(21) "Significant Investigativeinvestigative Information"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)LCO "State"No. means any state, commonwealth, district, or territory of the United States.

334.1810.3782 4 of 33 Raised Bill No.6835 (22) "State" means any state, commonwealth, district or territory of the United States.

1.Section 3.

State Participation in the Compact (a) To participate in thisthe Compact,compact, a Participatingparticipating Statestate shall:

HCS HB 3129 4 (1) License physicianPAs. assistants.

(2) Participate in the Compactcompact Commission'scommission's Datadata System.system.

(3) Have a mechanism in place for receiving and investigating complaints against Licenseeslicensees and Licenselicense applicants.

(4) Notify the Commission,commission, in compliance with the terms of thisthe Compactcompact and Commissioncommission Rules,rules, of any Adverseadverse Actionaction against a Licenseelicensee or Licenselicense applicant and the existence of Significantsignificant Investigativeinvestigative Informationinformation regarding a Licenseelicensee or Licenselicense applicant.

(5) Fully implement a Criminalcriminal Backgroundbackground Checkcheck requirement, withinwithinatime aframeestablishedbycommissionrule,by timetheparticipating framestate's establishedlicensing byboard Commission Rule, by its Licensing Board receiving the results of a Criminalcriminal Backgroundbackground Checkcheck and reporting to the Commissioncommission whether the Licenselicense applicant has been granted a License.license.

(6) Comply with the Rulesrules of the Compactcompact Commission.commission.

(7) Utilize passage of a recognized national examlicensure suchexamination, asincluding, but not limited to, the NCCPAPhysician PANCEAssistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants, as a requirement for physicianPA assistant licensure.

(8) Grant the Compactcompact Privilegeprivilege to a holder of a Qualifyingqualifying Licenselicense in a Participatingparticipating State.state.

2.(b) Nothing in the compact shall be construed to prohibit a participating state from charging a fee for granting the compact privilege.

NothingLCO inNo. this Compact prohibits a Participating State from charging a fee for granting the Compact Privilege.

334.1815.3782 5 of 33 Raised Bill No.6835 Section 4.

1.Compact Privilege (a) To exercise the compact privilege, a licensee shall:

To(1) exerciseHave graduated from a PA program accredited by the CompactAccreditation Privilege,Review aCommission Licenseeon must:Education for the Physician Assistant, Inc., or any other PA program authorized by commission rule.

(1)(2) HaveHold graduatedcurrent certification from a physician assistant program accredited by the AccreditationNational Review Commission on EducationCertification forof the Physician Assistant,Assistants. Inc.

or(3) otherHave programsno authorizedfelony byor Commissionmisdemeanor Rule.convictions.

(2)(4) HoldHave currentnever NCCPAhad certification.a controlled substance license, permit or registration suspended or revoked by a state or by the United States Drug Enforcement Administration.

(3)(5) Have noa felonyunique oridentifier misdemeanoras Conviction.determined by commission rule.

(4)(6) HaveHold never had a controlledqualifying substancelicense. license, permit, or registration suspended or revoked by a State or by the United States Drug Enforcement Administration.

(5)(7) Have had no revocation of a uniquelicense identifieror limitation or restriction on any license currently held or compact privilege due to anadverse action, provided (A) if a licensee had a limitation or restriction on a license or compactprivilegeduetoanadverseaction,twoyearsshallhaveelapsed from the date on which the license or compact privilege is no longer limited or restricted due to the adverse action, and (B) if 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 licensee is practicing or applying to practice under a compact privilege, such participating state shall have the discretion not to consider such action as determinedan byadverse Commissionaction Rule.requiring the denial or removal of a compact privilege in such state.

(6)(8) HoldNotify the compact commission that the licensee is seeking the compact privilege in a Qualifyingremote License.state.

(7)LCO HaveNo. had no revocation of a License or limitation or restriction on any License currently held due to an adverse action.

(8)3782 If6 aof Licensee33 hasRaised hadBill aNo. limitation or restriction on a License or Compact Privilege due to an Adverse Action, two years must have elapsed from the date on which the License or Compact Privilege is no longer limited or restricted due to the Adverse Action.

HCS6835 HB 3129 5 (9) IfMeet aany Compactjurisprudence Privilegerequirement hasof been revoked or is limited or restricted in a Participatingremote Statestate for conduct that would not be a basis for disciplinary action in a Participating State in which the Licenseelicensee is practicingseeking or applying to practice under athe Compactcompact Privilege,privilege thatand Participatingpay Stateany shallfees haveapplicable the discretion not to considersatisfying such action as an Adverse Action requiring the denialjurisprudence orrequirement. removal of a Compact Privilege in that State.

(10) NotifyReport to the Compactcommission Commissionany thatadverse theaction Licenseetaken isby seekinga thenonparticipating Compactstate Privilegenot inlater athan Remotethirty State.days after the adverse action was taken.

(11)(b) MeetThe anycompact Jurisprudenceprivilege Requirementshall ofbe avalid Remoteuntil State in which the Licenseeexpiration isor seekingrevocation toof practice under the Compactqualifying Privilegelicense andunless payterminated anypursuant fees applicable to satisfyingan theadverse Jurisprudenceaction. Requirement.

(12)The Reportlicensee toshall thecomply Commissionwith anyall Adverseof Actionthe takenrequirements byof asubsection non-participating(a) Stateof withinthis thirtysection (30)of daysthe aftercompact to maintain the actioncompact isprivilege taken.in a remote state.

2.If the participating state takes adverse action against a qualifying license, the licensee shall lose the compact privilege in any remote state in which the licensee has a compact privilege until both of the following occur:

(1) The Compactlicense Privilege is validno untillonger thelimited expiration or revocationrestricted; of the Qualifying License unless terminated pursuant to an Adverse Action.

Theand Licensee(2) mustTwo alsoyears complyhave withelapsed allfrom of the requirementsdate ofon subsectionwhich 1the oflicense thisis sectionno tolonger maintainlimited theor Compactrestricted Privilegedue into athe Remoteadverse State.action.

If(c) Once a restricted or limited license satisfies the Participatingrequirements Stateof takessubdivisions Adverse(1) Actionand against(2) aof Qualifyingsubsection License,(b) of this section of the Licenseecompact, the licensee shall losemeet the Compactrequirements Privilegeof insubsection any(a) Remoteof Statethis insection whichof the Licenseecompact hasto obtain a Compactcompact Privilegeprivilege untilin allany ofremote thestate. following occur:

(1)(d) TheFor Licenseeach isremote nostate longerin limitedwhich a PA seeks authority to prescribe controlled substances, the PA shall satisfy all requirements imposed by such state in granting or restricted;renewing such authority.

andSection (2)5. Two (2) years have elapsed from the date on which the License is no longer limited or restricted due to the Adverse Action.

3.Designation of the State from Which Licensee is Applying for a Compact Privilege (a) Upon a licensee's application for a compact privilege, the licensee shall identify to the commission the participating state from which the licensee is applying, in accordance with applicable rules adopted by the LCO No.

Once3782 a7 restricted or limited License satisfies the requirements of subdivisions33 (1)Raised andBill (2)No. of subsection 2 of this section, the Licensee must meet the requirements of subsection 1 of this section to obtain a Compact Privilege in any Remote State.

4.6835 commission, and subject to the following requirements:

For(1) eachWhen Remoteapplying Statefor ina whichcompact aprivilege, physicianthe assistantlicensee seeksshall authority(A) toprovide prescribethe controlledcommission substances,with the physicianaddress assistantof shallthe satisfylicensee's allprimary requirementsresidence, imposedand by(B) suchreport Stateto the commission any change in grantingthe oraddress renewingof the licensee's primary residence immediately following such authority.change.

334.1820.(2) When applying for a compact privilege, the licensee shall be required to consent to accept service of process by mail at the licensee's primary residence on file with the commission with respect to any action brought against the licensee by the commission or a participating state, including, but not limited to, a subpoena.

UponSection a6. Licensee's application for a Compact Privilege, the Licensee shall identify to the Commission the Participating State from which the Licensee is applying, in accordance with applicable Rules adopted by the Commission, and subject to the following requirements:

(1)Adverse WhenActions applying(a) forA aparticipating Compactstate Privilege,in thewhich Licenseea shalllicensee provideis thelicensed Commission with the address of the Licensee's primary residence and thereafter shall immediatelyhave reportexclusive power to theimpose Commissionadverse anyaction changeagainst in the addressqualifying oflicense theissued Licensee'sby primarysuch residence.participating state.

HCS(b) HBIn 3129addition 6to (2) When applying for a Compact Privilege, the Licenseeother ispowers requiredconferred toby consentstate tolaw, accepta serviceremote ofstate processshall byhave mail at the Licensee'sauthority, primaryin residenceaccordance on file with theexisting Commissionstate withdue respectprocess torequirements, any action brought against the Licensee by the Commission or a Participating State, including a subpoena, with respect to anydo actionall broughtof or investigation conducted by the Commissionfollowing: or a Participating State.

334.1825.(1) Take adverse action against a PA's compact privilege in such remote 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.

1.(2) Issue subpoenas for hearings or investigations that require the attendance and testimony of witnesses and for the production of evidence.

AAny Participatingsubpoena Stateissued inby whicha licensing board in a Licenseeparticipating isstate licensedfor shallthe haveattendance exclusiveand powertestimony toof imposewitnesses Adverseor Actionthe againstproduction of evidence fromanotherparticipating state shallbeenforced insuchother participating state by any court of competent jurisdiction according to the Qualifyingpractice Licenseand procedure of such court applicable to subpoenas issued byin thatproceedings Participatingpending State.before such court.

2.The issuing authority shall LCO No.

In3782 addition8 toof the33 otherRaised powersBill conferredNo.6835 bypay Stateany law,witness afees, Remotetravel Stateexpenses, shallmileage haveand theother authority,fees inrequired accordanceby withthe existingservice Statestatutes dueof processthe law,state toin dowhich allthe ofwitnesses theor following:evidence is located.

(1)(3) TakeNotwithstanding Adversethe Actionprovisions againstof subdivision (2) of this subsection, a physicianparticipating assistant'sstate Compactshall Privilegenot withinissue thata Statesubpoena to removegather aevidence Licensee'sof Compactconduct Privilegein oranother takestate that is lawful in such other state for the purpose of taking adverse action necessaryagainst undera applicablelicensee's lawcompact toprivilege protector theapplication healthfor anda safetycompact ofprivilege itsin citizens.such participating state.

(2)(4) IssueNothing subpoenasin forthe bothcompact hearingsshall andbe investigationsconstrued thatto requireauthorize thea attendanceparticipating andstate testimonyto ofimpose witnessesdiscipline asagainst wella asPA's compact privilege ordenyanapplicationforacompactprivilegeinsuchparticipatingstate for the productionPA's ofotherwise evidence.lawful practice in another state.

Subpoenas(c) issuedFor bypurposes aof Licensingtaking Boardadverse inaction, athe Participatingparticipating Statestate forthat issued the attendancequalifying andlicense testimonyshall ofgive witnessesthe orsame thepriority productionand ofeffect evidenceto fromreported anotherconduct Participatingreceived Statefromany shallother beparticipating enforcedstate inas theit latterwould Stateif bythe anyconduct courthad ofoccurred competentwithin jurisdiction,the accordingparticipating tostate thethat practiceissued andthe procedurequalifying oflicense thatand courtshall applicableapply toits subpoenasown issuedstate inlaws proceedingsto pendingdetermine beforeappropriate it.action.

The(d) issuingA authorityparticipating shallstate, payif anyotherwise witnesspermitted fees,by travelstate expenses,law, mileagemay andrecoverfromtheaffectedPAthecostsof otheranyinvestigationordisposition fees required by the service statutes of thea Statecase inresulting whichfrom theany witnessesadverse oraction evidencetaken areagainst located.such PA.

(3)(e) NotwithstandingA subdivisionparticipating (2)state of this subsection, subpoenas may nottake beadverse issuedaction bybased aon Participatingthe Statefactual tofindings gather evidence of conducta inremote anotherstate, Stateprovided thatthe isparticipating lawfulstate infollows thatits otherown Stateprocedures for the purpose of taking Adversethe Actionadverse againstaction. a Licensee's Compact Privilege or application for a Compact Privilege in that Participating State.

(4)(f) NothingJoint inInvestigations this(1) CompactIn authorizesaddition a Participating State to imposethe disciplineauthority againstgranted to a physicianparticipating assistant'sstate Compactby Privilegeits orrespective tostate denystatutes anand applicationregulations forconcerning aPAs, Compactor Privilegeother inapplicable thatstate Participatinglaw, Stateany forparticipating thestate individual'smay otherwiseparticipate lawfulwith practiceany inLCO anotherNo. State.

3.3782 9 of 33 Raised Bill No.6835 other participating state in a joint investigation of a licensee.

For(2) purposesA ofparticipating takingstate Adverse Action, the Participating State which issued the Qualifying License shall giveshare theany sameinvestigative, prioritylitigation andor effectcompliance tomaterials reportedin conductfurtherance receivedof from any otherjoint Participatingor Stateindividual asinvestigation itinitiated wouldunder if the conductcompact. had occurred within the Participating State which issued the Qualifying License.

In(g) soIf doing,an thatadverse Participatingaction Stateis shalltaken applyagainst itsa ownPA's Statequalifying lawslicense, tothe determinePA'scompact appropriateprivilege action.inallremote statesshallbedeactivateduntiltwo yearshaveelapsed fromthedateonwhich allrestrictionswere removed from the state license.

HCSAll HBdisciplinary 3129orders 7by 4.the participating state that issued the qualifying license that impose one or more adverse actions against a PA's license shall include a statement that the PA's compact privilege is deactivated in all participating states during the pendency of the order.

A(h) ParticipatingIf State,any ifparticipating otherwisestate permittedtakes byadverse Stateaction, law,it mayshall recoverpromptly fromnotify the affectedadministrator physicianof assistant the costsdata ofsystem. investigations and disposition of cases resulting from any Adverse Action taken against that physician assistant.

5.Section 7.

AEstablishment Participatingof Statethe mayPA takeLicensure AdverseCompact ActionCommission based(a) onThe theparticipating factualstates findingshereby ofcreate aand Remoteestablish State,a providedjoint thatgovernment theagency Participatingand Statenational followsadministrative itsbody ownknown proceduresas forthe takingPA theLicensure AdverseCompact Action.Commission.

6.The commission shall be an instrumentality of the compact states acting jointly and not an instrumentality of any one state.

(1)The Incommission additionshall tocome theinto authorityexistence grantedon to a Participating State by its respective State physician assistant laws and regulations or otherafter applicablethe Stateeffective law,date anyof Participatingthe Statecompact mayas participateset withforth otherin Participatingsubsection States(a) inof jointsection investigations11 of Licensees.the compact.

(2)(b) ParticipatingMembership, StatesVoting and Meetings (1) Each participating state shall sharehave anyand investigative,be litigation,limited orto complianceone materialsdelegate inselected furtheranceby ofsuch anyparticipating jointstate's orlicensing individualboard investigationor, initiatedif underthe thisstate Compact.has more than one licensing board, selected collectively by the participating state's licensing boards.

7.

If an Adverse Action is taken against a physician assistant's Qualifying License, the physician assistant's Compact Privilege in all Remote States shall be deactivated until two (2) years have elapsed after all restrictions have been removed from the State 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.

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

or3782 (b)10 Anof administrator33 Raised Bill No.6835 (A) A current PA, physician or public member of a Licensinglicensing Board.board or a PA council or committee;

(3) Any delegate may be removed or suspended(B) fromAn officeadministrator as provided by the laws of thea Statelicensing fromboard. which the delegate is appointed.

HCS(3) HBAny 3129delegate 8may (4)be Theremoved Participatingor Statesuspended Licensingfrom Boardoffice shallas fillprovided anyby vacancythe occurringlaws inof the Commissionstate withinfrom sixtywhich (60)the days.delegate is appointed.

(5)(4) EachThe delegateparticipating shallstate belicensing entitledboard toshall onefill (1)any votevacancy onoccurring allin matters voted on by the Commissioncommission andnot shalllater otherwisethan havesixty andays opportunityafter to participate in the businessdate andon affairswhich of the Commission.vacancy occurred.

(5) Each delegate shall be entitled to one 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) The Commissioncommission shall meet at least once during each calendar year.

Additional meetings shall be held as set forth in thisthe Compactcompact and the bylaws.

(7) The Commissioncommission shall establish by Rulerule a term of office for delegates.

3.(c) The commission shall have the following powers and duties:

The(1) CommissionEstablish shalla havecode theof followingethics powersfor andthe duties:commission;

(1)(2) Establish athe codefiscal year of ethics for the Commission;commission;

(2) Establish the fiscal year of the Commission;

(6)LCO MeetNo. and take such actions as are consistent with the provisions of this Compact and the bylaws;

(7)3782 Promulgate11 Rulesof limited33 toRaised theBill Commission'sNo. authority to facilitate and coordinate implementation and administration of this Compact.

The6835 Rules(6) authorizedMeet byand thetake Compactsuch shallactions haveas theare forceconsistent andwith effectthe provisions of lawthe compact and shallthe bebylaws; binding in all Participating States;

(8)(7) BringPromulgate andrules prosecuteto legalfacilitate proceedingsand orcoordinate actionsimplementation inand theadministration name of the Commission,compact. provided that the standing of any State Licensing Board to sue or be sued under applicable law shall not be affected;

The rules shall have the force and effect of law and shall be binding in all participating states;

(8) Bring and prosecute legal proceedings or actions in the name of the commission, provided the standing of any state licensing board to sue or be sued under applicable law shall not be affected;

(10) Borrow, accept,accept or contract for services of personnel, including, but not limited to, employees of a Participatingparticipating State;state;

(11) Hire employees and engage contractors, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of thisthe Compact,compact and establish the Commission'scommission's personnel policies and programs relating to conflicts of interest, qualifications of personnel,personnel andandotherrelated other related personnel matters;

(12) Accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and receive, utilize and dispose of such money, equipment, supplies material and services, provided the same;commission shall avoid any appearance of impropriety or conflict of interest at all times;

provided(13) thatLease, atpurchase, allaccept timesappropriate gifts or donations of, or otherwise own, hold, improve or use, any property, real, personal or mixed, provided the Commissioncommission shall avoid any appearance of impropriety orat conflictall oftimes; interest;

HCS(14) HBSell, 3129convey, 9mortgage, (13)pledge, Lease,lease, purchase,exchange, acceptabandon appropriate gifts or donations of, or otherwise own,dispose hold,of improve or use, any property,property real, personal or mixed;

provided that at all times the Commission shall avoid any appearance of impropriety;

(14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed;

(16)LCO BorrowNo. money;

(17)3782 Appoint12 committees, including standing committees composed of members,33 StateRaised regulators,Bill StateNo.6835 legislators(16) orBorrow theirmoney; representatives, and consumer representatives, and such other interested persons as may be designated in this Compact and the bylaws;

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

(19) Elect a Chair,chair, Vicevice Chair,chair, Secretarysecretary and Treasurertreasurer and such other officers of the Commissioncommission as provided in the Commission'scommission's bylaws;

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

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

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

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

4.(d) Meetings of the Commission (1) All meetings of the commission that are not closed pursuant to subdivision (3) of this subsection shall be open to the public.

(1)Notice Allof public meetings ofshall thebe Commissionposted thaton arethe notcommission's closedInternet pursuantweb tosite thisnot subsectionlater shallthan bethirty opendays prior to the public.public meeting.

Notice(2) ofNotwithstanding public meetings shall be posted on the Commission'sprovisions websiteof atsubdivision least(1) thirtyof (30)this daysLCO priorNo. to the public meeting.

(2)3782 Notwithstanding13 subdivision (1) of this33 subsection,Raised theBill CommissionNo.6835 maysubsection,the convenecommissionmay aconvenea public meeting by providing notice of the meeting at least twenty-four (24) hours prior noticeto the meeting on the Commission'scommission's website,Internet web site, and any other means as provided in the Commission'scommission's Rules,rules, for any of the reasons it may dispense with notice of proposed rulemaking under subsection 12(l) of section 334.1840.9 of the compact.

(3) The Commissioncommission 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) Non-complianceNoncompliance of a Participatingparticipating Statestate with its obligations under thisthe Compact;compact;

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

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

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

(e)(E) Accusing any person of a crime or formally censuring any person;

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

(g)(G) Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;

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

(i)(I) Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the Commissioncommission or other committeecommitteechargedwithresponsibilityofinvestigationordetermination charged with responsibility of investigation or determination of compliance issues pursuant to thisthe Compact;compact;

(j)LCO LegalNo. advice;

or3782 (k)14 Mattersof specifically33 exemptedRaised fromBill disclosureNo.6835 by(J) federalLegal oradvice; Participating States' statutes.

(4) If a meeting, or portion(K) ofMatters aspecifically meeting,exempted isfrom closeddisclosure pursuantby tofederal this provision, the chair of the meeting or theparticipating chair'sstates' designeestatutes. shall certify that the meeting or portion of the meeting may be closed and shall reference each relevant exempting provision.

(5)(4) TheIf Commissiona shallmeeting, keepor minutesportion thatof fullya andmeeting, clearlyis describeclosed allpursuant mattersto discussedsubdivision in(3) aof meetingthis andsubsection, shallthe providechair aof fullthe andmeeting, accurateor summarythe ofchair's actionsdesignee, taken,shall includingcertify athat descriptionthe meeting or portion of the viewsmeeting expressed.may be closed and shall reference 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, but not limited to, a description of the views expressed at the meeting.

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

(1)(2) The Commissioncommission shallmay pay,accept orany provideand forall theappropriate paymentrevenue of,sources, thedonations reasonableand expensesgrants of itsmoney, establishment,equipment, organization,supplies, materials and ongoingservices. activities.

(2)(3) The Commissioncommission may acceptlevy anyon and allcollect appropriatean revenueannual sources,assessment donations,from each participating state and grantsmay impose compact privilege fees on licensees of money,participating equipment,states supplies,to materials,whom a compact privilege is granted to cover the cost of the operations and services.activities of the commission and its staff.

(3)Such The Commission may levy on and collect an annual assessment from each Participating State and may impose Compact Privilege fees onshall Licensees of Participating States to whom a Compact Privilege is granted to cover the cost of the operations and activities of the Commission and its staff, which must be in a total amount that is sufficient to cover its annual budget as approved by the Commissioncommission each year HCS HB 3129 11 for which revenue is not provided by other sources.

The aggregate annual assessmentLCO amountNo. levied on Participating States shall be allocated based upon a formula to be determined by Commission Rule.

(a)3782 A15 Compactof Privilege33 expiresRaised whenBill theNo.6835 Licensee'sassessment Qualifyingamount Licenselevied inon theparticipating Participatingstates Stateshall frombe whichallocated thebased Licenseeupon applieda forformula theto Compactbe Privilegedetermined expires.by commission rule.

(b)(A) IfA thecompact Licenseeprivilege terminatesexpires thewhen Qualifying License through which the Licenseelicensee's appliedqualifying forlicense the Compact Privilege before its scheduled expiration, and the Licensee has a Qualifying License in another Participating State, the Licenseeparticipating shallstate informfrom thewhich Commission that it is changing to that Participating State the Participatinglicensee Stateapplied through which it applies for a Compact Privilege and pay to the Commissioncompact anyprivilege Compactexpires. Privilege fee required by Commission Rule.

(4)(B) TheIf Commissionthe licensee terminates the qualifying license through which the licensee applied for the compact privilege before its scheduled expiration and the licensee has a qualifying license in another participating state, the licensee shall notinform incurthe obligationscommission ofthat anyit kindis priorchanging to securingsuch participating state the fundsparticipating adequatestate tothrough meetwhich it applies for a compact privilege and pay to the same;commission any compact privilege fee required by commission rule.

nor(4) The commission shall not (A) incur an obligation of any kind prior to securing the Commissionfunds adequate to meet the same, or (B) pledge the credit of any of the Participatingparticipating States,states, except by and with the authority of the Participatingparticipating State.state.

(5) The Commissioncommission shall keep accurate accounts of all receipts and disbursements.

The receipts and disbursements of the Commissioncommission shall bebesubject subject to thethefinancialreviewandaccounting financialproceduresestablished review and accounting procedures established under its bylaws.

All receipts and disbursements of funds handled by the Commissioncommission shall be subject to an annual financial review by a certified or licensed public accountant, and the report of the financial review shall be included in and become part of the annual report of the Commission.commission.

6.(f) The Executive Committee (1) The executive committee shall have the power to act on behalf of the commission according to the terms of the compact and commission rules.

(1)(2) The Executiveexecutive Committeecommittee shall havebe thecomposed power to act on behalf of the Commissionfollowing accordingnine toLCO theNo. terms of this Compact and Commission Rules.

(2)3782 The16 Executiveof Committee33 shallRaised beBill composedNo.6835 of nine (9) members:

(a)(A) Seven voting members who areshall be elected by the Commissioncommission from the current membership of the Commission;commission;

(b)(B) One ex-officio, nonvoting member from a recognized national physicianPA assistant professional association;

and (c)(C) One ex-officio, nonvoting member from a recognized national physicianPA assistant certification organization.

(3) The ex-officio members willshall be selected by their respective organizations.

(4) The Commissioncommission may remove any member of the Executiveexecutive Committeecommittee as provided in its bylaws.

(5) The Executiveexecutive Committeecommittee shall meet at least annually.

(6) The Executiveexecutive Committeecommittee shall have the following duties and responsibilities:

(a)(A)Recommendtothecommissionchangestothecommission'srules Recommendorbylaws,changestothecompactlegislation,feestobepaidbycompact toparticipating thestates, Commissionincluding, changesbut tonot thelimited Commission'sto, 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 Commissioncommission Compactcompact fee charged to Licenseeslicensees for the Compactcompact Privilege;privilege;

(b)(B) Ensure Compactcompact administration services are appropriately provided, contractual or otherwise;

(c)(C) Prepare and recommend the budget;

(d)(D) Maintain financial records on behalf of the Commission;commission;

(e)(E) Monitor Compactcompact compliance of Participatingparticipating Statesstates and provide compliance reports to the Commission;commission;

(f)(F) Establish additional committees as necessary;

(g)LCO ExerciseNo. the powers and duties of the Commission during the interim between Commission meetings, except for issuing proposed rulemaking or adopting Commission Rules or bylaws, or exercising any other powers and duties exclusively reserved to the Commission by the Commission's Rules;

3782 17 of 33 Raised Bill No.6835 (G) Exercise the powers and (h)duties Performof the commission during the interim between commission meetings, except the issuance of proposed rulemaking, the adoption of commission rules or bylaws or the exercise of any other powers and duties asexclusively providedreserved into the Commission'scommission Rulesby orthe bylaws.commission's rules;

(7)and All(H) meetingsPerform ofother the Executive 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 publicprovided meetingsin of the Commissioncommission's arerules given.or bylaws.

(8)(7) TheAll Executivemeetings Committeeof may convene in a closed, non-public meeting for the sameexecutive reasonscommittee thatat thewhich Commissionit mayvotes conveneor inplans ato non-publicvote meetingon asmatters set forth in subdivisionexercising (3)the ofpowers subsectionand 4duties of thisthe sectioncommission and shall announcebe theopen closedto meeting as the Commissionpublic isand requiredpublic tonotice under subdivision (4) of subsectionsuch 4meetings ofshall thisbe sectiongiven andas keeppublic minutesmeetings of the closedcommission meetingare asgiven. the Commission is required to under subdivision (5) of subsection 4 of this section.

7.(8) The executive committee may convene in a closed, nonpublic meeting for the same reasons that the commission may convene in a nonpublic meeting as set forth in subdivision (3) of subsection (d) of this section of the compact and shall announce the closed meeting as the commission is required to under subdivision (4) of subsection (d) of this section of the compact and keep minutes of the closed meeting as the commission is required to under subdivision (5) of subsection (d) of this section of the compact.

(g) Qualified Immunity, Defense and Indemnification (1) The members, officers, executive director, employees and representatives of the Commissioncommission shall be immune from suit and liability, both personally and in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error,error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurredoccurred, within the scope of Commissioncommission employment, duties or responsibilities;responsibilities, provided nothing in this subdivision shall be construed to protect any such person from suit or liabilityforanydamage,loss,injuryorliabilitycausedbytheintentional or wilful or wanton misconduct of that person.

providedThe thatprocurement nothing in this subdivision shall be construed to protect any such person from suit or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of thatLCO person.No.

The3782 procurement18 of 33 Raised Bill No.6835 insurance of any type by the Commissioncommission shall not in any way compromise or limit the immunity granted hereunder.under this subdivision.

(2) The Commissioncommission shall defend any member, officer, executive director, employee,employee and representative of the Commissioncommission in any civil action seeking to impose HCS HB 3129 13 liability arising out of any actual or allegedallegedact, act,error error, or omission that occurred within the scope of Commissioncommission employment, duties,duties or responsibilities, or as determined by the commission that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commissioncommission employment, duties,duties or responsibilities;responsibilities, provided (A) nothing in this subdivision shall be construed to prohibit such person from retaining such person's own counsel at such person's own expense, and (B) the actual or alleged act, error or omission did not result from such person's intentional or wilful or wanton misconduct.

provided(3) The commission shall indemnify and hold harmless any member, officer, executive director, employee or representative of the commission for the amount of any settlement or judgment obtained against such person arising out of any actual or alleged act, error or omission that nothingoccurred hereinwithin shallthe bescope construedof tocommission prohibitemployment, duties or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities, provided the actual or alleged act, error or omission did not result from retainingthe theirintentional ownor counselwilful ator theirwanton ownmisconduct expense;of such person.

(4) Venue shall be proper and providedjudicial further,proceedings thatby or against the actualcommission orshall allegedbe act,brought error,solely orand omissionexclusively didin nota resultcourt fromof thatcompetent person'sjurisdiction intentionalwhere orthe willfulprincipal oroffice wantonof misconduct.the commission is located.

(3) The Commissioncommission shallmay indemnifywaive andvenue hold harmless any member, officer, executive director, employee, and representativejurisdictional ofdefenses thein Commission for the amount of any settlementproceedings oras judgmentauthorized obtainedby againstcommission thatrules. person arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person.

(4)(5) VenueNothing isin proper and judicial proceedings by or against the Commissioncompact shall be broughtconstrued solelyas anda exclusivelylimitation inon athe courtliability of competentany jurisdictionlicensee wherefor theprofessional principalmalpractice officeor ofmisconduct, theLCO CommissionNo. is located.

The3782 Commission19 mayof waive33 venueRaised andBill jurisdictionalNo.6835 defenseswhich inshall anybe proceedingsgoverned assolely authorized by Commissionany Rules.other applicable state laws.

(5)(6) Nothing hereinin the compact shall be construed asto adesignate limitationthe onvenue theor liabilityjurisdiction ofto anybring Licenseeactions for professionalalleged malpracticeacts orof malpractice, professional misconduct, whichnegligence shallor beother governedsuch solelycivil byaction anypertaining otherto applicablethe Statepractice laws.of a PA.

(6)All Nothingsuch hereinmatters shall be construeddetermined toexclusively designateby thestate venuelaw or jurisdiction to bring actions for alleged acts of malpractice, professional misconduct, negligence, or other suchthan civil action pertaining to the practicecompact. of a physician assistant.

All(7) suchNothing mattersin the compact shall be determinedconstrued exclusivelyto bywaive Stateor lawotherwise abrogate a participating state's state action immunity or state action affirmative defense with respect to antitrust claims under the Sherman Act, 15 USC 1 et seq., as amended from time to time, Clayton Antitrust Act, 15 USC 12-27, as amended from time to time, or any other thanstate thisor Compact.federal antitrust or anticompetitive law or regulation.

(7)(8) Nothing in thisthe Compactcompact shall be interpretedconstrued to waivebe or otherwise abrogate a Participatingwaiver State'sof statesovereign action immunity orby state action affirmative defense with respect to antitrust claims under the Shermanparticipating Act,states Clayton Act, or anyby otherthe Statecommission. or federal antitrust or anticompetitive law or regulation.

(8)Section Nothing8. in this Compact shall be construed to be a waiver of sovereign immunity by the Participating States or by the Commission.

334.1835.Data System (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 denied a license in participating states.

1.(b)Notwithstandinganyother statelaw,eachparticipatingstateshall submit a uniform data set to the data system, utilizing a unique identifier for such state, on all PAs to whom the compact is applicable as required by the rules of the commission, including the following:

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 HCS HB 3129 14 Information on all licensed physician assistants and applicants denied a License in Participating States.

2.

Notwithstanding any other State law to the contrary, a Participating State shall submit a uniform data set to the Data System on all physician assistants to whom this Compact is applicable (utilizing a unique identifier) as required by the Rules of the Commission, including:

(3) Adverse Actionsactions against a Licenselicense or Compactcompact Privilege;privilege;

(4)LCO AnyNo. denial of application for licensure, and the reason or reasons for such denial (excluding the reporting of any Criminal history record information where prohibited by law);

(5)3782 The20 existenceof 33 Raised Bill No.6835 (4) Any denial of Significantapplication Investigativefor Information;licensure, except any criminal history record information where the reporting of such information is prohibited by law, and the reason or reasons for such denial;

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

3.and (6)Any other informationthatmay facilitatetheadministrationofthe compact, as determined by the rules of the commission.

(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 actiontakenagainst a licensee or anindividualapplying for a license that has been reported to the 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) AdverseEach Actionparticipating state contributing information shallto the data system may, in accordance with state or federal law, designate information that may 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 Statesinformationsubmittedto contributingthe informationdatasystemthat toissubsequently theexpunged Datapursuant Systemto may,federal inlaw accordanceor withthe Statelaws orof federalthe law,participating designatestate informationcontributing thatthe mayinformation notshall be sharedremoved withfrom the publicdata withoutsystem upon the expressreporting permission of such expungement by the contributingparticipating State.state to the commission.

Notwithstanding(g) anyThe suchrecords designation,and such information shallprovided beto reporteda participating state pursuant to the 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 LCO No.

6.3782 21 of 33 Raised Bill No.

Any6835 informationadministrative submittedproceedings toin thea Dataparticipating Systemstate. that is subsequently expunged pursuant to federal law or the laws of the Participating State contributing the information shall be removed from the Data System upon reporting of such by the Participating State to the Commission.

7.Section 9.

TheRulemaking records(a) andThe informationcommission providedshall toexercise aits Participatingrulemaking Statepowers pursuant to this Compact or through the Datacriteria System,set whenforth certifiedin bythis thesection Commission or an agent thereof, shall constitute the authenticated business records of the Commission,compact and shallthe berules entitledadopted tounder anythe associatedcompact. hearsay exception in any relevant judicial, quasi- judicial or administrative proceedings in a Participating State.

HCSA HBcommission 3129rule 15shall 334.1840.become binding as of the date specified by the commission for each rule.

1.(b) The commission shall promulgate reasonable rules to effectively and efficiently implement and administer the compact and achieve the compact's purposes.

TheA Commissioncommission rule shall exercisebe itsinvalid Rulemakingand powershave pursuantno toforce or effect only ifa court ofcompetent jurisdictionholdsthat the criteriarule setis forthinvalid because the commission exercised its rulemaking authority in thisa Sectionmanner andthat is beyond the Rulesscope adoptedof thereunder.the purposes of the compact, or the powers granted under the compact, or based upon another applicable standard of review.

Commission(c) RulesThe rules of the commission shall becomehave bindingthe asforce of law in each participating state, provided where the daterules specifiedof 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, the Commissionrules forof eachthe Rule.commission shall be ineffective in such state to the extent of the conflict.

2.(d) If a majority of the legislatures of the participating states rejects a commission rule by enactment of a statute or resolution in the same manner used to adopt the compact not later than four years after the date of adoption of the commission rule, such rule shall have no further force and effect in any participating state or to any state applying to participate in the compact.

The(e) Commission rules shall promulgatebe reasonableadopted Rulesat ina orderregular toor effectivelyspecial andmeeting efficientlyof implementthe andcommission. administer this Compact and achieve its purposes.

A(f) CommissionPrior Ruleto shallpromulgation be invalid and haveadoption no force or effect only if a court of competent jurisdiction holds that the Rule is invalid because the Commission exercised its rulemaking authority in a mannerfinal thatrule isor beyondrules theby scope of the purposesLCO ofNo. this Compact, or the powers granted hereunder, or based upon another applicable standard of review.

3.3782 22 of 33 Raised Bill No.6835 commission, and at least thirty days prior to the meeting at which the rule will be considered and voted upon, the commission shall file a notice of proposed rulemaking:

The(1) RulesOn of the CommissionInternet shallweb havesite the force of law in each Participating State, provided however that where the Rulescommission ofor theother Commissionpublicly conflictaccessible withplatform; 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.(2) To persons who have requested notice of the commission's notices of proposed rulemaking;

Ifand a(3) majorityIn ofsuch theother legislaturesmanners ofas the Participatingcommission Statesmay rejects a Commission Rule, by enactmentrule ofspecify. a statute or resolution in the same manner 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.(g) The notice of proposed rulemaking shall include the following:

Commission(1) RulesThe shalltime, bedate adoptedand atlocation aof regularthe orpublic specialhearing meetingon the proposed rule and the proposed time, date and location of the Commission.meeting in which the proposed rule will be considered and voted upon;

6.(2) The text of the proposed rule and thereason for theproposed rule;

Prior(3) toA promulgationrequest andfor adoptioncomments ofon athe finalproposed Rulerule orfrom Rulesany byinterested theperson Commission, and at least thirty (30) days in advance of the meetingdate atby which thewritten Rulecomments willmust be consideredreceived; and voted upon, the Commission shall file a Notice of Proposed Rulemaking:

(1)and On(4) The manner in which interested persons may submit notice to the websitecommission of their intention to attend the Commissionpublic hearing or otherprovide publiclyany accessiblewritten platform;comments.

and(h) (2)Prior Toto adoption of a proposed rule, the commission shall allow persons whoto havesubmit requestedwritten noticedata, offacts, theopinions Commission'sand noticesarguments, ofwhich proposedshall rulemaking;be made available to the public.

and(i) (3)If Inthe suchhearing otheris way(s)to asbe held via electronic means, the Commissioncommission mayshall bypublish Rulethe specify.mechanism for access to the electronic hearing.

7.(1) All persons wishing to be heard at the hearing shall, as directed in the notice of proposedrulemaking, notify thecommissionoftheir desire to appear and testify at the hearing not less than five business days prior to the scheduled date of the hearing.

TheLCO NoticeNo. of Proposed Rulemaking shall include:

(1)3782 The23 time,of date,33 andRaised locationBill ofNo.6835 the(2) publicHearings hearingshall onbe theconducted proposedin Rulea andmanner theproviding proposedeach time,person datewho andwishes locationto ofcomment thea meetingfair inand whichreasonable theopportunity proposedto Rulecomment willorally beor consideredin andwriting. voted upon;

(2) The text of the proposed Rule and the reason for the proposed Rule;

(3) A request for comments on the proposed Rule from any interested person and the date by which written comments must be received;

and HCS HB 3129 16 (4) The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing or provide any written comments.

8.

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.

9.

If the hearing is to be held via electronic means, the Commission shall publish the mechanism for access to the electronic hearing.

(1) All persons wishing to be heard at the hearing shall as directed in the Notice of Proposed Rulemaking, not less than five (5) business days before the scheduled date of the hearing, notify the Commission of their desire to appear and testify at the hearing.

(2) Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.

A copy of the recording and the written comments, data, facts, opinions,opinions and arguments received in response to the proposed rulemaking shall be made available to a person upon request.

(4) Nothing in this section of the compact shall be construed asto requiringrequire a separate hearing on each proposed Rule.rule.

Proposed Rulesrules may be grouped for the convenience of the Commissioncommission at hearings required by this section.section of the compact.

10.(j) Following the public hearing, the commission shall consider all written and oral comments timely received.

Following(k) The commission shall, by majority vote of all delegates, take final action on the publicproposed hearingrule and determine the Commissioneffective shalldate considerof allthe writtenrule, if adopted, based on the rulemaking record and oralthe commentsfull timelytext received.of the rule.

11.(1) If adopted, the rule shall be posted on the commission's Internet web site.

(2) The Commissioncommission shall,may byadopt majoritychanges voteto of all delegates, take final action on the proposed Rulerule, andprovided shall determine the effectivechanges datedo ofnot theexpand Rule, if adopted, based on the Rulemakingoriginal recordpurpose and the full text of the Rule.proposed rule.

(1)(3) IfThe adopted,commission shall post on its Internet web site an explanation of the Rulereasons shallfor besubstantive postedchanges onmade to the Commission'sproposed website.rule and the reasons for any substantive changes that were recommended by commenters but not made.

(2)(4)The Thecommissionshalldetermine Commissionareasonable mayeffective adoptdate changesforthe torule. the proposed Rule provided the changes do not enlarge the original purpose of the proposed Rule.

(3)Except Thefor Commissionan shallemergency provideas onprovided itsin websitesubsection an(l) explanationof this section of the reasonscompact, forthe substantiveeffective changesdate madeof to the proposedrule Ruleshall asbe wellno assooner reasonsthan forthirty substantivedays changesafter notthe madecommission issued the notice that wereit recommendedadopted byLCO commenters.No.

(4)3782 The24 Commissionof shall33 determineRaised aBill reasonableNo.6835 effective date for the Rule.rule.

Except(l) forUpon determination that an emergency asexists, the commission may consider and adopt an emergency rule with twenty-four hours' prior notice, without the opportunity for comment or hearing, provided inthe subsectionusual 12rulemaking ofprocedures thisprovided section,in the effectivecompact dateand in this section of the Rulecompact shall be noretroactively soonerapplied thanto thirtythe (30)rule daysas aftersoon theas Commissionreasonably issuedpossible, thebut noticein thatno itevent adoptedlater than ninety days after the Rule.effective date of the rule.

12.For the purposes of this subsection, "emergency rule" means a rule that shall be adopted immediately by the commission to:

Upon(1) determinationMeet that an emergencyimminent exists,threat theto Commissionpublic mayhealth, considersafety and adopt an emergency Rule with twenty-four (24) hours prior notice, without the opportunity for comment, or hearing,welfare; 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(2) thePrevent purposesa loss of thiscommission provision,or anparticipating emergencystate Rulefunds; is one that must be adopted immediately by the Commission in order to:

(1)(3) Meet ana imminentdeadline threatfor tothe publicpromulgation health,of safety,a commission rule that is established by federal law or welfare;rule;

(2)or Prevent(4) aProtect losspublic ofhealth Commission or Participatingsafety. State funds;

(3)(m) MeetThe acommission deadlineor foran theauthorized promulgationcommittee of the commission may direct revisions to a Commissionpreviously Ruleadopted thatcommission isrule establishedfor bypurposes federalof lawcorrecting typographical errors, errors in format, errors in consistency or Rule;grammatical errors.

orPublic (4)notice Protectof publicany healthrevisions andshall safety.be posted on the Internet web site of the commission.

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

The Commissionrevision or an authorized committee of the Commission may directbe revisionschallenged toonly aon previouslygrounds adoptedthat Commissionthe Rulerevision forresults purposes of correcting typographical errors, errors in format,a errorsmaterial inchange consistency,to ora grammaticalrule. errors.

PublicA noticechallenge ofshall anybe revisionsmade shallas beset postedforth onin the websitenotice of revisions and delivered to the Commission.commission prior to theendofthenotice period.Ifno challenge ismade,therevision shall take effect without further action.

TheIf the revision shallis bechallenged, subjectthe torevision challengemay bynot anytake personeffect forwithout athe periodapproval of thirtythe (30)commission. days after posting.

The(n) revisionNo mayparticipating bestate's challengedrulemaking onlyrequirements onshall groundsapply thatunder the revisioncompact. results in a material change to a Rule.

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

If3782 no25 challengeof is33 made,Raised theBill revisionNo.6835 willSection take10. effect without further action.

IfOversight, theDispute revisionResolution isand challenged,Enforcement the(a) revisionOversight may(1) notThe takeexecutive effectand withoutjudicial branches of state government in each participating state shall enforce the approvalcompact ofand take all actions necessary and appropriate to implement the Commission.compact.

14.(2) Venue shall be 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.

NoThe Participatingcommission State'smay rulemakingwaive requirementsvenue shalland applyjurisdictional underdefenses thisto Compact.the extent it adopts or consents to participate in alternative dispute resolution proceedings.

334.1845.Nothing in this subdivision shall be construed to affect or limit the selection or propriety of venue in any action against a licensee for professional malpractice, misconduct or any such similar matter.

1.(3) The commission shall be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the compact or the commission's rules and shall have standing to intervene insucha proceeding for allpurposes.Failure to providethe commission with service of process shall render a judgment or order in such proceedingvoidastothecommission,thecompactorcommissionrules.

(1)(b) TheDefault, executiveTechnical Assistance and judicialTermination branches(1) ofIf Statethe governmentcommission determines that a participating state has defaulted in eachthe Participatingperformance Stateof shallits enforceobligations thisor Compactresponsibilities andunder takethe allcompact actionsor necessarythe andcommission appropriaterules, tothe implementcommission shall provide written notice to the Compact.defaulting state and other participating states.

(2)The Venuenotice isshall properdescribe andthe judicialdefault, proceedingsthe byproposed ormeans againstof curing the Commissiondefault shalland beany broughtother solelyaction andthat exclusivelythe incommission amay courttake ofand competentshall jurisdictionoffer whereremedial thetraining principaland officespecific oftechnical theassistance Commissionregarding isthe located.default.

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

Nothing3782 herein26 shallof affect33 orRaised limitBill No.6835 (2) If a state in default fails to cure the selectiondefault, orthe proprietydefaulting ofstate venuemay inbe anyterminated actionfrom againstthe compact upon an affirmative vote of a licenseemajority forof professionalthe malpractice,delegates misconductof orthe anyparticipating states, and all rights, privileges and benefits conferred by the compact upon such similarstate matter.may be terminated on the effective date of termination.

(3)A Thecure Commission shall be entitled to receive service of processthe indefault anyshall proceedingnot regardingrelieve the enforcementoffending orstate interpretation of theobligations Compact or theliabilities Commission'sincurred Rulesduring andthe shallperiod haveof standingdefault. to intervene in such a proceeding for all purposes.

Failure(3) toTermination provideof theparticipation Commissionin withthe servicecompact of process shall renderbe aimposed judgmentonly orafter orderall inother suchmeans proceedingof voidsecuring ascompliance tohave thebeen Commission,exhausted. this Compact, or Commission Rules.

HCSThe HBcommission 3129shall 18provide 2.notice of intent to suspend or terminate to the governor and majority and minority leaders of the defaulting state's legislature and the licensing board or boards of each of the participating states.

(1)(4) IfA thestate Commission determines that ahas Participatingbeen Stateterminated hasshall defaultedbe inresponsible thefor performanceall ofassessments, its obligations orand responsibilitiesliabilities underincurred thisthrough Compact or the Commissioneffective Rules,dateoftermination,including,butnotlimitedto,obligationsthatextend thebeyond Commission shall provide written notice to the defaultingeffective Statedate andof othertermination. Participating States.

(5) The noticecommission shall describenot thebear default,any thecosts proposedrelated meansto ofa curingstate thethat defaultis andfound anyto otherbe actionin default or that thehas Commissionbeen mayterminated takefrom andthe shallcompact, offerunless remedialagreed trainingupon andin specificwriting technicalbetween assistancethe regardingcommission and the default.defaulting state.

(2)(6) IfThe a State in default fails to cure the default, the defaulting Statestate may beappeal terminatedits termination from this Compact upon an affirmative vote of a majority of the delegatescompact ofby the Participatingcommission States,by andpetitioning allthe rights,United privilegesStates andDistrict benefitsCourt conferredfor bythe thisDistrict Compactof uponColumbia suchor Statethe mayfederal bedistrict terminatedwhere on the effectivecommission datehas ofits termination.principal offices.

AThe cureprevailing ofmember theshall defaultbe doesawarded notall relievecosts the offending State of obligationssuch orlitigation, liabilitiesincluding, incurredbut duringnot thelimited periodto, ofreasonable default.attorney's fees.

(3)(7) TerminationUpon the termination of a state's participation in thisthe Compactcompact, the state shall beimmediately imposedprovide onlynotice afterto all otherlicensees meanswithin ofsuch securingstate complianceof havesuch beentermination. exhausted.

NoticeLCO ofNo. intent to suspend or terminate shall be given by the Commission to the governor, the majority and minority leaders of the defaulting State's legislature, and to the Licensing Board(s) of each of the Participating States.

(4)3782 A27 Stateof that33 hasRaised beenBill terminatedNo.6835 is(A) responsibleLicensees forwho allhave assessments,been obligations,granted anda liabilitiescompact incurredprivilege throughin thesuch effectivestate dateshall ofretain termination,the includingcompact obligationsprivilege thatfor extendone beyondhundred eighty days following the effective date of such termination.

(5)(B) TheLicensees Commissionwho shallare notlicensed bearin anysuch costsstate relatedwho tohave been granted a Statecompact thatprivilege isin founda toparticipating bestate inshall defaultretain orthe thatcompact hasprivilege beenfor terminatedone fromhundred thiseighty Compact,days unless agreedthe uponlicensee also has a qualifying license in writinga betweenparticipating state or obtains a qualifying license in a participating state before the Commissionone-hundred-eighty-day andperiod ends, in which case the defaultingcompact State.privilege shall continue.

(6)(c) TheDispute defaultingResolution State(1) mayUpon appealrequest itsby terminationa fromparticipating state, the Compactcommission byshall theattempt Commissionto byresolve petitioningdisputes related to the U.S.compact that arise among participating states and between participating and nonparticipating states.

District(2) CourtThe forcommission theshall Districtpromulgate ofa Columbiarule orproviding thefor federalboth districtmediation whereand thebinding Commissiondispute hasresolution itsfor principaldisputes offices.as appropriate.

(d) Enforcement (1) The prevailingcommission, memberin shallthe bereasonable awardedexercise allof costsits discretion, shall enforce the provisions of suchthe litigation,compact includingand reasonablerules attorney'sof fees.the commission.

(7)(2) UponIf compliance is not secured after all means to secure compliance have been exhausted, the terminationcommission ofmay, aby State'smajority participationvote, initiate legal action in the Compact,United States District Court for the StateDistrict shallof immediatelyColumbia, provideor noticethe federal district where the commission has its principal offices, against a participating state in default to allenforce Licenseescompliance withinwith thatthe Stateprovisions of suchthe termination:compact and the commission's promulgated rules and bylaws.

(a) Licensees who have been granted a Compact Privilege in that State shall retain the Compact Privilege for one hundred eighty (180) days following the effective date of such termination.

(b) Licensees who are licensed in that State who have been granted a Compact Privilege in a Participating State shall retain the Compact Privilege for one hundred eighty (180) days unless the Licensee also has a Qualifying License in a Participating State or obtains a Qualifying License in a Participating State before the one hundred eighty (180)-day period ends, in which case the Compact Privilege shall continue.

HCS HB 3129 19 3.

(1) Upon request by a Participating State, the Commission shall attempt to resolve disputes related to this Compact that arise among Participating States and between participating and non-Participating States.

(2) The Commission shall promulgate a Rule providing for both mediation and binding dispute resolution for disputes as appropriate.

4.

(1) The Commission, in the reasonable exercise of its discretion, shall enforce the provisions of this Compact and Rules of the Commission.

(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.

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

(3)LCO TheNo. remedies herein shall not be the exclusive remedies of the Commission.

The3782 Commission28 mayof pursue33 anyRaised otherBill No.6835 (3) The remedies availableset underforth federalin orsubdivision State(2) law.of this subsection shall not be the exclusive remedies of the commission.

5.The commission may pursue any other remedies available under federal or state law.

(e) Legal Action Against the Commission (1) A Participatingparticipating Statestate 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.

InIf the event judicial enforcement is necessary, the prevailing party shall be awardedawardedallcosts allofsuchlitigation,including costsreasonableattorney'sfees. of such litigation, including reasonable attorney's fees.

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

334.1850.Section 11.

1.Date of Implementation of the PA Licensure Compact Commission (a) The compact shall come into effect on the date on which this compact statute is enacted into law in the seventh participating state.

This(1) CompactOn or after the effective date of the compact, the commission shall comeconvene intoand effectreview onthe enactment of each of the datestates onthat enacted the compact prior to the commission convening, which thisshall Compactbe statuteknown isas enactedthe intocharter lawparticipating instates, to determine if the seventhstatute Participatingenacted State.by each such charter participating state is materially different from the compact.

(1)(A) OnA orcharter afterparticipating thestate effectivewhose date of the Compact, the Commission shall convene and review the enactment ofis eachfound ofto thebe Statesmaterially thatdifferent enactedfrom the Compactcompact priorshall tobe theentitled Commission convening ("Charter Participating States") to determine if the statutedefault enactedprocess byset eachforth suchin Chartersubsection Participating(b) Stateof issection materially10 differentof than the Modelcompact. Compact.

(a)(B) AIf Charterany Participatingparticipating Statestate whoselater enactmentwithdraws isfrom foundthe tocompact beor materiallyits differentparticipation fromis terminated, the Modelcommission Compact shall beremain entitledin toexistence and the defaultcompact processshall setremain forth in subsectioneffect 2even if the number of sectionLCO 334.1845.No.

(b)3782 If29 anyof Participating33 StateRaised laterBill withdrawsNo.6835 fromparticipating thestates Compact or its participation is terminated,less thethan Commissionseven shallafter remainsuch inwithdrawal. existence and the Compact HCS HB 3129 20 shall remain in effect even if the number of Participating States should be less than seven.

Participating Statesstates enacting the Compactcompact subsequent to the Commissioncommission convening shall be subject to the process set forth in subdivision (21) of subsection 3(c) of section 334.18307 of the compact to determine if theirsuch enactments are materially different from the Modelcompact Compact and whether theysuch participating states qualify for participation in the Compact.compact.

(2) Participating Statesstates enacting the Compactcompact subsequent to the seven initial Chartercharter Participatingparticipating Statesstates shall be subject to the process set forth in subdivision (21) of subsection 3(c) of section 334.18307 of the compact to determine if theirsuch enactments are materially different from the Modelcompact Compact and whether theysuch participating states qualify for participation in the Compact.compact.

(3) All actions taken for the benefit of the Commissioncommission or in furtherance of the purposes of the administration of the Compactcompact prior to the effective date of the Compactcompact or the Commissioncommission coming into existence shall be considered to be actions of the Commissioncommission unless specifically repudiated by the Commission.commission.

(b) Any state that joins the compact shall be subject to the commission's rules and bylaws as such rules and bylaws exist on the date on which the compact becomes law in such state.

Any rule that has beenpreviously adoptedby the commissionshallhave thefullforceand effect of law on the day the compact becomes law in such state.

(c) Any participating state may withdraw from the compact by enacting a statute repealing the compact.

(1) A participating state's withdrawal from the compact shall not take effect until one hundred eighty days after enactment of the repealing statute.

During such one-hundred-eighty-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.

If any licensee licensed in the withdrawing state is also licensed in another participating state or obtains a license in another participating state on LCO No.

3782 30 of 33 Raised Bill No.6835 or before one hundred eighty days after such withdrawal, the licensee's compact privileges in other participating states shall not be affected by the passage of such one hundred eighty days.

(2) Withdrawal under subsection (d) of this section of the compact shall not affect the continuing requirement of the state licensing board or boards of the withdrawing state to comply with the investigative and adverse action reporting requirements of the compact prior to the effective date of withdrawal.

(3) Upon the enactment of a statute withdrawing a state from the compact, the state shall immediately provide notice of such withdrawal to all licensees in such state.

Such withdrawing state shall continue to recognize all licenses granted pursuant to the compact for a minimum of one hundred eighty days after the date of such notice of withdrawal.

(d)Nothinginthecompactshallbeconstruedtoinvalidateorprevent any PA licensure agreement or other cooperative arrangement between participating states and between a participating state and nonparticipating state that does not conflict with the provisions of the compact.

(e) The compact may be amended by the participating states.

No amendment to the 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.

Section 12.

Construction and Severability (a) The compact and the commission's rulemaking authority shall be liberally construed to effectuate the purposes and the implementation and administration of the compact.

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

LCO No.

3782 31 of 33 Raised Bill No.6835 (b)Theprovisionsofthecompactshallbeseverableandifanyphrase, clause, sentence or provision of the compact is held by a court of competent jurisdiction to be contrary to the constitution of any participating state, a state seeking participation in the compact or of the United States, or the applicability of the compact to any government, agency, person or circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of the compact and the applicability thereof to any other government, agency, person or circumstance shall not be affected thereby.

(c) Notwithstanding the provisions of subsection (b) of this section of the compact, the commission may deny a state's participation in the compact or, in accordance with the requirements of subsection (b) of section 10 of the compact, 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 the compact is held to be contrary to the constitution of any participating state, the compact shall remain in full force and effect as to the remaining participating states and in full force and effect as to the participating state affected as to all severable matters.

Section 13.

Binding Effect of Compact (a)Nothinginthecompactshallpreventtheenforcementofanyother law of a participating state that is not inconsistent with the compact.

(b) Any laws in a participating state in conflict with the compact are superseded to the extent of the conflict.

(c) All agreements between the commission and the participating states are binding in accordance with the terms of such agreements.

Sec.

Any(NEW) State(Effective thatJuly joins1, this2025) CompactThe shallCommissioner beof subjectPublic toHealth theshall Commission'srequire Ruleseach andperson bylawsapplying for licensure as theya existphysician onassistant theto datesubmit onto whicha thisstate Compactand becomesnational lawfingerprint-based incriminal thatLCO State.No.

Any3782 Rule32 that has been previously adopted by the Commission shall have the full force and effect of law33 onRaised theBill dayNo. this Compact becomes law in that State.

3.6835 history records check pursuant to section 29-17a of the general statutes.

AnyAs Participatingused Statein maythis withdrawsection, from(1) this"physician Compactassistant" means an individual licensed to practice as a physician assistant, and (2) "licensure" means authorization by enactinga state physician assistant regulatory authority to practice as a statutephysician repealingassistant, the same.practice of which would be unlawful without such authorization.

(1)This Aact Participating State's withdrawal shall not take effect untilas onefollows hundredand eightyshall (180)amend days after enactment of the repealingfollowing statute.sections:

DuringSection this1 oneJuly hundred1, eighty2025 (180)New day-period,section allSec. Compact Privileges that were in effect in the withdrawing State and were granted to Licensees licensed in the withdrawing State shall remain in effect.

If2 anyJuly Licensee1, licensed2025 inNew thesection withdrawingStatement State is also licensed in another Participating State or obtains a license in another Participating State within the one hundred eighty (180) days, the Licensee's Compact Privileges in other Participating States shall not be affected by the passage of thePurpose: one hundred eighty (180) days.

(2)To Withdrawaladopt shall not affect the continuingPhysician requirementAssistant ofLicensure theCompact. State Licensing Board(s) of the withdrawing State to comply with the investigative, and Adverse Action reporting requirements of this Compact prior to the effective date of withdrawal.

(3)[Proposed Upondeletions theare enactmentenclosed ofin abrackets. statute withdrawing a State from this Compact, the State shall immediately provide notice of such withdrawal to all Licensees within that State.

SuchProposed withdrawingadditions Stateare shallindicated continueby tounderline, recognizeexcept allthat licenseswhen grantedthe pursuantentire totext thisof Compacta forbill or resolution or a minimumsection of onea hundredbill eightyor (180)resolution daysis afternew, theit dateis ofnot suchunderlined.] noticeLCO ofNo. withdrawal.

HCS3782 HB33 3129of 2133 4.

Nothing contained in this Compact shall be construed to invalidate or prevent any physician assistant licensure agreement or other cooperative arrangement between Participating States and between a Participating State and non-Participating State that does not conflict with the provisions of this Compact.

5.

This Compact may be amended by the Participating States.

No amendment to this Compact shall become effective and binding upon any Participating State until it is enacted materially in the same manner into the laws of all Participating States as determined by the Commission.

334.1855.

1.

This Compact and the Commission's rulemaking authority shall be liberally construed so as to effectuate the purposes, and the implementation and administration of the Compact.

Provisions of the Compact expressly authorizing or requiring the promulgation of Rules shall not be construed to limit the Commission's rulemaking authority solely for those purposes.

2.

The provisions of this Compact shall be severable and if any phrase, clause, sentence or provision of this Compact is held by a court of competent jurisdiction to be contrary to the constitution of any Participating State, a State seeking participation in the Compact, or of the United States, or the applicability thereof to any government, 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.

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.