission is considered to be an 37
instrumentality of the s tates for the purposes of any such action. 38
Nothing in this paragraph shall be construed to protect such person 39
from suit or liability for damage, loss, injury or liability caused by 40
the intentional or willful and wanton misconduct of such person. 41
(2) The Interstate Commission shall defend the Executive 42
Director, its employees and, subject to the approval of the attorney 43
general or other appropriate legal counsel of the member state 44
represented by an Interstate Commission representative, such 45

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Interstate Commission representative in any civil action seeking to 1
impose liability arising out of an actual or alleged act, error or 2
omission that occurred within the scope of Interstate Commission 3
employment, duties or responsibilities, or that the defendant had a 4
reasonable basis for believing occurred within the scope of Interstate 5
Commission employment, duties or responsibilities, provided that 6
the actual or alleged act, error or omission did not result from 7
intentional or willful and wanton misconduct on the part of such 8
person. 9
(3) To the extent not covered by the state involved, the 10
member state or the Interstate Commission, the representatives or 11
employees of the Interstate Commission shall be held harmless in 12
the amount of a settlement or judgment, including attorney’s fees 13
and costs, obtained against such persons arising out of an actual or 14
alleged act, error or omission that occurred within the scope of 15
Interstate Commission employment, duties or responsibilities, or 16
that such persons had a reasonable basis for believing occurred 17
within the scope of Interstate Commission employment, duties or 18
responsibilities, provided that the actual or alleged act, error or 19
omission did not result from intentional or willful and wanton 20
misconduct on the part of such persons. 21
22
ARTICLE 15. RULEMAKING FUNCTIONS 23
OF THE INTERSTATE COMMISSION 24
25
(a) The Interstate Commission shall promulgate reasonable rules 26
in order to effectively and efficiently achieve the purposes of the 27
Compact. Notwithstanding the foregoing, in the event t he Interstate 28
Commission exercises its rulemaking authority in a manner that is 29
beyond the scope of the purposes of the Compact, or the powers 30
granted hereunder, then such an action by the Interstate Commission 31
shall be invalid and have no force or effect. 32
(b) Rules deemed appropriate for the operations of the Interstate 33
Commission shall be made pursuant to a rulemaking process that 34
substantially conforms to the Model State Administrative Procedure 35
Act of 2010, and subsequent amendments thereto. 36
(c) Not later than 30 days after a rule is promulgated, any person 37
may file a petition for judicial review of the rule in the United States 38
District Court for the District of Columbia or the federal district 39
where the Interstate Commission has its principal offices , provided 40
that the filing of such a petition shall not stay or otherwise prevent 41
the rule from becoming effective unless the court finds that the 42
petitioner has a substantial likelihood of success. The court shall 43
give deference to the actions of the Interstate Commission consistent 44
with applicable law and shall not find the rule to be unlawful if the 45

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rule represents a reasonable exercise of the authority granted to the 1
Interstate Commission. 2
3
ARTICLE 16. OVERSIGHT OF INTERSTATE COMPACT 4
5
(a) The executiv e, legislative and judicial branches of state 6
government in each member state shall enforce the Compact and 7
shall take all actions necessary and appropriate to effectuate the 8
Compact’s purposes and intent. The provisions of the Compact and 9
the rules promulgated hereunder shall have standing as statutory law 10
but shall not override existing state authority to regulate the practice 11
of medicine. 12
(b) All courts shall take judicial notice of the Compact and the 13
rules in any judicial or administrative proceeding in a member state 14
pertaining to the subject matter of the Compact which may affect the 15
powers, responsibilities or actions of the Interstate Commission. 16
(c) The Interstate Commission shall be entitled to receive all 17
service of process in any such proceedi ng, and shall have standing 18
to intervene in the proceeding for all purposes. Failure to provide 19
service of process to the Interstate Commission shall render a 20
judgment or order void as to the Interstate Commission, the 21
Compact or promulgated rules. 22
23
ARTICLE 17. ENFORCEMENT OF INTERSTATE COMPACT 24
25
(a) The Interstate Commission, in the reasonable exercise of its 26
discretion, shall enforce the provisions and rules of the Compact. 27
(b) The Interstate Commission may, by majority vote of the 28
Commissioners, initia te legal action in the United States District 29
Court for the District of Columbia or, at the discretion of the 30
Interstate Commission, in the federal district where the Interstate 31
Commission has its principal offices, to enforce compliance with the 32
provisions of the Compact, and its promulgated rules and bylaws, 33
against a member state in default. The relief sought may include 34
both injunctive relief and damages. In the event judicial 35
enforcement is necessary, the prevailing party shall be awarded all 36
costs of such litigation, including reasonable attorney’s fees. 37
(c) The remedies herein shall not be the exclusive remedies of 38
the Interstate Commission. The Interstate Commission may avail 39
itself of any other remedies available under state law or the 40
regulation of a profession. 41

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ARTICLE 18. DEFAULT PROCEDURES 1
2
(a) The grounds for default include, but are not limited to, 3
failure of a member state to perform such obligations or 4
responsibilities imposed upon it by the Compact, or the rules and 5
bylaws of the Interstate Commission promulgated under the 6
Compact. 7
(b) If the Interstate Commission determines that a member state 8
has defaulted in the performance of its obligations or responsibilities 9
under the Compact, or the bylaws or promulgated rules, the 10
Interstate Commission shall: 11
(1) Provide written notice to the defaulting state and other 12
member states of the nature of the default, the means of curing the 13
default and any action taken by the Interstate Commission. The 14
Interstate Commission shall specify the conditions by which the 15
defaulting state must cure its default; and 16
(2) Provide remedial training and specific technical 17
assistance regarding the default. 18
(c) If the defaulting state fails to cure the default, the defaulting 19
state shall be terminated from the Compact upon an affirmative vote 20
of a majority of the Commissioners and all rights, privileges and 21
benefits conferred by the Compact shall terminate on the effective 22
date of the termination. A cure of the default does not relieve the 23
offending state of obligations or liabilities incurred during the period 24
of the default. 25
(d) Termination of membership in the Compact shall be 26
imposed only after all other means of securing compliance have 27
been exhausted. Notice of intent to terminate shall be given by the 28
Interstate Commission to the governor, the majority and minority 29
leaders of the defaulting state’s legislature and each of the member 30
states. 31
(e) The Interstate Commission shall establish rules and 32
procedures to address licenses and physicians that ar e materially 33
impacted by the termination of a member state, or the withdrawal of 34
a member state. 35
(f) The member state which has been terminated is responsible 36
for all dues, obligations and liabilities incurred through the effective 37
date of the termination , including obligations the performance of 38
which extends beyond the effective date of the termination. 39
(g) The Interstate Commission shall not bear any costs relating 40
to any state that has been found to be in default or which has been 41
terminated from the Compact, unless otherwise mutually agreed 42
upon in writing between the Interstate Commission and the 43
defaulting state. 44

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(h) The defaulting state may appeal the action of the Interstate 1
Commission by petitioning the United States District Court for the 2
District of Columbia or the federal district where the Interstate 3
Commission has its principal offices. The prevailing party shall be 4
awarded all costs of such litigation, including reasonable attorney’s 5
fees. 6
7
ARTICLE 19. DISPUTE RESOLUTION 8
9
(a) The Interstate Commission shall attempt, upon the request of 10
a member state, to resolve disputes which are subject to the 11
Compact and which may arise among member states or member 12
boards. 13
(b) The Interstate Commission shall promulgate rules providing 14
for both mediation and binding dispute resolution as appropriate. 15
16
ARTICLE 20. MEMBER STATES, EFFECTIVE 17
DATE AND AMENDMENT 18
19
(a) Any state is eligible to become a member state of the 20
Compact. 21
(b) The Compact shall become effective and binding upon 22
legislative enactment of the Compact into law by no less than seven 23
states. Thereafter, it shall become effective and binding on a state 24
upon enactment of the Compact into law by that state. 25
(c) The governors of nonmember states, or their designees, shall 26
be invited to partic ipate in the activities of the Interstate 27
Commission on a nonvoting basis prior to adoption of the Compact 28
by all states. 29
(d) The Interstate Commission may propose amendments to the 30
Compact for enactment by the member states. No amendment shall 31
become effective and binding upon the Interstate Commission and 32
the member states unless and until it is enacted into law by 33
unanimous consent of the member states. 34
35
ARTICLE 21. WITHDRAWAL 36
37
(a) Once effective, the Compact shall continue in force and 38
remain binding upon each and every member state, provided that a 39
member state may withdraw from the Compact by specifically 40
repealing the statute which enacted the Compact into law. 41
(b) Withdrawal from the Compact shall be by the enactment of a 42
statute repealing the same, but shall not take effect until 1 year after 43
the effective date of such statute and until written notice of the 44

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withdrawal has been given by the withdrawing state to the governor 1
of each other member state. 2
(c) The withdrawing state shall immediately notify the 3
Chairperson of the Interstate Commission in writing upon the 4
introduction of legislation repealing the Compact in the withdrawing 5
state. 6
(d) The Interstate Commission shall notify the other member 7
states of the withdrawing state’s intent to wit hdraw within 60 days 8
of its receipt of notice provided under subsection (c). 9
(e) The withdrawing state is responsible for all dues, obligations 10
and liabilities incurred through the effective date of the withdrawal, 11
including obligations, the performance of which extends beyond the 12
effective date of the withdrawal. 13
(f) Reinstatement following withdrawal of a member state shall 14
occur upon the withdrawing state reenacting the Compact or upon 15
such later date as determined by the Interstate Commission. 16
(g) The Interstate Commission is authorized to develop rules to 17
address the impact of the withdrawal of a member state on licenses 18
granted in other member states to physicians who designated the 19
withdrawing member state as the state of principal license. 20
21
ARTICLE 22. DISSOLUTION 22
23
(a) The Compact shall dissolve effective upon the date of the 24
withdrawal or default of the member state which reduces the 25
membership in the Compact to one member state. 26
(b) Upon the dissolution of the Compact, the Compact becomes 27
null and void and shall be of no further force or effect, and the 28
business and affairs of the Interstate Commission shall be concluded 29
and surplus funds shall be distributed in accordance with the bylaws. 30
31
ARTICLE 23. SEVERABILITY AND CONSTRUCTION 32
33
(a) The provisions of the Compact shall be severable, and if any 34
phrase, clause, sentence or provision is deemed unenforceable, the 35
remaining provisions of the Compact shall be enforceable. 36
(b) The provisions of the Compact shall be liberally construed to 37
effectuate its purposes. 38
(c) Nothing in the Compact shall be construed to prohibit the 39
applicability of other interstate compacts to which the states are 40
members. 41

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ARTICLE 24. BINDING EFFECT OF 1
COMPACT AND OTHER LAWS 2
3
(a) Nothing herein prevents the enforcement of any other law of 4
a member state that is not inconsistent with the Compact. 5
(b) All laws in a member state in conflict with the Compact are 6
superseded to the extent of the conflict. 7
(c) All lawful actions of the Interstate Commission, including all 8
rules and bylaws promulgated by the Commission, are binding upon 9
the member states. 10
(d) All agreements between the Interstate Commission and the 11
member states are binding in accordance with their terms. 12
(e) In the event any provision of the Compact exce eds the 13
constitutional limits imposed on the legislature of any member state, 14
such provisions shall be ineffective to the extent of the conflict with 15
the constitutional provision in question in that member state. 16
Sec. 3. Chapter 630 of NRS is hereby amended by adding 17
thereto the provisions set forth as sections 4 and 5 of this act. 18
Sec. 4. “PA Licensure Compact” means the PA Licensure 19
Compact ratified and entered into in section 1 of this act. 20
Sec. 5. 1. The Board shall perform all duties imposed on 21
this State by the PA Licensure Compact with respect to a physician 22
assistant who is licensed pursuant to this chapter. 23
2. The Board has jurisdiction over a physician assistant who 24
is practicing in this State under a compact privilege pursuant to 25
the PA Licensure Compact if the physician assistant: 26
(a) Is licensed by a professional licensing board o r other 27
governmental entity in another jurisdiction that licenses allopathic 28
physician assistants and does not license osteopathic physician 29
assistants; or 30
(b) Received his or her education as a physician assistant 31
primarily in allopathic techniques and is licensed by a 32
professional licensing board or other governmental entity in 33
another jurisdiction that licenses both allopathic and osteopathic 34
physician assistants. 35
Sec. 6. NRS 630.005 is hereby amended to read as follows: 36
630.005 As used in this chapter, unless the context otherwise 37
requires, the words and terms defined in NRS 630.007 to 630.026, 38
inclusive, and section 4 of this act have the meanings ascribed to 39
them in those sections. 40
Sec. 7. NRS 630.015 is hereby amended to read as follows: 41
630.015 “Physician assistant” means a person who is [a] : 42
1. A graduate of an academic program approved by the Board 43
or who, by general education, practical training and experience 44
determined to be satisfactory by the Board, is qualified to perform 45

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medical services under the supervision of a su pervising physician 1
and who has been issued a license by the Board [.] ; or 2
2. Practicing in this State under a compact privilege pursuant 3
to the PA Licensure Compact and is under the jurisdiction of the 4
Board pursuant to section 5 of this act. 5
Sec. 8. NRS 630.30665 is hereby amended to read as follows: 6
630.30665 1. The Board shall require each holder of a license 7
to practice medicine to submit to the Board, on a form provided by 8
the Board, a report stating t he number and type of surgeries 9
requiring conscious sedation, deep sedation or general anesthesia 10
performed by the holder of the license at his or her office or any 11
other facility, excluding any surgical care performed: 12
(a) At a medical facility as that term is defined in NRS 13
449.0151; or 14
(b) Outside of this State. 15
2. The Board shall require each holder of a license to practice 16
medicine to submit a report to the Board concerning the occurrence 17
of any sentinel event arising from any surgery described in 18
subsection 1 within 14 days after the occurrence of the sentinel 19
event. The report must be submitted in the manner prescribed by the 20
Board. 21
3. The Board shall: 22
(a) Collect and maintain reports received pursuant to subsections 23
1 and 2; and 24
(b) Ensure that the reports, and any additional documents 25
created from the reports, are protected adequately from fire, theft, 26
loss, destruction and other hazards, and from unauthorized access. 27
4. Except as otherwise provided in NRS 239.0115 [,] and 28
section 1 of this act, a report received pursuant to subsection 1 or 2 29
is confidential, not subject to subpoena or discovery, and not subject 30
to inspection by the general public. 31
5. The provisions of this section do not apply to surgical care 32
requiring only the administration of oral medication to a patient to 33
relieve the patient’s anxiety or pain, if the medication is not given in 34
a dosage that is sufficient to induce in a patient a controlled state of 35
depressed consciousness or unconsciousness similar to general 36
anesthesia, deep sedation or conscious sedation. 37
6. In addition to any othe r remedy or penalty, if a holder of a 38
license to practice medicine fails to submit a report or knowingly or 39
willfully files false information in a report submitted pursuant to this 40
section, the Board may, after providing the holder of a license to 41
practice medicine with notice and opportunity for a hearing, impose 42
against the holder of a license to practice medicine an administrative 43
penalty for each such violation. The Board shall establish by 44
regulation a sliding scale based on the severity of the violati on to 45

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determine the amount of the administrative penalty to be imposed 1
against the holder of the license pursuant to this subsection. The 2
regulations must include standards for determining the severity of 3
the violation and may provide for a more severe penalty for multiple 4
violations. 5
7. As used in this section: 6
(a) “Conscious sedation” has the meaning ascribed to it in 7
NRS 449.436. 8
(b) “Deep sedation” has the meaning ascribed to it in 9
NRS 449.437. 10
(c) “General anesthesia” has the meaning ascribed to it in 11
NRS 449.438. 12
(d) “Sentinel event” has the meaning ascribed to it in 13
NRS 439.830. 14
Sec. 9. NRS 630.336 is hereby amended to read as follows: 15
630.336 1. Any deliberations conducted or v ote taken by the 16
Board or any investigative committee of the Board regarding its 17
ordering of a physician, perfusionist, physician assistant, 18
anesthesiologist assistant or practitioner of respiratory care to 19
undergo a physical or mental examination or any o ther examination 20
designated to assist the Board or committee in determining the 21
fitness of a physician, perfusionist, physician assistant, 22
anesthesiologist assistant or practitioner of respiratory care are not 23
subject to the requirements of NRS 241.020. 24
2. Except as otherwise provided in subsection 3 or 4, all 25
applications for a license to practice medicine, perfusion or 26
respiratory care, any charges filed by the Board, financial records of 27
the Board, formal hearings on any charges heard by the Board or a 28
panel selected by the Board, records of such hearings and any order 29
or decision of the Board or panel must be open to the public. 30
3. Except as otherwise provided in NRS 239.0115 [,] and 31
section 1 of this act, the following may be kept confidential: 32
(a) Any statement, evidence, credential or other proof submitted 33
in support of or to verify the contents of an application; 34
(b) Any report concerning the fitness of any person to receive or 35
hold a license to practice medicine, perfusion or respiratory care; 36
and 37
(c) Any communication between: 38
(1) The Board and any of its committees or panels; and 39
(2) The Board or its staff, investigators, expert s, committees, 40
panels, hearing officers, advisory members or consultants and 41
counsel for the Board. 42
4. Except as otherwise provided in subsection 5 and NRS 43
239.0115 [,] and section 1 of this act, a complaint filed with the 44
Board pursuant to NRS 630.307, all documents and other 45

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information filed with the complaint and all documents and other 1
information compiled as a result of an investigation conducted to 2
determine whether to initiate disciplinary action are confidential. 3
5. The formal complaint or other document filed by the Board 4
to initiate disciplinary action and all documents and information 5
considered by the Board when determining whether to impose 6
discipline are public records. 7
6. The Board shall, to the extent feasible, communicate or 8
cooperate with or provide any documents or other information to 9
any other licensing board or agency or any agency which is 10
investigating a person, including a law enforcement agen cy. Such 11
cooperation may include, without limitation, providing the board or 12
agency with minutes of a closed meeting, transcripts of oral 13
examinations and the results of oral examinations. 14
Sec. 10. Chapter 632 of NRS is her eby amended by adding 15
thereto a new section to read as follows: 16
The Nurse Licensure Compact is hereby ratified and entered 17
into with all other jurisdictions legally joining the Compact, in the 18
form substantially as follows: 19
20
NURSE LICENSURE COMPACT 21
22
ARTICLE I. 23
24
FINDINGS AND DECLARATION OF PURPOSE 25
26
a. The party states find that: 27
1. The health and safety of the public are affected by the 28
degree of compliance with and the effectiveness of enforcement 29
activities related to state nurse licensure laws; 30
2. Violations of nurse licensure and other laws regulating 31
the practice of nursing may result in injury or harm to the public; 32
3. The expanded mobility of nurses and the use of 33
advanced communication technologies as part of our nation’s 34
health care del ivery system require greater coordination and 35
cooperation among states in the areas of nurse licensure and 36
regulation; 37
4. New practice modalities and technology make 38
compliance with individual state nurse licensure laws difficult and 39
complex; 40
5. The current system of duplicative licensure for nurses 41
practicing in multiple states is cumbersome and redundant for 42
both nurses and states; and 43
6. Uniformity of nurse licensure requirements throughout 44
the states promotes public safety and public health benefits. 45

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b. The general purposes of this Compact are to: 1
1. Facilitate the states’ responsibility to protect the 2
public’s health and safety; 3
2. Ensure and encourage the cooperation of party states in 4
the areas of nurse licensure and regulation; 5
3. Facilitate the exchange of information between party 6
states in the areas of nurse regulation, investigation and adverse 7
actions; 8
4. Promote compliance with the laws governing the 9
practice of nursing in each jurisdiction; 10
5. Invest all party states with the authority to hold a nurse 11
accountable for meeting all state practice laws in the state in 12
which the patient is located at the time care is rendered through 13
the mutual recognition of party state licenses; 14
6. Decrease redundancies in the consi deration and 15
issuance of nurse licenses; and 16
7. Provide opportunities for interstate practice by nurses 17
who meet uniform licensure requirements. 18
19
ARTICLE II. 20
21
DEFINITIONS 22
23
As used in this Compact: 24
a. “Adverse action” means any administrative, civil, equitable 25
or criminal action permitted by a state’s laws which is imposed by 26
a licensing board or other authority against a nurse, including 27
actions against an individual’s license or multistate licensure 28
privilege such as revocation, suspension, probation , monitoring of 29
the licensee, limitation on the licensee’s practice, or any other 30
encumbrance on licensure affecting a nurse’s authorization to 31
practice, including issuance of a cease and desist action. 32
b. “Alternative program” means a non -disciplinary 33
monitoring program approved by a licensing board. 34
c. “Coordinated licensure information system” means an 35
integrated process for collecting, storing and sharing information 36
on nurse licensure and enforcement activities related to nurse 37
licensure laws that is administered by a nonprofit organization 38
composed of and controlled by licensing boards. 39
d. “Current significant investigative information” means: 40
1. Investigative information that a licensing board, after a 41
preliminary inquiry that includes notifi cation and an opportunity 42
for the nurse to respond, if required by state law, has reason to 43
believe is not groundless and, if proved true, would indicate more 44
than a minor infraction; or 45

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2. Investigative information that indicates that the nurse 1
represents an immediate threat to public health and safety 2
regardless of whether the nurse has been notified and had an 3
opportunity to respond. 4
e. “Encumbrance” means a revocation or suspension of, or 5
any limitation on, the full and unrestricted practice of nur sing 6
imposed by a licensing board. 7
f. “Home state” means the party state which is the nurse’s 8
primary state of residence. 9
g. “Licensing board” means a party state’s regulatory body 10
responsible for issuing nurse licenses. 11
h. “Multistate license” means a license to practice as a 12
registered or a licensed practical/vocational nurse (LPN/VN) 13
issued by a home state licensing board that authorizes the licensed 14
nurse to practice in all party states under a multistate licensure 15
privilege. 16
i. “Multistate lice nsure privilege” means a legal 17
authorization associated with a multistate license permitting the 18
practice of nursing as either a registered nurse (RN) or LPN/VN 19
in a remote state. 20
j. “Nurse” means RN or LPN/VN, as those terms are defined 21
by each party state’s practice laws. 22
k. “Party state” means any state that has adopted this 23
Compact. 24
l. “Remote state” means a party state, other than the home 25
state. 26
m. “Single-state license” means a nurse license issued by a 27
party state that authorizes practice on ly within the issuing state 28
and does not include a multistate licensure privilege to practice in 29
any other party state. 30
n. “State” means a state, territory or possession of the United 31
States and the District of Columbia. 32
o. “State practice laws” means a party state’s laws, rules and 33
regulations that govern the practice of nursing, define the scope of 34
nursing practice, and create the methods and grounds for 35
imposing discipline. “State practice laws” do not include 36
requirements necessary to obtain and ret ain a license, except for 37
qualifications or requirements of the home state. 38
39
ARTICLE III. 40
41
GENERAL PROVISIONS AND JURISDICTION 42
43
a. A multistate license to practice registered or licensed 44
practical/vocational nursing issued by a home state to a resident in 45

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that state will be recognized by each party state as authorizing a 1
nurse to practice as a registered nurse (RN) or as a licensed 2
practical/vocational nurse (LPN/VN), under a multistate licensure 3
privilege, in each party state. 4
b. A state must implement procedures for considering the 5
criminal history records of applicants for initial multistate license 6
or licensure by endorsement. Such procedures shall include the 7
submission of fingerprints or other biometric -based information 8
by applicants for the purpo se of obtaining an applicant’s criminal 9
history record information from the Federal Bureau of 10
Investigation and the agency responsible for retaining that state’s 11
criminal records. 12
c. Each party state shall require the following for an 13
applicant to obtain or retain a multistate license in the home state: 14
1. Meets the home state’s qualifications for licensure or 15
renewal of licensure, as well as all other applicable state laws; 16
2. i. Has graduated or is eligible to graduate from a 17
licensing board-approved RN or LPN/VN prelicensure education 18
program; or 19
ii. Has graduated from a foreign RN or LPN/VN 20
prelicensure education program that (a) has been approved by the 21
authorized accrediting body in the applicable country and (b) has 22
been verified by an in dependent credentials review agency to be 23
comparable to a licensing board -approved prelicensure education 24
program; 25
3. Has, if a graduate of a foreign prelicensure education 26
program not taught in English or if English is not the individual’s 27
native langu age, successfully passed an English proficiency 28
examination that includes the components of reading, speaking, 29
writing and listening; 30
4. Has successfully passed an NCLEX -RN or NCLEX-PN 31
Examination or recognized predecessor, as applicable; 32
5. Is eligible for or holds an active, unencumbered license; 33
6. Has submitted, in connection with an application for 34
initial licensure or licensure by endorsement, fingerprints or other 35
biometric data for the purpose of obtaining criminal history record 36
information from the Federal Bureau of Investigation and the 37
agency responsible for retaining that state’s criminal records; 38
7. Has not been convicted or found guilty, or has entered 39
into an agreed disposition, of a felony offense under applicable 40
state or federal criminal law; 41
8. Has not been convicted or found guilty, or has entered 42
into an agreed disposition, of a misdemeanor offense related to the 43
practice of nursing as determined on a case-by-case basis; 44
9. Is not currently enrolled in an alternative program; 45

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10. Is subject to self -disclosure requirements regarding 1
current participation in an alternative program; and 2
11. Has a valid United States Social Security number. 3
d. All party states shall be authorized, in accordance with 4
existing state due process law, to take adverse action against a 5
nurse’s multistate licensure privilege such as revocation, 6
suspension, probation or any other action that affects a nurse’s 7
authorization to practice under a multistate licensure privilege, 8
including cease and desist actions. If a party state takes such 9
action, it shall promptly notify the administrator of the 10
coordinated licensure information system. The administrator of 11
the coordinated licensure information system shall promptly notify 12
the home state of any such actions by remote states. 13
e. A nurse practicing in a party state must comply with the 14
state practice laws of the state in which the client is located at the 15
time service is provided. The practice of nursing is not limited to 16
patient care, but shal l include all nursing practice as defined by 17
the state practice laws of the party state in which the client is 18
located. The practice of nursing in a party state under a multistate 19
licensure privilege will subject a nurse to the jurisdiction of the 20
licensing board, the courts and the laws of the party state in which 21
the client is located at the time service is provided. 22
f. Individuals not residing in a party state shall continue to be 23
able to apply for a party state’s single -state license as provided 24
under the laws of each party state. However, the single -state 25
license granted to these individuals will not be recognized as 26
granting the privilege to practice nursing in any other party state. 27
Nothing in this Compact shall affect the requirements established 28
by a party state for the issuance of a single-state license. 29
g. Any nurse holding a home state multistate license, on the 30
effective date of this Compact, may retain and renew the multistate 31
license issued by the nurse’s then -current home state, provided 32
that: 33
1. A nurse, who changes primary state of residence after 34
this Compact’s effective date, must meet all applicable Article 35
III.c. requirements to obtain a multistate license from a new home 36
state. 37
2. A nurse who fails to satisfy the multistate lic ensure 38
requirements in Article III.c. due to a disqualifying event 39
occurring after this Compact’s effective date shall be ineligible to 40
retain or renew a multistate license, and the nurse’s multistate 41
license shall be revoked or deactivated in accordance w ith 42
applicable rules adopted by the Interstate Commission of Nurse 43
Licensure Compact Administrators (“Commission”). 44

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ARTICLE IV. 1
2
APPLICATIONS FOR LICENSURE IN A PARTY STATE 3
4
a. Upon application for a multistate license, the licensing 5
board in the issuin g party state shall ascertain, through the 6
coordinated licensure information system, whether the applicant 7
has ever held, or is the holder of, a license issued by any other 8
state, whether there are any encumbrances on any license or 9
multistate licensure pr ivilege held by the applicant, whether any 10
adverse action has been taken against any license or multistate 11
licensure privilege held by the applicant and whether the applicant 12
is currently participating in an alternative program. 13
b. A nurse may hold a mul tistate license, issued by the home 14
state, in only one party state at a time. 15
c. If a nurse changes primary state of residence by moving 16
between two party states, the nurse must apply for licensure in the 17
new home state, and the multistate license issued by the prior 18
home state will be deactivated in accordance with applicable rules 19
adopted by the Commission. 20
1. The nurse may apply for licensure in advance of a 21
change in primary state of residence. 22
2. A multistate license shall not be issued by the new home 23
state until the nurse provides satisfactory evidence of a change in 24
primary state of residence to the new home state and satisfies all 25
applicable requirements to obtain a multistate license from the 26
new home state. 27
d. If a nurse changes primary state of residence by moving 28
from a party state to a non-party state, the multistate license issued 29
by the prior home state will convert to a single -state license, valid 30
only in the former home state. 31
32
ARTICLE V. 33
34
ADDITIONAL AUTHORITIES INVESTED IN 35
PARTY STATE LICENSING BOARDS 36
37
a. In addition to the other powers conferred by state law, a 38
licensing board shall have the authority to: 39
1. Take adverse action against a nurse’s multistate 40
licensure privilege to practice within that party state. 41
i. Only the home state shall have the power to take 42
adverse action against a nurse’s license issued by the home state. 43
ii. For purposes of taking adverse action, the home 44
state licensing board shall give the same priority and effect to 45

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reported conduct receive d from a remote state as it would if such 1
conduct had occurred within the home state. In so doing, the 2
home state shall apply its own state laws to determine appropriate 3
action. 4
2. Issue cease and desist orders or impose an 5
encumbrance on a nurse’s auth ority to practice within that party 6
state. 7
3. Complete any pending investigations of a nurse who 8
changes primary state of residence during the course of such 9
investigations. The licensing board shall also have the authority to 10
take appropriate action(s) and shall promptly report the 11
conclusions of such investigations to the administrator of the 12
coordinated licensure information system. The administrator of 13
the coordinated licensure information system shall promptly notify 14
the new home state of any such actions. 15
4. Issue subpoenas for both hearings and investigations 16
that require the attendance and testimony of witnesses, as well as 17
the production of evidence. Subpoenas issued by a licensing board 18
in a party state for the attendance and testimony of wit nesses or 19
the production of evidence from another party state shall be 20
enforced in the latter state by any court of competent jurisdiction, 21
according to the practice and procedure of that court applicable to 22
subpoenas issued in proceedings pending before i t. The issuing 23
authority shall pay any witness fees, travel expenses, mileage and 24
other fees required by the service statutes of the state in which the 25
witnesses or evidence are located. 26
5. Obtain and submit, for each nurse licensure applicant, 27
fingerprint or other biometric -based information to the Federal 28
Bureau of Investigation for criminal background checks, receive 29
the results of the Federal Bureau of Investigation record search 30
on criminal background checks and use the results in making 31
licensure decisions. 32
6. If otherwise permitted by state law, recover from the 33
affected nurse the costs of investigations and disposition of cases 34
resulting from any adverse action taken against that nurse. 35
7. Take adverse action based on the factual findings of the 36
remote state, provided that the licensing board follows its own 37
procedures for taking such adverse action. 38
b. If adverse action is taken by the home state against a 39
nurse’s multistate license, the nurse’s multistate licensure 40
privilege to practice i n all other party states shall be deactivated 41
until all encumbrances have been removed from the multistate 42
license. All home state disciplinary orders that impose adverse 43
action against a nurse’s multistate license shall include a 44

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statement that the nurse’ s multistate licensure privilege is 1
deactivated in all party states during the pendency of the order. 2
c. Nothing in this Compact shall override a party state’s 3
decision that participation in an alternative program may be used 4
in lieu of adverse action. T he home state licensing board shall 5
deactivate the multistate licensure privilege under the multistate 6
license of any nurse for the duration of the nurse’s participation 7
in an alternative program. 8
9
ARTICLE VI. 10
11
COORDINATED LICENSURE INFORMATION SYSTEM 12
AND EXCHANGE OF INFORMATION 13
14
a. All party states shall participate in a coordinated licensure 15
information system of all licensed registered nurses (RNs) and 16
licensed practical/vocational nurses (LPNs/VNs). This system will 17
include information on the licensu re and disciplinary history of 18
each nurse, as submitted by party states, to assist in the 19
coordination of nurse licensure and enforcement efforts. 20
b. The Commission, in consultation with the administrator of 21
the coordinated licensure information system, shall formulate 22
necessary and proper procedures for the identification, collection 23
and exchange of information under this Compact. 24
c. All licensing boards shall promptly report to the 25
coordinated licensure information system any adverse action, any 26
current significant investigative information, denials of 27
applications (with the reasons for such denials) and nurse 28
participation in alternative programs known to the licensing board 29
regardless of whether such participation is deemed nonpublic or 30
confidential under state law. 31
d. Current significant investigative information and 32
participation in nonpublic or confidential alternative programs 33
shall be transmitted through the coordinated licensure 34
information system only to party state licensing boards. 35
e. Notwithstanding any other provision of law, all party state 36
licensing boards contributing information to the coordinated 37
licensure information system may designate information that may 38
not be shared with non-party states or disclosed to other entities or 39
individuals without the express permission of the contributing 40
state. 41
f. Any personally identifiable information obtained from the 42
coordinated licensure information system by a party state licensing 43
board shall not be shared with non -party states or disclose d to 44

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other entities or individuals except to the extent permitted by the 1
laws of the party state contributing the information. 2
g. Any information contributed to the coordinated licensure 3
information system that is subsequently required to be expunged 4
by the laws of the party state contributing that information shall 5
also be expunged from the coordinated licensure information 6
system. 7
h. The Compact administrator of each party state shall 8
furnish a uniform data set to the Compact administrator of each 9
other party state, which shall include, at a minimum: 10
1. Identifying information; 11
2. Licensure data; 12
3. Information related to alternative program 13
participation; and 14
4. Other information that may facilitate the administration 15
of this Compact, as determined by Commission rules. 16
i. The Compact administrator of a party state shall provide all 17
investigative documents and information requested by another 18
party state. 19
20
ARTICLE VII. 21
22
ESTABLISHMENT OF THE INTERSTATE COMMISSION 23
OF NURSE LICENSURE COMPACT ADMINISTRATORS 24
25
a. The party states hereby create and establish a joint public 26
entity known as the Interstate Commission of Nurse Licensure 27
Compact Administrators. 28
1. The Commission is an instrumentality of the party 29
states. 30
2. Venue is proper, and judicial proceedings by or against 31
the Commission shall be brought solely and exclusively, in a court 32
of competent jurisdiction where the principal office of the 33
Commission is located. The Commission may waive venue and 34
jurisdictional defenses to the extent it adopts or consents to 35
participate in alternative dispute resolution proceedings. 36
3. Nothing in this Compact shall be construed to be a 37
waiver of sovereign immunity. 38
b. Membership, Voting and Meetings 39
1. Each party state shall have and be limited to one 40
administrator. The head of the state licensing board or designee 41
shall be the administrator of this Compact for each party state. 42
Any administrator may be removed or suspended from office as 43
provided by the law of the state from which th e Administrator is 44
appointed. Any vacancy occurring in the Commission shall be 45

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filled in accordance with the laws of the party state in which the 1
vacancy exists. 2
2. Each administrator shall be entitled to one (1) vote with 3
regard to the promulgation of rules and creation of bylaws and 4
shall otherwise have an opportunity to participate in the business 5
and affairs of the Commission. An administrator shall vote in 6
person or by such other means as provided in the bylaws. The 7
bylaws may provide for an adminis trator’s participation in 8
meetings by telephone or other means of communication. 9
3. The Commission shall meet at least once during each 10
calendar year. Additional meetings shall be held as set forth in the 11
bylaws or rules of the commission. 12
4. All mee tings shall be open to the public, and public 13
notice of meetings shall be given in the same manner as required 14
under the rulemaking provisions in Article VIII. 15
5. The Commission may convene in a closed, nonpublic 16
meeting if the Commission must discuss: 17
i. Noncompliance of a party state with its obligations 18
under this Compact; 19
ii. The employment, compensation, discipline or other 20
personnel matters, practices or procedures related to specific 21
employees or other matters related to the Commission’s i nternal 22
personnel practices and procedures; 23
iii. Current, threatened or reasonably anticipated 24
litigation; 25
iv. Negotiation of contracts for the purchase or sale of 26
goods, services or real estate; 27
v. Accusing any person of a crime or formally 28
censuring any person; 29
vi. Disclosure of trade secrets or commercial or 30
financial information that is privileged or confidential; 31
vii. Disclosure of information of a personal nature 32
where disclosure would constitute a clearly unwarranted invasion 33
of personal privacy; 34
viii. Disclosure of investigatory records compiled for 35
law enforcement purposes; 36
ix. Disclosure of information related to any reports 37
prepared by or on behalf of the Commission for the purpose of 38
investigation of compliance with this Compact; or 39
x. Matters specifically exempted from disclosure by 40
federal or state statute. 41
6. If a meeting, or portion of a meeting, is closed pursuant 42
to this provision, the Commission’s legal counsel or designee shall 43
certify that the meeting ma y be closed and shall reference each 44
relevant exempting provision. The Commission shall keep minutes 45

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that fully and clearly describe all matters discussed in a meeting 1
and shall provide a full and accurate summary of actions taken, 2
and the reasons therefor , including a description of the views 3
expressed. All documents considered in connection with an action 4
shall be identified in such minutes. All minutes and documents of 5
a closed meeting shall remain under seal, subject to release by a 6
majority vote of the Commission or order of a court of competent 7
jurisdiction. 8
c. The Commission shall, by a majority vote of the 9
administrators, prescribe bylaws or rules to govern its conduct as 10
may be necessary or appropriate to carry out the purposes and 11
exercise the powers of this Compact, including but not limited to: 12
1. Establishing the fiscal year of the Commission; 13
2. Providing reasonable standards and procedures: 14
i. For the establishment and meetings of other 15
committees; and 16
ii. Governing any general or specific delegation of any 17
authority or function of the Commission; 18
3. Providing reasonable procedures for calling and 19
conducting meetings of the Commission, ensuring reasonable 20
advance notice of all meetings and providing an opportunity for 21
attendance of such meetings by interested parties, with 22
enumerated exceptions designed to protect the public’s interest, 23
the privacy of individuals, and proprietary information, including 24
trade secrets. The Commission may meet in closed session only 25
after a majority of the administrators vote to close a meeting in 26
whole or in part. As soon as practicable, the Commission must 27
make public a copy of the vote to close the meeting revealing the 28
vote of each administrator, with no proxy votes allowed; 29
4. Establishing the titles, duties and authority and 30
reasonable procedures for the election of the officers of the 31
Commission; 32
5. Providing reasonable standards and procedures for the 33
establishment of the personnel policies and programs of the 34
Commission. Notwi thstanding any civil service or other similar 35
laws of any party state, the bylaws shall exclusively govern the 36
personnel policies and programs of the Commission; and 37
6. Providing a mechanism for winding up the operations 38
of the Commission and the equita ble disposition of any surplus 39
funds that may exist after the termination of this Compact after 40
the payment or reserving of all of its debts and obligations; 41
d. The Commission shall publish its bylaws and rules, and 42
any amendments thereto, in a convenien t form on the website of 43
the Commission. 44

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e. The Commission shall maintain its financial records in 1
accordance with the bylaws. 2
f. The Commission shall meet and take such actions as are 3
consistent with the provisions of this Compact and the bylaws. 4
g. The Commission shall have the following powers: 5
1. To promulgate uniform rules to facilitate and 6
coordinate implementation and administration of this Compact. 7
The rules shall have the force and effect of law and shall be 8
binding in all party states; 9
2. To bring and prosecute legal proceedings or actions in 10
the name of the Commission, provided that the standing of any 11
licensing board to sue or be sued under applicable law shall not be 12
affected; 13
3. To purchase and maintain insurance and bonds; 14
4. To borrow, accept or contract for services of personnel, 15
including, but not limited to, employees of a party state or 16
nonprofit organizations; 17
5. To cooperate with other organizations that administer 18
state compacts related to the regulation of nursing, including but 19
not limited to sharing administrative or staff expenses, office space 20
or other resources; 21
6. To hire employees, elect or appoint officers, fix 22
compensation, define duties, grant such individuals appropriate 23
authority to carry out the purp oses of this Compact, and to 24
establish the Commission’s personnel policies and programs 25
relating to conflicts of interest, qualifications of personnel and 26
other related personnel matters; 27
7. To accept any and all appropriate donations, grants and 28
gifts of money, equipment, supplies, materials and services, and to 29
receive, utilize and dispose of the same; provided that at all times 30
the Commission shall avoid any appearance of impropriety or 31
conflict of interest; 32
8. To lease, purchase, accept appropriat e gifts or 33
donations of, or otherwise to own, hold, improve or use, any 34
property, whether real, personal or mixed; provided that at all 35
times the Commission shall avoid any appearance of impropriety; 36
9. To sell, convey, mortgage, pledge, lease, exchange , 37
abandon or otherwise dispose of any property, whether real, 38
personal or mixed; 39
10. To establish a budget and make expenditures; 40
11. To borrow money; 41
12. To appoint committees, including advisory committees 42
comprised of administrators, state nurs ing regulators, state 43
legislators or their representatives, and consumer representatives, 44
and other such interested persons; 45

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13. To provide and receive information from, and to 1
cooperate with, law enforcement agencies; 2
14. To adopt and use an official seal; and 3
15. To perform such other functions as may be necessary 4
or appropriate to achieve the purposes of this Compact consistent 5
with the state regulation of nurse licensure and practice. 6
h. Financing of the Commission 7
1. The Commission shall pay, or provide for the payment 8
of, the reasonable expenses of its establishment, organization and 9
ongoing activities. 10
2. The Commission may also levy on and collect an 11
annual assessment from each party state to cover the cost of its 12
operations, activi ties and staff in its annual budget as approved 13
each year. The aggregate annual assessment amount, if any, shall 14
be allocated based upon a formula to be determined by the 15
Commission, which shall promulgate a rule that is binding upon 16
all party states. 17
3. The Commission shall not incur obligations of any kind 18
prior to securing the funds adequate to meet the same; nor shall 19
the Commission pledge the credit of any of the party states, except 20
by, and with the authority of, such party state. 21
4. The Commiss ion shall keep accurate accounts of all 22
receipts and disbursements. The receipts and disbursements of the 23
Commission shall be subject to the audit and accounting 24
procedures established under its bylaws. However, all receipts and 25
disbursements of funds hand led by the Commission shall be 26
audited yearly by a certified or licensed public accountant, and the 27
report of the audit shall be included in and become part of the 28
annual report of the Commission. 29
i. Qualified Immunity, Defense and Indemnification 30
1. The administrators, officers, executive director, 31
employees and representatives of the Commission shall be immune 32
from suit and liability, either personally or in their official 33
capacity, for any claim for damage to or loss of property or 34
personal injury or other civil liability caused by or arising out of 35
any actual or alleged act, error or omission that occurred, or that 36
the person against whom the claim is made had a reasonable basis 37
for believing occurred, within the scope of Commission 38
employment, duties or responsibilities; provided that nothing in 39
this paragraph shall be construed to protect any such person from 40
suit or liability for any damage, loss, injury or liability caused by 41
the intentional, willful or wanton misconduct of that person. 42
2. The Commission shall defend any administrator, 43
officer, executive director, employee or representative of the 44
Commission in any civil action seeking to impose liability arising 45

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out of any actual or alleged act, error or omission that occurred 1
within the s cope of Commission employment, duties or 2
responsibilities, or that the person against whom the claim is made 3
had a reasonable basis for believing occurred within the scope of 4
Commission employment, duties or responsibilities; provided that 5
nothing herein s hall be construed to prohibit that person from 6
retaining his or her own counsel; and provided further that the 7
actual or alleged act, error or omission did not result from that 8
person’s intentional, willful or wanton misconduct. 9
3. The Commission shall indemnify and hold harmless 10
any administrator, officer, executive director, employee or 11
representative of the Commission for the amount of any settlement 12
or judgment obtained against that person arising out of any actual 13
or alleged act, error or omission t hat occurred within the scope of 14
Commission employment, duties or responsibilities, or that such 15
person had a reasonable basis for believing occurred within the 16
scope of Commission employment, duties or responsibilities, 17
provided that the actual or alleged act, error or omission did not 18
result from the intentional, willful or wanton misconduct of that 19
person. 20
21
ARTICLE VIII. 22
23
RULEMAKING 24
25
a. The Commission shall exercise its rulemaking powers 26
pursuant to the criteria set forth in this Article and the rules 27
adopted thereunder. Rules and amendments shall become binding 28
as of the date specified in each rule or amendment and shall have 29
the same force and effect as provisions of this Compact. 30
b. Rules or amendments to the rules shall be adopted at a 31
regular or special meeting of the Commission. 32
c. Prior to promulgation and adoption of a final rule or rules 33
by the Commission, and at least sixty (60) days in advance of the 34
meeting at which the rule will be considered and voted upon, the 35
Commission shall file a notice of proposed rulemaking: 36
1. On the website of the Commission; and 37
2. On the website of each licensing board or the 38
publication in which each state would otherwise publish proposed 39
rules. 40
d. The notice of proposed rulemaking shall include: 41
1. The proposed time, date and location of the meeting in 42
which the rule will be considered and voted upon; 43
2. The text of the proposed rule or amendment, and the 44
reason for the proposed rule; 45

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3. A request for comments on the proposed rule from any 1
interested person; and 2
4. The manner in which interested persons may submit 3
notice to the Commission of their intention to attend the public 4
hearing and any written comments. 5
e. Prior to adoption of a proposed rule, the Commission shall 6
allow persons to submit written data, facts, opinions and 7
arguments, which shall be made available to the public. 8
f. The Commission shall grant an opportunity for a public 9
hearing before it adopts a rule or amendment. 10
g. The Commission shall publish the place, time and date of 11
the scheduled public hearing. 12
1. Hearings shall be conducted in a manner providing 13
each person who wishes to comment a fair and reasonable 14
opportunity to comment orally or in writing. All hearings will be 15
recorded, and a copy will be made available upon request. 16
2. Nothing in this section shall be construed as requiring a 17
separate hearing on each rule. Rules may be grouped for the 18
convenience of the Commission at hearings required by this 19
section. 20
h. If no one appears at the public heari ng, the Commission 21
may proceed with promulgation of the proposed rule. 22
i. Following the scheduled hearing date, or by the close of 23
business on the scheduled hearing date if the hearing was not 24
held, the Commission shall consider all written and oral comments 25
received. 26
j. The Commission shall, by majority vote of all 27
administrators, take final action on the proposed rule and shall 28
determine the effective date of the rule, if any, based on the 29
rulemaking record and the full text of the rule. 30
k. Upon det ermination that an emergency exists, the 31
Commission may consider and adopt an emergency rule without 32
prior notice, opportunity for comment or hearing, provided that 33
the usual rulemaking procedures provided in this Compact and in 34
this section shall be retro actively applied to the rule as soon as 35
reasonably possible, in no event later than ninety (90) days after 36
the effective date of the rule. For the purposes of this provision, an 37
emergency rule is one that must be adopted immediately in order 38
to: 39
1. Meet an imminent threat to public health, safety or 40
welfare; 41
2. Prevent a loss of Commission or party state funds; or 42
3. Meet a deadline for the promulgation of an 43
administrative rule that is required by federal law or rule. 44

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l. The Commission may direct revisions to a previously 1
adopted rule or amendment for purposes of correcting 2
typographical errors, errors in format, errors in consistency or 3
grammatical errors. Public notice of any revisions shall be posted 4
on the website of the Commission. The revision shall be subject to 5
challenge by any person for a period of thirty (30) days after 6
posting. The revision may be challenged only on grounds that the 7
revision results in a material change to a rule. A challenge shall 8
be made in writing, and delivere d to the Commission, prior to the 9
end of the notice period. If no challenge is made, the revision will 10
take effect without further action. If the revision is challenged, the 11
revision may not take effect without the approval of the 12
Commission. 13
14
ARTICLE IX. 15
16
OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT 17
18
a. Oversight 19
1. Each party state shall enforce this Compact and take all 20
actions necessary and appropriate to effectuate this Compact’s 21
purposes and intent. 22
2. The Commission shall be entitled to rece ive service of 23
process in any proceeding that may affect the powers, 24
responsibilities or actions of the Commission, and shall have 25
standing to intervene in such a proceeding for all purposes. 26
Failure to provide service of process in such proceeding to the 27
Commission shall render a judgment or order void as to the 28
Commission, this Compact or promulgated rules. 29
b. Default, Technical Assistance and Termination 30
1. If the Commission determines that a party state has 31
defaulted in the performance of its oblig ations or responsibilities 32
under this Compact or the promulgated rules, the Commission 33
shall: 34
i. Provide written notice to the defaulting state and 35
other party states of the nature of the default, the proposed means 36
of curing the default or any other a ction to be taken by the 37
Commission; and 38
ii. Provide remedial training and specific technical 39
assistance regarding the default. 40
2. If a state in default fails to cure the default, the 41
defaulting state’s membership in this Compact may be terminated 42
upon an affirmative vote of a majority of the administrators, and 43
all rights, privileges and benefits conferred by this Compact may 44
be terminated on the effective date of termination. A cure of the 45

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default does not relieve the offending state of obligations or 1
liabilities incurred during the period of default. 2
3. Termination of membership in this Compact shall be 3
imposed only after all other means of securing compliance have 4
been exhausted. Notice of intent to suspend or terminate shall be 5
given by the Co mmission to the governor of the defaulting state 6
and to the executive officer of the defaulting state’s licensing 7
board and each of the party states. 8
4. A state whose membership in this Compact has been 9
terminated is responsible for all assessments, obl igations and 10
liabilities incurred through the effective date of termination, 11
including obligations that extend beyond the effective date of 12
termination. 13
5. The Commission shall not bear any costs related to a 14
state that is found to be in default or whos e membership in this 15
Compact has been terminated unless agreed upon in writing 16
between the Commission and the defaulting state. 17
6. The defaulting state may appeal the action of the 18
Commission by petitioning the U.S. District Court for the District 19
of Columbia or the federal district in which the Commission has 20
its principal offices. The prevailing party shall be awarded all 21
costs of such litigation, including reasonable attorneys’ fees. 22
c. Dispute Resolution 23
1. Upon request by a party state, the Com mission shall 24
attempt to resolve disputes related to the Compact that arise 25
among party states and between party and non-party states. 26
2. The Commission shall promulgate a rule providing for 27
both mediation and binding dispute resolution for disputes, as 28
appropriate. 29
3. In the event the Commission cannot resolve disputes 30
among party states arising under this Compact: 31
i. The party states may submit the issues in dispute to 32
an arbitration panel, which will be comprised of individuals 33
appointed by the Compact administrator in each of the affected 34
party states and an individual mutually agreed upon by the 35
Compact administrators of all the party states involved in the 36
dispute. 37
ii. The decision of a majority of the arbitrators shall be 38
final and binding. 39
d. Enforcement 40
1. The Commission, in the reasonable exercise of its 41
discretion, shall enforce the provisions and rules of this Compact. 42
2. By majority vote, the Commission may initiate legal 43
action in the U.S. District Court for the District of Columbia or the 44
federal district in which the Commission has its principal offices 45

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against a party state that is in default to enforce compliance with 1
the provisions of this Compact and its promulgated rules and 2
bylaws. The relief sought may include both injunctive relief and 3
damages. In the event judicial enforcement is necessary, the 4
prevailing party shall be awarded all costs of such litigation, 5
including reasonable attorneys’ fees. 6
3. The remedies herein shall not be the exclusive remedies 7
of the Co mmission. The Commission may pursue any other 8
remedies available under federal or state law. 9
10
ARTICLE X. 11
12
EFFECTIVE DATE, WITHDRAWAL AND AMENDMENT 13
14
a. This Compact shall become effective and binding on the 15
earlier of the date of legislative enactment of this Compact into 16
law by no less than twenty -six (26) states or December 31, 2018. 17
All party states to this Compact, that also were parties to the prior 18
Nurse Licensure Compact, superseded by this Compact, ( “Prior 19
Compact”), shall be deemed to have withdra wn from said Prior 20
Compact within six (6) months after the effective date of this 21
Compact. 22
b. Each party state to this Compact shall continue to 23
recognize a nurse’s multistate licensure privilege to practice in 24
that party state issued under the Prior Com pact until such party 25
state has withdrawn from the Prior Compact. 26
c. Any party state may withdraw from this Compact by 27
enacting a statute repealing the same. A party state’s withdrawal 28
shall not take effect until six (6) months after enactment of the 29
repealing statute. 30
d. A party state’s withdrawal or termination shall not affect 31
the continuing requirement of the withdrawing or terminated 32
state’s licensing board to report adverse actions and significant 33
investigations occurring prior to the effective da te of such 34
withdrawal or termination. 35
e. Nothing contained in this Compact shall be construed to 36
invalidate or prevent any nurse licensure agreement or other 37
cooperative arrangement between a party state and a non -party 38
state that is made in accordance w ith the other provisions of this 39
Compact. 40
f. This Compact may be amended by the party states. No 41
amendment to this Compact shall become effective and binding 42
upon the party states unless and until it is enacted into the laws of 43
all party states. 44

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g. Representatives of non -party states to this Compact shall 1
be invited to participate in the activities of the Commission, on a 2
nonvoting basis, prior to the adoption of this Compact by all states. 3
4
ARTICLE XI. 5
6
CONSTRUCTION AND SEVERABILITY 7
8
This Compact shal l be liberally construed so as to effectuate 9
the purposes thereof. The provisions of this Compact shall be 10
severable, and if any phrase, clause, sentence or provision of this 11
Compact is declared to be contrary to the constitution of any party 12
state or of t he United States, or if the applicability thereof to any 13
government, agency, person or circumstance is held invalid, the 14
validity of the remainder of this Compact and the applicability 15
thereof to any government, agency, person or circumstance shall 16
not be affected thereby. If this Compact shall be held to be 17
contrary to the constitution of any party state, this Compact shall 18
remain in full force and effect as to the remaining party states and 19
in full force and effect as to the party state affected as to all 20
severable matters. 21
Sec. 11. NRS 632.307 is hereby amended to read as follows: 22
632.307 1. The Board may place any condition, limitation or 23
restriction on any license or certificate issued pursuant to this 24
chapter if the Board determines that such action is necessary to 25
protect the public health, safety or welfare. 26
2. [The] Except as otherwise provided in section 10 of this 27
act, the Board shall not report any condition, limitation or restriction 28
placed on a license or certificate issued pursuant to this section to 29
the National Council of State Boards of Nursing D isciplinary Data 30
Bank or any other repository which records disciplinary action taken 31
against licensees or holders of certificates, unless the licensee or 32
holder of the certificate fails to comply with the condition, limitation 33
or restriction placed on the license or certificate. The Board may, 34
upon request, report any such information to an agency of another 35
state which regulates the practice of nursing. 36
3. The Board may modify any condition, limitation or 37
restriction placed on a license or certificate i ssued pursuant to this 38
section if the Board determines it is necessary to protect the public 39
health, safety or welfare. 40
4. Any condition, limitation or restriction placed on a license or 41
certificate issued pursuant to this section shall not be deemed to be 42
disciplinary action taken pursuant to NRS 632.349. 43

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Sec. 12. NRS 632.405 is hereby amended to read as follows: 1
632.405 1. Except as otherwise provided in this section and 2
NRS 239.0115 [,] and section 10 of this act, any records or 3
information obtained during the course of an investigation by the 4
Board and any record of the investigation are confidential. 5
2. The complaint or other document filed by the Board to 6
initiate disciplinary action and all documents and information 7
considered by the Board when determining whether to impose 8
disciplinary action are public records. 9
3. The Board shall, to the extent feasible , communicate or 10
cooperate with or provide any documents or other information to 11
another licensing board or any agency that is investigating a person, 12
including a law enforcement agency. 13
Sec. 13. Chapter 633 of NRS is hereb y amended by adding 14
thereto the provisions set forth as sections 14 and 15 of this act. 15
Sec. 14. “PA Licensure Compact” means the PA Licensure 16
Compact ratified and entered into in section 1 of this act. 17
Sec. 15. 1. The Board shall perform all duties imposed on 18
this State by the PA Licensure Compact with respect to a physician 19
assistant who is licensed pursuant to this chapter. 20
2. The Board has jurisdiction over a physician assistant who 21
is practicing in this State under a compact privilege pursuant to 22
the PA Licensure Compact if the physician assistant: 23
(a) Is licensed by a professional licensing board or other 24
governmental entity in another jurisdiction that licenses 25
osteopathic physician assistants and does not license allopathic 26
physician assistants; or 27
(b) Received his or her education as a physician assistant 28
primarily in osteopathic techniques and is licensed by a 29
professional licensing board or other governmental entity in 30
another jurisdiction that licenses both allopathic and osteopathic 31
physician assistants. 32
Sec. 16. NRS 633.011 is hereby amended to read as follows: 33
633.011 As used in this chapter, unless the context otherwise 34
requires, the words and terms defined in NRS 633.013 to 633.131, 35
inclusive, and section 14 of this act have the meanings as cribed to 36
them in those sections. 37
Sec. 17. NRS 633.107 is hereby amended to read as follows: 38
633.107 “Physician assistant” means a person who is [a] : 39
1. A graduate of an academic program approved by the Board 40
or who, by general education, practical training and experience 41
determined to be satisfactory by the Board, is qualified to perform 42
medical services under the supervision of a supervising osteopathic 43
physician and who has been issued a license by the Board [.] ; or 44

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2. Practicing in this State under a compact privilege pursuant 1
to the PA Licensure Compact and is under the jurisdiction of the 2
Board pursuant to section 15 of this act. 3
Sec. 18. NRS 633.301 is hereby amended to read as follows: 4
633.301 1. The Board shall keep a record of its proceedings 5
relating to licensing and disciplinary actions. Except as otherwise 6
provided in this section, the record must be open to public 7
inspection at all reasonable times and contain the name, known 8
place of business and residence, and the date and number of the 9
license of every osteopathic physician, physician assistant and 10
anesthesiologist assistant licensed under this chapter. 11
2. Except as otherwise provided in this section and NRS 12
239.0115 [,] and section 1 of this act, a complaint filed with the 13
Board, all documents and other information filed with the complaint 14
and all documents and other information compiled as a result of an 15
investigation conducted to determine whether to initiate disciplinary 16
action against a person are confidential, unless the person submits a 17
written statement to the Board requesting that such documents and 18
information be made public records. 19
3. The charging documents filed with the Board to initiate 20
disciplinary action pursuant to chapter 622A of NRS and all other 21
documents and information considere d by the Board when 22
determining whether to impose discipline are public records. 23
4. The Board shall, to the extent feasible, communicate or 24
cooperate with or provide any documents or other information to 25
any other licensing board or any other agency that is investigating a 26
person, including, without limitation, a law enforcement agency. 27
Sec. 19. NRS 633.442 is hereby amended to read as follows: 28
633.442 1. A physician assistant shall: 29
(a) Keep his or her license or proof that he or she is authorized 30
to practice in this State under the PA Licensure Compact, as 31
applicable, available for inspection at his or her primary place of 32
business; and 33
(b) When engaged in professional duties, identify himself or 34
herself as a physician assistant. 35
2. A physician assistant shall not bill a patient separately from 36
his or her supervising osteopathic physician. 37
Sec. 20. NRS 633.524 is hereby amended to read as follows: 38
633.524 1. The Board shall require each holder of a license to 39
practice osteopathic medicine issued pursuant to this chapter to 40
submit to the Board, on a form provided by the Board, and in the 41
format required by the Board by regulation, a report stating t he 42
number and type of surg eries requiring conscious sedation, deep 43
sedation or general anesthesia performed by the holder of the license 44

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at his or her office or any other facility, excluding any surgical care 1
performed: 2
(a) At a medical facility as that term is defined in NRS 3
449.0151; or 4
(b) Outside of this State. 5
2. In addition to the report required pursuant to subsection 1, 6
the Board shall require each holder of a license to practice 7
osteopathic medicine to submit a report to the Board concerning the 8
occurrence of any sentinel event arising from any surgery described 9
in subsection 1. The report must be submitted in the manner 10
prescribed by the Board which must be substantially similar to the 11
manner prescribed by the State Board of Health for reporting 12
information pursuant to NRS 439.835. 13
3. Each holder of a license to practice osteopathic medicine 14
shall submit the reports required pursuant to subsections 1 and 2: 15
(a) At the time the holder of the license renews his or her 16
license; and 17
(b) Whether or not the hol der of the license performed any 18
surgery described in subsection 1. Failure to submit a report or 19
knowingly or willfully filing false information in a report constitutes 20
grounds for initiating disciplinary action pursuant to NRS 633.511. 21
4. In addition t o the reports required pursuant to subsections 1 22
and 2, the Board shall require each holder of a license to practice 23
osteopathic medicine to submit a report to the Board concerning the 24
occurrence of any sentinel event arising from any surgery described 25
in subsection 1 within 14 days after the occurrence of the sentinel 26
event. The report must be submitted in the manner prescribed by the 27
Board. 28
5. The Board shall: 29
(a) Collect and maintain reports received pursuant to subsections 30
1, 2 and 4; 31
(b) Ensure tha t the reports, and any additional documents 32
created from the reports, are protected adequately from fire, theft, 33
loss, destruction and other hazards, and from unauthorized access; 34
and 35
(c) Submit to the Division of Public and Behavioral Health a 36
copy of the report submitted pursuant to subsection 1. The Division 37
shall maintain the confidentiality of such reports in accordance with 38
subsection 6. 39
6. Except as otherwise provided in NRS 239.0115 [,] and 40
section 1 of this act, a report received pursuant to subsection 1, 2 or 41
4 is confidential, not subject to subpoena or discovery, and not 42
subject to inspection by the general public. 43
7. The provisions of this s ection do not apply to surgical care 44
requiring only the administration of oral medication to a patient to 45

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relieve the patient’s anxiety or pain, if the medication is not given in 1
a dosage that is sufficient to induce in a patient a controlled state of 2
depressed consciousness or unconsciousness similar to general 3
anesthesia, deep sedation or conscious sedation. 4
8. In addition to any other remedy or penalty, if a holder of a 5
license to practice osteopathic medicine fails to submit a report or 6
knowingly or w illfully files false information in a report submitted 7
pursuant to this section, the Board may, after providing the holder of 8
a license to practice osteopathic medicine with notice and 9
opportunity for a hearing, impose against the holder of a license an 10
administrative penalty for each such violation. The Board shall 11
establish by regulation a sliding scale based on the severity of the 12
violation to determine the amount of the administrative penalty to be 13
imposed against the holder of the license to practice o steopathic 14
medicine. The regulations must include standards for determining 15
the severity of the violation and may provide for a more severe 16
penalty for multiple violations. 17
9. As used in this section: 18
(a) “Conscious sedation” has the meaning ascribed to it in 19
NRS 449.436. 20
(b) “Deep sedation” has the meaning ascribed to it in 21
NRS 449.437. 22
(c) “General anesthesia” has the meaning ascribed to it in 23
NRS 449.438. 24
(d) “Sentinel event” has the meaning ascribed to it in 25
NRS 439.830. 26
Sec. 21. Chapter 637B of NRS is hereby amended by adding 27
thereto a new section to read as follows: 28
The Audiology and Speech -Language Pathology Interstate 29
Compact is hereby ratified and entered into with all other 30
jurisdictions legally joining the Compact, in substantially the form 31
set forth in this section: 32
33
AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY 34
INTERSTATE COMPACT 35
36
SECTION 1. PURPOSE 37
38
The purpose of this Compact is to facilitate interstate practice 39
of audiology and speech -language pathology with the goal of 40
improving public access to audiology and speech -language 41
pathology services. The practice of audiology and speech -42
language patholog y occurs in the state where the 43
patient/client/student is located at the time of the 44
patient/client/student encounter. The Compact preserves 45

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the regulatory authority of states to protect public health and 1
safety through the current system of state licensure. 2
This Compact is designed to achieve the following objectives: 3
1. Increase public access to audiology and speech -language 4
pathology services by providing for the mutual recognition of 5
other member state licenses; 6
2. Enhance the states’ ability to pr otect the public’s health 7
and safety; 8
3. Encourage the cooperation of member states in regulating 9
multistate audiology and speech-language pathology practice; 10
4. Support spouses of relocating active duty military 11
personnel; 12
5. Enhance the exchange of licensure, investigative and 13
disciplinary information between member states; 14
6. Allow a remote state to hold a provider of services with a 15
compact privilege in that state accountable to that state’s practice 16
standards; and 17
7. Allow for the use of tele health technology to facilitate 18
increased access to audiology and speech -language pathology 19
services. 20
21
SECTION 2. DEFINITIONS 22
23
As used in this Compact, and except as otherwise provided, the 24
following definitions shall apply: 25
A. “Active duty military” me ans full -time duty status in the 26
active uniformed service of the United States, including members 27
of the National Guard and Reserve on active duty orders pursuant 28
to 10 U.S.C. Chapter 1209 and 1211. 29
B. “Adverse action” means any administrative, civil, 30
equitable or criminal action permitted by a state’s laws which is 31
imposed by a licensing board or other authority against an 32
audiologist or speech -language pathologist, including actions 33
against an individual’s license or privilege to practice such as 34
revocation, suspension, probation, monitoring of the licensee, or 35
restriction on the licensee’s practice. 36
C. “Alternative program” means a non -disciplinary 37
monitoring process approved by an audiology or speech -language 38
pathology licensing board to address impaired practitioners. 39
D. “Audiologist” means an individual who is licensed by a 40
state to practice audiology. 41
E. “Audiology” means the care and services provided by a 42
licensed audiologist as set forth in the member state’s statutes and 43
rules. 44

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F. “Audiology and Speech -Language Pathology Compact 1
Commission” or “Commission” means the national administrative 2
body whose membership consists of all states that have enacted the 3
Compact. 4
G. “Audiology and speech -language pathology licensing 5
board,” “audiology licensing board,” “speech-language pathology 6
licensing board,” or “licensing board” means the agency of a state 7
that is responsible for the licensing and regulation of audiologists 8
and/or speech-language pathologists. 9
H. “Compact privilege” means the authorization granted by a 10
remote state to allow a licensee from another member state to 11
practice as an audiologist or speech -language pathologist in the 12
remote state under its laws and rules. The practice of audiology or 13
speech-language pathology occurs in th e member state where the 14
patient/client/student is located at the time of the 15
patient/client/student encounter. 16
I. “Current significant investigative information” means 17
investigative information that a licensing board, after an inquiry 18
or investigation t hat includes notification and an opportunity for 19
the audiologist or speech -language pathologist to respond, if 20
required by state law, has reason to believe is not groundless and, 21
if proved true, would indicate more than a minor infraction. 22
J. “Data syste m” means a repository of information about 23
licensees, including, but not limited to, continuing education, 24
examination, licensure, investigative, compact privilege and 25
adverse action. 26
K. “Encumbered license” means a license in which an 27
adverse action res tricts the practice of audiology or speech -28
language pathology by the licensee and said adverse action has 29
been reported to the National Practitioners Data Bank (NPDB). 30
L. “Executive Committee” means a group of directors elected 31
or appointed to act on beh alf of, and within the powers granted to 32
them by, the Commission. 33
M. “Home state” means the member state that is the 34
licensee’s primary state of residence. 35
N. “Impaired practitioner” means individuals whose 36
professional practice is adversely affected b y substance abuse, 37
addiction, or other health-related conditions. 38
O. “Licensee” means an individual who currently holds an 39
authorization from the state licensing board to practice as an 40
audiologist or speech-language pathologist. 41
P. “Member state” means a state that has enacted the 42
Compact. 43

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Q. “Privilege to practice” means a legal authorization 1
permitting the practice of audiology or speech-language pathology 2
in a remote state. 3
R. “Remote state” means a member state other than the home 4
state whe re a licensee is exercising or seeking to exercise the 5
compact privilege. 6
S. “Rule” means a regulation, principle or directive 7
promulgated by the Commission that has the force of law. 8
T. “Single-state license” means an audiology or speech -9
language path ology license issued by a member state that 10
authorizes practice only within the issuing state and does not 11
include a privilege to practice in any other member state. 12
U. “Speech-language pathologist” means an individual who 13
is licensed by a state to practice speech-language pathology. 14
V. “Speech-language pathology” means the care and services 15
provided by a licensed speech -language pathologist as set forth in 16
the member state’s statutes and rules. 17
W. “State” means any state, commonwealth, district or 18
territory of the United States of America that regulates the practice 19
of audiology and speech-language pathology. 20
X. “State practice laws” means a member state’s laws, rules 21
and regulations that govern the practice of audiology or speech -22
language pathology , define the scope of audiology or speech -23
language pathology practice, and create the methods and grounds 24
for imposing discipline. 25
Y. “Telehealth” means the application of telecommunication 26
technology to deliver audiology or speech -language pathology 27
services at a distance for assessment, intervention and/or 28
consultation. 29
30
SECTION 3. STATE PARTICIPATION IN THE COMPACT 31
32
A. A license issued to an audiologist or speech -language 33
pathologist by a home state to a resident in that state shall be 34
recognized by each member state as authorizing an audiologist or 35
speech-language pathologist to practice audiology or speech -36
language pathology, under a privilege to practice, in each member 37
state. 38
B. A state must implement or utilize procedures for 39
considering the cr iminal history records of applicants for initial 40
privilege to practice. These procedures shall include the 41
submission of fingerprints or other biometric -based information 42
by applicants for the purpose of obtaining an applicant’s criminal 43
history record inf ormation from the Federal Bureau of 44

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Investigation and the agency responsible for retaining that state’s 1
criminal records. 2
1. A member state must fully implement a criminal 3
background check requirement, within a time frame established by 4
rule, by receivin g the results of the Federal Bureau of 5
Investigation record search on criminal background checks and 6
use the results in making licensure decisions. 7
2. Communication between a member state, the 8
Commission and among member states regarding the verification 9
of eligibility for licensure through the Compact shall not include 10
any information received from the Federal Bureau of 11
Investigation relating to a federal criminal records check 12
performed by a member state under Public Law 92-544. 13
C. Upon application fo r a privilege to practice, the licensing 14
board in the issuing remote state shall ascertain, through the data 15
system, whether the applicant has ever held, or is the holder of, a 16
license issued by any other state, whether there are any 17
encumbrances on any li cense or privilege to practice held by the 18
applicant, whether any adverse action has been taken against any 19
license or privilege to practice held by the applicant. 20
D. Each member state shall require an applicant to obtain or 21
retain a license in the home state and meet the home state’s 22
qualifications for licensure or renewal of licensure, as well as, all 23
other applicable state laws. 24
E. For an audiologist: 25
1. Must meet one of the following educational 26
requirements: 27
a. On or before, Dec. 31, 2007, has graduated with a 28
master’s degree or doctorate in audiology, or equivalent degree 29
regardless of degree name, from a program that is accredited by 30
an accrediting agency recognized by the Council for Higher 31
Education Accreditation, or its successor, or by th e United States 32
Department of Education and operated by a college or university 33
accredited by a regional or national accrediting organization 34
recognized by the board; or 35
b. On or after, Jan. 1, 2008, has graduated with a 36
Doctoral degree in audiology, or equivalent degree, regardless of 37
degree name, from a program that is accredited by an accrediting 38
agency recognized by the Council for Higher Education 39
Accreditation, or its successor, or by the United States Department 40
of Education and operated by a coll ege or university accredited by 41
a regional or national accrediting organization recognized by the 42
board; or 43
c. Has graduated from an audiology program that is 44
housed in an institution of higher education outside of the United 45

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States (a) for which the pr ogram and institution have been 1
approved by the authorized accrediting body in the applicable 2
country and (b) the degree program has been verified by an 3
independent credentials review agency to be comparable to a state 4
licensing board-approved program. 5
2. Has completed a supervised clinical practicum 6
experience from an accredited educational institution or its 7
cooperating programs as required by the Commission; 8
3. Has successfully passed a national examination 9
approved by the Commission; 10
4. Holds an active, unencumbered license; 11
5. Has not been convicted or found guilty, and has not 12
entered into an agreed disposition, of a felony related to the 13
practice of audiology, under applicable state or federal criminal 14
law; 15
6. Has a valid United States Social Security or National 16
Practitioner Identification number. 17
F. For a speech-language pathologist: 18
1. Must meet one of the following educational 19
requirements: 20
a. Has graduated with a master’s degree from a speech -21
language pathology program that i s accredited by an organization 22
recognized by the United States Department of Education and 23
operated by a college or university accredited by a regional or 24
national accrediting organization recognized by the board; or 25
b. Has graduated from a speech -language pathology 26
program that is housed in an institution of higher education 27
outside of the United States (a) for which the program and 28
institution have been approved by the authorized accrediting body 29
in the applicable country and (b) the degree program ha s been 30
verified by an independent credentials review agency to be 31
comparable to a state licensing board-approved program. 32
2. Has completed a supervised clinical practicum 33
experience from an educational institution or its cooperating 34
programs as required by the Commission; 35
3. Has completed a supervised postgraduate professional 36
experience as required by the Commission; 37
4. Has successfully passed a national examination 38
approved by the Commission; 39
5. Holds an active, unencumbered license; 40
6. Has not been convicted or found guilty, and has not 41
entered into an agreed disposition, of a felony related to the 42
practice of speech -language pathology, under applicable state or 43
federal criminal law; 44

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7. Has a valid United States Social Security or National 1
Practitioner Identification number. 2
G. The privilege to practice is derived from the home state 3
license. 4
H. An audiologist or speech -language pathologist practicing 5
in a member state must comply with the state practice laws of the 6
state in which the clien t is located at the time service is provided. 7
The practice of audiology and speech -language pathology shall 8
include all audiology and speech -language pathology practice as 9
defined by the state practice laws of the member state in which the 10
client is locate d. The practice of audiology and speech -language 11
pathology in a member state under a privilege to practice shall 12
subject an audiologist or speech -language pathologist to the 13
jurisdiction of the licensing board, the courts and the laws of the 14
member state i n which the client is located at the time service is 15
provided. 16
I. Individuals not residing in a member state shall continue to 17
be able to apply for a member state’s single -state license as 18
provided under the laws of each member state. However, the 19
single-state license granted to these individuals shall not be 20
recognized as granting the privilege to practice audiology or 21
speech-language pathology in any other member state. Nothing in 22
this Compact shall affect the requirements established by a 23
member state for the issuance of a single-state license. 24
J. Member states may charge a fee for granting a compact 25
privilege. 26
K. Member states must comply with the bylaws and rules and 27
regulations of the Commission. 28
29
SECTION 4. COMPACT PRIVILEGE 30
31
A. To exercise th e compact privilege under the terms and 32
provisions of the Compact, the audiologist or speech -language 33
pathologist shall: 34
1. Hold an active license in the home state; 35
2. Have no encumbrance on any state license; 36
3. Be eligible for a compact privilege in any member state 37
in accordance with Section 3; 38
4. Have not had any adverse action against any license or 39
compact privilege within the previous 2 years from date of 40
application; 41
5. Notify the Commission that the licensee is seeking the 42
compact privilege within a remote state(s); 43
6. Pay any applicable fees, including any state fee, for the 44
compact privilege; 45

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7. Report to the Commission adverse action taken by any 1
non-member state within 30 days from the date the adverse action 2
is taken. 3
B. For the purposes of the compact privilege, an audiologist 4
or speech -language pathologist shall only hold one home state 5
license at a time. 6
C. Except as provided in Section 6, if an audiologist or 7
speech-language pathologist changes primary state of residence by 8
moving between two -member states, the audiologist or speech -9
language pathologist must apply for licensure in the new home 10
state, and the license issued by the prior home state shall be 11
deactivated in accordance with applicable rules adopted by the 12
Commission. 13
D. The audiologist or speech-language pathologist may apply 14
for licensure in advance of a change in primary state of residence. 15
E. A license shall not be issued by the new home state until 16
the audiologist or speech -language pathologist provides 17
satisfactory evidence of a change in primary state of residence to 18
the new home state and satisfies all applicable requirements to 19
obtain a license from the new home state. 20
F. If an audiologist or speech -language pathologist changes 21
primary state of residence by moving from a member state to a 22
non-member state, the license issued by the prior home state shall 23
convert to a single -state license, valid only in the former home 24
state. 25
G. The compact privilege is valid until the expiration date of 26
the hom e state license. The licensee must comply with the 27
requirements of Section 4A to maintain the compact privilege in 28
the remote state. 29
H. A licensee providing audiology or speech -language 30
pathology services in a remote state under the compact privilege 31
shall function within the laws and regulations of the remote state. 32
I. A licensee providing audiology or speech -language 33
pathology services in a remote state is subject to that state’s 34
regulatory authority. A remote state may, in accordance with due 35
process and that state’s laws, remove a licensee’s compact 36
privilege in the remote state for a specific period of time, impose 37
fines, and/or take any other necessary actions to protect the health 38
and safety of its citizens. 39
J. If a home state license is encumbe red, the licensee shall 40
lose the compact privilege in any remote state until the following 41
occur: 42
1. The home state license is no longer encumbered; and 43
2. Two years have elapsed from the date of the adverse 44
action. 45

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K. Once an encumbered license in t he home state is restored 1
to good standing, the licensee must meet the requirements of 2
Section 4A to obtain a compact privilege in any remote state. 3
L. Once the requirements of Section 4J have been met, the 4
licensee must meet the requirements in Section 4A to obtain a 5
compact privilege in a remote state. 6
7
SECTION 5. COMPACT PRIVILEGE TO 8
PRACTICE TELEHEALTH 9
10
Member states shall recognize the right of an audiologist or 11
speech-language pathologist, licensed by a home state in 12
accordance with Section 3 and under rules promulgated by the 13
Commission, to practice audiology or speech -language pathology 14
in any member state via telehealth under a privilege to practice as 15
provided in the Compact and rules promulgated by the 16
Commission. 17
18
SECTION 6. ACTIVE DUTY MILITARY 19
PERSONNEL OR THEIR SPOUSES 20
21
Active duty military personnel, or their spouse, shall designate 22
a home state where the individual has a current license in good 23
standing. The individual may retain the home state designation 24
during the period the service member is on active duty. 25
Subsequent to designating a home state, the individual shall only 26
change their home state through application for licensure in the 27
new state. 28
29
SECTION 7. ADVERSE ACTIONS 30
31
A. In addition to the other powers conferred by state law , a 32
remote state shall have the authority, in accordance with existing 33
state due process law, to: 34
1. Take adverse action against an audiologist’s or speech -35
language pathologist’s privilege to practice within that member 36
state. 37
2. Issue subpoenas for bo th hearings and investigations 38
that require the attendance and testimony of witnesses as well as 39
the production of evidence. Subpoenas issued by a licensing board 40
in a member state for the attendance and testimony of witnesses or 41
the production of evidence from another member state shall be 42
enforced in the latter state by any court of competent jurisdiction, 43
according to the practice and procedure of that court applicable to 44
subpoenas issued in proceedings pending before it. The issuing 45

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authority shall pay any witness fees, travel expenses, mileage and 1
other fees required by the service statutes of the state in which the 2
witnesses or evidence are located. 3
3. Only the home state shall have the power to take adverse 4
action against a audiologist’s or speech-language pathologist’s 5
license issued by the home state. 6
B. For purposes of taking adverse action, the home state shall 7
give the same priority and effect to reported conduct received from 8
a member state as it would if the conduct had occurred with in the 9
home state. In so doing, the home state shall apply its own state 10
laws to determine appropriate action. 11
C. The home state shall complete any pending investigations 12
of an audiologist or speech -language pathologist who changes 13
primary state of resid ence during the course of the investigations. 14
The home state shall also have the authority to take appropriate 15
action(s) and shall promptly report the conclusions of the 16
investigations to the administrator of the data system. The 17
administrator of the coord inated licensure information system 18
shall promptly notify the new home state of any adverse actions. 19
D. If otherwise permitted by state law, the member state may 20
recover from the affected audiologist or speech -language 21
pathologist the costs of investigat ions and disposition of cases 22
resulting from any adverse action taken against that audiologist or 23
speech-language pathologist. 24
E. The member state may take adverse action based on the 25
factual findings of the remote state, provided that the member 26
state f ollows the member state’s own procedures for taking the 27
adverse action. 28
F. Joint Investigations 29
1. In addition to the authority granted to a member state by 30
its respective audiology or speech -language pathology practice act 31
or other applicable state la w, any member state may participate 32
with other member states in joint investigations of licensees. 33
2. Member states shall share any investigative, litigation, or 34
compliance materials in furtherance of any joint or individual 35
investigation initiated under the Compact. 36
G. If adverse action is taken by the home state against an 37
audiologist’s or speech -language pathologist’s license, the 38
audiologist’s or speech-language pathologist’s privilege to practice 39
in all other member states shall be deactivated unti l all 40
encumbrances have been removed from the state license. All home 41
state disciplinary orders that impose adverse action against an 42
audiologist’s or speech -language pathologist’s license shall 43
include a statement that the audiologist’s or speech -language 44

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pathologist’s privilege to practice is deactivated in all member 1
states during the pendency of the order. 2
H. If a member state takes adverse action, it shall promptly 3
notify the administrator of the data system. The administrator of 4
the data system shall promptly notify the home state of any adverse 5
actions by remote states. 6
I. Nothing in this Compact shall override a member state’s 7
decision that participation in an alternative program may be used 8
in lieu of adverse action. 9
10
SECTION 8. ESTABLISHMENT OF THE 11
AUDIOLOGY AND SPEECH-LANGUAGE 12
PATHOLOGY COMPACT COMMISSION 13
14
A. The Compact member states hereby create and establish a 15
joint public agency known as the Audiology and Speech-Language 16
Pathology Compact Commission: 17
1. The Commission is an instrumen tality of the Compact 18
states. 19
2. Venue is proper and judicial proceedings by or against 20
the Commission shall be brought solely and exclusively in a court 21
of competent jurisdiction where the principal office of the 22
Commission is located. The Commission ma y waive venue and 23
jurisdictional defenses to the extent it adopts or consents to 24
participate in alternative dispute resolution proceedings. 25
3. Nothing in this Compact shall be construed to be a 26
waiver of sovereign immunity. 27
B. Membership, Voting and Meetings 28
1. Each member state shall have two (2) delegates selected 29
by that member state’s licensing board. The delegates shall be 30
current members of the licensing board. One shall be an 31
audiologist and one shall be a speech-language pathologist. 32
2. An additional five (5) delegates, who are either a public 33
member or board administrator from a state licensing board, shall 34
be chosen by the Executive Committee from a pool of nominees 35
provided by the Commission at Large. 36
3. Any delegate may be removed or s uspended from office 37
as provided by the law of the state from which the delegate is 38
appointed. 39
4. The member state board shall fill any vacancy occurring 40
on the Commission, within 90 days. 41
5. Each delegate shall be entitled to one (1) vote with 42
regard to the promulgation of rules and creation of bylaws and 43
shall otherwise have an opportunity to participate in the business 44
and affairs of the Commission. 45

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6. A delegate shall vote in person or by other means as 1
provided in the bylaws. The bylaws may provi de for delegates’ 2
participation in meetings by telephone or other means of 3
communication. 4
7. The Commission shall meet at least once during each 5
calendar year. Additional meetings shall be held as set forth in the 6
bylaws. 7
C. The Commission shall have the following powers and 8
duties: 9
1. Establish the fiscal year of the Commission; 10
2. Establish bylaws; 11
3. Establish a Code of Ethics; 12
4. Maintain its financial records in accordance with the 13
bylaws; 14
5. Meet and take actions as are consistent with the 15
provisions of this Compact and the bylaws; 16
6. Promulgate uniform rules to facilitate and coordinate 17
implementation and administration of this Compact. The rules 18
shall have the force and effect of law and shall be binding in all 19
member states; 20
7. Bring and prosecute legal proceedings or actions in the 21
name of the Commission, provided that the standing of any state 22
audiology or speech-language pathology licensing board to sue or 23
be sued under applicable law shall not be affected; 24
8. Purchase and maintain insurance and bonds; 25
9. Borrow, accept, or contract for services of personnel, 26
including, but not limited to, employees of a member state; 27
10. Hire employees, elect or appoint officers, fix 28
compensation, define duties, grant individuals appropria te 29
authority to carry out the purposes of the Compact, and to 30
establish the Commission’s personnel policies and programs 31
relating to conflicts of interest, qualifications of personnel, and 32
other related personnel matters; 33
11. Accept any and all appropria te donations and grants of 34
money, equipment, supplies, materials and services, and to receive, 35
utilize and dispose of the same; provided that at all times the 36
Commission shall avoid any appearance of impropriety and/or 37
conflict of interest; 38
12. Lease, pu rchase, accept appropriate gifts or donations 39
of, or otherwise to own, hold, improve or use, any property, real, 40
personal or mixed; provided that at all times the Commission shall 41
avoid any appearance of impropriety; 42
13. Sell, convey, mortgage, pledge, l ease, exchange, 43
abandon, or otherwise dispose of any property real, personal, or 44
mixed; 45

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14. Establish a budget and make expenditures; 1
15. Borrow money; 2
16. Appoint committees, including standing committees 3
composed of members, and other interested pe rsons as may be 4
designated in this Compact and the bylaws; 5
17. Provide and receive information from, and cooperate 6
with, law enforcement agencies; 7
18. Establish and elect an Executive Committee; and 8
19. Perform other functions as may be necessary or 9
appropriate to achieve the purposes of this Compact consistent 10
with the state regulation of audiology and speech -language 11
pathology licensure and practice. 12
D. The Executive Committee 13
The Executive Committee shall have the power to act on behalf 14
of the Commission according to the terms of this Compact: 15
1. The Executive Committee shall be composed of ten (10) 16
members: 17
a. Seven (7) voting members who are elected by the 18
Commission from the current membership of the Commission; 19
b. Two (2) ex -officios, consisting of one nonvoting 20
member from a recognized national audiology professional 21
association and one nonvoting member from a recognized 22
national speech-language pathology association; and 23
c. One (1) ex -officio, nonvoting member from the 24
recognized membership organization of the audiology and speech-25
language pathology licensing boards. 26
E. The ex -officio members shall be selected by their 27
respective organizations. 28
1. The Commission may remove any member of the 29
Executive Committee as provided in bylaws. 30
2. The Executive Committee shall meet at least annually. 31
3. The Executive Committee shall have the following duties 32
and responsibilities: 33
a. Recommend to the entire Commission changes to the 34
rules or bylaws, changes to this Compact legislation, fees paid by 35
Compact member states such as annual dues, and any commission 36
Compact fee charged to licensees for the compact privilege; 37
b. Ensure Compact administration services are 38
appropriately provided, contractual or otherwise; 39
c. Prepare and recommend the budget; 40
d. Maintain financial records on behalf of the 41
Commission; 42
e. Monitor Compact compliance of member states and 43
provide compliance reports to the Commission; 44
f. Establish additional committees as necessary; and 45

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g. Other duties as provided in rules or bylaws. 1
4. Meetings of the Commission 2
All meetings shall be open to the public, and public notice of 3
meetings shall be given in the same manner as required under the 4
rulemaking provisions in Section 10. 5
5. The Commission or the Executive Committee or other 6
committees of the Commission may convene in a closed, non -7
public meeting if the Commission or Executive Committee or 8
other committees of the Commission must discuss: 9
a. Non-compliance of a member state with its 10
obligations under the Compact; 11
b. The employment, compensation, discipline or other 12
matters, practices or procedures related to specific employees or 13
other matters related to the Commission’s internal personnel 14
practices and procedures; 15
c. Current, threatened, or reasonably anticipated 16
litigation; 17
d. Negotiation of contracts for the purchase, lease, or 18
sale of goods, services, or real estate; 19
e. Accusing any person of a crime or formally censuring 20
any person; 21
f. Disclosure of trade secrets or commercial or financial 22
information that is privileged or confidential; 23
g. Disclosure of information of a personal nature where 24
disclosure would constitute a clearly unwarranted invasion of 25
personal privacy; 26
h. Disclosure of investigative recor ds compiled for law 27
enforcement purposes; 28
i. Disclosure of information related to any investigative 29
reports prepared by or on behalf of or for use of the Commission 30
or other committee charged with responsibility of investigation or 31
determination of compliance issues pursuant to the Compact; or 32
j. Matters specifically exempted from disclosure by 33
federal or member state statute. 34
6. If a meeting, or portion of a meeting, is closed pursuant 35
to this provision, the Commission’s legal counsel or designee shall 36
certify that the meeting may be closed and shall reference each 37
relevant exempting provision. 38
7. The Commission shall keep minutes that fully and 39
clearly describe all matters discussed in a meeting and shall 40
provide a full and accurate summary of ac tions taken, and the 41
reasons therefore, including a description of the views expressed. 42
All documents considered in connection with an action shall be 43
identified in minutes. All minutes and documents of a closed 44
meeting shall remain under seal, subject to release by a majority 45

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vote of the Commission or order of a court of competent 1
jurisdiction. 2
8. Financing of the Commission 3
a. The Commission shall pay, or provide for the 4
payment of, the reasonable expenses of its establishment, 5
organization, and ongoing activities. 6
b. The Commission may accept any and all appropriate 7
revenue sources, donations, and grants of money, equipment, 8
supplies, materials, and services. 9
c. The Commission may levy on and collect an annual 10
assessment from each member state or impose fees on other 11
parties to cover the cost of the operations and activities of the 12
Commission and its staff, which must be in a total amount 13
sufficient to cover its annual budget as approved each year for 14
which revenue is not provided by other sourc es. The aggregate 15
annual assessment amount shall be allocated based upon a 16
formula to be determined by the Commission, which shall 17
promulgate a rule binding upon all member states. 18
9. The Commission shall not incur obligations of any kind 19
prior to securi ng the funds adequate to meet the same; nor shall 20
the Commission pledge the credit of any of the member states, 21
except by and with the authority of the member state. 22
10. The Commission shall keep accurate accounts of all 23
receipts and disbursements. The receipts and disbursements of the 24
Commission shall be subject to the audit and accounting 25
procedures established under its bylaws. However, all receipts and 26
disbursements of funds handled by the Commission shall be 27
audited yearly by a certified or licensed public accountant, and the 28
report of the audit shall be included in and become part of the 29
annual report of the Commission. 30
F. Qualified Immunity, Defense, and Indemnification 31
1. The members, officers, executive director, employees and 32
representatives of the Commission shall be immune from suit and 33
liability, either personally or in their official capacity, for any 34
claim for damage to or loss of property or personal injury or other 35
civil liability caused by or arising out of any actual or alleged act, 36
error or omission that occurred, or that the person against whom 37
the claim is made had a reasonable basis for believing occurred 38
within the scope of Commission employment, duties or 39
responsibilities; provided that nothing in this paragraph shall be 40
construed to protect any person from suit and/or liability for any 41
damage, loss, injury, or liability caused by the intentional or 42
willful or wanton misconduct of that person. 43
2. The Commission shall defend any member, officer, 44
executive director, employee or re presentative of the Commission 45

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in any civil action seeking to impose liability arising out of any 1
actual or alleged act, error, or omission that occurred within the 2
scope of Commission employment, duties, or responsibilities, or 3
that the person against who m the claim is made had a reasonable 4
basis for believing occurred within the scope of Commission 5
employment, duties, or responsibilities; provided that nothing 6
herein shall be construed to prohibit that person from retaining 7
his or her own counsel; and pro vided further, that the actual or 8
alleged act, error, or omission did not result from that person’s 9
intentional or willful or wanton misconduct. 10
3. The Commission shall indemnify and hold harmless any 11
member, officer, executive director, employee, or rep resentative of 12
the Commission for the amount of any settlement or judgment 13
obtained against that person arising out of any actual or alleged 14
act, error or omission that occurred within the scope of 15
Commission employment, duties, or responsibilities, or that person 16
had a reasonable basis for believing occurred within the scope of 17
Commission employment, duties, or responsibilities, provided that 18
the actual or alleged act, error, or omission did not result from the 19
intentional or willful or wanton misconduct of that person. 20
21
SECTION 9. DATA SYSTEM 22
23
A. The Commission shall provide for the development, 24
maintenance, and utilization of a coordinated database and 25
reporting system containing licensure, adverse action, and 26
investigative information on all licensed i ndividuals in member 27
states. 28
B. Notwithstanding any other provision of state law to the 29
contrary, a member state shall submit a uniform data set to the 30
data system on all individuals to whom this Compact is applicable 31
as required by the rules of the Commission, including: 32
1. Identifying information; 33
2. Licensure data; 34
3. Adverse actions against a license or compact privilege; 35
4. Non-confidential information related to alternative 36
program participation; 37
5. Any denial of application for licensure, and the reason(s) 38
for denial; and 39
6. Other information that may facilitate the administration 40
of this Compact, as determined by the rules of the Commission. 41
C. Investigative information pertaining to a licensee in any 42
member state shall only be available to other member states. 43
D. The Commission shall promptly notify all member states 44
of any adverse action taken against a licensee or an individual 45

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applying for a license. Adverse action information pertaining to a 1
licensee in any member state shall be available to any other 2
member state. 3
E. Member states contributing information to the data system 4
may designate information that may not be shared with the public 5
without the express permission of the contributing state. 6
F. Any information submitted t o the data system that is 7
subsequently required to be expunged by the laws of the member 8
state contributing the information shall be removed from the data 9
system. 10
11
SECTION 10. RULEMAKING 12
13
A. The Commission shall exercise its rulemaking powers 14
pursuant to the criteria set forth in this Section and the rules 15
adopted thereunder. Rules and amendments shall become binding 16
as of the date specified in each rule or amendment. 17
B. If a majority of the legislatures of the member states 18
rejects a rule, by enactment of a statute or resolution in the same 19
manner used to adopt the Compact within 4 years of the date of 20
adoption of the rule, the rule shall have no further force and effect 21
in any member state. 22
C. Rules or amendments to the rules shall be adopted at a 23
regular or special meeting of the Commission. 24
D. Prior to promulgation and adoption of a final rule or rules 25
by the Commission, and at least thirty (30) days in advance of the 26
meeting at which the rule shall be considered and voted upon, the 27
Commission shall file a Notice of Proposed Rulemaking: 28
1. On the website of the Commission or other publicly 29
accessible platform; and 30
2. On the website of each member state audiology or 31
speech-language pathology licensing board or other publicly 32
accessible platform or the publication in which each state would 33
otherwise publish proposed rules. 34
E. The Notice of Proposed Rulemaking shall include: 35
1. The proposed time, date, and location of the meeting in 36
which the rule shall be considered and voted upon; 37
2. The text of the proposed rule or amendment and the 38
reason for the proposed rule; 39
3. A request for comments on the proposed rule from any 40
interested person; and 41
4. The manner in which interested persons may submit 42
notice to the Commission of their intention to attend the public 43
hearing and any written comments. 44

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F. Prior to the adoption of a proposed rule, the Commission 1
shall allow persons to submit written data, facts, opinions and 2
arguments, which shall be made available to the public. 3
G. The Commissio n shall grant an opportunity for a public 4
hearing before it adopts a rule or amendment if a hearing is 5
requested by: 6
1. At least twenty-five (25) persons; 7
2. A state or federal governmental subdivision or agency; 8
or 9
3. An association having at least twenty-five (25) members. 10
H. If a hearing is held on the proposed rule or amendment, 11
the Commission shall publish the place, time, and date of the 12
scheduled public hearing. If the hearing is held via electronic 13
means, the Commission shall publish the mec hanism for access to 14
the electronic hearing. 15
1. All persons wishing to be heard at the hearing shall 16
notify the executive director of the Commission or other 17
designated member in writing of their desire to appear and testify 18
at the hearing not less than five (5) business days before the 19
scheduled date of the hearing. 20
2. Hearings shall be conducted in a manner providing each 21
person who wishes to comment a fair and reasonable opportunity 22
to comment orally or in writing. 23
3. All hearings shall be recorded . A copy of the recording 24
shall be made available on request. 25
4. Nothing in this section shall be construed as requiring a 26
separate hearing on each rule. Rules may be grouped for the 27
convenience of the Commission at hearings required by this 28
section. 29
I. Following the scheduled hearing date, or by the close of 30
business on the scheduled hearing date if the hearing was not 31
held, the Commission shall consider all written and oral comments 32
received. 33
J. If no written notice of intent to attend the public he aring 34
by interested parties is received, the Commission may proceed with 35
promulgation of the proposed rule without a public hearing. 36
K. The Commission shall, by majority vote of all members, 37
take final action on the proposed rule and shall determine the 38
effective date of the rule, if any, based on the rulemaking record 39
and the full text of the rule. 40
L. Upon determination that an emergency exists, the 41
Commission may consider and adopt an emergency rule without 42
prior notice, opportunity for comment, or he aring, provided that 43
the usual rulemaking procedures provided in the Compact and in 44
this section shall be retroactively applied to the rule as soon as 45

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reasonably possible, in no event later than ninety (90) days after 1
the effective date of the rule. For the purposes of this provision, an 2
emergency rule is one that must be adopted immediately in order 3
to: 4
1. Meet an imminent threat to public health, safety, or 5
welfare; 6
2. Prevent a loss of Commission or member state funds; or 7
3. Meet a deadline for the promulgation of an 8
administrative rule that is established by federal law or rule. 9
M. The Commission or an authorized committee of the 10
Commission may direct revisions to a previously adopted rule or 11
amendment for purposes of correcting typographical errors, errors 12
in format, errors in consistency, or grammatical errors. Public 13
notice of any revisions shall be posted on the website of the 14
Commission. The revision shall be subject to challenge by any 15
person for a period of thirty (30) days after posting. T he revision 16
may be challenged only on grounds that the revision results in a 17
material change to a rule. A challenge shall be made in writing 18
and delivered to the chair of the Commission prior to the end of 19
the notice period. If no challenge is made, the re vision shall take 20
effect without further action. If the revision is challenged, the 21
revision may not take effect without the approval of the 22
Commission. 23
24
SECTION 11. OVERSIGHT, DISPUTE RESOLUTION, 25
AND ENFORCEMENT 26
27
A. Dispute Resolution 28
1. Upon request by a member state, the Commission shall 29
attempt to resolve disputes related to the Compact that arise 30
among member states and between member and non -member 31
states. 32
2. The Commission shall promulgate a rule providing for 33
both mediation and binding disput e resolution for disputes as 34
appropriate. 35
B. Enforcement 36
1. The Commission, in the reasonable exercise of its 37
discretion, shall enforce the provisions and rules of this Compact. 38
2. By majority vote, the Commission may initiate legal 39
action in the Uni ted States District Court for the District of 40
Columbia or the federal district where the Commission has its 41
principal offices against a member state in default to enforce 42
compliance with the provisions of the Compact and its 43
promulgated rules and bylaws. The relief sought may include both 44
injunctive relief and damages. In the event judicial enforcement is 45

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necessary, the prevailing member shall be awarded all costs of 1
litigation, including reasonable attorney’s fees. 2
3. The remedies herein shall not be the exclusive remedies 3
of the Commission. The Commission may pursue any other 4
remedies available under federal or state law. 5
6
SECTION 12. DATE OF IMPLEMENTATION OF THE 7
INTERSTATE COMMISSION FOR AUDIOLOGY AND 8
SPEECH-LANGUAGE PATHOLOGY PRACTICE AND 9
ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT 10
11
A. The Compact shall come into effect on the date on which 12
the Compact statute is enacted into law in the 10th member state. 13
The provisions, which become effective at that time, shall be 14
limited to the powers granted t o the Commission relating to 15
assembly and the promulgation of rules. Thereafter, the 16
Commission shall meet and exercise rulemaking powers necessary 17
to the implementation and administration of the Compact. 18
B. Any state that joins the Compact subsequent to the 19
Commission’s initial adoption of the rules shall be subject to the 20
rules as they exist on the date on which the Compact becomes law 21
in that state. Any rule that has been previously adopted by the 22
Commission shall have the full force and effect of law on the day 23
the Compact becomes law in that state. 24
C. Any member state may withdraw from this Compact by 25
enacting a statute repealing the same. 26
1. A member state’s withdrawal shall not take effect until 27
six (6) months after enactment of the repealing statute. 28
2. Withdrawal shall not affect the continuing requirement 29
of the withdrawing state’s audiology or speech -language 30
pathology licensing board to comply with the investigative and 31
adverse action reporting requirements of this act prior to the 32
effective date of withdrawal. 33
D. Nothing contained in this Compact shall be construed to 34
invalidate or prevent any audiology or speech -language pathology 35
licensure agreement or other cooperative arrangement between a 36
member state and a non -member state that d oes not conflict with 37
the provisions of this Compact. 38
E. This Compact may be amended by the member states. No 39
amendment to this Compact shall become effective and binding 40
upon any member state until it is enacted into the laws of all 41
member states. 42

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SECTION 13. CONSTRUCTION AND SEVERABILITY 1
2
This Compact shall be liberally construed so as to effectuate 3
the purposes thereof. The provisions of this Compact shall be 4
severable and if any phrase, clause, sentence or provision of this 5
Compact is declared to be contrary to the constitution of any 6
member state or of the United States or the applicability thereof to 7
any government, agency, person or circumstance is held invalid, 8
the validity of the remainder of this Compact and the applicability 9
thereof to any g overnment, agency, person or circumstance shall 10
not be affected thereby. If this Compact shall be held contrary to 11
the constitution of any member state, the Compact shall remain in 12
full force and effect as to the remaining member states and in full 13
force and effect as to the member state affected as to all severable 14
matters. 15
16
SECTION 14. BINDING EFFECT OF 17
COMPACT AND OTHER LAWS 18
19
A. Nothing herein prevents the enforcement of any other law 20
of a member state that is not inconsistent with the Compact. 21
B. All laws in a member state in conflict with the Compact 22
are superseded to the extent of the conflict. 23
C. All lawful actions of the Commission, including all rules 24
and bylaws promulgated by the Commission, are binding upon the 25
member states. 26
D. All agreements between the Commission and the member 27
states are binding in accordance with their terms. 28
E. In the event any provision of the Compact exceeds the 29
constitutional limits imposed on the legislature of any member 30
state, the provision shall be inef fective to the extent of the conflict 31
with the constitutional provision in question in that member state. 32
Sec. 22. NRS 637B.288 is hereby amended to read as follows: 33
637B.288 1. Except as otherwise provided in this section and 34
NRS 239.0115 [,] and section 21 of this act, a complaint filed with 35
the Board, all documents and other information filed with the 36
complaint and all documents and other information compiled as a 37
result of an investigation conducted to determine whether to initiate 38
disciplinary action against a person are confidential, unless the 39
person submits a written statement to the Board requesting that such 40
documents and information be made public records. 41
2. The charging documents filed with the Board to initiate 42
disciplinary action pursuant to chapter 622A of NRS and all 43
documents and information considered by the Board when 44
determining whether to impose discipline are public records. 45

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3. The Board shall, to the extent feasible, communicate or 1
cooperate with or provide any documents or other information to 2
any other licensing board or any other agency that is investigating a 3
person, including, without limitation, a law enforcement agency. 4
Sec. 23. Chapter 640 of NRS is hereby amended by adding 5
thereto a new section to read as follows: 6
The Physical Therapy Licensure Compact is hereby ratified 7
and entered into with all other jurisdictions legally joining the 8
Compact, in substantially the form set forth in this section: 9
10
PHYSICAL THERAPY LICENSURE COMPACT 11
12
SECTION 1. PURPOSE 13
14
The purpose of this Compact is to facilitate interstate practice 15
of physical therapy with the goal of improving publ ic access to 16
physical therapy services. The practice of physical therapy occurs 17
in the state where the patient/client is located at the time of the 18
patient/client encounter. The Compact preserves the regulatory 19
authority of states to protect public health and safety through the 20
current system of state licensure. 21
This Compact is designed to achieve the following objectives: 22
1. Increase public access to physical therapy services by 23
providing for the mutual recognition of other member state 24
licenses; 25
2. Enhance the states’ ability to protect the public’s health 26
and safety; 27
3. Encourage the cooperation of member states in regulating 28
multi-state physical therapy practice; 29
4. Support spouses of relocating military members; 30
5. Enhance the exchange of lic ensure, investigative, and 31
disciplinary information between member states; and 32
6. Allow a remote state to hold a provider of services with a 33
compact privilege in that state accountable to that state’s practice 34
standards. 35
36
SECTION 2. DEFINITIONS 37
38
As used in this Compact, and except as otherwise provided, the 39
following definitions shall apply: 40
1. “Active Duty Military” means full -time duty status in the 41
active uniformed service of the United States, including members 42
of the National Guard and Reserve on active duty orders pursuant 43
to 10 U.S.C. Chapters 1209 and 1211. 44

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2. “Adverse Action” means disciplinary action taken by a 1
physical therapy licensing board based upon misconduct, 2
unacceptable performance, or a combination of both. 3
3. “Alternative Progra m” means a non -disciplinary 4
monitoring or practice remediation process approved by a physical 5
therapy licensing board. This includes, but is not limited to, 6
substance abuse issues. 7
4. “Compact privilege” means the authorization granted by a 8
remote state to allow a licensee from another member state to 9
practice as a physical therapist or work as a physical therapist 10
assistant in the remote state under its laws and rules. The practice 11
of physical therapy occurs in the member state where the 12
patient/client is located at the time of the patient/client encounter. 13
5. “Continuing competence” means a requirement, as a 14
condition of license renewal, to provide evidence of participation 15
in, and/or completion of, educational and professional activities 16
relevant to practice or area of work. 17
6. “Data system” means a repository of information about 18
licensees, including examination, licensure, investigative, compact 19
privilege, and adverse action. 20
7. “Encumbered license” means a license that a physical 21
therapy licensing board has limited in any way. 22
8. “Executive Board” means a group of directors elected or 23
appointed to act on behalf of, and within the powers granted to 24
them by, the Commission. 25
9. “Home state” means the member state that is the licensee’s 26
primary state of residence. 27
10. “Investigative information” means information, records, 28
and documents received or generated by a physical therapy 29
licensing board pursuant to an investigation. 30
11. “Jurisprudence Requirement” means the assessment of 31
an individual’s knowledge of the laws and rules governing the 32
practice of physical therapy in a state. 33
12. “Licensee” means an individual who currently holds an 34
authorization from the state to practice as a physical therapist or 35
to work as a physical therapist assistant. 36
13. “Member state” means a state that has enacted the 37
Compact. 38
14. “Party state” means any member state in which a licensee 39
holds a current license or compact privilege or is applying for a 40
license or compact privilege. 41
15. “Physical therapist” means an individual who is licensed 42
by a state to practice physical therapy. 43

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16. “Physical therapist assistant” means an individual who is 1
licensed/certified by a state and who assists the physical therapist 2
in selected components of physical therapy. 3
17. “Physical therapy,” “physical therapy practice,” and “the 4
practice of physical therapy” mean the care and services provided 5
by or under the direction and supervision of a licensed physical 6
therapist. 7
18. “Physical Therapy Compact Commission ” or 8
“Commission” means the national administrative body whose 9
membership consists of all states that have enacted the Compact. 10
19. “Physical therapy licensing board” or “licensing board” 11
means the agency of a state that is responsible for the licensing 12
and regulation of physical therapists and physical therapist 13
assistants. 14
20. “Remote State” means a member state other than the 15
home state, where a licensee is exercising or seeking to exercise 16
the compact privilege. 17
21. “Rule” means a regulation, prin ciple, or directive 18
promulgated by the Commission that has the force of law. 19
22. “State” means any state, commonwealth, district, or 20
territory of the United States of America that regulates the practice 21
of physical therapy. 22
23
SECTION 3. STATE PARTICIPATION IN THE COMPACT 24
25
A. To participate in the Compact, a state must: 26
1. Participate fully in the Commission’s data system, 27
including using the Commission’s unique identifier as defined in 28
rules; 29
2. Have a mechanism in place for receiving and 30
investigating complaints about licensees; 31
3. Notify the Commission, in compliance with the terms of 32
the Compact and rules, of any adverse action or the availability of 33
investigative information regarding a licensee; 34
4. Fully implement a criminal backg round check 35
requirement, within a time frame established by rule, by receiving 36
the results of the Federal Bureau of Investigation record search 37
on criminal background checks and use the results in making 38
licensure decisions in accordance with Section 3.B.; 39
5. Comply with the rules of the Commission; 40
6. Utilize a recognized national examination as a 41
requirement for licensure pursuant to the rules of the 42
Commission; and 43
7. Have continuing competence requirements as a 44
condition for license renewal. 45

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B. Upon adoption of this statute, the member state shall have 1
the authority to obtain biometric -based information from each 2
physical therapy licensure applicant and submit this information 3
to the Federal Bureau of Investigation for a criminal background 4
check in accordance with 28 U.S.C. § 534 and 42 U.S.C. § 14616. 5
C. A member state shall grant the compact privilege to a 6
licensee holding a valid unencumbered license in another member 7
state in accordance with the terms of the Compact and rules. 8
D. Member s tates may charge a fee for granting a compact 9
privilege. 10
11
SECTION 4. COMPACT PRIVILEGE 12
13
A. To exercise the compact privilege under the terms and 14
provisions of the Compact, the licensee shall: 15
1. Hold a license in the home state; 16
2. Have no encumbrance on any state license; 17
3. Be eligible for a compact privilege in any member state 18
in accordance with Section 4D, G and H; 19
4. Have not had any adverse action against any license or 20
compact privilege within the previous 2 years; 21
5. Notify the Commissi on that the licensee is seeking the 22
compact privilege within a remote state(s); 23
6. Pay any applicable fees, including any state fee, for the 24
compact privilege; 25
7. Meet any jurisprudence requirements established by the 26
remote state(s) in which the licen see is seeking a compact 27
privilege; and 28
8. Report to the Commission adverse action taken by any 29
non-member state within 30 days from the date the adverse action 30
is taken. 31
B. The compact privilege is valid until the expiration date of 32
the home license. The licensee must comply with the requirements 33
of Section 4.A. to maintain the compact privilege in the remote 34
state. 35
C. A licensee providing physical therapy in a remote state 36
under the compact privilege shall function within the laws and 37
regulations of the remote state. 38
D. A licensee providing physical therapy in a remote state is 39
subject to that state’s regulatory authority. A remote state may, in 40
accordance with due process and that state’s laws, remove a 41
licensee’s compact privilege in the remote state for a specific 42
period of time, impose fines, and/or take any other necessary 43
actions to protect the health and safety of its citizens. The licensee 44

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is not eligible for a compact privilege in any state until the specific 1
time for removal has passed and all fines are paid. 2
E. If a home state license is encumbered, the licensee shall 3
lose the compact privilege in any remote state until the following 4
occur: 5
1. The home state license is no longer encumbered; and 6
2. Two years have elapsed from the date of the adverse 7
action. 8
F. Once an encumbered license in the home state is restored 9
to good standing, the licensee must meet the requirements of 10
Section 4A to obtain a compact privilege in any remote state. 11
G. If a licensee’s compact privilege in a ny remote state is 12
removed, the individual shall lose the compact privilege in any 13
remote state until the following occur: 14
1. The specific period of time for which the compact 15
privilege was removed has ended; 16
2. All fines have been paid; and 17
3. Two y ears have elapsed from the date of the adverse 18
action. 19
H. Once the requirements of Section 4G have been met, the 20
license must meet the requirements in Section 4A to obtain a 21
compact privilege in a remote state. 22
23
SECTION 5. ACTIVE DUTY MILITARY 24
PERSONNEL OR THEIR SPOUSES 25
26
A licensee who is active duty military or is the spouse of an 27
individual who is active duty military may designate one of the 28
following as the home state: 29
A. Home of record; 30
B. Permanent Change of Station (PCS); or 31
C. State of cur rent residence if it is different than the PCS 32
state or home of record. 33
34
SECTION 6. ADVERSE ACTIONS 35
36
A. A home state shall have exclusive power to impose adverse 37
action against a license issued by the home state. 38
B. A home state may take adverse action based on the 39
investigative information of a remote state, so long as the home 40
state follows its own procedures for imposing adverse action. 41
C. Nothing in this Compact shall override a member state’s 42
decision that participation in an alternative program may be used 43
in lieu of adverse action and that such participation shall remain 44
non-public if required by the member state’s laws. Member states 45

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must require licensees who enter any alternative programs in lieu 1
of discipline to agree not to practice in any other member state 2
during the term of the alternative program without prior 3
authorization from such other member state. 4
D. Any member state may investigate actual or alleged 5
violations of the statutes and rules authorizing the practice of 6
physical therap y in any other member state in which a physical 7
therapist or physical therapist assistant holds a license or compact 8
privilege. 9
E. A remote state shall have the authority to: 10
1. Take adverse actions as set forth in Section 4.D. against 11
a licensee’s compact privilege in the state; 12
2. Issue subpoenas for both hearings and investigations 13
that require the attendance and testimony of witnesses, and the 14
production of evidence. Subpoenas issued by a physical therapy 15
licensing board in a party state for the a ttendance and testimony 16
of witnesses, and/or the production of evidence from another party 17
state, shall be enforced in the latter state by any court of 18
competent jurisdiction, according to the practice and procedure of 19
that court applicable to subpoenas is sued in proceedings pending 20
before it. The issuing authority shall pay any witness fees, travel 21
expenses, mileage, and other fees required by the service statutes 22
of the state where the witnesses and/or evidence are located; and 23
3. If otherwise permitted by state law, recover from the 24
licensee the costs of investigations and disposition of cases 25
resulting from any adverse action taken against that licensee. 26
F. Joint Investigations 27
1. In addition to the authority granted to a member state by 28
its respective physical therapy practice act or other applicable state 29
law, a member state may participate with other member states in 30
joint investigations of licensees. 31
2. Member states shall share any investigative, litigation, or 32
compliance materials in f urtherance of any joint or individual 33
investigation initiated under the Compact. 34
35
SECTION 7. ESTABLISHMENT OF THE PHYSICAL 36
THERAPY COMPACT COMMISSION 37
38
A. The Compact member states hereby create and establish a 39
joint public agency known as the Physical Th erapy Compact 40
Commission: 41
1. The Commission is an instrumentality of the Compact 42
states. 43
2. Venue is proper and judicial proceedings by or against 44
the Commission shall be brought solely and exclusively in a court 45

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of competent jurisdiction where the pri ncipal office of the 1
Commission is located. The Commission may waive venue and 2
jurisdictional defenses to the extent it adopts or consents to 3
participate in alternative dispute resolution proceedings. 4
3. Nothing in this Compact shall be construed to be a 5
waiver of sovereign immunity. 6
B. Membership, Voting, and Meetings 7
1. Each member state shall have and be limited to one (1) 8
delegate selected by that member state’s licensing board. 9
2. The delegate shall be a current member of the licensing 10
board, w ho is a physical therapist, physical therapist assistant, 11
public member, or the board administrator. 12
3. Any delegate may be removed or suspended from office 13
as provided by the law of the state from which the delegate is 14
appointed. 15
4. The member state board shall fill any vacancy occurring 16
in the Commission. 17
5. Each delegate shall be entitled to one (1) vote with 18
regard to the promulgation of rules and creation of bylaws and 19
shall otherwise have an opportunity to participate in the business 20
and affairs of the Commission. 21
6. A delegate shall vote in person or by such other means as 22
provided in the bylaws. The bylaws may provide for delegates’ 23
participation in meetings by telephone or other means of 24
communication. 25
7. The Commission shall meet at leas t once during each 26
calendar year. Additional meetings shall be held as set forth in the 27
bylaws. 28
C. The Commission shall have the following powers and 29
duties: 30
1. Establish the fiscal year of the Commission; 31
2. Establish bylaws; 32
3. Maintain its finan cial records in accordance with the 33
bylaws; 34
4. Meet and take such actions as are consistent with the 35
provisions of this Compact and the bylaws; 36
5. Promulgate uniform rules to facilitate and coordinate 37
implementation and administration of this Compact. The rules 38
shall have the force and effect of law and shall be binding in all 39
member states; 40
6. Bring and prosecute legal proceedings or actions in the 41
name of the Commission, provided that the standing of any state 42
physical therapy licensing board to sue or be sued under 43
applicable law shall not be affected; 44
7. Purchase and maintain insurance and bonds; 45

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8. Borrow, accept, or contract for services of personnel, 1
including, but not limited to, employees of a member state; 2
9. Hire employees, elect or appoint officers, fix 3
compensation, define duties, grant such individuals appropriate 4
authority to carry out the purposes of the Compact, and to 5
establish the Commission’s personnel policies and programs 6
relating to conflicts of interest, qualifications of personnel, and 7
other related personnel matters; 8
10. Accept any and all appropriate donations and grants of 9
money, equipment, supplies, materials and services, and to receive, 10
utilize and dispose of the same; provided that at all times the 11
Commission sha ll avoid any appearance of impropriety and/or 12
conflict of interest; 13
11. Lease, purchase, accept appropriate gifts or donations 14
of, or otherwise to own, hold, improve or use, any property, real, 15
personal or mixed; provided that at all times the Commission shall 16
avoid any appearance of impropriety; 17
12. Sell convey, mortgage, pledge, lease, exchange, 18
abandon, or otherwise dispose of any property real, personal, or 19
mixed; 20
13. Establish a budget and make expenditures; 21
14. Borrow money; 22
15. Appoint comm ittees, including standing committees 23
composed of members, state regulators, state legislators or their 24
representatives, and consumer representatives, and such other 25
interested persons as may be designated in this Compact and the 26
bylaws; 27
16. Provide and receive information from, and cooperate 28
with, law enforcement agencies; 29
17. Establish and elect an Executive Board; and 30
18. Perform such other functions as may be necessary or 31
appropriate to achieve the purposes of this Compact consistent 32
with the stat e regulation of physical therapy licensure and 33
practice. 34
D. The Executive Board 35
The Executive Board shall have the power to act on behalf of 36
the Commission according to the terms of this Compact. 37
1. The Executive Board shall be composed of nine 38
members: 39
a. Seven voting members who are elected by the 40
Commission from the current membership of the Commission; 41
b. One ex -officio, nonvoting member from the 42
recognized national physical therapy professional association; and 43

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c. One ex -officio, nonvotin g member from the 1
recognized membership organization of the physical therapy 2
licensing boards. 3
2. The ex -officio members will be selected by their 4
respective organizations. 5
3. The Commission may remove any member of the 6
Executive Board as provided in bylaws. 7
4. The Executive Board shall meet at least annually. 8
5. The Executive Board shall have the following Duties and 9
responsibilities: 10
a. Recommend to the entire Commission changes to the 11
rules or bylaws, changes to this Compact legislation, fees paid by 12
Compact member states such as annual dues, and any commission 13
Compact fee charged to licensees for the compact privilege; 14
b. Ensure Compact administration services are 15
appropriately provided, contractual or otherwise; 16
c. Prepare and recommend the budget; 17
d. Maintain financial records on behalf of the 18
Commission; 19
e. Monitor Compact compliance of member states and 20
provide compliance reports to the Commission; 21
f. Establish additional committees as necessary; and 22
g. Other duties as provided in rules or bylaws. 23
E. Meetings of the Commission 24
1. All meetings shall be open to the public, and public 25
notice of meetings shall be given in the same manner as required 26
under the rulemaking provisions in Section 9. 27
2. The Commission or the Executive Board or other 28
committees of the Commission may convene in a closed, non -29
public meeting if the Commission or Executive Board or other 30
committees of the Commission must discuss: 31
a. Non-compliance of a member state with its 32
obligations under the Compact; 33
b. The employment, compensation, discipline or other 34
matters, practices or procedures related to specific employees or 35
other matters related to the Commission’s internal personnel 36
practices and procedures; 37
c. Current, threatened, or reason ably anticipated 38
litigation; 39
d. Negotiation of contracts for the purchase, lease, or 40
sale of goods, services, or real estate; 41
e. Accusing any person of a crime or formally censuring 42
any person; 43
f. Disclosure of trade secrets or commercial or finan cial 44
information that is privileged or confidential; 45

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g. Disclosure of information of a personal nature where 1
disclosure would constitute a clearly unwarranted invasion of 2
personal privacy; 3
h. Disclosure of investigative records compiled for law 4
enforcement purposes; 5
i. Disclosure of information related to any investigative 6
reports prepared by or on behalf of or for use of the Commission 7
or other committee charged with responsibility of investigation or 8
determination of compliance issues pursuant to the Compact; or 9
j. Matters specifically exempted from disclosure by 10
federal or member state statute. 11
3. If a meeting, or portion of a meeting, is closed pursuant 12
to this provision, the Commission’s legal counsel or designee shall 13
certify that the mee ting may be closed and shall reference each 14
relevant exempting provision. 15
4. The Commission shall keep minutes that fully and 16
clearly describe all matters discussed in a meeting and shall 17
provide a full and accurate summary of actions taken, and the 18
reasons therefore, including a description of the views expressed. 19
All documents considered in connection with an action shall be 20
identified in such minutes. All minutes and documents of a closed 21
meeting shall remain under seal, subject to release by a majorit y 22
vote of the Commission or order of a court of competent 23
jurisdiction. 24
F. Financing of the Commission 25
1. The Commission shall pay, or provide for the payment 26
of, the reasonable expenses of its establishment, organization, and 27
ongoing activities. 28
2. The Commission may accept any and all appropriate 29
revenue sources, donations, and grants of money, equipment, 30
supplies, materials, and services. 31
3. The Commission may levy on and collect an annual 32
assessment from each member state or impose fees on other 33
parties to cover the cost of the operations and activities of the 34
Commission and its staff, which must be in a total amount 35
sufficient to cover its annual budget as approved each year for 36
which revenue is not provided by other sources. The aggregate 37
annual assessment amount shall be allocated based upon a 38
formula to be determined by the Commission, which shall 39
promulgate a rule binding upon all member states. 40
4. The Commission shall not incur obligations of any kind 41
prior to securing the funds adequate t o meet the same; nor shall 42
the Commission pledge the credit of any of the member states, 43
except by and with the authority of the member state. 44

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5. The Commission shall keep accurate accounts of all 1
receipts and disbursements. The receipts and disbursement s of the 2
Commission shall be subject to the audit and accounting 3
procedures established under its bylaws. However, all receipts and 4
disbursements of funds handled by the Commission shall be 5
audited yearly by a certified or licensed public accountant, and the 6
report of the audit shall be included in and become part of the 7
annual report of the Commission. 8
G. Qualified Immunity, Defense, and Indemnification 9
1. The members, officers, executive director, employees and 10
representatives of the Commission shall be immune from suit and 11
liability, either personally or in their official capacity, for any 12
claim for damage to or loss of property or personal injury or other 13
civil liability caused by or arising out of any actual or alleged act, 14
error or omission that oc curred, or that the person against whom 15
the claim is made had a reasonable basis for believing occurred 16
within the scope of Commission employment, duties or 17
responsibilities; provided that nothing in this paragraph shall be 18
construed to protect any such pe rson from suit and/or liability for 19
any damage, loss, injury, or liability caused by the intentional or 20
willful or wanton misconduct of that person. 21
2. The Commission shall defend any member, officer, 22
executive director, employee or representative of the Commission 23
in any civil action seeking to impose liability arising out of any 24
actual or alleged act, error, or omission that occurred within the 25
scope of Commission employment, duties, or responsibilities, or 26
that the person against whom the claim is made had a reasonable 27
basis for believing occurred within the scope of Commission 28
employment, duties, or responsibilities; provided that nothing 29
herein shall be construed to prohibit that person from retaining 30
his or her own counsel; and provided further, that the actual or 31
alleged act, error, or omission did not result from that person’s 32
intentional or willful or wanton misconduct. 33
3. The Commission shall indemnify and hold harmless any 34
member, officer, executive director, employee, or representative of 35
the Commission for the amount of any settlement or judgment 36
obtained against that person arising out of any actual or alleged 37
act, error or omission that occurred within the scope of 38
Commission employment, duties, or responsibilities, or that such 39
person had a reasonable basis for believing occurred within the 40
scope of Commission employment, duties, or responsibilities, 41
provided that the actual or alleged act, error, or omission did not 42
result from the intentional or willful or wanton misconduct of that 43
person. 44

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SECTION 8. DATA SYSTEM 1
2
A. The Commission shall provide for the development, 3
maintenance, and utilization of a coordinated database and 4
reporting system containing licensure, adverse action, and 5
investigative information on all licensed individuals in member 6
states. 7
B. Notwithstanding any other provision of state law to the 8
contrary a member state shall submit a uniform data set to the 9
data system on all individuals to whom this Compact is applicable 10
as required by the rules of the Commission, including: 11
1. Identifying information; 12
2. Licensure data; 13
3. Adverse actions against a license or compact privilege; 14
4. Non-confidential information related to alternative 15
program participation; 16
5. Any denial of application for licensure, and the reason(s) 17
for such denial; and 18
6. Other information that may facilitate the administration 19
of this Compact, as determined by the rules of the Commission. 20
C. Investigative information pertaining to a licensee in any 21
member state will only be available to other party states. 22
D. The Commission shall promptly notify all member states 23
of any adverse action taken against a licensee or an individual 24
applying for a license. Adverse action information pertaining to a 25
licensee in any member state will be avail able to any other 26
member state. 27
E. Member states contributing information to the data system 28
may designate information that may not be shared with the public 29
without the express permission of the contributing state. 30
F. Any information submitted to the data system that is 31
subsequently required to be expunged by the laws of the member 32
state contributing the information shall be removed from the data 33
system. 34
35
SECTION 9. RULEMAKING 36
37
A. The Commission shall exercise its rulemaking powers 38
pursuant to the cr iteria set forth in this Section and the rules 39
adopted thereunder. Rules and amendments shall become binding 40
as of the date specified in each rule or amendment. 41
B. If a majority of the legislatures of the member states 42
rejects a rule, by enactment of a s tatute or resolution in the same 43
manner used to adopt the Compact within 4 years of the date of 44

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adoption of the rule, then such rule shall have no further force 1
and effect in any member state. 2
C. Rules or amendments to the rules shall be adopted at a 3
regular or special meeting of the Commission. 4
D. Prior to promulgation and adoption of a final rule or rules 5
by the Commission, and at least thirty (30) days in advance of the 6
meeting at which the rule will be considered and voted upon, the 7
Commission shall file a Notice of Proposed Rulemaking: 8
1. On the website of the Commission or other publicly 9
accessible platform; and 10
2. On the website of each member state physical therapy 11
licensing board or other publicly accessible platform or the 12
publication in which each state would otherwise publish proposed 13
rules. 14
E. The Notice of Proposed Rulemaking shall include: 15
1. The proposed time, date, and location of the meeting in 16
which the rule will be considered and voted upon; 17
2. The text of the proposed rule o r amendment and the 18
reason for the proposed rule; 19
3. A request for comments on the proposed rule from any 20
interested person; and 21
4. The manner in which interested persons may submit 22
notice to the Commission of their intention to attend the public 23
hearing and any written comments. 24
F. Prior to adoption of a proposed rule, the Commission shall 25
allow persons to submit written data, facts, opinions, and 26
arguments, which shall be made available to the public. 27
G. The Commission shall grant an opportunity f or a public 28
hearing before it adopts a rule or amendment if a hearing is 29
requested by: 30
1. At least twenty-five (25) persons; 31
2. A state or federal governmental subdivision or agency; 32
or 33
3. An association having at least twenty-five (25) members. 34
H. If a hearing is held on the proposed rule or amendment, 35
the Commission shall publish the place, time, and date of the 36
scheduled public hearing. If the hearing is held via electronic 37
means, the Commission shall publish the mechanism for access to 38
the electronic hearing. 39
1. All persons wishing to be heard at the hearing shall 40
notify the executive director of the Commission or other 41
designated member in writing of their desire to appear and testify 42
at the hearing not less than five (5) business days befo re the 43
scheduled date of the hearing. 44

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2. Hearings shall be conducted in a manner providing each 1
person who wishes to comment a fair and reasonable opportunity 2
to comment orally or in writing. 3
3. All hearings will be recorded. A copy of the recording 4
will be made available on request. 5
4. Nothing in this section shall be construed as requiring a 6
separate hearing on each rule. Rules may be grouped for the 7
convenience of the Commission at hearings required by this 8
section. 9
I. Following the scheduled hea ring date, or by the close of 10
business on the scheduled hearing date if the hearing was not 11
held, the Commission shall consider all written and oral comments 12
received. 13
J. If no written notice of intent to attend the public hearing 14
by interested parties is received, the Commission may proceed with 15
promulgation of the proposed rule without a public hearing. 16
K. The Commission shall, by majority vote of all members, 17
take final action on the proposed rule and shall determine the 18
effective date of the rule, if any, based on the rulemaking record 19
and the full text of the rule. 20
L. Upon determination that an emergency exists, the 21
Commission may consider and adopt an emergency rule without 22
prior notice, opportunity for comment, or hearing, provided that 23
the usual rulemaking procedures provided in the Compact and in 24
this section shall be retroactively applied to the rule as soon as 25
reasonably possible, in no event later than ninety (90) days after 26
the effective date of the rule. For the purposes of this provision, an 27
emergency rule is one that must be adopted immediately in order 28
to: 29
1. Meet an imminent threat to public health, safety, or 30
welfare; 31
2. Prevent a loss of Commission or member state funds; 32
3. Meet a deadline for the promulgation of an 33
administrative rule that is established by federal law or rule; or 34
4. Protect public health and safety. 35
M. The Commission or an authorized committee of the 36
Commission may direct revisions to a previously adopted rule or 37
amendment for purposes of correcting typographical errors, errors 38
in format, errors in consistency, or grammatical errors. Public 39
notice of any revisions shall be posted on the website of the 40
Commission. The revision shall be subject to challenge by any 41
person for a period of thirty (30) days after posting. The revision 42
may be challenged only on grounds that the revision results in a 43
material change to a rule. A challenge shall be made in writing, 44
and delivered to the chair of the Commission prior to the end of 45

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the notice period. If no challenge is made, the revision will take 1
effect without further action. If the revision is challenged, the 2
revision may not take effect without the approval of the 3
Commission. 4
5
SECTION 10. OVERSIGHT, DISPUTE RESOLUTION, 6
AND ENFORCEMENT 7
8
A. Oversight 9
1. The executive, legislative, and judicial branches of state 10
government in each member state shall enforce this Compact and 11
take all actions necessary and appropriate to effectuate the 12
Compact’s purposes and intent. The provisions of this Compact 13
and the rules promulg ated hereunder shall have standing as 14
statutory law. 15
2. All courts shall take judicial notice of the Compact and 16
the rules in any judicial or administrative proceeding in a member 17
state pertaining to the subject matter of this Compact which may 18
affect the powers, responsibilities or actions of the Commission. 19
3. The Commission shall be entitled to receive service of 20
process in any such proceeding, and shall have standing to 21
intervene in such a proceeding for all purposes. Failure to provide 22
service of p rocess to the Commission shall render a judgment or 23
order void as to the Commission, this Compact, or promulgated 24
rules. 25
B. Default, Technical Assistance, and Termination 26
1. If the Commission determines that a member state has 27
defaulted in the performa nce of its obligations or responsibilities 28
under this Compact or the promulgated rules, the Commission 29
shall: 30
a. Provide written notice to the defaulting state and 31
other member states of the nature of the default, the proposed 32
means of curing the default and/or any other action to be taken by 33
the Commission; and 34
b. Provide remedial training and specific technical 35
assistance regarding the default. 36
2. If a state in default fails to cure the default, the 37
defaulting state may be terminated from the Comp act upon an 38
affirmative vote of a majority of the member states, and all rights, 39
privileges and benefits conferred by this Compact may be 40
terminated on the effective date of termination. A cure of the 41
default does not relieve the offending state of obligat ions or 42
liabilities incurred during the period of default. 43
3. Termination of membership in the Compact shall be 44
imposed only after all other means of securing compliance have 45

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been exhausted. Notice of intent to suspend or terminate shall be 1
given by the Commission to the governor, the majority and 2
minority leaders of the defaulting state’s legislature, and each of 3
the member states. 4
4. A state that has been terminated is responsible for all 5
assessments, obligations, and liabilities incurred through the 6
effective date of termination, including obligations that extend 7
beyond the effective date of termination. 8
5. The Commission shall not bear any costs related to a 9
state that is found to be in default or that has been terminated 10
from the Compact, unless a greed upon in writing between the 11
Commission and the defaulting state. 12
6. The defaulting state may appeal the action of the 13
Commission by petitioning the U.S. District Court for the District 14
of Columbia or the federal district where the Commission has it s 15
principal offices. The prevailing member shall be awarded all 16
costs of such litigation, including reasonable attorney’s fees. 17
C. Dispute Resolution 18
1. Upon request by a member state, the Commission shall 19
attempt to resolve disputes related to the Com pact that arise 20
among member states and between member and non -member 21
states. 22
2. The Commission shall promulgate a rule providing for 23
both mediation and binding dispute resolution for disputes as 24
appropriate. 25
D. Enforcement 26
1. The Commission, in the reasonable exercise of its 27
discretion, shall enforce the provisions and rules of this Compact. 28
2. By majority vote, the Commission may initiate legal 29
action in the United States District Court for the District of 30
Columbia or the federal district where th e Commission has its 31
principal offices against a member state in default to enforce 32
compliance with the provisions of the Compact and its 33
promulgated rules and bylaws. The relief sought may include both 34
injunctive relief and damages. In the event judicial enforcement is 35
necessary, the prevailing member shall be awarded all costs of 36
such litigation, including reasonable attorney’s fees. 37
3. The remedies herein shall not be the exclusive remedies 38
of the Commission. The Commission may pursue any other 39
remedies available under federal or state law. 40

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SECTION 11. DATE OF IMPLEMENTATION OF 1
THE INTERSTATE COMMISSION FOR PHYSICAL 2
THERAPY PRACTICE AND ASSOCIATED RULES, 3
WITHDRAWAL, AND AMENDMENT 4
5
A. The Compact shall come into effect on the date on which 6
the Compact statute is enacted into law in the tenth member state. 7
The provisions, which become effective at that time, shall be 8
limited to the powers granted to the Commission relating to 9
assembly and the promulgation of rules. Thereafter, the 10
Commission shall meet and exercise rulemaking powers necessary 11
to the implementation and administration of the Compact. 12
B. Any state that joins the Compact subsequent to the 13
Commission’s initial adoption of the rules shall be subject to the 14
rules as they exist on the d ate on which the Compact becomes law 15
in that state. Any rule that has been previously adopted by the 16
Commission shall have the full force and effect of law on the day 17
the Compact becomes law in that state. 18
C. Any member state may withdraw from this Compa ct by 19
enacting a statute repealing the same. 20
1. A member state’s withdrawal shall not take effect until 21
six (6) months after enactment of the repealing statute. 22
2. Withdrawal shall not affect the continuing requirement 23
of the withdrawing state’s physic al therapy licensing board to 24
comply with the investigative and adverse action reporting 25
requirements of this act prior to the effective date of withdrawal. 26
D. Nothing contained in this Compact shall be construed to 27
invalidate or prevent any physical the rapy licensure agreement or 28
other cooperative arrangement between a member state and a 29
non-member state that does not conflict with the provisions of this 30
Compact. 31
E. This Compact may be amended by the member states. No 32
amendment to this Compact shall become effective and binding 33
upon any member state until it is enacted into the laws of all 34
member states. 35
36
SECTION 12. CONSTRUCTION AND SEVERABILITY 37
38
This Compact shall be liberally construed so as to effectuate 39
the purposes thereof. The provisions of th is Compact shall be 40
severable and if any phrase, clause, sentence or provision of this 41
Compact is declared to be contrary to the constitution of any party 42
state or of the United States or the applicability thereof to any 43
government, agency, person or circu mstance is held invalid, the 44
validity of the remainder of this Compact and the applicability 45

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thereof to any government, agency, person or circumstance shall 1
not be affected thereby. If this Compact shall be held contrary to 2
the constitution of any party st ate, the Compact shall remain in 3
full force and effect as to the remaining party states and in full 4
force and effect as to the party state affected as to all severable 5
matters. 6
Sec. 24. NRS 640.075 is hereby amended to read as follows: 7
640.075 1. Except as otherwise provided in this section and 8
NRS 239.0115 [,] and section 23 of this act, a complaint filed with 9
the Board, all documents and other information filed with the 10
complaint and all documents and other information compiled as a 11
result of an investigation conducted to determine whether to initiate 12
disciplinary action against a person are confidential, unless the 13
person submits a written statement to the Board requesting that such 14
documents and information be made public records. 15
2. The charging documents filed with t he Board to initiate 16
disciplinary action pursuant to chapter 622A of NRS and all 17
documents and information considered by the Board when 18
determining whether to impose discipline are public records. 19
3. The Board shall, to the extent feasible, communicate o r 20
cooperate with or provide any documents or other information to 21
any other licensing board or any other agency that is investigating a 22
person, including, without limitation, a law enforcement agency. 23
4. An order that imposes discipline and the findings of fact and 24
conclusions of law supporting that order are public records. 25
Sec. 25. NRS 640.110 is hereby amended to read as follows: 26
640.110 1. The Board shall license as a physical therapist or 27
physical therapist assistant each applicant who proves to the 28
satisfaction of the Board his or her qualifications for licensure. 29
2. The Board shall issue to each applicant who proves to the 30
satisfaction of the Board his or her qualification for licensure: 31
(a) As a physical therapist, a license as a physical therapist. The 32
license authorizes the applicant to represent himself or herself as a 33
licensed physical therapist and to practice physical therapy in the 34
State of Nevada subject to the conditions and limitations of this 35
chapter. 36
(b) As a physical therapist assistant, a license as a physical 37
therapist assistant. The license authorizes the applicant to represent 38
himself or herself as a licensed physical therapist assistant and to 39
practice as a licensed physical therapist a ssistant subject to the 40
conditions and limitations of this chapter. 41
3. Each physical therapist shall display his or her current 42
license or proof that he or she is authorized to practice in this 43
State under the Physical Therapy Licensure Compact enacted b y 44

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section 23 of this act, as applicable, in a location which is 1
accessible to the public. 2
4. The Board may charge a fee, not to exceed $25, to change a 3
name on a license. 4
5. A license as a physical therapist assistant remains valid 5
while a supervising physical therapist continues to supervise the 6
physical therapist assistant. 7
Sec. 26. Chapter 640A of NRS is hereby amended by adding 8
thereto a new section to read as follows: 9
The Occupational Therapy Licensure Compact is hereby 10
ratified and entered into with all other jurisdictions legally joining 11
the Compact, in substantially the form set forth in this section: 12
OCCUPATIONAL THERAPY LICENSURE COMPACT 13
14
SECTION 1. PURPOSE 15
16
The purpose of this Compact is to facilitate interstate practice 17
of Occupational Therapy with the goal of improving public access 18
to Occupational Therapy services. The Practice of Occupational 19
Therapy occurs in the Sta te where the patient/client is located at 20
the time of the patient/client encounter. The Compact preserves 21
the regulatory authority of States to protect public health and 22
safety through the current system of State licensure. 23
This Compact is designed to achieve the following objectives: 24
A. Increase public access to Occupational Therapy services 25
by providing for the mutual recognition of other Member State 26
licenses; 27
B. Enhance the States’ ability to protect the public’s health 28
and safety; 29
C. Encourage the cooperation of Member States in 30
regulating multi-State Occupational Therapy Practice; 31
D. Support spouses of relocating military members; 32
E. Enhance the exchange of licensure, investigative, and 33
disciplinary information between Member States; 34
F. Allow a Remote State to hold a provider of services with a 35
Compact Privilege in that State accountable to that State’s 36
practice standards; and 37
G. Facilitate the use of Telehealth technology in order to 38
increase access to Occupational Therapy services. 39
40
SECTION 2. DEFINITIONS 41
42
As used in this Compact, and except as otherwise provided, the 43
following definitions shall apply: 44

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A. “Active Duty Military” means full -time duty status in the 1
active uniformed service of the United States, including members 2
of the National Guard and Reserve on active duty orders pursuant 3
to 10 U.S.C. Chapter 1209 and 10 U.S.C. Chapter 1211. 4
B. “Adverse Action” means any administrative, civil, 5
equitable, or criminal action permitted by a State’s laws which is 6
imposed by a Licensing Board or other authority against an 7
Occupational Therapist or Occupational Therapy Assistant, 8
including actions against an individual’s license or Compact 9
Privilege such as censure, revocation, suspension, probation, 10
monitoring of the Licensee, or restric tion on the Licensee’s 11
practice. 12
C. “Alternative Program” means a non -disciplinary 13
monitoring process approved by an Occupational Therapy 14
Licensing Board. 15
D. “Compact Privilege” means the authorization, which is 16
equivalent to a license, granted by a Re mote State to allow a 17
Licensee from another Member State to practice as an 18
Occupational Therapist or practice as an Occupational Therapy 19
Assistant in the Remote State under its laws and rules. The 20
Practice of Occupational Therapy occurs in the Member State 21
where the patient/client is located at the time of the patient/client 22
encounter. 23
E. “Continuing Competence/Education” means a 24
requirement, as a condition of license renewal, to provide evidence 25
of participation in, and/or completion of, educational and 26
professional activities relevant to practice or area of work. 27
F. “Current Significant Investigative Information” means 28
Investigative Information that a Licensing Board, after an inquiry 29
or investigation that includes notification and an opportunity for 30
the Occupational Therapist or Occupational Therapy Assistant to 31
respond, if required by State law, has reason to believe is not 32
groundless and, if proved true, would indicate more than a minor 33
infraction. 34
G. “Data System” means a repository of information about 35
Licensees, including but not limited to license status, Investigative 36
Information, Compact Privileges, and Adverse Actions. 37
H. “Encumbered License” means a license in which an 38
Adverse Action restricts the Practice of Occupational Therapy by 39
the Li censee or said Adverse Action has been reported to the 40
National Practitioner Data Bank (NPDB). 41
I. “Executive Committee” means a group of directors elected 42
or appointed to act on behalf of, and within the powers granted to 43
them by, the Commission. 44

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J. “Home State” means the Member State that is the 1
Licensee’s Primary State of Residence. 2
K. “Impaired Practitioner” means individuals whose 3
professional practice is adversely affected by substance abuse, 4
addiction, or other health-related conditions. 5
L. “Investigative Information” means information, records, 6
and/or documents received or generated by an Occupational 7
Therapy Licensing Board pursuant to an investigation. 8
M. “Jurisprudence Requirement” means the assessment of 9
an individual’s knowledge of the laws and rules governing the 10
Practice of Occupational Therapy in a State. 11
N. “Licensee” means an individual who currently holds an 12
authorization from the State to practice as an Occupational 13
Therapist or as an Occupational Therapy Assistant. 14
O. “Member State” means a State that has enacted the 15
Compact. 16
P. “Occupational Therapist” means an individual who is 17
licensed by a State to practice Occupational Therapy. 18
Q. “Occupational Therapy Assistant” means an individual 19
who is licensed by a State to assis t in the Practice of Occupational 20
Therapy. 21
R. “Occupational Therapy,” “Occupational Therapy 22
Practice,” and the “Practice of Occupational Therapy” mean the 23
care and services provided by an Occupational Therapist or an 24
Occupational Therapy Assistant as set forth in the Member State’s 25
statutes and regulations. 26
S. “Occupational Therapy Compact Commission” or 27
“Commission” means the national administrative body whose 28
membership consists of all States that have enacted the Compact. 29
T. “Occupational Therapy L icensing Board” or “Licensing 30
Board” means the agency of a State that is authorized to license 31
and regulate Occupational Therapists and Occupational Therapy 32
Assistants. 33
U. “Primary State of Residence” means the state (also known 34
as the Home State) in whi ch an Occupational Therapist or 35
Occupational Therapy Assistant who is not Active Duty Military 36
declares a primary residence for legal purposes as verified by: 37
driver’s license, federal income tax return, lease, deed, mortgage 38
or voter registration or other verifying documentation as further 39
defined by Commission Rules. 40
V. “Remote State” means a Member State other than the 41
Home State, where a Licensee is exercising or seeking to exercise 42
the Compact Privilege. 43
W. “Rule” means a regulation promulgated by the 44
Commission that has the force of law. 45

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X. “State” means any state, commonwealth, district, or 1
territory of the United States of America that regulates the 2
Practice of Occupational Therapy. 3
Y. “Single-State License” means an Occupational Therapist 4
or Occupational Therapy Assistant license issued by a Member 5
State that authorizes practice only within the issuing State and 6
does not include a Compact Privilege in any other Member State. 7
Z. “Telehealth” means the application of telecommunication 8
technology to deliver Occupational Therapy services for 9
assessment, intervention and/or consultation. 10
11
SECTION 3. STATE PARTICIPATION IN THE COMPACT 12
13
A. To participate in the Compact, a Member State shall: 14
1. License Occupational Therapists and Occupational 15
Therapy Assistants; 16
2. Participate fully in the Commission’s Data System, 17
including but not limited to using the Commission’s unique 18
identifier as defined in Rules of the Commission; 19
3. Have a mechanism in place for receiving and 20
investigating complaints about Licensees; 21
4. Notify the Commission, in compliance with the terms of 22
the Compact and Rules, of any Adverse Action or the availability 23
of Investigative Information regarding a Licensee; 24
5. Implement or utilize procedures for considering the 25
criminal history records of applicants for an initial Compact 26
Privilege. These procedures shall include the submission of 27
fingerprints or other biometric -based information by applicants 28
for the purpose of obtaining an applicant’s criminal history record 29
information from the Federal Bureau of Investigation and the 30
agency responsible for retaining that State’s criminal records; 31
a. A Member State shall, within a time frame established 32
by the Commission, require a criminal background check for a 33
Licensee seeking/applying for a Compact Privilege whose Primary 34
State of Residence is that Member State, by receiving the results of 35
the Federal Bureau of Investigation criminal record search, and 36
shall use the results in making licensure decisions. 37
b. Communication be tween a Member State, the 38
Commission and among Member States regarding the verification 39
of eligibility for licensure through the Compact shall not include 40
any information received from the Federal Bureau of 41
Investigation relating to a federal criminal reco rds check 42
performed by a Member State under Public Law 92-544. 43
6. Comply with the Rules of the Commission; 44

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7. Utilize only a recognized national examination as a 1
requirement for licensure pursuant to the Rules of the 2
Commission; and 3
8. Have Continuin g Competence/Education requirements 4
as a condition for license renewal. 5
B. A Member State shall grant the Compact Privilege to a 6
Licensee holding a valid unencumbered license in another 7
Member State in accordance with the terms of the Compact and 8
Rules. 9
C. Member States may charge a fee for granting a Compact 10
Privilege. 11
D. A Member State shall provide for the State’s delegate to 12
attend all Occupational Therapy Compact Commission meetings. 13
E. Individuals not residing in a Member State shall continue 14
to be able to apply for a Member State’s Single -State License as 15
provided under the laws of each Member State. However, the 16
Single-State License granted to these individuals shall not be 17
recognized as granting the Compact Privilege in any other 18
Member State. 19
F. Nothing in this Compact shall affect the requirements 20
established by a Member State for the issuance of a Single -State 21
License. 22
23
SECTION 4. COMPACT PRIVILEGE 24
25
A. To exercise the Compact Privilege under the terms and 26
provisions of the Compact, the Licensee shall: 27
1. Hold a license in the Home State; 28
2. Have a valid United States Social Security Number or 29
National Practitioner Identification number; 30
3. Have no encumbrance on any State license; 31
4. Be eligible for a Compact Privilege in any Me mber State 32
in accordance with Section 4D, F, G, and H; 33
5. Have paid all fines and completed all requirements 34
resulting from any Adverse Action against any license or Compact 35
Privilege, and two years have elapsed from the date of such 36
completion; 37
6. Notify the Commission that the Licensee is seeking the 38
Compact Privilege within a Remote State(s); 39
7. Pay any applicable fees, including any State fee, for the 40
Compact Privilege; 41
8. Complete a criminal background check in accordance 42
with Section 3A(5); 43

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a. The Licensee shall be responsible for the payment of 1
any fee associated with the completion of a criminal background 2
check. 3
9. Meet any Jurisprudence Requirements established by the 4
Remote State(s) in which the Licensee is seeking a Compact 5
Privilege; and 6
10. Report to the Commission Adverse Action taken by any 7
non-Member State within 30 days from the date the Adverse 8
Action is taken. 9
B. The Compact Privilege is valid until the expiration date of 10
the Home State license. The Licensee must comply wi th the 11
requirements of Section 4A to maintain the Compact Privilege in 12
the Remote State. 13
C. A Licensee providing Occupational Therapy in a Remote 14
State under the Compact Privilege shall function within the laws 15
and regulations of the Remote State. 16
D. Occupational Therapy Assistants practicing in a Remote 17
State shall be supervised by an Occupational Therapist licensed or 18
holding a Compact Privilege in that Remote State. 19
E. A Licensee providing Occupational Therapy in a Remote 20
State is subject to that State’s regulatory authority. A Remote State 21
may, in accordance with due process and that State’s laws, remove 22
a Licensee’s Compact Privilege in the Remote State for a specific 23
period of time, impose fines, and/or take any other necessary 24
actions to protect the health and safety of its citizens. The Licensee 25
may be ineligible for a Compact Privilege in any State until the 26
specific time for removal has passed and all fines are paid. 27
F. If a Home State license is encumbered, the Licensee shall 28
lose the Compact Privilege in any Remote State until the following 29
occur: 30
1. The Home State license is no longer encumbered; and 31
2. Two years have elapsed from the date on which the 32
Home State license is no longer encumbered in accordance with 33
Section 4(F)(1). 34
G. Once an Encumbered License in the Home State is 35
restored to good standing, the Licensee must meet the 36
requirements of Section 4A to obtain a Compact Privilege in any 37
Remote State. 38
H. If a Licensee’s Compact Privilege in any Remote State is 39
removed, the i ndividual may lose the Compact Privilege in any 40
other Remote State until the following occur: 41
1. The specific period of time for which the Compact 42
Privilege was removed has ended; 43
2. All fines have been paid and all conditions have been 44
met; 45

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3. Two y ears have elapsed from the date of completing 1
requirements for 4(H)(1) and (2); and 2
4. The Compact Privileges are reinstated by the 3
Commission, and the compact Data System is updated to reflect 4
reinstatement. 5
I. If a Licensee’s Compact Privilege in any Remote State is 6
removed due to an erroneous charge, privileges shall be restored 7
through the compact Data System. 8
J. Once the requirements of Section 4H have been met, the 9
Licensee must meet the requirements in Section 4A to obtain a 10
Compact Privilege in a Remote State. 11
12
SECTION 5. OBTAINING A NEW HOME STATE LICENSE 13
BY VIRTUE OF COMPACT PRIVILEGE 14
15
A. An Occupational Therapist or Occupational Therapy 16
Assistant may hold a Home State license, which allows for 17
Compact Privileges in Member States, in only one Member State 18
at a time. 19
B. If an Occupational Therapist or Occupational Therapy 20
Assistant changes Primary State of Residence by moving between 21
two Member States: 22
1. The Occupational Therapist or Occupational Therapy 23
Assistant shall file an application for obtaining a new Home State 24
license by virtue of a Compact Privilege, pay all applicable fees, 25
and notify the current and new Home State in accordance with 26
applicable Rules adopted by the Commission. 27
2. Upon receipt of an application for obtaining a new Home 28
State license by virtue of compact privilege, the new Home State 29
shall verify that the Occupational Therapist or Occupational 30
Therapy Assistant meets the pertinent criteria outlined in Section 31
4 via the Data System, without need for primary sou rce 32
verification except for: 33
a. an FBI fingerprint based criminal background check 34
if not previously performed or updated pursuant to applicable 35
Rules adopted by the Commission in accordance with Public 36
Law 92-544; 37
b. other criminal background check as required by the 38
new Home State; and 39
c. submission of any requisite Jurisprudence 40
Requirements of the new Home State. 41
3. The former Home State shall convert the former Home 42
State license into a Compact Privilege once the new Home State 43
has activate d the new Home State license in accordance with 44
applicable Rules adopted by the Commission. 45

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4. Notwithstanding any other provision of this Compact, if 1
the Occupational Therapist or Occupational Therapy Assistant 2
cannot meet the criteria in Section 4, the new Home State shall 3
apply its requirements for issuing a new Single-State License. 4
5. The Occupational Therapist or the Occupational 5
Therapy Assistant shall pay all applicable fees to the new Home 6
State in order to be issued a new Home State license. 7
C. If an Occupational Therapist or Occupational Therapy 8
Assistant changes Primary State of Residence by moving from a 9
Member State to a non -Member State, or from a non -Member 10
State to a Member State, the State criteria shall apply for issuance 11
of a Single-State License in the new State. 12
D. Nothing in this compact shall interfere with a Licensee’s 13
ability to hold a Single -State License in multiple States; however, 14
for the purposes of this compact, a Licensee shall have only one 15
Home State license. 16
E. Nothing in this Compact shall affect the requirements 17
established by a Member State for the issuance of a Single -State 18
License. 19
20
SECTION 6. ACTIVE DUTY MILITARY 21
PERSONNEL OR THEIR SPOUSES 22
23
A. Active Duty Military personnel, or their spouses, shall 24
designate a Home State where the individual has a current license 25
in good standing. The individual may retain the Home State 26
designation during the period the service member is on active 27
duty. Subsequent to designating a Home State, the individual shall 28
only change their Home State through application for licensure in 29
the new State or through the process described in Section 5. 30
31
SECTION 7. ADVERSE ACTIONS 32
33
A. A Home State shall have exclusive power to impose 34
Adverse Action against an Occupational Therapist ’s or 35
Occupational Therapy Assistant’s license issued by the Home 36
State. 37
B. In addition to the other powers conferred by State law, a 38
Remote State shall have the authority, in accordance with existing 39
State due process law, to: 40
1. Take Adverse Action against an Occupational 41
Therapist’s or Occupational Therapy Assistant’s Compact 42
Privilege within that Member State. 43
2. Issue subpoenas for both hearings and investigations 44
that require the attendance and testimony of witnesses as well as 45

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the production o f evidence. Subpoenas issued by a Licensing 1
Board in a Member State for the attendance and testimony of 2
witnesses or the production of evidence from another Member 3
State shall be enforced in the latter State by any court of 4
competent jurisdiction, according to the practice and procedure of 5
that court applicable to subpoenas issued in proceedings pending 6
before it. The issuing authority shall pay any witness fees, travel 7
expenses, mileage and other fees required by the service statutes of 8
the State in which the witnesses or evidence are located. 9
C. For purposes of taking Adverse Action, the Home State 10
shall give the same priority and effect to reported conduct received 11
from a Member State as it would if the conduct had occurred 12
within the Home State. In so doing, the Home State shall apply its 13
own State laws to determine appropriate action. 14
D. The Home State shall complete any pending investigations 15
of an Occupational Therapist or Occupational Therapy Assistant 16
who changes Primary State of Residence during the course of the 17
investigations. The Home State, where the investigations were 18
initiated, shall also have the authority to take appropriate action(s) 19
and shall promptly report the conclusions of the investigations to 20
the OT Compact Commission Data System . The Occupational 21
Therapy Compact Commission Data System administrator shall 22
promptly notify the new Home State of any Adverse Actions. 23
E. A Member State, if otherwise permitted by State law, may 24
recover from the affected Occupational Therapist or Occup ational 25
Therapy Assistant the costs of investigations and disposition of 26
cases resulting from any Adverse Action taken against that 27
Occupational Therapist or Occupational Therapy Assistant. 28
F. A Member State may take Adverse Action based on the 29
factual f indings of the Remote State, provided that the Member 30
State follows its own procedures for taking the Adverse Action. 31
G. Joint Investigations 32
1. In addition to the authority granted to a Member State by 33
its respective State Occupational Therapy laws an d regulations or 34
other applicable State law, any Member State may participate with 35
other Member States in joint investigations of Licensees. 36
2. Member States shall share any investigative, litigation, or 37
compliance materials in furtherance of any joint o r individual 38
investigation initiated under the Compact. 39
H. If an Adverse Action is taken by the Home State against 40
an Occupational Therapist’s or Occupational Therapy Assistant’s 41
license, the Occupational Therapist’s or Occupational Therapy 42
Assistant’s Compact Privilege in all other Member States shall be 43
deactivated until all encumbrances have been removed from the 44
State license. All Home State disciplinary orders that impose 45

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Adverse Action against an Occupational Therapist’s or 1
Occupational Therapy Assi stant’s license shall include a 2
Statement that the Occupational Therapist’s or Occupational 3
Therapy Assistant’s Compact Privilege is deactivated in all 4
Member States during the pendency of the order. 5
I. If a Member State takes Adverse Action, it shall pr omptly 6
notify the administrator of the Data System. The administrator of 7
the Data System shall promptly notify the Home State of any 8
Adverse Actions by Remote States. 9
J. Nothing in this Compact shall override a Member State’s 10
decision that participation in an Alternative Program may be used 11
in lieu of Adverse Action. 12
13
SECTION 8. ESTABLISHMENT OF THE OCCUPATIONAL 14
THERAPY COMPACT COMMISSION 15
16
A. The Compact Member States hereby create and establish a 17
joint public agency known as the Occupational Therapy C ompact 18
Commission: 19
1. The Commission is an instrumentality of the Compact 20
States. 21
2. Venue is proper and judicial proceedings by or against 22
the Commission shall be brought solely and exclusively in a court 23
of competent jurisdiction where the principal office of the 24
Commission is located. The Commission may waive venue and 25
jurisdictional defenses to the extent it adopts or consents to 26
participate in alternative dispute resolution proceedings. 27
3. Nothing in this Compact shall be construed to be a 28
waiver of sovereign immunity. 29
B. Membership, Voting, and Meetings 30
1. Each Member State shall have and be limited to one (1) 31
delegate selected by that Member State’s Licensing Board. 32
2. The delegate shall be either: 33
a. A current member of the Licensing Board, who is an 34
Occupational Therapist, Occupational Therapy Assistant, or 35
public member; or 36
b. An administrator of the Licensing Board. 37
3. Any delegate may be removed or suspended from office 38
as provided by the law of the State from which the delega te is 39
appointed. 40
4. The Member State board shall fill any vacancy occurring 41
in the Commission within 90 days. 42
5. Each delegate shall be entitled to one (1) vote with 43
regard to the promulgation of Rules and creation of bylaws and 44
shall otherwise have an opportunity to participate in the business 45

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and affairs of the Commission. A delegate shall vote in person or 1
by such other means as provided in the bylaws. The bylaws may 2
provide for delegates’ participation in meetings by telephone or 3
other means of communication. 4
6. The Commission shall meet at least once during each 5
calendar year. Additional meetings shall be held as set forth in the 6
bylaws. 7
7. The Commission shall establish by Rule a term of office 8
for delegates. 9
C. The Commission shall have the following powers and 10
duties: 11
1. Establish a Code of Ethics for the Commission; 12
2. Establish the fiscal year of the Commission; 13
3. Establish bylaws; 14
4. Maintain its financial records in accordance with the 15
bylaws; 16
5. Meet and take such actions as are consistent with the 17
provisions of this Compact and the bylaws; 18
6. Promulgate uniform Rules to facilitate and coordinate 19
implementation and administration of this Compact. The Rules 20
shall have the force and effect of law and shall be binding in all 21
Member States; 22
7. Bring and prosecute legal proceedings or actions in the 23
name of the Commission, provided that the standing of any State 24
Occupational Therapy Licensing Board to sue or be sued under 25
applicable law shall not be affected; 26
8. Purchase and maintain insurance and bonds; 27
9. Borrow, accept, or contract for services of personnel, 28
including, but not limited to, employees of a Member State; 29
10. Hire employees, elect or appoint officers, fix 30
compensation, define duties, grant such individuals ap propriate 31
authority to carry out the purposes of the Compact, and establish 32
the Commission’s personnel policies and programs relating to 33
conflicts of interest, qualifications of personnel, and other related 34
personnel matters; 35
11. Accept any and all appro priate donations and grants of 36
money, equipment, supplies, materials and services, and receive, 37
utilize and dispose of the same; provided that at all times the 38
Commission shall avoid any appearance of impropriety and/or 39
conflict of interest; 40
12. Lease, p urchase, accept appropriate gifts or donations 41
of, or otherwise own, hold, improve or use, any property, real, 42
personal or mixed; provided that at all times the Commission shall 43
avoid any appearance of impropriety; 44

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13. Sell, convey, mortgage, pledge, lea se, exchange, 1
abandon, or otherwise dispose of any property real, personal, or 2
mixed; 3
14. Establish a budget and make expenditures; 4
15. Borrow money; 5
16. Appoint committees, including standing committees 6
composed of members, State regulators, State l egislators or their 7
representatives, and consumer representatives, and such other 8
interested persons as may be designated in this Compact and the 9
bylaws; 10
17. Provide and receive information from, and cooperate 11
with, law enforcement agencies; 12
18. Establish and elect an Executive Committee; and 13
19. Perform such other functions as may be necessary or 14
appropriate to achieve the purposes of this Compact consistent 15
with the State regulation of Occupational Therapy licensure and 16
practice. 17
D. The Executive Committee 18
The Executive Committee shall have the power to act on behalf 19
of the Commission according to the terms of this Compact. 20
1. The Executive Committee shall be composed of nine 21
members: 22
a. Seven voting members who are elected by the 23
Commission from the current membership of the Commission; 24
b. One ex-officio, nonvoting member from a recognized 25
national Occupational Therapy professional association; and 26
c. One ex-officio, nonvoting member from a recognized 27
national Occupational Therapy certification organization. 28
2. The ex -officio members will be selected by their 29
respective organizations. 30
3. The Commission may remove any member of the 31
Executive Committee as provided in bylaws. 32
4. The Executive Committee shall meet at least annually. 33
5. The Executive Committee shall have the following Duties 34
and responsibilities: 35
a. Recommend to the entire Commission changes to the 36
Rules or bylaws, changes to this Compact legislation, fees paid by 37
Compact Member States such as annual dues, and any 38
Commission Compact fee charged to Licensees for the Compact 39
Privilege; 40
b. Ensure Compact administration services are 41
appropriately provided, contractual or otherwise; 42
c. Prepare and recommend the budget; 43
d. Maintain financial records on behalf of t he 44
Commission; 45

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e. Monitor Compact compliance of Member States and 1
provide compliance reports to the Commission; 2
f. Establish additional committees as necessary; and 3
g. Perform other duties as provided in Rules or bylaws. 4
E. Meetings of the Commission 5
1. All meetings shall be open to the public, and public 6
notice of meetings shall be given in the same manner as required 7
under the Rulemaking provisions in Section 10. 8
2. The Commission or the Executive Committee or other 9
committees of the Commis sion may convene in a closed, non -10
public meeting if the Commission or Executive Committee or 11
other committees of the Commission must discuss: 12
a. Non-compliance of a Member State with its 13
obligations under the Compact; 14
b. The employment, compensation, discipline or other 15
matters, practices or procedures related to specific employees or 16
other matters related to the Commission’s internal personnel 17
practices and procedures; 18
c. Current, threatened, or reasonably anticipated 19
litigation; 20
d. Negotiation of contracts for the purchase, lease, or 21
sale of goods, services, or real estate; 22
e. Accusing any person of a crime or formally censuring 23
any person; 24
f. Disclosure of trade secrets or commercial or financial 25
information that is privileged or confidential; 26
g. Disclosure of information of a personal nature where 27
disclosure would constitute a clearly unwarranted invasion of 28
personal privacy; 29
h. Disclosure of investigative records compiled for law 30
enforcement purposes; 31
i. Disclosure of information related to any investigative 32
reports prepared by or on behalf of or for use of the Commission 33
or other committee charged with responsibility of investigation or 34
determination of compliance issues pursuant to the Compact; or 35
j. Matters specif ically exempted from disclosure by 36
federal or Member State statute. 37
3. If a meeting, or portion of a meeting, is closed pursuant 38
to this provision, the Commission’s legal counsel or designee shall 39
certify that the meeting may be closed and shall referenc e each 40
relevant exempting provision. 41
4. The Commission shall keep minutes that fully and 42
clearly describe all matters discussed in a meeting and shall 43
provide a full and accurate summary of actions taken, and the 44
reasons therefore, including a descriptio n of the views expressed. 45

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All documents considered in connection with an action shall be 1
identified in such minutes. All minutes and documents of a closed 2
meeting shall remain under seal, subject to release by a majority 3
vote of the Commission or order of a court of competent 4
jurisdiction. 5
F. Financing of the Commission 6
1. The Commission shall pay, or provide for the payment 7
of, the reasonable expenses of its establishment, organization, and 8
ongoing activities. 9
2. The Commission may accept any and all appropriate 10
revenue sources, donations, and grants of money, equipment, 11
supplies, materials, and services. 12
3. The Commission may levy on and collect an annual 13
assessment from each Member State or impose fees on other 14
parties to cover the cost of the operations and activities of the 15
Commission and its staff, which must be in a total amount 16
sufficient to cover its annual budget as approved by the 17
Commission each year for which revenue is not provided by other 18
sources. The aggregate annual assessment amo unt shall be 19
allocated based upon a formula to be determined by the 20
Commission, which shall promulgate a Rule binding upon all 21
Member States. 22
4. The Commission shall not incur obligations of any kind 23
prior to securing the funds adequate to meet the same; nor shall 24
the Commission pledge the credit of any of the Member States, 25
except by and with the authority of the Member State. 26
5. The Commission shall keep accurate accounts of all 27
receipts and disbursements. The receipts and disbursements of the 28
Commission shall be subject to the audit and accounting 29
procedures established under its bylaws. However, all receipts and 30
disbursements of funds handled by the Commission shall be 31
audited yearly by a certified or licensed public accountant, and the 32
report of the audit shall be included in and become part of the 33
annual report of the Commission. 34
G. Qualified Immunity, Defense, and Indemnification 35
1. The members, officers, executive director, employees and 36
representatives of the Commission shall be immune from s uit and 37
liability, either personally or in their official capacity, for any 38
claim for damage to or loss of property or personal injury or other 39
civil liability caused by or arising out of any actual or alleged act, 40
error or omission that occurred, or that the person against whom 41
the claim is made had a reasonable basis for believing occurred 42
within the scope of Commission employment, duties or 43
responsibilities; provided that nothing in this paragraph shall be 44
construed to protect any such person from suit a nd/or liability for 45

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any damage, loss, injury, or liability caused by the intentional or 1
willful or wanton misconduct of that person. 2
2. The Commission shall defend any member, officer, 3
executive director, employee, or representative of the Commission 4
in any civil action seeking to impose liability arising out of any 5
actual or alleged act, error, or omission that occurred within the 6
scope of Commission employment, duties, or responsibilities, or 7
that the person against whom the claim is made had a reasonab le 8
basis for believing occurred within the scope of Commission 9
employment, duties, or responsibilities; provided that nothing 10
herein shall be construed to prohibit that person from retaining 11
his or her own counsel; and provided further, that the actual or 12
alleged act, error, or omission did not result from that person’s 13
intentional or willful or wanton misconduct. 14
3. The Commission shall indemnify and hold harmless any 15
member, officer, executive director, employee, or representative of 16
the Commission for the amount of any settlement or judgment 17
obtained against that person arising out of any actual or alleged 18
act, error or omission that occurred within the scope of 19
Commission employment, duties, or responsibilities, or that such 20
person had a reasonable bas is for believing occurred within the 21
scope of Commission employment, duties, or responsibilities, 22
provided that the actual or alleged act, error, or omission did not 23
result from the intentional or willful or wanton misconduct of that 24
person. 25
26
SECTION 9. DATA SYSTEM 27
28
A. The Commission shall provide for the development, 29
maintenance, and utilization of a coordinated database and 30
reporting system containing licensure, Adverse Action, and 31
Investigative Information on all licensed individuals in Member 32
States. 33
B. A Member State shall submit a uniform data set to the 34
Data System on all individuals to whom this Compact is applicable 35
(utilizing a unique identifier) as required by the Rules of the 36
Commission, including: 37
1. Identifying information; 38
2. Licensure data; 39
3. Adverse Actions against a license or Compact Privilege; 40
4. Non-confidential information related to Alternative 41
Program participation; 42
5. Any denial of application for licensure, and the reason(s) 43
for such denial; 44

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6. Other information that may facilitate the administration 1
of this Compact, as determined by the Rules of the Commission; 2
and 3
7. Current Significant Investigative Information. 4
C. Current Significant Investigative Information and other 5
Investigative Information pertaining to a Licensee in any Member 6
State will only be available to other Member States. 7
D. The Commission shall promptly notify all Member States 8
of any Adverse Action taken against a Licensee or an individual 9
applying for a license. Adverse Action information pert aining to a 10
Licensee in any Member State will be available to any other 11
Member State. 12
E. Member States contributing information to the Data 13
System may designate information that may not be shared with the 14
public without the express permission of the contributing State. 15
F. Any information submitted to the Data System that is 16
subsequently required to be expunged by the laws of the Member 17
State contributing the information shall be removed from the Data 18
System. 19
20
SECTION 10. RULEMAKING 21
22
A. The Commission shall exercise its Rulemaking powers 23
pursuant to the criteria set forth in this Section and the Rules 24
adopted thereunder. Rules and amendments shall become binding 25
as of the date specified in each Rule or amendment. 26
B. The Commission shall promulgate rea sonable rules in 27
order to effectively and efficiently achieve the purposes of the 28
Compact. Notwithstanding the foregoing, in the event the 29
Commission exercises its rulemaking authority in a manner that is 30
beyond the scope of the purposes of the Compact, or the powers 31
granted hereunder, then such an action by the Commission shall 32
be invalid and have no force and effect. 33
C. If a majority of the legislatures of the Member States 34
rejects a Rule, by enactment of a statute or resolution in the same 35
manner used to adopt the Compact within 4 years of the date of 36
adoption of the Rule, then such Rule shall have no further force 37
and effect in any Member State. 38
D. Rules or amendments to the Rules shall be adopted at a 39
regular or special meeting of the Commission. 40
E. Prior to promulgation and adoption of a final Rule or 41
Rules by the Commission, and at least thirty (30) days in advance 42
of the meeting at which the Rule will be considered and voted 43
upon, the Commission shall file a Notice of Proposed 44
Rulemaking: 45

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1. On the website of the Commission or other publicly 1
accessible platform; and 2
2. On the website of each Member State Occupational 3
Therapy Licensing Board or other publicly accessible platform or 4
the publication in which each State would otherwise publish 5
proposed Rules. 6
F. The Notice of Proposed Rulemaking shall include: 7
1. The proposed time, date, and location of the meeting in 8
which the Rule will be considered and voted upon; 9
2. The text of the proposed Rule or amendment and the 10
reason for the proposed Rule; 11
3. A request for comments on the proposed Rule from any 12
interested person; and 13
4. The manner in which interested persons may submit 14
notice to the Commission of their intention to attend the public 15
hearing and any written comments. 16
G. Prior t o adoption of a proposed Rule, the Commission 17
shall allow persons to submit written data, facts, opinions, and 18
arguments, which shall be made available to the public. 19
H. The Commission shall grant an opportunity for a public 20
hearing before it adopts a Ru le or amendment if a hearing is 21
requested by: 22
1. At least twenty five (25) persons; 23
2. A State or federal governmental subdivision or agency; 24
or 25
3. An association or organization having at least twenty five 26
(25) members. 27
I. If a hearing is held on the proposed Rule or amendment, 28
the Commission shall publish the place, time, and date of the 29
scheduled public hearing. If the hearing is held via electronic 30
means, the Commission shall publish the mechanism for access to 31
the electronic hearing. 32
1. All p ersons wishing to be heard at the hearing shall 33
notify the executive director of the Commission or other 34
designated member in writing of their desire to appear and testify 35
at the hearing not less than five (5) business days before the 36
scheduled date of the hearing. 37
2. Hearings shall be conducted in a manner providing each 38
person who wishes to comment a fair and reasonable opportunity 39
to comment orally or in writing. 40
3. All hearings will be recorded. A copy of the recording 41
will be made available on request. 42
4. Nothing in this section shall be construed as requiring a 43
separate hearing on each Rule. Rules may be grouped for the 44

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convenience of the Commission at hearings required by this 1
section. 2
J. Following the scheduled hearing date, or by the close o f 3
business on the scheduled hearing date if the hearing was not 4
held, the Commission shall consider all written and oral comments 5
received. 6
K. If no written notice of intent to attend the public hearing 7
by interested parties is received, the Commission may proceed with 8
promulgation of the proposed Rule without a public hearing. 9
L. The Commission shall, by majority vote of all members, 10
take final action on the proposed Rule and shall determine the 11
effective date of the Rule, if any, based on the Rulemaking record 12
and the full text of the Rule. 13
M. Upon determination that an emergency exists, the 14
Commission may consider and adopt an emergency Rule without 15
prior notice, opportunity for comment, or hearing, provided that 16
the usual Rulemaking procedures provided in the Compact and in 17
this section shall be retroactively applied to the Rule as soon as 18
reasonably possible, in no event later than ninety (90) days after 19
the effective date of the Rule. For the purposes of this provision, 20
an emergency Rule i s one that must be adopted immediately in 21
order to: 22
1. Meet an imminent threat to public health, safety, or 23
welfare; 24
2. Prevent a loss of Commission or Member State funds; 25
3. Meet a deadline for the promulgation of an 26
administrative Rule that is established by federal law or Rule; or 27
4. Protect public health and safety. 28
N. The Commission or an authorized committee of the 29
Commission may direct revisions to a previously adopted Rule or 30
amendment for purposes of correcting typographical errors, errors 31
in format, errors in consistency, or grammatical errors. Public 32
notice of any revisions shall be posted on the website of the 33
Commission. The revision shall be subject to challenge by any 34
person for a period of thirty (30) days after posting. The revisio n 35
may be challenged only on grounds that the revision results in a 36
material change to a Rule. A challenge shall be made in writing 37
and delivered to the chair of the Commission prior to the end of 38
the notice period. If no challenge is made, the revision wil l take 39
effect without further action. If the revision is challenged, the 40
revision may not take effect without the approval of the 41
Commission. 42

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SECTION 11. OVERSIGHT, DISPUTE RESOLUTION, 1
AND ENFORCEMENT 2
3
A. Oversight 4
1. The executive, legislative, and judicial branches of State 5
government in each Member State shall enforce this Compact and 6
take all actions necessary and appropriate to effectuate the 7
Compact’s purposes and intent. The provisions of this Compact 8
and the Rules promulgated hereunder shall have standing as 9
statutory law. 10
2. All courts shall take judicial notice of the Compact and 11
the Rules in any judicial or administrative proceeding in a 12
Member State pertaining to the subject matter of this Compact 13
which may affect the powers, responsibil ities, or actions of the 14
Commission. 15
3. The Commission shall be entitled to receive service of 16
process in any such proceeding, and shall have standing to 17
intervene in such a proceeding for all purposes. Failure to provide 18
service of process to the Commis sion shall render a judgment or 19
order void as to the Commission, this Compact, or promulgated 20
Rules. 21
B. Default, Technical Assistance, and Termination 22
1. If the Commission determines that a Member State has 23
defaulted in the performance of its obligatio ns or responsibilities 24
under this Compact or the promulgated Rules, the Commission 25
shall: 26
a. Provide written notice to the defaulting State and 27
other Member States of the nature of the default, the proposed 28
means of curing the default and/or any other action to be taken by 29
the Commission; and 30
b. Provide remedial training and specific technical 31
assistance regarding the default. 32
2. If a State in default fails to cure the default, the 33
defaulting State may be terminated from the Compact upon an 34
affirmative vote of a majority of the Member States, and all rights, 35
privileges and benefits conferred by this Compact may be 36
terminated on the effective date of termination. A cure of the 37
default does not relieve the offending State of obligations or 38
liabilities incurred during the period of default. 39
3. Termination of membership in the Compact shall be 40
imposed only after all other means of securing compliance have 41
been exhausted. Notice of intent to suspend or terminate shall be 42
given by the Commission to the go vernor, the majority and 43
minority leaders of the defaulting State’s legislature, and each of 44
the Member States. 45

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4. A State that has been terminated is responsible for all 1
assessments, obligations, and liabilities incurred through the 2
effective date of te rmination, including obligations that extend 3
beyond the effective date of termination. 4
5. The Commission shall not bear any costs related to a 5
State that is found to be in default or that has been terminated 6
from the Compact, unless agreed upon in writin g between the 7
Commission and the defaulting State. 8
6. The defaulting State may appeal the action of the 9
Commission by petitioning the U.S. District Court for the District 10
of Columbia or the federal district where the Commission has its 11
principal offices. The prevailing member shall be awarded all 12
costs of such litigation, including reasonable attorney’s fees. 13
C. Dispute Resolution 14
1. Upon request by a Member State, the Commission shall 15
attempt to resolve disputes related to the Compact that arise 16
among Member States and between member and non -Member 17
States. 18
2. The Commission shall promulgate a Rule providing for 19
both mediation and binding dispute resolution for disputes as 20
appropriate. 21
D. Enforcement 22
1. The Commission, in the reasonable exerc ise of its 23
discretion, shall enforce the provisions and Rules of this Compact. 24
2. By majority vote, the Commission may initiate legal 25
action in the United States District Court for the District of 26
Columbia or the federal district where the Commission has its 27
principal offices against a Member State in default to enforce 28
compliance with the provisions of the Compact and its 29
promulgated Rules and bylaws. The relief sought may include 30
both injunctive relief and damages. In the event judicial 31
enforcement is necessary, the prevailing member shall be awarded 32
all costs of such litigation, including reasonable attorney’s fees. 33
3. The remedies herein shall not be the exclusive remedies 34
of the Commission. The Commission may pursue any other 35
remedies available under federal or State law. 36
37
SECTION 12. DATE OF IMPLEMENTATION OF THE 38
INTERSTATE COMMISSION FOR OCCUPATIONAL 39
THERAPY PRACTICE AND ASSOCIATED RULES, 40
WITHDRAWAL, AND AMENDMENT 41
42
A. The Compact shall come into effect on the date on which 43
the Compact statute is enacted into law in the tenth Member State. 44
The provisions, which become effective at that time, shall be 45

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limited to the powers granted to the Commission relating to 1
assembly and the promulgation of Rules. Thereafter, the 2
Commission shall meet and exerc ise Rulemaking powers 3
necessary to the implementation and administration of the 4
Compact. 5
B. Any State that joins the Compact subsequent to the 6
Commission’s initial adoption of the Rules shall be subject to the 7
Rules as they exist on the date on which the Compact becomes law 8
in that State. Any Rule that has been previously adopted by the 9
Commission shall have the full force and effect of law on the day 10
the Compact becomes law in that State. 11
C. Any Member State may withdraw from this Compact by 12
enacting a statute repealing the same. 13
1. A Member State’s withdrawal shall not take effect until 14
six (6) months after enactment of the repealing statute. 15
2. Withdrawal shall not affect the continuing requirement 16
of the withdrawing State’s Occupational Therapy Licensing Board 17
to comply with the investigative and Adverse Action reporting 18
requirements of this act prior to the effective date of withdrawal. 19
D. Nothing contained in this Compact shall be construed to 20
invalidate or prevent any Occupational Therapy lic ensure 21
agreement or other cooperative arrangement between a Member 22
State and a non -Member State that does not conflict with the 23
provisions of this Compact. 24
E. This Compact may be amended by the Member States. No 25
amendment to this Compact shall become eff ective and binding 26
upon any Member State until it is enacted into the laws of all 27
Member States. 28
29
SECTION 13. CONSTRUCTION AND SEVERABILITY 30
31
This Compact shall be liberally construed so as to effectuate 32
the purposes thereof. The provisions of this Compact shall be 33
severable and if any phrase, clause, sentence or provision of this 34
Compact is declared to be contrary to the constitution of any 35
Member State or of the United States or the applicability thereof to 36
any government, agency, person, or circumstance is held invalid, 37
the validity of the remainder of this Compact and the applicability 38
thereof to any government, agency, person, or circumstance shall 39
not be affected thereby. If this Compact shall be held contrary to 40
the constitution of any Member State, the Compact shall remain in 41
full force and effect as to the remaining Member States and in full 42
force and effect as to the Member State affected as to all severable 43
matters. 44

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SECTION 14. BINDING EFFECT OF 1
COMPACT AND OTHER LAWS 2
3
A. A Licensee providing Oc cupational Therapy in a Remote 4
State under the Compact Privilege shall function within the laws 5
and regulations of the Remote State. 6
B. Nothing herein prevents the enforcement of any other law 7
of a Member State that is not inconsistent with the Compact. 8
C. Any laws in a Member State in conflict with the Compact 9
are superseded to the extent of the conflict. 10
D. Any lawful actions of the Commission, including all Rules 11
and bylaws promulgated by the Commission, are binding upon the 12
Member States. 13
E. All agreements between the Commission and the Member 14
States are binding in accordance with their terms. 15
F. In the event any provision of the Compact exceeds the 16
constitutional limits imposed on the legislature of any Member 17
State, the provision shall be ineffective to the extent of the conflict 18
with the constitutional provision in question in that Member State. 19
Sec. 27. NRS 640A.220 is hereby amended to read as follows: 20
640A.220 1. Except as otherwise provided in this section and 21
NRS 239.0115 [,] and section 26 of this act, a complaint filed with 22
the Board, all documents and other information filed with the 23
complaint and all documents and other information compiled as a 24
result of an investigation conducted to determine whether to initiate 25
disciplinary action against a person are confidential, unless the 26
person submits a written statement to the Board requesting that such 27
documents and information be made public records. 28
2. The charging documents filed with the Board to initiate 29
disciplinary action pursuant to chapter 622A of NRS and all 30
documents and information considered by the Board when 31
determining whether to impose discipline are public records. 32
3. The Board shall, to the extent feasible, communicate or 33
cooperate with or provide any documents or other information to 34
any other licensing board or any other agency that is investigating a 35
person, including, without limitation, a law enforcement agency. 36
4. The Board shall retain all complaints filed with the Board 37
for at least 10 years, including, without limitation, any complaints 38
not acted upon. 39
Sec. 28. The preliminary chapter of NRS is hereby amended 40
by adding thereto a new section to read as follows: 41
Except as otherwise expressly provided in a particular statute 42
or required by the context: 43
1. Privilege to practice as a physician assistant in this State 44
under the PA Licensure Compact ratified and e ntered into in 45

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section 1 of this act shall be deemed to be equivalent to a license as 1
a physician assistant issued by: 2
(a) The Board of Medical Examiners pursuant to chapter 630 3
of NRS if the physician assistant is under the jurisdiction of the 4
Board of Medical Examiners pursuant to section 5 of this act. 5
(b) The State Board of Osteopathic Medicine pursuant to 6
chapter 633 of NRS if the physician assistant is under the 7
jurisdiction of the State Board of Osteopathic Medicine pursuant 8
to section 15 of this act. 9
2. Privilege to practice as an audiologist or speech -language 10
pathologist in this State under the Audiology and Speech -11
Language Pathology Interstate Compact ratified a nd entered into 12
in section 21 of this act shall be deemed to be equivalent to the 13
corresponding license. 14
3. Privilege to practice as a physical therapist o r a physical 15
therapist assistant in this State under the Physical Therapy 16
Licensure Compact ratified and entered into in section 23 of this 17
act shall be deemed to be equivalent to the corresponding license. 18
4. Privilege to practice as an occupational therapist or 19
occupational therapy assistant in this State under the 20
Occupational Therapy Licensure Compact ratified and entered 21
into in section 26 of this act shall be deemed to be equivalent to the 22
corresponding license. 23
Sec. 29. NRS 7.095 is hereby amended to read as follows: 24
7.095 1. An attorney shall not co ntract for or collect a fee 25
contingent on the amount of recovery for representing a person 26
seeking damages in connection with an action for injury or death 27
against a provider of health care based upon professional negligence 28
in excess of 35 percent of the amount recovered. 29
2. The limitations set forth in subsection 1 apply to all forms of 30
recovery, including, without limitation, settlement, arbitration and 31
judgment. 32
3. For the purposes of this section, “recovered” means the net 33
sum recovered by the plai ntiff after deducting any disbursements or 34
costs incurred in connection with the prosecution or settlement of 35
the claim. Costs of medical care incurred by the plaintiff and general 36
and administrative expenses incurred by the office of the attorney 37
are not deductible disbursements or costs. 38
4. As used in this section: 39
(a) “Professional negligence” means a negligent act or omission 40
to act by a provider of health care in the rendering of professional 41
services, which act or omission is the proximate cause of a personal 42
injury or wrongful death. The term does not include services that are 43
outside the scope of services for which the provider of health care is 44

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licensed or services for which any restriction has been imposed by 1
the applicable regulatory board or health care facility. 2
(b) “Provider of health care” means a physician licensed under 3
chapter 630 or 633 of NRS, dentist, registered nurse, dispensing 4
optician, optometrist, [registered] licensed physical therapist, 5
podiatric physician, licensed psychologist, chiropractic physician, 6
naprapath, doctor of Oriental medicine, holder of a license or a 7
limited license issued under the provisions of chapter 653 of NRS, 8
medical laboratory director or technician, licensed dietitian or a 9
licensed hospital and its employees. 10
Sec. 30. NRS 41A.017 is hereby amended to read as follows: 11
41A.017 “Provider of health care” means a physician licensed 12
pursuant to chapter 630 or 633 of NRS, physician assistant, 13
anesthesiologist assist ant, dentist, licensed nurse, dispensing 14
optician, optometrist, [registered] licensed physical therapist, 15
podiatric physician, licensed psychologist, chiropractic physician, 16
naprapath, doctor of Oriental medicine, holder of a license or a 17
limited license i ssued under the provisions of chapter 653 of NRS, 18
medical laboratory director or technician, licensed dietitian or a 19
licensed hospital, clinic, surgery center, physicians’ professional 20
corporation or group practice that employs any such person and its 21
employees. 22
Sec. 31. NRS 42.021 is hereby amended to read as follows: 23
42.021 1. In an action for injury or death against a provider 24
of health care based upon professional negligence, if the defendant 25
so elects, the defendant may introduce evidence of any amount 26
payable as a benefit to the plaintiff as a result of the injury or death 27
pursuant to the United States Social Security Act, any state or 28
federal income disability or worker’s compensation act, any health, 29
sickness or in come-disability insurance, accident insurance that 30
provides health benefits or income -disability coverage, and any 31
contract or agreement of any group, organization, partnership or 32
corporation to provide, pay for or reimburse the cost of medical, 33
hospital, dental or other health care services. If the defendant elects 34
to introduce such evidence, the plaintiff may introduce evidence of 35
any amount that the plaintiff has paid or contributed to secure the 36
plaintiff’s right to any insurance benefits concerning whi ch the 37
defendant has introduced evidence. 38
2. A source of collateral benefits introduced pursuant to 39
subsection 1 may not: 40
(a) Recover any amount against the plaintiff; or 41
(b) Be subrogated to the rights of the plaintiff against a 42
defendant. 43
3. In an action for injury or death against a provider of health 44
care based upon professional negligence, a district court shall, at the 45

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request of either party, enter a judgment ordering that money 1
damages or its equivalent for future damages of the judgment 2
creditor be paid in whole or in part by periodic payments rather than 3
by a lump -sum payment if the award equals or exceeds $50,000 in 4
future damages. 5
4. In entering a judgment ordering the payment of future 6
damages by periodic payments pursuant to subsection 3, the court 7
shall make a specific finding as to the dollar amount of periodic 8
payments that will compensate the judgment creditor for such future 9
damages. As a condition to authorizing periodic payments of future 10
damages, the court shall require a judgmen t debtor who is not 11
adequately insured to post security adequate to assure full payment 12
of such damages awarded by the judgment. Upon termination of 13
periodic payments of future damages, the court shall order the return 14
of this security, or so much as remains, to the judgment debtor. 15
5. A judgment ordering the payment of future damages by 16
periodic payments entered pursuant to subsection 3 must specify the 17
recipient or recipients of the payments, the dollar amount of the 18
payments, the interval between payme nts, and the number of 19
payments or the period of time over which payments will be made. 20
Such payments must only be subject to modification in the event of 21
the death of the judgment creditor. Money damages awarded for loss 22
of future earnings must not be red uced or payments terminated by 23
reason of the death of the judgment creditor, but must be paid to 24
persons to whom the judgment creditor owed a duty of support, as 25
provided by law, immediately before the judgment creditor’s death. 26
In such cases, the court th at rendered the original judgment may, 27
upon petition of any party in interest, modify the judgment to award 28
and apportion the unpaid future damages in accordance with this 29
subsection. 30
6. If the court finds that the judgment debtor has exhibited a 31
continuing pattern of failing to make the periodic payments as 32
specified pursuant to subsection 5, the court shall find the judgment 33
debtor in contempt of court and, in addition to the required periodic 34
payments, shall order the judgment debtor to pay the judgmen t 35
creditor all damages caused by the failure to make such periodic 36
payments, including, but not limited to, court costs and attorney’s 37
fees. 38
7. Following the occurrence or expiration of all obligations 39
specified in the periodic payment judgment, any obli gation of the 40
judgment debtor to make further payments ceases and any security 41
given pursuant to subsection 4 reverts to the judgment debtor. 42
8. As used in this section: 43

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(a) “Future damages” includes damages for future medical 1
treatment, care or custody , loss of future earnings, loss of bodily 2
function, or future pain and suffering of the judgment creditor. 3
(b) “Periodic payments” means the payment of money or 4
delivery of other property to the judgment creditor at regular 5
intervals. 6
(c) “Professional negligence” means a negligent act or omission 7
to act by a provider of health care in the rendering of professional 8
services, which act or omission is the proximate cause of a personal 9
injury or wrongful death. The term does not include services that are 10
outside the scope of services for which the provider of health care is 11
licensed or services for which any restriction has been imposed by 12
the applicable regulatory board or health care facility. 13
(d) “Provider of health care” means a physician licensed under 14
chapter 630 or 633 of NRS, dentist, licensed nurse, dispensing 15
optician, optometrist, [registered] licensed physical therapist, 16
podiatric physician, naprapath, licensed psychologist, chiropractic 17
physician, doctor of Oriental medicine, holder of a license or a 18
limited license issued under the provisions of chapter 653 of NRS, 19
medical laboratory director or technician, licensed dietitian or a 20
licensed hospital and its employees. 21
Sec. 32. NRS 52.320 is hereby amended to read as follows: 22
52.320 As used in NRS 52.320 to 52.375, inclusive, unless the 23
context otherwise requires: 24
1. “Custodian of medical records” means a chiropractic 25
physician, naprapath, physician, [registered] licensed physical 26
therapist or licensed nurse who prepares and maintains medical 27
records, or any employee or agent of such a person or a facility for 28
convalescent care, medical laboratory or hospital who has care, 29
custody and control of medical records for such a person or 30
institution. 31
2. “Medical recor ds” includes bills, ledgers, statements and 32
other accounts which show the cost of medical services or care 33
provided to a patient. 34
Sec. 33. NRS 239.010 is hereby amended to read as follows: 35
239.010 1. Except as otherwise provided in this section and 36
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095, 37
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 38
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 39
80.113, 81.850, 82.183, 86.246, 86.54615, 8 7.515, 87.5413, 40
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 41
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 42
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 43
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640, 44
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 45

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127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 1
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245, 2
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156, 3
176A.630, 178.39801, 178.4715, 178.5691, 178.5717, 179.495, 4
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772, 5
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 6
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 7
213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 8
218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615, 9
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570, 10
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300, 11
239.0105, 239.0113, 239.014, 239B.026, 239B.030, 239B.040, 12
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 13
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 14
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130, 15
250.140, 250.145, 250.150, 268.095, 26 8.0978, 268.490, 268.910, 16
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 17
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086, 18
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 19
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 20
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110, 21
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 22
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 23
353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360 .240, 24
360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 25
366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 26
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 27
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 28
388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 29
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 30
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 31
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143, 32
396.159, 396.3295, 396.405, 396.525, 396.535, 396.9685, 33
398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 34
414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 35
425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205, 36
432B.175, 432B.280, 432B.290, 432B.4018, 432B.407, 432B.430, 37
432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 38
439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116, 39
439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170, 40
441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 41
442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245, 42
449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164, 43
453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 44
459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 45

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463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 1
481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 2
483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833, 3
484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 4
571.160, 584.6 55, 587.877, 598.0964, 598.098, 598A.110, 5
598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 6
604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315, 7
616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 8
624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 9
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671, 10
630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327, 11
630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415, 12
632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716, 13
633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169, 14
634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085, 15
637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183, 16
639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220, 17
640B.405, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 18
640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090, 19
641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170, 20
641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320, 21
642.524, 643.189, 644A. 870, 645.180, 645.625, 645A.050, 22
645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 23
645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 24
648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900, 25
654.110, 656.105, 657A.510, 661.115, 665 .130, 665.133, 669.275, 26
669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480, 27
675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 28
678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 29
679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 30
681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 31
687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480, 32
688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 33
692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 34
696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 35
711.600, and sections 1, 10, 21, 23 and 26 of this act, sections 35, 36
38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of 37
chapter 391, Statutes of Nevada 2013 and unless otherwise declared 38
by law to be confidential, all public books and public records of a 39
governmental entity must be open at all times during office hours to 40
inspection by any person, and may be fully copied or an abstract or 41
memorandum may be prepared from those public books and public 42
records. Any such co pies, abstracts or memoranda may be used to 43
supply the general public with copies, abstracts or memoranda of the 44
records or may be used in any other way to the advantage of the 45

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governmental entity or of the general public. This section does not 1
supersede o r in any manner affect the federal laws governing 2
copyrights or enlarge, diminish or affect in any other manner the 3
rights of a person in any written book or record which is 4
copyrighted pursuant to federal law. 5
2. A governmental entity may not reject a b ook or record 6
which is copyrighted solely because it is copyrighted. 7
3. A governmental entity that has legal custody or control of a 8
public book or record shall not deny a request made pursuant to 9
subsection 1 to inspect or copy or receive a copy of a public book or 10
record on the basis that the requested public book or record contains 11
information that is confidential if the governmental entity can 12
redact, delete, conceal or separate, including, without limitation, 13
electronically, the confidential informat ion from the information 14
included in the public book or record that is not otherwise 15
confidential. 16
4. If requested, a governmental entity shall provide a copy of a 17
public record in an electronic format by means of an electronic 18
medium. Nothing in this subsection requires a governmental entity 19
to provide a copy of a public record in an electronic format or by 20
means of an electronic medium if: 21
(a) The public record: 22
(1) Was not created or prepared in an electronic format; and 23
(2) Is not available in an electronic format; or 24
(b) Providing the public record in an electronic format or by 25
means of an electronic medium would: 26
(1) Give access to proprietary software; or 27
(2) Require the production of information that is confidential 28
and that cannot be r edacted, deleted, concealed or separated from 29
information that is not otherwise confidential. 30
5. An officer, employee or agent of a governmental entity who 31
has legal custody or control of a public record: 32
(a) Shall not refuse to provide a copy of that public record in the 33
medium that is requested because the officer, employee or agent has 34
already prepared or would prefer to provide the copy in a different 35
medium. 36
(b) Except as otherwise provided in NRS 239.030, shall, upon 37
request, prepare the copy of t he public record and shall not require 38
the person who has requested the copy to prepare the copy himself 39
or herself. 40
Sec. 34. NRS 372.7285 is hereby amended to read as follows: 41
372.7285 1. In administering the provisions of NRS 372.325, 42
the Department shall apply the exemption to the sale of a medical 43
device to a governmental entity that is exempt pursuant to that 44
section without regard to whether the person using the medical 45

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device or the governmental entity that purchas ed the device is 1
deemed to be the holder of title to the device if: 2
(a) The medical device was ordered or prescribed by a provider 3
of health care, within his or her scope of practice, for use by the 4
person to whom it is provided; 5
(b) The medical device is covered by Medicaid or Medicare; and 6
(c) The purchase of the medical device is made pursuant to a 7
contract between the governmental entity that purchases the medical 8
device and the person who sells the medical device to the 9
governmental entity. 10
2. As used in this section: 11
(a) “Medicaid” means the program established pursuant to Title 12
XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., to 13
provide assistance for part or all of the cost of medical care rendered 14
on behalf of indigent persons. 15
(b) “Medicare” means the program of health insurance for aged 16
persons and persons with disabilities established pursuant to Title 17
XVIII of the Social Security Act, 42 U.S.C. §§ 1395 et seq. 18
(c) “Provider of health care” means a physician or physician 19
assistant licensed pursuant to chapter 630, 630A or 633 of NRS, 20
perfusionist, dentist, licensed nurse, dispensing optician, 21
optometrist, practitioner of respiratory care, [registered] licensed 22
physical therapist, podiatric physician, licensed psychologist, 23
licensed audiologist, licensed speech -language pathologist, licensed 24
hearing aid specialist, licensed marriage and family therapist, 25
licensed clinical professional counselor, chiropractic physician, 26
naprapath, licensed dietitian or doctor of Oriental medicine in any 27
form. 28
Sec. 35. NRS 374.731 is hereby amended to read as follows: 29
374.731 1. In administering the provisions of NRS 374.330, 30
the Department shall apply the exemption to the sale of a medical 31
device to a governmental entity that is exempt pursuant to that 32
section without regard to whether the person using the medical 33
device or the governmental entity that purchased the device is 34
deemed to be the holder of title to the device if: 35
(a) The medical device was ordered or prescribed by a provider 36
of health care, within his or her scope of practice, for use by the 37
person to whom it is provided; 38
(b) The medical device is covered by Medicaid or Medicare; and 39
(c) The purchase of the medical device is made pursuant to a 40
contract between the governmental entity that purchases the medical 41
device and the person who sells the medical device to the 42
governmental entity. 43
2. As used in this section: 44

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(a) “Medicaid” means the program established pursuant to Title 1
XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., to 2
provide assistance for part or all of the cost of medical care rendered 3
on behalf of indigent persons. 4
(b) “Medicare” means the program of health insur ance for aged 5
persons and persons with disabilities established pursuant to Title 6
XVIII of the Social Security Act, 42 U.S.C. §§ 1395 et seq. 7
(c) “Provider of health care” means a physician or physician 8
assistant licensed pursuant to chapter 630, 630A or 633 of NRS, 9
perfusionist, dentist, licensed nurse, dispensing optician, 10
optometrist, practitioner of respiratory care, [registered] licensed 11
physical therapist, podiatric physician, licensed psychologist, 12
licensed audiologist, licensed speech -language pathologist, licensed 13
hearing aid specialist, licensed marriage and family therapist, 14
licensed clinical professional counselor, chiropractic physician, 15
naprapath, licensed dietitian or doctor of Oriental medicine in any 16
form. 17
Sec. 36. NRS 439A.0195 is hereby amended to read as 18
follows: 19
439A.0195 “Practitioner” means a physician licensed under 20
chapter 630, 630A or 633 of NRS, dentist, licensed nurse, 21
dispensing optician, optometrist, [registered] licensed physical 22
therapist, podiatric physician, licensed psychologist, chiropractic 23
physician, naprapath, doctor of Oriental medicine in any form, 24
medical laboratory director or technician, pharmacist or other person 25
whose principal occupation is the provision of services for health. 26
Sec. 37. NRS 453.371 is hereby amended to read as follows: 27
453.371 As used in NRS 453.371 to 453.552, inclusive: 28
1. “Medical intern” means a medical graduate acting as an 29
assistant in a hospital for the purpose of clinical training. 30
2. “Pharmacist” means a person who holds a certificate of 31
registration issued pursuant to NRS 639.127 and is registered with 32
the Board. 33
3. “Physician,” “dentist,” “podiatric physician,” “veterinarian” 34
and “euthanasia technician” mean persons authorized by a license to 35
practice their respective professions in this State who are registered 36
with the Board. 37
4. “Physician assistant” means a person who is registered with 38
the Board and [: 39
(a) Holds] holds a license issued pursuant to chapter 630 or 633 40
of NRS . [630.273; or 41
(b) Holds a license issued pursuant to NRS 633.433.] 42
Sec. 38. NRS 454.00958 is hereby amended to read as 43
follows: 44
454.00958 “Practitioner” means: 45

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1. A physician, dentist, veterinarian or podiatric physician who 1
holds a valid license to practice his or her profession in this State. 2
2. A pharmacy, hospital or other institution licensed or 3
registered to distribute, dispense, conduct research with respect to or 4
to administer a dangerous drug in the course of professional practice 5
in this State. 6
3. When relating to the prescription of poisons, dangerous 7
drugs and devices: 8
(a) An advanced practice registered nurse who holds a certificate 9
from the State Board of Pharmacy permitting him or her so to 10
prescribe; or 11
(b) A physician assistant who [holds a license from the Board of 12
Medical Examiners] is licensed pursuant to chapter 630 or 633 of 13
NRS and holds a certificate from the State Board of Pharmacy 14
permitting him or her so to prescribe. 15
4. An optometrist who is certified to prescribe and administer 16
pharmaceutical agents pursuant to NRS 636.288 when the 17
optometrist prescribes or administers dangerous drugs which are 18
within the scope of his or her certification. 19
5. A de ntal hygienist who holds a valid license to practice 20
dental hygiene in this State and: 21
(a) Is authorized to prescribe and dispense the dangerous drugs 22
listed in NRS 631.3105 in accordance with the provisions of that 23
section and the regulations adopted pursuant thereto; and 24
(b) Holds a certificate issued by the State Board of Pharmacy 25
pursuant to NRS 639.1374 authorizing him or her to so prescribe. 26
6. A certified registered nurse anesthetist who orders, 27
prescribes, possesses or administers poisons, dan gerous drugs or 28
devices in accordance with NRS 632.2397. 29
7. A pharmacist who is registered pursuant to NRS 639.28079 30
to prescribe and dispense drugs for medication-assisted treatment. 31
Sec. 39. NRS 598A.360 is hereby amended to read as follows: 32
598A.360 “Practitioner” means a physician licensed pursuant 33
to chapter 630 or 633 of NRS, physician assistant, licensed nurse, 34
dispensing optician, optometrist, practitioner of respiratory care, 35
[registered] licensed physical therapist, occupational therapist, 36
licensed psychologist or perfusionist. 37
Sec. 40. On or before August 1, 2026, the Department of 38
Health and Human Services shall: 39
1. Study the potential impact of: 40
(a) The PA Licensure Co mpact ratified and entered into in 41
section 1 of this act on the availability of services provided by 42
physician assistants in this State; 43

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(b) The Nurse Licensure Compact ra tified and entered into in 1
section 10 of this act on the availability of services provided by 2
registered nurses and licensed practical nurses in this State; 3
(c) The Audi ology and Speech -Language Pathology Interstate 4
Compact ratified and entered into in section 21 of this act on the 5
availability of services provided by audiologists and spee ch-6
language pathologists in this State; 7
(d) The Physical Therapy Licensure Compact ratified and 8
entered into in section 23 of this act on the availability of services 9
provided by physical therapists and physical therapist assistants in 10
this State; and 11
(e) The Occupational Therapy Licensure Compact ratified and 12
entered into in section 26 of this act on the availability of services 13
provided by occupational therapists and occupational therapy 14
assistants in this State. 15
2. Submit the report to: 16
(a) The Patient Protection Commission crea ted by NRS 17
439.908; and 18
(b) The Director of the Legislative Counsel Bureau for 19
transmittal to the Joint Interim Standing Committee on Health and 20
Human Services, the Joint Interim Standing Committee on 21
Commerce and Labor and the Legislative Committee on S enior 22
Citizens, Veterans and Adults With Special Needs. 23
Sec. 41. This act becomes effective on July 1, 2025. 24

H