(20)(t) "Rule" "Rule" means aany rule or regulation promulgatedadopted by an entity that has the force and effect of law.

(21)(u) "Significant "Significantinvestigative Investigativeinformation" Information" means Investigativeinvestigative Informationinformation that a Licensinglicensing Board,board, after an inquiry or investigation that includes notification and an opportunity for the physicianPA assistant to respond if required by Statestate law, has reason to believe is not groundless and, if proven true, would indicate more than a minor infraction.

(22)(v) "State" "State" means any state, commonwealth, district,district or territory of the United States.

334.1810. SECTION 3—STATE PARTICIPATION IN THIS COMPACT (a) To participate in this compact, a participating state shall:

1.(1) License PAs;

To(2) participate participate in thisthe Compact,compact acommission's Participatingdata Statesystem; shall:

HCS(3) have HBa 3129mechanism 4in (1)place Licensefor physicianreceiving assistants.and investigating complaints against licensees and applicants for licensure;

(2)(4) notify Participatethe commission, in compliance with the Compactterms Commission'sof Datathis System.compact and commission rules, of any adverse action against a licensee or applicant for licensure and the existence of significant investigative information regarding a licensee or applicant for licensure;

(3)(5) fully Haveimplement a mechanismcriminal inbackground placecheck forrequirement, within a time frame established by commission rule, examination by its licensing board receiving andthe investigatingresults complaintsof againsta Licenseescriminal background check and Licensereporting applicants.to the commission whether the applicant for licensure has been granted a license;

(4)HB Notify2219—Am. the Commission, in compliance with the terms of this Compact and Commission Rules, of any Adverse Action against a Licensee or License applicant and the existence of Significant Investigative Information regarding a Licensee or License applicant.

(5) Fully implement a Criminal Background Check requirement, within a time frame established by CommissionHC Rule,4 by(6) comply itswith Licensing Board receiving the resultsrules of a Criminal Background Check and reporting to the Commissioncompact whethercommission; the License applicant has been granted a License.

(6)(7) utilize Complypassage withof thea Rulesrecognized ofnational examination such as the CompactNCCPAPANCE Commission.as a requirement for PAlicensure;

(7)and Utilize(8) grant passagethe ofcompact aprivilege recognizedto nationala examholder suchof asa thequalifying NCCPAlicense PANCEin as a requirementparticipating forstate. physician assistant licensure.

(8)(b) Nothing Grantin thethis Compactcompact Privilegeshall be construed to prohibit a holderparticipating ofstate from charging a Qualifyingfee Licensefor ingranting athe Participatingcompact State.privilege.

2.9 SECTION 4—COMPACT PRIVILEGE (a) To exercise the compact privilege, a licensee shall:

Nothing(1) Have ingraduated thisfrom Compacta prohibitsPA aprogram Participatingaccredited Stateby fromthe chargingaccreditation areview feecommission foron grantingeducation for the Compactphysician Privilege.assistant, inc., or other programs authorized by commission rule;

334.1815.(2) hold current NCCPAcertification;

1.(3) have no felony or misdemeanor convictions;

To(4) have exercisenever thehad Compacta Privilege,controlled substance license, permit or registration suspended or revoked by a Licenseestate must:or by the United States drug enforcement administration;

(1)(5) have Have graduated from a physicianunique assistantidentifier programas accrediteddetermined by thecommission Accreditationrule; Review Commission on Education for the Physician Assistant, Inc.

or(6) hold othera programsqualifying authorizedlicense; by Commission Rule.

(2)(7) have Holdhad currentno NCCPArevocation certification.of a license or limitation or restriction on any license currently held due to an adverse action;

(3)(A) if Havea licensee has had a limitation or restriction on a license or compact privilege due to an adverse action, two years shall have elapsed from the date on which the license or compact privilege is no felonylonger limited or misdemeanorrestricted Conviction.due to the adverse action;

(4)(B) if Havea nevercompact hadprivilege ahas controlledbeen substancerevoked license,or permit,is limited or registrationrestricted suspendedin ora revokedparticipating bystate for conduct that would not be a Statebasis for disciplinary action in a participating state in which the licensee is practicing or byapplying to practice under a compact privilege, that participating state shall have the Uniteddiscretion Statesnot Drugto Enforcementconsider Administration.such action as an adverse action requiring the denial or removal of a compact privilege in that state;

(5)(8) notify Havethe acompact uniquecommission identifierthat asthe determinedlicensee byis Commissionseeking Rule.the compact privilege in a remote state;

(6)(9) meet Holdany jurisprudence requirement of a Qualifyingremote License.state in which the licensee is seeking to practice under the compact privilege and pay any fees applicable to satisfying the jurisprudence requirement;

(7)and Have(10) report hadto nothe revocationcommission ofany aadverse Licenseaction ortaken limitationby ora restrictionnonparticipating onstate anywithin License30 currentlydays heldafter duesuch toadverse anaction adverseis action.taken.

(8)(b) The Ifcompact aprivilege Licenseeshall hasbe hadvalid auntil limitation or restriction on a License or Compact Privilege due to an Adverse Action, two years must have elapsed from the dateexpiration on which the License or CompactHB Privilege2219—Am. is no longer limited or restricted due to the Adverse Action.

HCSby HBHC 3129 5 (9)revocation Ifof a Compact Privilege has been revoked or is limited or restricted in a Participating State for conduct that would not be a basis for disciplinary action in a Participating State in which the Licenseequalifying islicense practicingunless orterminated applyingpursuant to practice under a Compact Privilege, that Participating State shall have the discretion not to consider such action as an Adverseadverse Actionaction. requiring the denial or removal of a Compact Privilege in that State.

(10)The Notifylicensee theshall Compactcomply Commissionwith that the Licenseerequirements isof seekingsubsection (a) to maintain the Compactcompact Privilegeprivilege in a Remoteremote State.state.

(11)If Meetthe anyparticipating Jurisprudencestate Requirementtakes ofadverse action against a Remotequalifying Statelicense, inthe whichlicensee shall lose the Licenseecompact isprivilege seekingin toany practiceremote understate in which the Compactlicensee Privilegehas anda paycompact anyprivilege feesuntil applicablethe tolicensee satisfyingmeets the Jurisprudencefollowing Requirement.conditions:

(12)(1) The Reportlicense tois theno Commissionlonger anylimited Adverseor Actionrestricted; taken by a non-participating State within thirty (30) days after the action is taken.

2.and (2) two years have elapsed from the date on which the license is no longer limited or restricted due to the adverse action.

The(c) Once Compacta Privilegerestricted isor validlimited untillicense satisfies the expirationrequirements orof revocationsubsection of(b), the Qualifyinglicensee Licenseshall unlessmeet terminatedthe pursuantrequirements of subsection (a) to anobtain Adversea Action.compact privilege in any remote state.

The(d) For Licenseeeach mustremote alsostate complyin withwhich alla ofPA theseeks requirementsauthority ofto subsectionprescribe 1controlled ofsubstances, thisthe sectionPA toshall maintainsatisfy all the Compactrequirements Privilegeimposed by such state in agranting Remoteor State.renewing such authority.

IfSECTION the5—DESIGNATION ParticipatingOF StateTHE takesSTATE AdverseFROM ActionWHICH againstTHE LICENSEE IS APPLYING FORACOMPACT PRIVILEGE Upon a Qualifyinglicensee's License,application for a compact privilege, the Licenseelicensee shall loseidentify to the Compactcommission Privilegethe inparticipating anystate Remotefrom Statewhich the licensee is applying, in whichaccordance thewith Licenseeapplicable hasrules aadopted Compactby Privilegethe untilcommission alland ofsubject to the following occur:requirements:

(1)(a) When Theapplying Licensefor isa nocompact longerprivilege, limitedthe orlicensee restricted;shall provide the commission with the address of the licensee's primary residence and, thereafter, shall immediately report to the commission any change in the address of the licensee's primary residence;

and (2)(b) when Twoapplying (2)for yearsa havecompact elapsedprivilege, fromthe licensee is required to consent to accept service of process by mail at the datelicensee's primary residence on whichfile with the Licensecommission iswith norespect longerto limitedany action brought against the licensee by the commission or restricteda dueparticipating state, including a subpoena, with respect to any action brought or investigation conducted by the Adversecommission Action.or a participating state.

3.SECTION 6—ADVERSE ACTIONS (a) A participating state in which a licensee is licensed shall have exclusive power to impose adverse action against the qualifying license issued by that participating state.

Once(b) In aaddition restrictedto or limited License satisfies the requirementsother ofpowers subdivisionsconferred (1)by andstate (2)law, of subsection 2 of this section, the Licensee must meet the requirements of subsection 1 of this section to obtain a Compactremote PrivilegeHB in2219—Am. any Remote State.

4.by HC 6 state shall have the authority, in accordance with existing state due process law, to:

For(1) Take eachadverse Remoteaction Stateagainst ina whichPA's acompact physicianprivilege assistantwithin seeksthat authoritystate to prescriberemove controlleda substances,licensee's thecompact physicianprivilege assistantor shalltake satisfyother allaction requirementsnecessary imposedunder byapplicable suchlaw Stateto inprotect grantingthe orhealth renewingand suchsafety authority.of its citizens;

334.1820.and (2) issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence.

UponSubpoenas issued by a Licensee'slicensing applicationboard forin a Compactparticipating Privilege,state for the Licenseeattendance shalland identifytestimony toof thewitnesses Commissionor the Participatingproduction Stateof evidence from whichanother theparticipating Licenseestate isshall applying,be enforced in accordancethe withlatter applicablestate Rulesby adoptedany bycourt of competent jurisdiction, according to the Commission,practice and subjectprocedure of such court applicable to thesubpoenas followingissued requirements:in proceedings pending before it.

(1)The Whenissuing applyingauthority forshall apay Compactany Privilege,witness thefees, Licenseetravel shallexpenses, providemileage theand Commissionother withfees therequired addressby of the Licensee'sservice primarystatutes residenceof and thereafter shall immediately report to the Commissionstate any change in which the addresswitnesses ofor theevidence Licensee'sis primarylocated. residence.

HCS(c) Notwithstanding HBsubsection 3129(b)(2), 6subpoenas (2)shall Whennot applyingbe forissued by a Compactparticipating Privilege,state the Licensee is required to consentgather toevidence accept service of processconduct byin mailanother atstate thethat Licensee'sis primarylawful residencein onsuch fileother withstate for the Commissionpurpose withof respecttaking toadverse any action brought against thea Licenseelicensee's bycompact theprivilege Commission or aapplication Participatingfor State, including a subpoena,compact withprivilege respectin to any action brought or investigation conducted by the Commissionparticipating orstate. a Participating State.

334.1825.(d) Nothing in this compact shall be deemed to authorize a participating state to impose discipline against a PA's compact privilege or to deny an application for a compact privilege in that participating state for the individual's otherwise lawful practice in another state.

1.(e) For purposes of taking adverse action, the participating state that issued the qualifying license shall give the same priority and effect to reported conduct received from any other participating state as it would if the conduct had occurred within the participating state that issued the qualifying license.

AThe Participatingparticipating Statestate inshall whichapply aits Licenseeown isstate licensedlaws shall have exclusive power to imposedetermine Adverseappropriate Actionaction. against the Qualifying License issued by that Participating State.

2.(f) A participating state, if otherwise permitted by state law, may recover from the affected PA the costs of investigations and disposition of cases resulting from any adverse action taken against that PA.

In(g) A additionparticipating tostate themay othertake powersadverse conferredaction bybased Stateon law,the afactual Remotefindings Stateof shalla haveremote thestate authority,if inthe accordanceparticipating withstate existingfollows Stateits dueown processprocedures law,for totaking do all of the following:adverse action.

(1)(h) Joint Takeinvestigations. Adverse Action against a physician assistant's Compact Privilege within that State to remove a Licensee's Compact Privilege or take other action necessary under applicable law to protect the health and safety of its citizens.

(2)(1) In Issueaddition subpoenasto forthe bothauthority hearingsgranted andto investigationsa thatparticipating requirestate theby attendancesuch state's PA laws and testimonyregulations ofor witnessesother asapplicable wellstate aslaw, theany productionparticipating state may participate with other participating states in joint investigations of evidence.licensees.

Subpoenas(2) Participating issuedstates by a Licensing Board in a Participating State for the attendance and testimony of witnesses or the production of evidence from another Participating State shall beshare enforced in the latter State by any courtinvestigative, oflitigation competentor jurisdiction,HB according2219—Am. to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it.

Theby issuingHC authority7 shallcompliance paymaterials anyin witnessfurtherance fees, travel expenses, mileage and other fees required by the service statutes of theany Statejoint inor whichindividual theinvestigation witnessesinitiated orunder evidencethis arecompact. located.

(3)(i) If Notwithstandingan subdivisionadverse (2)action ofis thistaken subsection,against subpoenas may not be issued by a ParticipatingPA's Statequalifying tolicense, gatherthe evidencePA's ofcompact conductprivilege in anotherall Stateremote thatstates isshall lawfulbe indeactivated thatuntil othertwo Stateyears forhave theelapsed purposeafter ofall takingrestrictions Adversehave Actionbeen againstremoved afrom Licensee'sthe Compactstate Privilegelicense. or application for a Compact Privilege in that Participating State.

(4)All Nothingdisciplinary inorders thisby Compactthe authorizesparticipating astate Participatingthat Stateissued tothe qualifying license that impose disciplineadverse action against a physicianPA's assistant'slicense Compactshall Privilegeinclude ora tostatement denythat anthe applicationPA's forcompact aprivilege Compactis Privilegedeactivated in thatall Participatingparticipating Statestates forduring the individual'spendency otherwiseof lawfulthe practiceorder. in another State.

3.(j) If any participating state takes adverse action, it promptly shall notify the administrator of the data system.

ForSECTION purposes7—ESTABLISHMENT ofOF takingTHE AdversePALICENSURE Action,COMPACT theCOMMISSION Participating(a) The Stateparticipating whichstates issuedhereby thecreate Qualifyingand Licenseestablish shalla givejoint thegovernment sameagency priority and effectnational toadministrative reportedbody conductknown received from any other Participating State as it would if the conductPA hadlicensure occurredcompact withincommission. the Participating State which issued the Qualifying License.

InThe socommission doing,is thatan Participatinginstrumentality Stateof shallthe applycompact itsstates ownacting Statejointly lawsand tonot determinean appropriateinstrumentality action.of any one state.

HCSThe HBcommission 3129shall 7come 4.into existence on or after the effective date of the compact as set forth in section 11(a).

A(b) Membership, Participatingvoting State, if otherwise permitted by State law, may recover from the affected physician assistant the costs of investigations and dispositionmeetings. of cases resulting from any Adverse Action taken against that physician assistant.

5.(1) Each participating state shall have and be limited to one delegate selected by such participating state's licensing board or, if such participating state has more than one licensing board, selected collectively by the participating state's licensing boards.

A(2) Adelegate Participatingshall Statebe mayeither: take Adverse Action based on the factual findings of a Remote State, provided that the Participating State follows its own procedures for taking the Adverse Action.

6.(A) A current PA, physician or public member of a licensing board or PAcouncil or committee;

(1)or In(B) an additionadministrator toof the authority granted to a Participatinglicensing Stateboard. by its respective State physician assistant laws and regulations or other applicable State law, any Participating State may participate with other Participating States in joint investigations of Licensees.

(2)(3) Any Participatingdelegate Statesmay shallbe shareremoved anyor investigative,suspended litigation,from oroffice complianceas materialsprovided inby furtherancethe laws of anythe jointstate orfrom individualwhich investigationthe initiateddelegate underis thisappointed. Compact.

7.(4) The participating state licensing board shall fill any vacancy occurring in the commission within 60 days.

If(5) Each andelegate Adverseshall Actionbe isentitled takento againstone avote physicianon assistant'sall Qualifyingmatters License,voted theon physicianby assistant'sthe Compactcommission Privilegeand in all Remote States shall beotherwise deactivated until two (2) years have elapsedan afteropportunity allto restrictionsparticipate havein beenthe removedcommission's frombusiness theand Stateaffairs. License.

All disciplinary orders by the Participating State which issued the Qualifying License that impose Adverse Action against a physician assistant's License shall include a Statement that the physician assistant's Compact Privilege is deactivated in all Participating States during the pendency of the order.

8.

If any Participating State takes Adverse Action, it promptly shall notify the administrator of the Data System.

334.1830.

1.

The Participating States hereby create and establish a joint government agency and national administrative body known as the PA Licensure Compact Commission.

The Commission is an instrumentality of the Compact States acting jointly and not an instrumentality of any one State.

The Commission shall come into existence on or after the effective date of the Compact as set forth in subsection 1 of section 334.1850.

2.

(1) Each Participating State shall have and be limited to one (1) delegate selected by that Participating State's Licensing Board or, if the State has more than one Licensing Board, selected collectively by the Participating State's Licensing Boards.

(2) The delegate shall be either:

(a) A current physician assistant, physician or public member of a Licensing Board or physician assistant Council/Committee;

or (b) An administrator of a Licensing Board.

(3) Any delegate may be removed or suspended from office as provided by the laws of the State from which the delegate is appointed.

HCS HB 3129 8 (4) The Participating State Licensing Board shall fill any vacancy occurring in the Commission within sixty (60) days.

(5) Each delegate shall be entitled to one (1) vote on all matters voted on by the Commission and shall otherwise have an opportunity to participate in the business and affairs of the Commission.

The bylaws may provide for delegates' participation in meetings by telecommunications, video conference,conference or other means of communication.

(6)(6) The Thecommission Commission shall meet at least once during each calendar year.

Additional meetings shall be held as set forth in this Compactcompact and the bylaws.HB 2219—Am.

(7) The Commission shall establish by RuleHC a8 termbylaws. of office for delegates.

3.(7) The commission shall establish by rule a term of office for delegates.

The(c) The Commissioncommission shall have the following powers and duties:

(1)(1) Establish Establish a code of ethics for the Commission;commission;

(2)(2) establish Establish the fiscal year of the Commission;commission;

(3)(3) establish Establish fees;

(4)(4) establish Establish bylaws;

(5)(5) maintain Maintain its financial records in accordance with the bylaws;

(6)(6) meet Meet and take such actions as are consistent with the provisions of this Compactcompact and the bylaws;

(7)(7) adopt Promulgaterules Rules limited to the Commission's authority to facilitate and coordinate implementation and administration of this Compact.compact, and such rules shall have the force and effect of law and shall be binding in all participating states;

The(8) bring Rulesand authorizedprosecute bylegal theproceedings Compactor shallactions havein the forcename andof effectthe commission, except that the standing of lawany andstate shalllicensing board to sue or be bindingsued inunder allapplicable Participatinglaw States;shall not be affected;

(8)(9) purchase Bring and prosecutemaintain legalinsurance proceedingsand orbonds; actions in the name of the Commission, provided that the standing of any State Licensing Board to sue or be sued under applicable law shall not be affected;

(9)(10) borrow, Purchaseaccept andor maintaincontract insurancefor andservices bonds;of personnel, including, but not limited to, employees of a participating state;

(10)(11) hire Borrow,employees accept,and engage contractors, elect or contractappoint forofficers, servicesfix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of personnel,this including,compact butand notestablish limitedthe to,commission's employeespersonnel policies and programs relating to conflicts of ainterest, Participatingqualifications State;of personnel and other related personnel matters;

(11)(12) accept Hireany employees and engageall contractors, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authoritydonations toand carrygrants outof themoney, purposesequipment, ofsupplies, thismaterials Compact, and establishservices theand Commission'sreceive, personnelutilize policies and programsdispose relating to conflicts of interest,the qualificationssame. of personnel, and other related personnel matters;

(12)At Acceptall anytimes andthe allcommission appropriateshall donationsavoid andany grantsappearance of money,impropriety equipment,or supplies,conflict materials and services, and receive, utilize and dispose of theinterest; same;

provided(13) lease, thatpurchase, ataccept allappropriate timesgifts theor Commissiondonations shallof avoidor anyotherwise appearanceown, ofhold, improprietyimprove or conflictuse ofany interest;property real, personal or mixed.

HCSIn HBperforming 3129these 9actions, (13)the Lease,commission purchase,shall acceptavoid appropriatethe giftsappearance orof donationsimpropriety of,at orall otherwisetimes; own, hold, improve or use, any property, real, personal or mixed;

provided(14) sell, thatconvey, atmortgage, allpledge, timeslease, theexchange, Commissionabandon shallor avoidotherwise dispose of any appearanceproperty ofreal, impropriety;personal or mixed;

(14)(15) establish Sell,a convey,budget mortgage,and pledge,make lease,expenditures; exchange, abandon, or otherwise dispose of any property real, personal, or mixed;

(15)(16) borrow Establishmoney; a budget and make expenditures;

(16)(17) appoint Borrowcommittees, money;including standing committees composed of members, state regulators, state legislators or their representatives, consumer representatives and such other interested persons as may be designated in this compact and the bylaws;

(17)(18) provide Appointand committees,receive includinginformation standingfrom, committees composed of members, State regulators, State legislators or their representatives, and consumercooperate representatives,with, andlaw suchenforcement otheragencies; interested persons as may be designated in this Compact and the bylaws;

(18)HB Provide2219—Am. and receive information from, and cooperate with, law enforcement agencies;

(19)by ElectHC 9 (19) elect a Chair,chairperson, Vicevice Chair,chairperson, Secretarysecretary and Treasurertreasurer and such other officers of the Commissioncommission as provided in the Commission'scommission's bylaws;

(20)(20) reserve Reserve for itself, in addition to those reserved exclusively to the Commissioncommission under the Compact,compact, powers that the Executiveexecutive Committeecommittee mayshall not exercise;

(21)(21) approve Approve or disapprove a State'sstate's participation in the Compactcompact based upon its determination as to whether the State'sstate's Compactcompact legislation materially departs in a material manner from the Modelmodel Compactcompact language;

(22)(22) prepare Prepare and provide to the Participatingparticipating Statesstates an annual report;

and (23)(23) perform Perform such other functions as may be necessary or appropriate to achieve the purposes of this Compactcompact, consistent with the Statestate regulation of physicianPAlicensure assistant licensure and practice.

4.(d) Meetings of the commission.

(1)(1) All All meetings of the Commissioncommission that are not closed pursuant to this subsection shall be open to the public.

Notice of public meetings shall be posted on the Commission'scommission's website at least thirty30 (30) days prior to the public meeting.

(2)(2) Notwithstanding Notwithstandingsubsection subdivision(d)(1), (1) of this subsection, the Commissioncommission may convene a public meeting by providing at least twenty-four24 (24)hours' hours prior notice on the Commission'scommission's website,website and any other means as provided in the Commission'scommission's Rules,rules for any of the reasons it may dispensedispense, with notice of proposed rulemaking under subsection 12 of section 334.1840.9(l).

(3)(3) The Thecommission Commission may convene in a closed, non-publicnonpublic meeting or non-publicnonpublic part of a public meeting to receive legal advice or to discuss:

(a)(A) Noncompliance Non-compliance of a Participatingparticipating Statestate with its obligations under this Compact;compact;

HCS(B) the HB 3129 10 (b) The employment, compensation, discipline or other matters, practices ororprocedures procedures related to specific employees or other matters related to the Commission'scommission's internal personnel practices and procedures;

(c)(C) any Current,current, threatened,threatened or reasonably anticipated litigation;

(d)(D) the Negotiationnegotiation of contracts for the purchase, lease,lease or sale of goods, services,services or real estate;

(e)(E) the Accusingaccusation of any personindividual of a crime or formallythe censuringformal censure any person;individual;

(f)(F) the Disclosuredisclosure of trade secrets or commercial or financial information that is privileged or confidential;

(g)(G) the Disclosuredisclosure of information of a personal naturenature, whereif disclosure would constitute a clearly unwarranted invasion of personal privacy;

(h)(H) the Disclosuredisclosure of investigative records compiled for law enforcement purposes;

(i)(I) the Disclosuredisclosure of information related to any investigative reports preparedHB by2219—Am. or on behalf of or for use of the Commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to this Compact;

(j)by LegalHC advice;10 prepared by or on behalf of or for use of the commission or other committee charged with the responsibilityof investigation or determination of compliance issues pursuant to this compact;

or(J) legal (k)advice; Matters specifically exempted from disclosure by federal or Participating States' statutes.

(4) If a meeting, or portion(K) any ofmatters aspecifically meeting,exempted isfrom closeddisclosure pursuantby tofederal this provision, the chair of the meeting or thea chair'sparticipating designeestate's shallstatutes. certify that the meeting or portion of the meeting may be closed and shall reference each relevant exempting provision.

(5)(4) If Thea Commissionmeeting, shallor keepportion minutesof thata fullymeeting, andis clearlyclosed describepursuant allto matterssubsection discussed(d)(3), inthe achairperson of the meeting andor the chairperson's designee shall providecertify athat fullthe andmeeting accurateor summaryportion of actionsthe taken,meeting includingmay abe descriptionclosed ofand theshall viewsreference expressed.each relevant exempting provision.

(5) The commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including a description of the views expressed.

All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commissioncommission or order of a court of competent jurisdiction.

5.(e) Financing of the commission.

(1)(1) The Thecommission Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization,organization and ongoing activities.

(2)(2) The Thecommission Commission may accept any and all appropriate revenue sources, donations,donations and grants of money, equipment, supplies, materials,materials and services.

(3)(3) The Thecommission Commission may levy on and collect an annual assessment from each Participatingparticipating Statestate and may impose Compactcompact Privilegeprivilege fees on Licenseeslicensees of Participatingparticipating Statesstates to whomwhich a Compactcompact Privilegeprivilege is granted to cover the cost of the operations and activities of the Commissioncommission and its staff,staff. which must be in a total amount sufficient to cover its annual budget as approved by the Commission each year HCS HB 3129 11 for which revenue is not provided by other sources.

TheSuch aggregateassessment annualshall assessmentbe in a total amount leviedsufficient onto Participatingcover Statesthe shallcommission's beannual allocatedbudget basedas uponapproved aby formulathe tocommission beeach determinedyear for which revenue is not provided by Commissionother Rule.sources.

(a)The Aaggregate Compactannual Privilegeassessment expiresamount whenlevied theon Licensee'sparticipating Qualifyingstates Licenseshall inbe theallocated Participatingbased Stateupon froma whichformula theto Licenseebe applieddetermined forby thecommission Compactrule. Privilege expires.

(b) If the Licensee terminates the Qualifying License through which the Licensee applied for the Compact Privilegeprivileges before its scheduled expiration, and thesuch Licenseecontract hascompact aprivilege's Qualifyingassociated Licensefees in another Participating State, the Licensee shall informbe thegoverned Commissionas thatfollows: it is changing to that Participating State the Participating State through which it applies for a Compact Privilege and pay to the Commission any Compact Privilege fee required by Commission Rule.

(4)(A) A Thecompact Commissionprivilege shallexpires notwhen incurthe obligationslicensee's ofqualifying anylicense kindin priorthe toparticipating securingstate thefrom fundswhich adequatethe tolicensee meetapplied for the same;compact privilege expires;

norand shall(B) if the Commissionlicensee pledgeterminates the creditqualifying oflicense anythrough ofwhich the Participatinglicensee States,applied exceptfor bythe compact privilege before its scheduled expiration and withthe licensee has a qualifying license in another participating state, the authoritylicensee ofshall inform the Participatingcommission State.that it is changing to that participating state through which it applies for a compact privilege to that HB 2219—Am.

(5)by TheHC Commission11 shallparticipating keepstate accurateand accountspay ofto allthe receiptscommission andany disbursements.compact privilege fee required by commission rule.

The(4) The receiptscommission andshall disbursementsnot incur obligations of any kind prior to securing the Commissionfunds adequate to meet such obligations, nor shall bethe subjectcommission topledge the financialcredit reviewof any of the participating states, except by and accountingwith proceduresthe establishedauthority underof itsthe bylaws.participating state.

All(5) The receiptscommission and disbursements of funds handled by the Commission shall bekeep subjectaccurate toaccounts an annual financial review by a certified or licensed public accountant, and the report of theall financialreceipts review shall be included in and becomedisbursements. part of the annual report of the Commission.

6.The receipts and disbursements of the commission shall be subject to the financial review and accounting procedures established under its bylaws.

(1)All Thereceipts Executiveand Committeedisbursements shallof havefunds handled by the powercommission shall be subject to actan onannual behalffinancial ofreview theby Commissiona accordingcertified toor licensed public accountant, and the termsreport of thisthe Compactfinancial review shall be included in and Commissionbecome Rules.part of the annual report of the commission.

(2)(f) The Theexecutive Executivecommittee. Committee shall be composed of nine (9) members:

(a)(1) The Sevenexecutive votingcommittee membersshall whohave areto electedpower byto theact Commissionon frombehalf of the currentcommission membershipaccording ofto the Commission;terms of this compact and commission rules.

(b)(2) The Oneexecutive ex-officio,committee nonvotingshall memberbe fromcomposed aof recognizednine nationalmembers physiciandescribed assistantas professionalfollows: association;

and(A) Seven (c)voting Onemembers ex-officio,who nonvotingare memberelected fromby athe recognizedcommission nationalfrom physicianthe assistantcurrent certificationmembership organization.of the commission;

(3)(B)(i)(a) one Theex ex-officioofficio, membersnonvoting willmember befrom selecteda byrecognized theirnational respectivePAprofessional organizations.association;

(4)and The(b) one Commissionex mayofficio, removenonvoting any member offrom thea Executiverecognized Committeenational asPA providedcertification inorganization. its bylaws.

(5)(ii) The Theex Executiveofficio Committeemembers shall meetbe atselected leastby annually.their respective organizations.

(6)(3) The Thecommission Executivemay Committeeremove shallany havemember of the followingexecutive dutiescommittee andas responsibilities:provided in its bylaws.

(a)(4) The Recommendexecutive tocommittee theshall Commissionmeet changesat toleast theannually. Commission's Rules or bylaws, changes to this Compact legislation, fees to be paid by Compact Participating HCS HB 3129 12 States such as annual dues, and any Commission Compact fee charged to Licensees for the Compact Privilege;

(b)(5) The Ensureexecutive Compactcommittee administrationshall serviceshave arethe appropriatelyfollowing provided,duties contractualand orresponsibilities: otherwise;

(c)(A) Recommend Prepareto the commission changes to the commission's rules or bylaws, changes to this compact legislation, fees to be paid by compact-participating states such as annual dues and recommendany commission compact fee charged to licensees for the budget;compact privilege;

(d)(B) ensure Maintainthat financialcompact recordsadministration onservices behalfare ofappropriately theprovided, Commission;whether contractual or otherwise;

(e)(C) prepare Monitor Compact compliance of Participating States and providerecommend compliance reports to the Commission;budget;

(f)(D) maintain Establishfinancial additionalrecords committeeson asbehalf necessary;of the commission;

(g)(E) monitor Exercisecompact thecompliance powers and duties of theparticipating Commissionstates during the interim between Commission meetings, except for issuing proposed rulemaking or adopting Commission Rules or bylaws, or exercising any other powers and dutiesprovide exclusivelycompliance reservedreports to the Commissioncommission; by the Commission's Rules;

andHB (h)2219—Am. Perform other duties as provided in the Commission's Rules or bylaws.

(7)by AllHC meetings12 of(F) establish theadditional Executivecommittees Committee at which it votes or plans to vote on matters in exercising the powers and duties of the Commission shall be open to the public and public notice of such meetings shall be given as publicnecessary; meetings of the Commission are given.

(8)(G) exercise Thethe Executivepowers Committeeand mayduties conveneof in a closed, non-public meeting for the samecommission reasonsduring that the Commissioninterim maybetween convenecommission inmeetings, aexcept non-publicfor meetingissuing asproposed setrulemaking forthor inadopting subdivisioncommission (3)rules ofor subsectionbylaws 4or ofexercising thisany sectionother powers and shallduties announceexclusively thereserved closed meeting as the Commission is required to under subdivision (4) of subsection 4 of this section and keep minutes of the closedcommission meetingby as the Commissioncommission's isrules; required to under subdivision (5) of subsection 4 of this section.

7.and (H) perform other duties as provided in the commission's rules or bylaws.

(1)(6) All Themeetings members, officers, executive director, employees and representatives of the Commissionexecutive shallcommittee beat immunewhich fromit suitvotes andor liability,plans both personally and in their official capacity, for any claim for damage to orvote losson ofmatters propertyin orexercising personalthe injurypowers orand otherduties civil liability caused by or arising out of anythe actualcommission orshall allegedbe act,open error,to or omission that occurred, or that the personpublic againstand whompublic thenotice claimof issuch mademeetings hadshall abe reasonablegiven basisas forpublic believingmeetings occurredof within the scopecommission ofare Commissiongiven. employment, duties or responsibilities;

provided(7) The thatexecutive nothingcommittee may convene in thisa subdivisionclosed, shallnonpublic bemeeting construedfor tothe protectsame anyreasons suchthat personthe fromcommission suitmay orconvene liabilityin fora anynonpublic damage,meeting loss,as injury,set orforth liabilityin causedsubsection by(d)(3), and shall announce the intentionalclosed ormeeting willfulas orthe wantoncommission misconductis required to do under subsection (d)(4) and keep minutes of thatthe person.closed meeting as the commission is required to do under subsection (d)(5).

The(g) Qualified procurementimmunity, ofdefense insuranceand ofindemnification. any type by the Commission shall not in any way compromise or limit the immunity granted hereunder.

(2)(1) The Themembers, Commissionofficers, shall defend any member, officer, executive director, employee,employees and representativerepresentatives of the Commissioncommission inshall anybe civilimmune actionfrom seekingsuit toand imposeliability, HCSboth HBpersonally 3129and 13in liabilitytheir arisingofficial outcapacity, offor any actualclaim for damage to or allegedloss act,of error,property or omissionpersonal thatinjury occurredor withinother thecivil scopeliability ofcaused Commissionby employment,or duties,arising orout responsibilities,of any actual or asalleged determinedact, byerror theor commissionomission that occurred or that the personindividual against whom the claim is made had a reasonable basis for believing occurred within the scope of Commissioncommission employment, duties,duties or responsibilities;responsibilities.

providedNothing thatin nothingthis hereinparagraph shall be construed to prohibitprotect thatany personsuch individual from retainingsuit theiror ownliability counselfor atany theirdamage, ownloss, expense;injury or liability caused by the intentional or willful or wanton misconduct of such individual.

andThe providedprocurement further,of thatinsurance theof actualany ortype allegedby act,the error,commission orshall omission did not resultin fromany thatway person'scompromise intentional or willfullimit orthe wantonimmunity misconduct.granted hereunder.

(3)(2) The Thecommission Commission shall indemnifydefend and hold harmless any member, officer, executive director, employee, and representative of the Commissioncommission forin the amount of any settlementcivil oraction judgmentseeking obtainedto againstimpose thatliability person arising out of any actual or alleged act, error,error or omission that occurred within the scope of Commissioncommission employment, duties,duties or responsibilities,responsibilities or as determined by the commission that suchthe personindividual against whom the claim is made had a reasonable basis for believing occurred within the scope of Commissioncommission employment, duties,duties or responsibilities,responsibilities. provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person.

(4)Nothing Venueherein isshall properbe andconstrued judicialto proceedingsprohibit bysuch orindividual againstfrom theretaining Commissionsuch shallindividual's beown broughtcounsel solelyat andthe exclusivelyindividual's inown aexpense courtor ofthat competentthe jurisdictionactual whereor thealleged principalact, officeerror ofor omission did not result from the Commissionindividual's isintentional, located.willful or wanton misconduct.

The(3) The Commissioncommission mayshall waiveindemnify venue and jurisdictionalhold defensesharmless in any proceedingsmember, asHB authorized2219—Am. by Commission Rules.

(5)by NothingHC herein13 shallofficer, beexecutive construeddirector, asemployee aor limitationrepresentative onof the liabilitycommission for the amount of any Licenseesettlement or judgment obtained against that individual arising out of any actual or alleged act, error or omission that occurred within the scope of commission employment, duties or responsibilities or that such individual had a reasonable basis for professionalbelieving malpracticeoccurred within the scope of commission employment, duties or misconduct,responsibilities, whichif shallthe beactual governedor solelyalleged byact, anyerror otheror applicableomission Statedid laws.not result from the intentional or willful or wanton misconduct of that individual.

(6)(4) Venue Nothingis hereinproper shalland bejudicial construedproceedings toby designate the venue or jurisdictionagainst tothe bringcommission actionsshall forbe allegedbrought actssolely ofand malpractice,exclusively professionalin misconduct,a negligence,court orof othercompetent suchjurisdiction civilwhere action pertaining to the practiceprincipal office of athe physiciancommission assistant.is located.

AllThe suchcommission mattersmay shallwaive bevenue determinedand exclusivelyjurisdictional bydefenses Statein lawany otherproceedings thanas thisauthorized Compact.by commission rules.

(7)(5) Nothing Nothingherein in this Compact shall be interpretedconstrued toas waive or otherwise abrogate a Participatinglimitation State'son statethe actionliability immunityof orany statelicensee actionfor affirmativeprofessional defensemalpractice withor respectmisconduct, towhich antitrustshall claimsbe undergoverned thesolely Shermanby Act, Clayton Act, or any other Stateapplicable orstate federallaws. antitrust or anticompetitive law or regulation.

(8)(6) Nothing Nothingherein in this Compact shall be construed to bedesignate athe waivervenue ofor sovereignjurisdiction immunityto bybring theactions Participatingfor Statesalleged acts of malpractice, professional misconduct, negligence or byother such civil action pertaining to the Commission.practice of a PA.

334.1835.All such matters shall be determined exclusively by state law other than this compact.

1.(7) Nothing in this compact shall be interpreted to waive or otherwise abrogate a participating state's state action immunity or state action affirmative defense with respect to antitrust claims under the Sherman act, Clayton act or any other state or federal antitrust or anticompetitive law or regulation.

The(8) Nothing Commissionin shallthis providecompact forshall thebe development,construed maintenance,to operation,be anda utilizationwaiver of asovereign coordinatedimmunity databy andthe reportingparticipating systemstates containingor licensure,by Adverse Action, and the reportingcommission. of the existence of Significant Investigative HCS HB 3129 14 Information on all licensed physician assistants and applicants denied a License in Participating States.

2.SECTION 8—DATASYSTEM (a) The commission shall provide for the development, maintenance, operation and utilization of a coordinated data and reporting system containing licensure, adverse action and the reporting of the existence of significant investigative information on all licensed PAs and applicants that are denied a license in participating states.

Notwithstanding(b) Notwithstanding any other Statestate law to the contrary, a Participatingparticipating Statestate shall submit a uniform data set to the Datadata Systemsystem on all physicianPAs assistants to whom this Compactcompact is applicableapplicable, (utilizingutilizing a unique identifier)identifier, as required by the Rulesrules of the Commission,commission, including:

(1)(1) Identifying Identifying information;

(2)(2) licensure Licensure data;

(3)HB Adverse2219—Am. Actions against a License or Compact Privilege;

(4)by AnyHC denial14 of(3) adverse applicationactions foragainst licensure,a andlicense the reason or reasonscompact forprivilege; such denial (excluding the reporting of any Criminal history record information where prohibited by law);

(5)(4) any Thedenial existenceof application for licensure and the reason for such denial, excluding the reporting of Significantany Investigativecriminal Information;history record information where such reporting is prohibited by law;

and(5) the (6)existence Other information that may facilitate the administration of thissignificant Compact,investigative asinformation; determined by the Rules of the Commission.

3.and (6) other information that may facilitate the administration of this compact, as determined by the rules of the commission.

Significant(c) Significant Investigativeinvestigative Informationinformation pertaining to a Licenseelicensee in any Participatingparticipating Statestate shall only be available to other Participatingparticipating States.states.

4.(d) The commission shall promptly notify all participating states of any adverse action taken against a licensee or an individual applying for a license that has been reported to such commission.

TheSuch Commissionadverse shallaction promptlyinformation notifyshall allbe Participatingavailable Statesto of any Adverseother Actionparticipating takenstate. against a Licensee or an individual applying for a License that has been reported to it.

This(e) Participating Adversestates Actioncontributing information to the data system may, in accordance with state or federal law, designate information that shall not be availableshared towith anythe otherpublic Participatingwithout State.the express permission of the contributing state.

5.Notwithstanding any such designation, such information shall be reported to the commission through the data system.

Participating(f) Any States contributing information submitted to the Datadata Systemsystem may,that inis accordancesubsequently withexpunged Statepursuant orto federal law,law designateor informationthe thatlaws mayof notthe beparticipating sharedstate withcontributing the publicinformation withoutshall be removed from the expressdata permissionsystem upon reporting of such by the contributingparticipating State.state to the commission.

Notwithstanding(g) The anyrecords suchand designation,information suchprovided informationto shalla beparticipating reportedstate pursuant to thethis Commissioncompact or through the Datadata System.system, when certified by the commission or an agent thereof, shall constitute the authenticated business records of the commission and shall be entitled to any associated hearsay exception in any relevant judicial, quasi-judicial or administrative proceedings in a participating state.

6.SECTION 9—RULEMAKING (a) The commission shall exercise its rulemaking powers pursuant to the criteria set forth in this section and the rules adopted thereunder.

AnyCommission informationrules submittedshall tobecome thebinding Dataas System that is subsequently expunged pursuant to federal law or the laws of the Participatingdate Statespecified contributing the information shall be removed from the Data System upon reporting of such by the Participatingcommission Statefor toeach therule. Commission.

7.(b) The commission shall adopt reasonable rules in order to effectively and efficiently implement and administer this compact and achieve its purposes.

TheA recordscommission andrule informationshall providedbe toinvalid aand Participatinghave Stateno pursuantforce toor thiseffect Compactonly orif througha thecourt Dataof System,competent whenjurisdiction certifiedholds bythat the Commissionrule oris aninvalid agentbecause thereof,the shallcommission constituteexercised theits authenticatedrulemaking businessauthority recordsin ofa themanner Commission,that andis shallbeyond bethe entitledscope toof anythe associatedpurposes hearsayof exceptionthis incompact, anythe relevantpowers judicial,granted quasi-hereunder judicial or administrativebased proceedingsupon inanother aapplicable Participatingstandard State.of HB 2219—Am.

HCSby HBHC 3129 15 334.1840.review.

1.(c) The rules of the commission shall have the force of law in each participating state, except that where the rules of the commission conflict with the laws of the participating state that establish the medical services, a PA may perform in the participating state, as held by a court of competent jurisdiction, and the rules of the commission shall be ineffective in that state to the extent of the conflict.

The(d) If Commissiona shallmajority exerciseof itsthe Rulemakinglegislatures powersof pursuantthe toparticipating thestates criteriarejects seta forthcommission rule, by enactment of a statute or resolution in the same manner used to adopt this Sectioncompact andwithin four years of the Rulesdate adoptedof thereunder.adoption of the rule, then such rule shall have no further force and effect in any participating state or to any state applying to participate in the compact.

Commission(e) Commission Rulesrules shall becomebe bindingadopted asat ofa theregular dateor specifiedspecial bymeeting of the Commissioncommission. for each Rule.

2.(f) Prior to promulgation and adoption of a final rule by the commission and at least 30 days in advance of the meeting at which the rule will be considered and voted upon, the commission shall file a notice of proposed rulemaking:

The(1) On Commissionthe shallcommission's promulgatewebsite reasonableor Rulesother inpublicly orderaccessible toplatform; effectively and efficiently implement and administer this Compact and achieve its purposes.

A(2) to Commissionpersons Rulewho shall be invalid and have norequested forcenotice or effect only if a court of competent jurisdiction holds that the Rulecommission's isnotices invalid because the Commission exercised its rulemaking authority in a manner that is beyond the scope of theproposed purposesrulemaking; of this Compact, or the powers granted hereunder, or based upon another applicable standard of review.

3.and (3) in such other ways as the commission may specify by rule.

The(g) The Rulesnotice of theproposed Commissionrulemaking shall haveinclude: the force of law in each Participating State, provided however that where the Rules of the Commission conflict with the laws of the Participating State that establish the medical services a physician assistant may perform in the Participating State, as held by a court of competent jurisdiction, the Rules of the Commission shall be ineffective in that State to the extent of the conflict.

4.(1) The time, date and location of the public hearing on the proposed rule and the proposed time, date and location of the meeting in which the proposed rule will be considered and voted upon;

If(2) the atext majority of theand legislatures of the Participatingreason Statesfor rejects a Commission Rule, by enactment of a statute or resolution in the sameproposed mannerrule; used to adopt this Compact within four (4) years of the date of adoption of the Rule, then such Rule shall have no further force and effect in any Participating State or to any State applying to participate in the Compact.

5.(3) a request for comments on the proposed rule from any interested person and the date by which written comments must be received;

Commissionand Rules(4) the shallmanner bein adoptedwhich atinterested apersons regularmay orsubmit specialnotice meetingto the commission of their intention to attend the Commission.public hearing or provide any written comments.

6.(h) Prior to adoption of a proposed rule, the commission shall allow persons to submit written data, facts, opinions and arguments, which shall be made available to the public.

Prior(i) If to promulgation and adoption of a final Rule or Rules by the Commission,hearing andis atto leastbe thirtyheld (30)via dayselectronic inmeans, advance of the meetingcommission atshall whichpublish the Rulemechanism willfor beaccess consideredto and voted upon, the Commissionelectronic shallhearing. file a Notice of Proposed Rulemaking:

(1)(1) All Onpersons wishing to be heard at the websitehearing shall, as directed in the notice of proposed rulemaking published not less than five business days before the Commissionscheduled ordate otherof publiclythe accessiblehearing, platform;notify the commission of their desire to appear and testify at the hearing.

andHB (2)2219—Am. To persons who have requested notice of the Commission's notices of proposed rulemaking;

andby (3)HC In16 such(2) Hearings othershall way(s)be asconducted thein Commissiona maymanner bythat Ruleprovides specify.each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.

7.(3) All hearings shall be recorded.

TheA Noticecopy of Proposedthe Rulemakingrecording and the written comments, data, facts, opinions and arguments received in response to the proposed rulemaking shall include:be made available to a person upon request.

(1)(4) Nothing Thein time,this date,section andshall locationbe ofconstrued theas publicrequiring a separate hearing on theeach proposed Rulerule. and the proposed time, date and location of the meeting in which the proposed Rule will be considered and voted upon;

(2)Proposed Therules textmay ofbe thegrouped proposedfor Rulethe andconvenience of the reasoncommission forat thehearings proposedrequired Rule;by this section.

(3)(j) Following Athe requestpublic forhearing, comments on the proposedcommission Ruleshall fromconsider anyall interestedwritten person and theoral date by which written comments musttimely bereceived. received;

and(k) The HCScommission HBshall, 3129by 16majority (4)vote Theof mannerall indelegates, whichtake interestedfinal personsaction mayon submitthe noticeproposed torule and shall determine the Commissioneffective date of theirthe intentionrule, toif attendadopted, based on the publicrulemaking hearingrecord orand providethe anyfull writtentext comments.of the rule.

8.(1) If adopted, the rule shall be posted on the commission's website.

Prior(2) The tocommission adoptionmay ofadopt achanges proposedto Rule, the Commissionproposed shallrule allowif personsthe tochanges submitdo writtennot data,expand facts,the opinions,original andpurpose arguments,of which shall be made available to the public.proposed rule.

9.(3) The commission shall provide an explanation on its website of the reasons for any substantive changes made to the proposed rule as well as reasons for any substantive changes not made that were recommended by commenters.

If(4) The thecommission hearingshall isdetermine toa bereasonable heldeffective viadate electronic means, the Commission shall publish the mechanism for access to the electronicrule. hearing.

(1)Except Allfor personsan wishingemergency toas beprovided heardin atsubsection (l), the hearingeffective shalldate asof directed in the Noticerule ofshall Proposedbe Rulemaking, not lesssooner than five30 (5) business days beforeafter the scheduledcommission dateissued of the hearing,notice notifythat theit Commissionadopted of their desire to appear and testify at the hearing.rule.

(2)(l) Upon Hearingsthe shalldetermination bethat conductedan inemergency aexists, mannerthe providingcommission eachmay personconsider whoand wishesadopt toan emergency rule with 24 hours' prior notice, without the opportunity for comment aor fairhearing, expect that the usual rulemaking procedures provided in this compact and reasonablein opportunitythis section shall be retroactively applied to commentthe orallyrule oras soon as reasonably possible but in writing.no event later than 90 days after the effective date of the rule.

(3)For Allthe hearingspurposes of this provision, an emergency rule is one that shall be recorded.adopted immediately by the commission in order to:

A(1) Address copyan ofimminent thethreat recording and the written comments, data, facts, opinions, and arguments received in response to thepublic proposedhealth, rulemakingsafety shallor bewelfare; made available to a person upon request.

(4)(2) prevent Nothing in this section shall be construed as requiring a separateloss hearingof oncommission eachor proposedparticipating Rule.state funds;

Proposed(3) meet Rulesa maydeadline be grouped for the conveniencepromulgation of thea Commissioncommission atrule hearingsthat requiredis established by thisfederal section.law or rule;

10.or (4) protect public health and safety.

Following(m) The thecommission, publicor hearingan authorized committee of the Commissioncommission, shallmay considerdirect allrevisions writtento anda oralpreviously commentsadopted timelycommission received.rule for purposes of correcting typographical errors, errors in format, errors in consistency HB 2219—Am.

11.by HC 17 or grammatical errors.

ThePublic Commissionnotice shall, by majority vote of allany delegates,revisions take final action on the proposed Rule and shall determinebe theposted effective date of the Rule, if adopted, based on the Rulemakingcommission's recordwebsite. and the full text of the Rule.

(1)The Ifrevision adopted,shall thebe Rulesubject shallto bechallenge postedby onany theperson Commission'sfor website.a period of 30 days after posting.

(2) The Commissionrevision may adoptbe changeschallenged toonly theon proposedgrounds Rulethat provided the changesrevision doresults notin enlargea thematerial originalchange purposeto ofa therule. proposed Rule.

(3)A Thechallenge Commission shall providebe onmade itsas websiteset anforth explanationin of the reasonsnotice forof substantiverevisions changesand madedelivered to the proposedcommission Ruleprior asto wellthe asend reasonsof forthe substantivenotice changesperiod. not made that were recommended by commenters.

(4)If Theno Commissionchallenge shallis determinemade, athe reasonablerevision effectiveshall datetake foreffect thewithout Rule.further action.

ExceptIf for an emergency as provided in subsection 12 of this section, the effectiverevision dateis ofchallenged, the Rulerevision shall benot notake soonereffect thanwithout thirty (30) days after the Commissionapproval issuedof the noticecommission. that it adopted the Rule.

12.(n) No participating state's rulemaking requirements shall apply under this compact.

UponSECTION determination10—OVERSIGHT, thatDISPUTE anRESOLUTIONAND emergencyENFORCEMENT exists,(a) Oversight. the Commission may consider and adopt an emergency Rule with twenty-four (24) hours prior notice, without the opportunity for comment, or hearing, provided that the usual rulemaking procedures HCS HB 3129 17 provided in this Compact and in this section shall be retroactively applied to the Rule as soon as reasonably possible, in no event later than ninety (90) days after the effective date of the Rule.

For(1) The theexecutive purposesand judicial branches of thisstate provision,government anin emergencyeach Ruleparticipating isstate oneshall thatenforce mustthis becompact adoptedand immediatelytake byall theactions Commissionnecessary inand orderappropriate to:to implement the compact.

(1)(2) Venue Meetis anproper imminentand threatjudicial toproceedings publicby health,or safety,against orthe welfare;commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located.

(2)The Preventcommission amay losswaive ofvenue Commissionand jurisdictional defenses to the extent that it adopts or Participatingconsents Stateto funds;participate in alternative dispute resolution proceedings.

(3) Meet a deadline for the promulgation of a Commission Rule that is established by federal law or Rule;

or (4) Protect public health and safety.

13.

The Commission or an authorized committee of the Commission may direct revisions to a previously adopted Commission Rule for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors.

Public notice of any revisions shall be posted on the website of the Commission.

The revision shall be subject to challenge by any person for a period of thirty (30) days after posting.

The revision may be challenged only on grounds that the revision results in a material change to a Rule.

A challenge shall be made as set forth in the notice of revisions and delivered to the Commission prior to the end of the notice period.

If no challenge is made, the revision will take effect without further action.

If the revision is challenged, the revision may not take effect without the approval of the Commission.

14.

No Participating State's rulemaking requirements shall apply under this Compact.

334.1845.

1.

(1) The executive and judicial branches of State government in each Participating State shall enforce this Compact and take all actions necessary and appropriate to implement the Compact.

(2) Venue is proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located.

The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.

(3)(3) The Thecommission Commission shall be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the Compactcompact or the Commission'scommission's Rulesrules and shall have standing to intervene in such a proceeding for all purposes.

Failure to provide the Commissioncommission with service of process shall render a judgment or order in such proceeding void as to the Commission,commission, this Compact,compact or Commissioncommission Rules.rules.

HCS(b) Default, HBtechnical 3129assistance 18and 2.termination.

(1)(1) If If the Commissioncommission determines that a Participatingparticipating Statestate has defaulted in the performance of its obligations or responsibilities under this Compactcompact or the Commissioncommission Rules,rules, the Commissioncommission shall provide written notice to the defaulting Statestate and other Participatingparticipating States.states.

The notice shall describe the default, the proposed means of curing the default and any other action that the Commissioncommission may take and shall offer remedial training and specific technical assistance regarding the default.

(2)HB If2219—Am. a State in default fails to cure the default, the defaulting State may be terminated from this Compact upon an affirmative vote of a majority of the delegates of the Participating States, and all rights, privileges and benefits conferred by this Compact upon such State may be terminated on the effective date of termination.

Aby cureHC of18 the(2) If a state in default doesfails notto relievecure the offendingdefault, Statethe defaulting state may be terminated from this compact upon an affirmative vote of obligationsa ormajority liabilitiesof incurredthe duringdelegates of the periodparticipating states, and all rights, privileges and benefits conferred by this compact upon such state may be terminated on the effective date of default.termination.

(3)A Terminationcure of participationthe indefault thisshall Compactnot shallrelieve bethe imposedoffending onlystate afterof allobligations otheror meansliabilities ofincurred securingduring compliancethe haveperiod beenof exhausted.default.

Notice(3) Termination of intentparticipation toin suspendthis orcompact terminate shall be givenimposed byonly theafter Commissionall toother themeans governor, the majority and minority leaders of thesecuring defaultingcompliance State'shave legislature,been andexhausted. to the Licensing Board(s) of each of the Participating States.

(4)Notice Aof Stateintent thatto hassuspend beenor terminatedterminate isshall responsiblebe forgiven allby assessments,the obligations,commission andto liabilitiesthe incurredgovernor, through the effectivemajority dateand minority leaders of termination,the includingdefaulting obligationsstate's thatlegislature extendand beyondto the effectivelicensing dateboard of termination.each of the participating states.

(5)(4) A Thestate Commissionthat shallhas notbeen bearterminated any costs related to a State that is foundresponsible tofor beall inassessments, defaultobligations orand thatliabilities hasincurred beenthrough terminatedthe fromeffective thisdate Compact,of unlesstermination, agreedincluding uponobligations inthat writingextend betweenbeyond the Commissioneffective anddate theof defaultingtermination. State.

(6)(5) The Thecommission defaultingshall Statenot maybear appealany itscosts terminationrelated to a state that is found to be in default or that has been terminated from thethis Compactcompact, byunless theagreed Commissionupon byin petitioningwriting between the U.S.commission and the defaulting state.

District(6) The Courtdefaulting state may appeal its termination from the compact by the commission by petitioning the United States district court for the District of Columbia or the federal district where the Commissioncommission has its principal offices.

The prevailing member shall be awarded all costs of such litigation, including reasonable attorney'sattorney fees.

(7)(7) Upon Upon the termination of a State'sstate's participation in the Compact,compact, the Statestate shall immediately provide notice to all Licenseeslicensees within that Statestate of such termination:

(a)(A) Licensees Licensees who have been granted a Compactcompact Privilegeprivilege in that Statestate shall retain the Compactcompact Privilegeprivilege for one180 hundred eighty (180) days following the effective date of such termination.termination;

(b)and Licensees(B) licensees who are licensed in that Statestate who have been granted a Compactcompact Privilegeprivilege in a Participatingparticipating Statestate shall retain the Compactcompact Privilegeprivilege for one180 hundred eighty (180) days unless the Licenseelicensee also has a Qualifyingqualifying Licenselicense in a Participatingparticipating Statestate or obtains a Qualifyingqualifying Licenselicense in a Participatingparticipating Statestate before the one180-day hundred eighty (180)-day period ends, in which casecase, the Compactcompact Privilegeprivilege shall continue.

HCS(c) Dispute HBresolution. 3129 19 3.

(1)(1) Upon Upon request by a Participatingparticipating State,state, the Commissioncommission shall attempt to resolve disputes related to this Compactcompact that arise among Participatingparticipating Statesstates and between participating and non-Participatingnonparticipating States.states.

(2)(2) The Thecommission Commission shall promulgateadopt a Rulerule providing for both mediation and binding dispute resolution for disputes as appropriate.

4.HB 2219—Am.

(1)by TheHC Commission,19 in(d) Enforcement. the reasonable exercise of its discretion, shall enforce the provisions of this Compact and Rules of the Commission.

(2)(1) The Ifcommission, compliance is not secured after all means to secure compliance have been exhausted, by majority vote, the Commission may initiate legal action in the Unitedreasonable Statesexercise District Court for the District of Columbia or the federal district where the Commission has its principaldiscretion, offices,shall against a Participating State in default to enforce compliance with the provisions of this Compactcompact and therules Commission'sof promulgatedthe Rulescommission. and bylaws.

(2) If compliance is not secured after all means to secure compliance have been exhausted, by majority vote, the commission may initiate legal action in the United States district court for the District of Columbia or the federal district where the commission has its principal offices against a participating state in default to enforce compliance with the provisions of this compact and the commission's promulgated rules and bylaws.

In the event that judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney'sattorney fees.

(3)(3) The The remedies herein shall not be the exclusive remedies of the Commission.commission.

The Commissioncommission may pursue any other remedies available under federal or Statestate law.

5.(e) Legal action against the commission.

(1)(1) A Aparticipating Participatingstate State may initiate legal action against the Commissioncommission in the U.S.United States district court for the District of Columbia or the federal district where the commission has its principal offices to enforce compliance with the provisions of the compact and its rules.

District Court for the District of Columbia or the federal district where the Commission has its principal offices to enforce compliance with the provisions of the Compact and its Rules.

In the event that judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney'sattorney fees.

(2)(2) No No person other than a Participatingparticipating Statestate shall enforce this Compactcompact against the Commission.commission.

334.1850.SECTION 11—DATE OF IMPLEMENTATION OF THE PA LICENSURE COMPACT COMMISSION (a) This compact shall come into effect on the date that this compact statute is enacted into law in the seventh participating state.

1.(1) On or after the effective date of the compact, the commission shall convene and review the enactment of each of the states that enacted the compact prior to the commission convening, called charter- participating states, to determine if the statute enacted by each such charter-participating state is materially different than the model compact.

This(A) A Compactcharter-participating shallstate comewhose intoenactment effectis onfound theto datebe onmaterially whichdifferent thisfrom Compactthe statutemodel iscompact enactedshall intobe lawentitled into the seventhdefault Participatingprocess State.set forth in section 10(b).

(1)(B) If Onany orparticipating afterstate thelater effectivewithdraws datefrom of the Compact,compact theor Commissionits shallparticipation conveneis andterminated, review the enactmentcommission ofshall eachremain ofin theexistence Statesand that enacted the Compactcompact priorshall toremain thein Commissioneffect conveningeven ("Charter Participating States") to determine if the statutenumber enactedof byparticipating eachHB such2219—Am. Charter Participating State is materially different than the Model Compact.

(a)by AHC Charter20 Participatingstates Stateshould whose enactment is found to be materiallyfewer differentthan fromseven. the Model Compact shall be entitled to the default process set forth in subsection 2 of section 334.1845.

(b)Participating Ifstates anyenacting Participatingthe Statecompact latersubsequent withdrawsto from the Compactcommission orconvening itsshall participationbe issubject terminated,to the Commissionprocess shallset remainforth in existencesection and7(c)(21) theto Compactdetermine HCSif HBtheir 3129enactments 20are shallmaterially remaindifferent infrom effectthe evenmodel ifcompact theand numberwhether ofthey Participatingqualify Statesfor shouldparticipation bein lessthe thancompact. seven.

Participating(2) Participating Statesstates enacting the Compactcompact subsequent to the Commissionseven conveninginitial charter-participating states shall be subject to the process set forth in subdivision (21) of subsection 3 of section 334.18307(c)(21) to determine if their enactments are materially different from the Modelmodel Compactcompact and whether they qualify for participation in the Compact.compact.

(2)(3) All Participatingactions Statestaken enactingfor the Compactbenefit subsequentof to the sevencommission initialor Charterin Participatingfurtherance Statesof shallthe bepurposes subjectof to the processadministration setof forththe incompact subdivisionprior (21)to ofthe subsectioneffective 3date of sectionthe 334.1830compact toor determinethe ifcommission theircoming enactmentsinto areexistence materiallyshall differentbe fromconsidered theto Modelbe Compactactions andof whetherthe theycommission qualifyunless forspecifically participationrepudiated inby the Compact.commission.

(3)(b) Any Allstate actionsthat takenjoins forthis thecompact benefitshall ofbe thesubject Commissionto or in furtherance of the purposescommission's ofrules theand administrationbylaws ofas thethey Compactexist prioron to the effective date ofthat thethis Compactcompact orbecomes thelaw Commissionin comingthat intostate. existence shall be considered to be actions of the Commission unless specifically repudiated by the Commission.

2.Any rule that has been previously adopted by the commission shall have the full force and effect of law on the day that this compact becomes law in that state.

Any(c) Any Stateparticipating thatstate joinsmay thiswithdraw Compactfrom shallthis becompact subjectby toenacting thea Commission'sstatute Rulesrepealing and bylaws as they exist on the datesame. on which this Compact becomes law in that State.

Any(1) A Ruleparticipating thatstate's haswithdrawal beenshall previouslynot adoptedtake byeffect theuntil Commission180 shalldays haveafter theenactment full force and effect of law on the dayrepealing thisstatute. Compact becomes law in that State.

3.During the 180-day period, all compact privileges that were in effect in the withdrawing state and were granted to licensees licensed in the withdrawing state shall remain in effect.

AnyIf Participatingany Statelicensee maylicensed withdrawin fromthe thiswithdrawing Compactstate byis enactingalso licensed in another participating state or obtains a statutelicense repealingin another participating state within the same.180 days, the licensee's compact privileges in other participating states shall not be affected by the passage of the 180 days.

(1)(2) Withdrawal Ashall Participatingnot State'saffect withdrawalthe shallcontinuing notrequirement takeof effectthe untilstate onelicensing hundredboard eightyof (180)the dayswithdrawing afterstate enactmentto comply with the investigative and adverse action reporting requirements of this compact prior to the repealingeffective statute.date of withdrawal.

During(3) Upon thisthe oneenactment hundredof eightya (180)statute day-period,withdrawing alla Compactstate Privilegesfrom thatthis werecompact, inthe effectstate inshall theimmediately withdrawingprovide Statenotice andof weresuch grantedwithdrawal to Licenseesall licensedlicensees inwithin thethat withdrawingstate. State shall remain in effect.

IfSuch anywithdrawing Licenseestate licensedshall incontinue theto withdrawingrecognize Stateall islicenses alsogranted licensedpursuant into anotherthis Participatingcompact Statefor or obtains a licenseminimum inof another180 Participatingdays Stateafter within the onedate hundredof eightysuch (180)notice days, the Licensee's Compact Privileges in other Participating States shall not be affected by the passage of thewithdrawal. one hundred eighty (180) days.

(2)(d) Nothing Withdrawalcontained shallin notthis affectcompact theshall continuingbe requirementconstrued ofto theinvalidate Stateor Licensingprevent Board(s)any ofPA thelicensure withdrawingagreement Stateor toother complycooperative witharrangement thebetween investigative,participating states and Adversebetween Actiona reportingparticipating requirementsstate ofand thisnonparticipating Compactstate priorthat todoes thenot effectiveconflict datewith the provisions of withdrawal.this HB 2219—Am.

(3)by UponHC the21 enactmentcompact. of a statute withdrawing a State from this Compact, the State shall immediately provide notice of such withdrawal to all Licensees within that State.

Such(e) This withdrawingcompact Statemay shallbe continueamended toby recognize all licenses granted pursuant to this Compact for a minimum of one hundred eighty (180) days after the dateparticipating ofstates. such notice of withdrawal.

HCSNo HBamendment 3129to 21this 4.compact shall become effective and binding upon any participating state until it is enacted materially in the same manner into the laws of all participating states as determined by the commission.

Nothing7 containedSECTION in12—CONSTRUCTIONAND thisSEVERABILITY Compact9 shall(a) This becompact construedand tothe invalidatecommission's orrulemaking preventauthority anyshall physicianbe assistantliberally licensureconstrued agreementso oras otherto cooperativeeffectuate arrangementthe betweenpurposes Participating States and betweenthe aimplementation Participating State and non-Participatingadministration Stateof that does not conflict with the provisionscompact. of this Compact.

5.Provisions of the compact expressly authorizing or requiring the adoption of rules shall not be construed to limit the commission's rulemaking authority solely for those purposes.

This(b) The Compactprovisions mayof this compact shall be amendedseverable, and if any phrase, clause, sentence or provision of this compact is held by a court of competent jurisdiction to be contrary to the Participatingconstitution States.of any participating state, a state seeking participation in the compact or of the United States, or the applicability thereof to any government, agency, person or circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of this compact and the applicability thereof to any other government, agency, person or circumstance shall not be affected thereby.

No(c) Notwithstanding amendmentthe toprovisions of this Compactsubsection shallor becomesubsection effective(b), andthe bindingcommission uponmay anydeny Participatinga Statestate's untilparticipation itin isthe enactedcompact materiallyor, in accordance with the samerequirements mannerof intosection 10(b), terminate a participating state's participation in the lawscompact, if it determines that a constitutional requirement of alla Participatingparticipating Statesstate asis, determinedor bywould be with respect to a state seeking to participate in the Commission.compact, a material departure from the compact.

334.1855.Otherwise, if this compact shall be held to be contrary to the constitution of any participating state, the compact shall remain in full force and effect as to the remaining participating states and in full force and effect as to the participating state affected as to all severable matters.

1.SECTION 13—BINDING EFFECT OF COMPACT (a) Nothing herein prevents the enforcement of any other law of a participating state that is not inconsistent with this compact.

This(b) Any Compactlaws andin thea Commission'sparticipating rulemakingstate authorityin shallconflict bewith liberallythis construedcompact soare assuperseded to effectuate the purposes,extent and the implementation and administration of the Compact.conflict.

Provisions(c) All ofagreements between the Compactcommission expresslyand authorizing or requiring the promulgationparticipating ofstates Rulesare shallbinding notin beaccordance construedwith totheir limitterms. the Commission's rulemaking authority solely for those purposes.

2.HB 2219—Am.

The provisions of this Compact shall be severable and if any phrase, clause, sentence or provision of this Compact is held by aHC court22 ofSec. competent jurisdiction to be contrary to the constitution of any Participating State, a State seeking participation in the Compact, or of the United States, or the applicability thereof to any government, agency, person or circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of this Compact and the applicability thereof to any other government, agency, person or circumstance shall not be affected thereby.

3.2. This act shall take effect and be in force from and after its publication in the statute book.

Notwithstanding subsection 2 of this section, the Commission may deny a State's participation in the Compact or, in accordance with the requirements of subsection 2 of section 334.1845, terminate a Participating State's participation in the Compact, if it determines that a constitutional requirement of a Participating State is, or would be with respect to a State seeking to participate in the Compact, a material departure from the Compact.

Otherwise, if this Compact shall be held to be contrary to the constitution of any Participating State, the Compact shall remain in full force and effect as to the remaining Participating States and in full force and effect as to the Participating State affected as to all severable matters.

334.1860.

1.

Nothing herein prevents the enforcement of any other law of a Participating State that is not inconsistent with this Compact.

2.

Any laws in a Participating State in conflict with this Compact are superseded to the extent of the conflict.

3.

All agreements between the Commission and the Participating States are binding in accordance with their terms.