SB181ENGROSSED
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SB181
2JX5GKI-2
By Senators Kelley, Kitchens, Smitherman, Stewart
RFD: Veterans, Military Affairs and Public Safety
First Read: 20-Feb-25
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First Read: 20-Feb-25
A BILL
TO BE ENTITLED
AN ACT
Relating to the practice of respiratory therapy; to
adopt the Respiratory Care Interstate Compact as Article 2 of
Chapter 27B of Title 34, Code of Alabama 1975; to allow
licensed respiratory therapists to practice among compact
states; to establish requirements and obligations for
participation in the compact; to provide for disciplinary
actions and joint investigation procedures; to establish and
provide for the operation of the Respiratory Care Interstate
Compact Commission; and to provide for the management,
implementation, and enforcement of the compact among member
states.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. Sections 34-27B-1 through 34-27B-14, Code of
Alabama 1975, are designated as Article 1 of Chapter 27B of
Title 34, Code of Alabama 1975.
Section 2. Article 2, commencing with Section
34-27B-50, is added to Chapter 27B of Title 34, Code of
Alabama 1975, to read as follows:
Article 2. RESPIRATORY CARE INTERSTATE COMPACT
§34-27B-50. Purpose.
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§34-27B-50. Purpose.
(a) The purpose of this compact is to facilitate the
interstate practice of respiratory therapy with the goal of
improving public access to respiratory therapy services by
providing respiratory therapists licensed in a member state
the ability to practice in other member states. The compact
preserves the regulatory authority of states to protect public
health and safety through the current system of state
licensure.
(b) This compact is designed to achieve the following
objectives:
(1) Increase public access to respiratory therapy
services by creating a responsible, streamlined pathway for
licensees to practice in member states with the goal of
improving outcomes for patients.
(2) Enhance states' ability to protect the public's
health and safety.
(3) Promote the cooperation of member states in
regulating the practice of respiratory therapy within those
member states.
(4) Ease administrative burdens on states by
encouraging the cooperation of member states in regulating
multi-state respiratory therapy practice.
(5) Support relocating active military members and
their spouses.
(6) Promote mobility and address workforce shortages.
§34-27B-51. Definitions.
As used in this compact, the following terms have the
following meanings:
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following meanings:
(1) ACTIVE MILITARY MEMBER. Any person with a full-time
duty status in the Armed Forces of the United States,
including members of the National Guard and Reserve.
(2) ADVERSE ACTION. Any administrative, civil,
equitable, or criminal action permitted by a state's laws
which is imposed by any state authority with regulatory
authority over respiratory therapists, such as license denial,
censure, revocation, suspension, probation, monitoring of the
licensee, or restriction on the licensee's practice, not
including participation in an alternative program.
(3) ALTERNATIVE PROGRAM. A nondisciplinary monitoring
or practice remediation process applicable to a respiratory
therapist approved by any state authority with regulatory
authority over respiratory therapists. This includes, but is
not limited to, programs to which licensees with substance
abuse or addiction issues are referred in lieu of adverse
action.
(4) CHARTER MEMBER STATES. Those member states who were
the first seven states to enact the compact into the laws of
their state.
(5) COMMISSION or RESPIRATORY CARE INTERSTATE COMPACT
COMMISSION. The government instrumentality and body politic
whose membership consists of all member states that have
enacted the compact.
(6) COMMISSIONER. The individual appointed by a member
state to serve as the member of the commission for that member
state.
(7) COMPACT. The Respiratory Care Interstate Compact.
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(7) COMPACT. The Respiratory Care Interstate Compact.
(8) COMPACT PRIVILEGE. The authorization granted by a
remote state to allow a licensee from another member state to
practice as a respiratory therapist in the remote state under
the remote state's laws and rules. The practice of respiratory
therapy occurs in the member state where the patient is
located at the time of the patient encounter.
(9) CRIMINAL BACKGROUND CHECK. The submission by the
member state of fingerprints or other biometric-based
information on license applicants at the time of initial
licensing for the purpose of obtaining that applicant's
criminal history record information, as defined in 28 C.F.R. §
20.3(d) or successor provision, from the Federal Bureau of
Investigation and the state's criminal history record
repository, as defined in 28 C.F.R. § 20.3(f) or successor
provision.
(10) DATA SYSTEM. The commission's repository of
information about licensees as further set forth in Section
34-27B-57.
(11) DOMICILE. The jurisdiction which is the licensee's
principal home for legal purposes.
(12) ENCUMBERED LICENSE. A license that a state's
respiratory therapy licensing authority has limited in any
way.
(13) EXECUTIVE COMMITTEE. A group of directors elected
or appointed to act on behalf of, and within the powers
granted to them, by the commission.
(14) HOME STATE. Except as set forth in Section
34-27B-54, the member state that is the licensee's primary
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34-27B-54, the member state that is the licensee's primary
domicile.
(15) HOME STATE LICENSE. An active license to practice
respiratory therapy in a home state that is not an encumbered
license.
(16) JURISPRUDENCE REQUIREMENT. An assessment of an
individual's knowledge of the state rules governing the
practice of respiratory therapy in such state.
(17) LICENSEE. An individual who currently holds an
authorization from the state to practice as a respiratory
therapist.
(18) MEMBER STATE. A state that has enacted the compact
and been admitted to the commission in accordance with the
provisions herein and commission rules.
(19) MODEL COMPACT. The model for the Respiratory Care
Interstate Compact on file with The Council of State
Governments or other entity as designated by the commission.
(20) REMOTE STATE. A member state where a licensee is
exercising or seeking to exercise the compact privilege.
(21) RESPIRATORY THERAPIST or RESPIRATORY CARE
PRACTITIONER. An individual who holds a credential issued by
the National Board for Respiratory Care, or its successor, and
who holds a license to practice respiratory therapy, and who
meets all of the requirements outlined in Section 34-27B-3.
For purposes of this compact, any other title or status
adopted by a state to replace the term "respiratory therapist"
or "respiratory care practitioner" shall be deemed synonymous
with "respiratory therapist" and shall confer the same rights
and responsibilities to the licensee under the provisions of
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and responsibilities to the licensee under the provisions of
this compact at the time of its enactment.
(22) RESPIRATORY THERAPY, RESPIRATORY THERAPY PRACTICE,
RESPIRATORY CARE, THE PRACTICE OF RESPIRATORY CARE, or THE
PRACTICE OF RESPIRATORY THERAPY. The care and services
provided by or under the direction and supervision of a
respiratory therapist or respiratory care practitioner as set
forth in the member state's statutes and rules in the state
where the services are being provided.
(23) RESPIRATORY THERAPY LICENSING AUTHORITY. The
agency, board, or other body of a state that is responsible
for licensing and regulation of respiratory therapists.
(24) RULE. A regulation adopted by an entity that has
the force and effect of law.
(25) SCOPE OF PRACTICE. The procedures, actions, and
processes a respiratory therapist licensed in a state or
practicing under a compact privilege in a state is permitted
to undertake in that state and the circumstances under which
the respiratory therapist is permitted to undertake those
procedures, actions, and processes. Such procedures, actions,
and processes, and the circumstances under which they may be
undertaken may be established through means, including, but
not limited to, statute, rules, case law, and other processes
available to the state respiratory therapy licensing authority
or other government agency.
(26) SIGNIFICANT INVESTIGATIVE INFORMATION.
Information, records, and documents received or generated by a
state respiratory therapy licensing authority pursuant to an
investigation for which a determination has been made that
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investigation for which a determination has been made that
there is probable cause to believe that the licensee has
violated a statute or rule that is considered more than a
minor infraction for which the state respiratory therapy
licensing authority could pursue adverse action against the
licensee.
(27) STATE. Any state, commonwealth, district, or
territory of the United States.
§34-27B-52. State Participation in the Compact.
(a) In order to participate in this compact and
thereafter continue as a member state, a member state shall do
all of the following:
(1) Enact a compact that is not materially different
from the model compact.
(2) License respiratory therapists.
(3) Participate in the commission's data system.
(4) Have a mechanism in place for receiving and
investigating complaints against licensees and compact
privilege holders.
(5) Notify the commission, in compliance with the terms
of this compact and commission rules, of any adverse action
against a licensee, a compact privilege holder, or a license
applicant.
(6) Notify the commission, in compliance with the terms
of this compact and commission rules, of the existence of
significant investigative information.
(7) Comply with the rules of the commission.
(8) Grant the compact privilege to a holder of an
active home state license and otherwise meet the applicable
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active home state license and otherwise meet the applicable
requirements of Section 34-27B-53 in a member state.
(9) Complete a criminal background check for each new
licensee at the time of initial licensure. Where expressly
authorized or permitted by federal law, whether such federal
law is in effect prior to, at, or after the time of a member
state's enactment of this compact, a member state's enactment
of this compact shall hereby authorize the member state's
respiratory therapy licensing authority to perform criminal
background checks as defined herein. The absence of such a
federal law as described in this subsection shall not prevent
or preclude such authorization where it may be derived or
granted through means other than the enactment of this
compact.
(b) Nothing in this compact prohibits a member state
from charging a fee for granting and renewing the compact
privilege.
§34-27B-53. Compact Privilege.
(a) To exercise the compact privilege under the terms
and provisions of the compact, the licensee shall do all of
the following:
(1) Hold and maintain an active home state license as a
respiratory therapist.
(2) Hold and maintain an active credential from the
National Board for Respiratory Care, or its successor, that
would qualify them for licensure in the remote state in which
they are seeking the privilege.
(3) Have not had any adverse action against a license
within the previous two years.
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within the previous two years.
(4) Notify the commission that the licensee is seeking
the compact privilege within a remote state or states.
(5) Pay any applicable fees, including any state and
commission fees and renewal fees, for the compact privilege.
(6) Meet any jurisprudence requirements established by
the remote state in which the licensee is seeking a compact
privilege.
(7) Report to the commission any adverse action taken
by any non-member state within 30 days from the date the
adverse action is taken.
(8) Report to the commission, when applying for a
compact privilege, the address of the licensee's domicile and
thereafter promptly report to the commission any change in the
address of the licensee's domicile within 30 days of the
effective date of the change in address.
(9) Consent to accept service of process by U.S. mail
at the licensee's domicile on record with the commission with
respect to any action brought against the licensee by the
commission or a member state, and consent to accept service of
a subpoena by U.S. mail at the licensee's domicile on record
with the commission with respect to any action brought or
investigation conducted by the commission or a member state.
(b) The compact privilege is valid until the expiration
date or revocation of the home state license unless terminated
pursuant to adverse action. The licensee must comply with all
of the requirements of subsection (a) to maintain the compact
privilege in a remote state. If those requirements are met, no
adverse actions are taken, and the licensee has paid any
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adverse actions are taken, and the licensee has paid any
applicable compact privilege renewal fees, then the licensee
will maintain the licensee's compact privilege.
(c) A licensee providing respiratory therapy in a
remote state under the compact privilege shall function within
the scope of practice authorized by the remote state for the
type of respiratory therapist license the licensee holds. Such
procedures, actions, processes, and the circumstances under
which they may be undertaken may be established through means,
including, but not limited to, statute, rules, case law, and
other processes available to the state respiratory therapy
licensing authority or other government agency.
(d) If a licensee's compact privilege in a remote state
is removed by the remote state, the individual shall lose or
be ineligible for the compact privilege in that remote state
until the compact privilege is no longer limited or restricted
by that state.
(e) If a home state license is encumbered, the licensee
shall lose the compact privilege in all remote states until
both of the following occur:
(1) The home state license is no longer encumbered.
(2) Two years have elapsed from the date on which the
license is no longer encumbered due to the adverse action.
(f) Once a licensee with a restricted or limited
license meets the requirements of subsection (e), the licensee
must also meet the requirements of subsection (a) to obtain a
compact privilege in a remote state.
§34-27B-54. Active Military Member or Their Spouse.
(a) An active military member or their spouse shall
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(a) An active military member or their spouse shall
designate a home state where the individual has a current
license in good standing. The individual may retain the home
state designation during the period the service member is on
active duty.
(b) An active military member and their spouse shall
not be required to pay to the commission for a compact
privilege any fee that may otherwise be charged by the
commission. If a remote state chooses to charge a fee for a
compact privilege, it may choose to charge a reduced fee or no
fee to an active military member and their spouse for a
compact privilege.
§34-27B-55. Adverse Actions.
(a) A member state in which a licensee is licensed
shall have authority to impose adverse action against the
license issued by that member state.
(b) A member state may take adverse action based on
significant investigative information of a remote state or the
home state, so long as the member state follows its own
procedures for imposing adverse action.
(c) Nothing in this compact shall override a member
state's decision that participation in an alternative program
may be used in lieu of adverse action and that such
participation shall remain nonpublic if required by the member
state's laws.
(d) A remote state shall have the authority to:
(1) Take adverse actions as set forth herein against a
licensee's compact privilege in that state.
(2) Issue subpoenas for both hearings and
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(2) Issue subpoenas for both hearings and
investigations that require the attendance and testimony of
witnesses, and the production of evidence.
a. Subpoenas may be issued by a respiratory therapy
licensing authority in a member state for the attendance and
testimony of witnesses and the production of evidence.
b. Subpoenas issued by a respiratory therapy licensing
authority in a member state for the attendance and testimony
of witnesses shall be enforced in the latter state by any
court of competent jurisdiction in the latter state, according
to the practice and procedure of that court applicable to
subpoenas issued in proceedings pending before it.
c. Subpoenas issued by a respiratory therapy licensing
authority in a member state for production of evidence from
another member state shall be enforced in the latter state,
according to the practice and procedure of that court
applicable to subpoenas issued in the proceedings pending
before it.
d. The issuing authority shall pay any witness fees,
travel expenses, mileage, and other fees required by the
service statutes of the state where the witnesses or evidence
are located.
(3) Unless otherwise prohibited by state law, recover
from the licensee the costs of investigations and disposition
of cases resulting from any adverse action taken against that
licensee.
(4) Notwithstanding subdivision (d)(2), a member state
may not issue a subpoena to gather evidence of conduct in
another member state that is lawful in such other member state
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another member state that is lawful in such other member state
for the purpose of taking adverse action against a licensee's
compact privilege or application for a compact privilege in
that member state.
(5) Nothing in this compact authorizes a member state
to impose discipline against a respiratory therapist's compact
privilege in that member state for the individual's otherwise
lawful practice in another state.
(e) Joint investigations.
(1) In addition to the authority granted to a member
state by its respective Respiratory Therapy Practice Act or
other applicable state law, a member state may participate
with other member states in joint investigations of licensees,
provided, however, that a member state receiving such a
request has no obligation to respond to any subpoena issued
regarding an investigation of conduct or practice that was
lawful in a member state at the time it was undertaken.
(2) Member states shall share any significant
investigative information, litigation, or compliance materials
in furtherance of any joint or individual investigation
initiated under the compact. In sharing such information
between member state respiratory therapy licensing
authorities, all information obtained shall be kept
confidential, except as otherwise mutually agreed upon by the
sharing and receiving member state or states.
(f) Nothing in this compact permits a member state to
take any adverse action against a licensee or holder of a
compact privilege for conduct or practice that was legal in
the member state at the time it was undertaken.
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the member state at the time it was undertaken.
(g) Nothing in this compact permits a member state to
take disciplinary action against a licensee or holder of a
compact privilege for conduct or practice that was legal in
the member state at the time it was undertaken.
§34-27B-56. Establishment of the Respiratory Care
Interstate Compact Commission.
(a) The compact member states hereby create and
establish a joint government agency whose membership consists
of all member states that have enacted the compact known as
the Respiratory Care Interstate Compact Commission. The
commission is an instrumentality of the compact member states
acting jointly and not an instrumentality of any one state.
The commission shall come into existence on or after the
effective date of the compact, as set forth in Section
34-27B-60.
(b) Membership, voting, and meetings.
(1) Each member state shall have and be limited to one
commissioner selected by that member state's respiratory
therapy licensing authority.
(2) The commissioner shall be an administrator or their
designated staff member of the member state's respiratory
therapy licensing authority.
(3) The commission, by rule or bylaw, shall establish a
term of office for commissioners and, by rule or bylaw, may
establish term limits.
(4) The commission may recommend to a member state the
removal or suspension of any commissioner from office.
(5) A member state's respiratory therapy licensing
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(5) A member state's respiratory therapy licensing
authority shall fill any vacancy of its commissioner occurring
on the commission within 60 days of the vacancy.
(6) Each commissioner shall be entitled to one vote on
all matters before the commission requiring a vote by
commissioners.
(7) A commissioner shall vote in person or by such
other means as provided in the bylaws. The bylaws may provide
for commissioners to meet by telecommunication, video
conference, or other means of communication.
(8) The commission shall meet at least once during each
calendar year. Additional meetings may be held as set forth in
the bylaws.
(c) The commission shall have all of the following
powers:
(1) Establish and amend the fiscal year of the
commission.
(2) Establish and amend bylaws and policies, including,
but not limited to, a code of conduct and conflict of
interest.
(3) Establish and amend rules, which shall be binding
in all member states.
(4) Maintain its financial records in accordance with
the bylaws.
(5) Meet and take such actions as are consistent with
the provisions of this compact, the commission's rules, and
the bylaws.
(6) Initiate and conduct legal proceedings or actions
in the name of the commission; provided, that the standing of
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in the name of the commission; provided, that the standing of
any respiratory therapy licensing authority to sue or be sued
under applicable law shall not be affected.
(7) Maintain and certify records and information
provided to a member state as the authenticated business
records of the commission, and designate an agent to do so on
the commission's behalf.
(8) Purchase and maintain insurance and bonds.
(9) Accept or contract for services of personnel,
including, but not limited to, employees of a member state.
(10) Conduct an annual financial review.
(11) Hire employees, elect or appoint officers, fix
compensation, define duties, grant such individuals
appropriate authority to carry out the purposes of the
compact, and establish the commission's personnel policies and
programs relating to conflicts of interest, qualifications of
personnel, and other related personnel matters.
(12) Assess and collect fees.
(13) Accept any and all appropriate gifts, donations,
grants of money, other sources of revenue, equipment,
supplies, materials, and services, and receive, utilize, and
dispose of the same, provided that at all times:
a. The commission shall avoid any appearance of
impropriety.
b. The commission shall avoid any appearance of
conflict of interest.
(14) Lease, purchase, retain, own, hold, improve, or
use any property, real, personal, or mixed, or any undivided
interest therein.
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interest therein.
(15) Sell, convey, mortgage, pledge, lease, exchange,
abandon, or otherwise dispose of any property real, personal,
or mixed.
(16) Establish a budget and make expenditures.
(17) Borrow money in a fiscally responsible manner.
(18) Appoint committees, including standing committees,
composed of commissioners, state regulators, state legislators
or their representatives, consumer representatives, and such
other interested persons as may be designated in this compact
and the bylaws.
(19) Provide and receive information from, and
cooperate with, law enforcement agencies.
(20) Establish and elect an executive committee,
including a chair, vice chair, secretary, treasurer, and such
other offices as the commission shall establish by rule or
bylaw.
(21) Enter into contracts or arrangements for the
management of the affairs of the commission.
(22) Determine whether a state's adopted language is
materially different from the model compact language such that
the state would not qualify for participation in the compact.
(23) Perform such other functions as may be necessary
or appropriate to achieve the purposes of this compact.
(d) The Executive Committee.
(1) The executive committee shall have the power to act
on behalf of the commission according to the terms of this
compact. The powers, duties, and responsibilities of the
executive committee shall include all of the following:
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executive committee shall include all of the following:
a. Overseeing the day-to-day activities of the
administration of the compact, including enforcement and
compliance with the provisions of the compact, its rules and
bylaws, and other such duties as deemed necessary.
b. Recommending to the commission changes to the rules
or bylaws, changes to this compact legislation, fees charged
to compact member states, fees charged to licensees, and other
fees.
c. Ensuring compact administration services are
appropriately provided, including by contract.
d. Preparing and recommending the budget.
e. Maintaining financial records on behalf of the
commission.
f. Monitoring compact compliance of member states and
providing compliance reports to the commission.
g. Establishing additional committees as necessary.
h. Exercising the powers and duties of the commission
during the interim between commission meetings, except for
adopting or amending rules, adopting or amending bylaws, and
exercising any other powers and duties expressly reserved to
the commission by rule or bylaw.
i. Performing other duties as provided in the rules or
bylaws of the commission.
(2) The executive committee shall be composed of up to
nine members, as further set forth in the bylaws of the
commission:
a. Seven voting members who are elected by the
commission from the current membership of the commission; and
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commission from the current membership of the commission; and
b. Two ex officio, nonvoting members.
(3) The commission may remove any member of the
executive committee as provided in the commission's bylaws.
(4) The executive committee shall meet at least
annually.
a. Executive committee meetings shall be open to the
public, except that the executive committee may meet in a
closed, nonpublic meeting as provided in subdivision (f)(4).
b. The executive committee shall give advance notice of
its meetings, posted on its website and as determined to
provide notice to persons with an interest in the business of
the commission.
c. The executive committee may hold a special meeting
in accordance with subdivision (f)(2).
(e) The commission shall adopt and provide to the
member states an annual report.
(f) Meetings of the commission.
(1) All meetings of the commission that are not closed
pursuant to subdivision (4) shall be open to the public.
Notice of public meetings shall be posted on the commission's
website at least 30 days prior to the public meeting.
(2) Notwithstanding subdivision (1), the commission may
convene an emergency public meeting by providing at least
24-hours' prior notice on the commission's website, and any
other means as provided in the commission's rules, for any of
the reasons it may dispense with notice of proposed rulemaking
under Section 34-27B-58(g). The commission's legal counsel
shall certify that one of the reasons justifying an emergency
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shall certify that one of the reasons justifying an emergency
public meeting has been met.
(3) Notice of all commission meetings shall provide the
time, date, and location of the meeting, and if the meeting is
to be held or accessible via telecommunication, video
conference, or other electronic means, the notice shall
include the mechanism for access to the meeting.
(4) The commission or the executive committee may
convene in a closed, nonpublic meeting for the commission or
executive committee to receive or solicit legal advice or to
discuss any of the following:
a. Noncompliance of a member state with its obligations
under the compact.
b. The employment, compensation, discipline, or other
matters, practices, or procedures related to specific
employees.
c. Current or threatened discipline of a licensee or
compact privilege holder by the commission or by a member
state's respiratory therapy licensing authority.
d. Current, threatened, or reasonably anticipated
litigation.
e. Negotiation of contracts for the purchase, lease, or
sale of goods, services, or real estate.
f. Accusing any person of a crime or formally censuring
any person.
g. Trade secrets or commercial or financial information
that is privileged or confidential.
h. Information of a personal nature where disclosure
would constitute a clearly unwarranted invasion of personal
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would constitute a clearly unwarranted invasion of personal
privacy.
i. Investigative records compiled for law enforcement
purposes.
j. Information related to any investigative reports
prepared by, or on behalf of or for use of, the commission or
other committee charged with responsibility of investigation
or determination of compliance issues pursuant to the compact.
k. Legal advice.
l. Matters specifically exempted from disclosure by
federal or member state law.
m. Other matters as adopted by the commission by rule.
(5) If a meeting, or portion of a meeting, is closed,
the presiding officer shall state that the meeting will be
closed and reference each relevant exempting provision, and
such reference shall be recorded in the minutes.
(6) The commission shall keep minutes in accordance
with commission rules and bylaws. All documents considered in
connection with an action shall be identified in such minutes.
All minutes and documents of a closed meeting shall remain
under seal, subject to release only by a majority vote of the
commission or order of a court of competent jurisdiction.
(g) Financing of the commission.
(1) The commission shall pay, or provide for the
payment of, the reasonable expenses of its establishment,
organization, and ongoing activities.
(2) The commission may accept any and all appropriate
revenue sources as provided herein.
(3) The commission may levy on and collect an annual
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(3) The commission may levy on and collect an annual
assessment from each member state and impose fees on licensees
of member states to whom it grants a compact privilege to
cover the cost of the operations and activities of the
commission and its staff. The aggregate annual assessment
amount for member states, if any, shall be allocated based
upon a formula that the commission shall adopt by rule.
(4) The commission shall not incur obligations of any
kind prior to securing the funds or a loan adequate to meet
the same; nor shall the commission pledge the credit of any of
the member states, except by and with the authority of the
member state.
(5) The commission shall keep accurate accounts of all
receipts and disbursements. The receipts and disbursements of
the commission shall be subject to the financial review and
accounting procedures established under its bylaws. However,
all receipts and disbursements of funds handled by the
commission shall be subject to an annual financial review by a
certified or licensed public accountant, and the report of the
financial review shall be included in and become part of the
annual report of the commission.
(h) Qualified immunity, defense, and indemnification.
(1) Nothing herein shall be construed as a limitation
on the liability of any licensee for professional malpractice
or misconduct, which shall be governed solely by any other
applicable state laws.
(2) The member states, commissioners, officers,
executive directors, employees, and agents of the commission
shall be immune from suit and liability, both personally and
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shall be immune from suit and liability, both personally and
in their official capacity, for any claim for damage to or
loss of property or personal injury or other civil liability
caused by or arising out of any actual or alleged act, error,
or omission that occurred, or that the person against whom the
claim is made had a reasonable basis for believing occurred
within the scope of commission employment, duties, or
responsibilities; provided, that nothing in this subsection
shall be construed to protect any such person from suit or
liability for any damage, loss, injury, or liability caused by
the intentional, willful, or wanton misconduct of that person.
The procurement of insurance of any type by the commission
shall not in any way compromise or limit the immunity granted
hereunder.
(3) The commission shall defend any commissioner,
officer, executive director, employee, and agent of the
commission in any civil action seeking to impose liability
arising out of any actual or alleged act, error, or omission
that occurred within the scope of commission employment,
duties, or responsibilities, or as determined by the
commission that the person against whom the claim is made had
a reasonable basis for believing occurred within the scope of
commission employment, duties, or responsibilities; provided,
that nothing herein shall be construed to prohibit that person
from retaining their own counsel at their own expense; and
provided further, that the actual or alleged act, error, or
omission did not result from that person's intentional,
willful, or wanton misconduct.
(4) The commission shall indemnify and hold harmless
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(4) The commission shall indemnify and hold harmless
any commissioner, member, officer, executive director,
employee, and agent of the commission for the amount of any
settlement or judgment obtained against that person arising
out of any actual or alleged act, error, or omission that
occurred within the scope of commission employment, duties, or
responsibilities, or that such 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, willful, or wanton misconduct of that person.
(5) Nothing in this compact shall be interpreted to
waive or otherwise abrogate a member state's state action
immunity or state action affirmative defense with respect to
antitrust claims under the Sherman Act, Clayton Act, or any
other state or federal antitrust or anticompetitive law or
rule.
(6) Nothing in this compact shall be construed to be a
waiver of sovereign immunity by the member states or by the
commission.
§34-27B-57. Data System.
(a) The commission shall provide for the development,
maintenance, operation, and utilization of a coordinated
database and reporting system containing licensure, adverse
action, and the presence of significant investigative
information.
(b) Notwithstanding any other provision of state law to
the contrary, a member state shall submit a uniform data set
to the data system as required by the rules of the commission,
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to the data system as required by the rules of the commission,
including, but not limited to, all of the following:
(1) Identifying information.
(2) Licensure data.
(3) Adverse actions against a licensee, license
applicant, or compact privilege holder and information related
thereto.
(4) Nonconfidential information related to alternative
program participation, the beginning and ending dates of such
participation, and other information related to such
participation not made confidential under member state law.
(5) Any denial of application for licensure, and the
reason or reasons for such denial.
(6) The presence of current significant investigative
information.
(7) Other information that may facilitate the
administration of this compact or the protection of the
public, as determined by the rules of the commission.
(c) No member state shall submit any information which
constitutes criminal history record information, as defined by
applicable federal law, to the data system established
hereunder.
(d) The records and information provided to a member
state pursuant to this compact or through the data system,
when certified by the commission or an agent thereof, shall
constitute the authenticated business records of the
commission, and shall be entitled to any associated hearsay
exception in any relevant judicial, quasi-judicial, or
administrative proceedings in a member state.
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administrative proceedings in a member state.
(e) Significant investigative information pertaining to
a licensee in any member state will only be available to other
member states.
(f) It is the responsibility of the member states to
report any adverse action against a licensee and to monitor
the database to determine whether adverse action has been
taken against a licensee. Adverse action information
pertaining to a licensee in any member state will be available
to any other member state.
(g) Member states contributing information to the data
system may designate information that may not be shared with
the public without the express permission of the contributing
state.
(h) Any information submitted to the data system that
is subsequently expunged pursuant to federal law or the laws
of the member state contributing the information shall be
removed from the data system.
§34-27B-58. Rulemaking.
(a) The commission shall adopt reasonable rules in
order to effectively and efficiently implement and administer
the purposes and provisions of the compact. A rule shall be
invalid and have no force or effect only if a court of
competent jurisdiction holds that the rule is invalid because
the commission exercised its rulemaking authority in a manner
that is beyond the scope and purposes of the compact, or the
powers granted hereunder, or based upon another applicable
standard of review.
(b) For purposes of the compact, the rules of the
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(b) For purposes of the compact, the rules of the
commission shall have the force of law in each member state.
(c) The commission shall exercise its rulemaking powers
pursuant to the criteria set forth in this section and the
rules adopted thereunder. Rules shall become binding as of the
date specified in each rule.
(d) If a majority of the legislatures of the member
states rejects a rule or portion of a rule, by enactment of a
statute or resolution in the same manner used to adopt the
compact within four years of the date of adoption of the rule,
then the rule shall have no further force and effect in any
member state.
(e) Rules shall be adopted at a regular or special
meeting of the commission.
(f) Prior to adoption of a proposed rule, the
commission shall hold a public hearing and allow persons to
provide oral and written comments, data, facts, opinions, and
arguments.
(g) Prior to adoption of a proposed rule by the
commission, and at least 30 days in advance of the meeting at
which the commission will hold a public hearing on the
proposed rule, the commission shall provide a notice of
proposed rulemaking:
(1) On the website of the commission or other publicly
accessible platform;
(2) To persons who have requested notice of the
commission's notices of proposed rulemaking; and
(3) In such other way or ways as the commission may by
rule specify.
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rule specify.
(h) The notice of proposed rulemaking shall include all
of the following:
(1) The time, date, and location of the public hearing
at which the commission will hear public comments on the
proposed rule and, if different, the time, date, and location
of the meeting where the commission will consider and vote on
the proposed rule.
(2) If the hearing is held via telecommunication, video
conference, or other electronic means, the commission shall
include the mechanism for access to the hearing in the notice
of proposed rulemaking.
(3) The text of the proposed rule and the reason
therefore.
(4) A request for comments on the proposed rule from
any interested person.
(5) The manner in which interested persons may submit
written comments.
(i) All hearings will be recorded. A copy of the
recording and all written comments and documents received by
the commission in response to the proposed rule shall be
available to the public.
(j) Nothing in this section shall be construed as
requiring a separate hearing on each rule. Rules may be
grouped for the convenience of the commission at hearings
required by this section.
(k) The commission shall, by majority vote of all
commissioners, take final action on the proposed rule based on
the rulemaking record and the full text of the rule.
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the rulemaking record and the full text of the rule.
(1) The commission may adopt changes to the proposed
rule provided the changes are consistent with the original
purpose of the proposed rule.
(2) The commission shall provide an explanation of the
reasons for substantive changes made to the proposed rule as
well as reasons for substantive changes not made that were
recommended by commenters.
(3) The commission shall determine a reasonable
effective date for the rule. Except for an emergency as
provided in subsection (l), the effective date of the rule
shall be no sooner than 30 days after issuing the notice that
it adopted or amended the rule.
(l) Upon determination that an emergency exists, the
commission may consider and adopt an emergency rule with 24
hours' notice, and with opportunity to comment; provided, that
the usual rulemaking procedures provided in the compact and in
this section shall be retroactively applied to the rule as
soon as reasonably possible, in no event later than 90 days
after the effective date of the rule. For the purposes of this
provision, an emergency rule is one that must be adopted
immediately in order to:
(1) Meet an imminent threat to public health, safety,
or welfare;
(2) Prevent a loss of commission or member state funds;
(3) Meet a deadline for the adoption of a rule that is
established by federal law or rule; or
(4) Protect public health and safety.
(m) The commission or an authorized committee of the
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(m) The commission or an authorized committee of the
commission may direct revisions to a previously adopted rule
for purposes of correcting typographical errors, errors in
format, errors in consistency, or grammatical errors. Public
notice of any revisions shall be posted on the website of the
commission. The revision shall be subject to challenge by any
person for a period of 30 days after posting. The revision may
be challenged only on grounds that the revision results in a
material change to a rule. A challenge shall be made in
writing and delivered to the commission prior to the end of
the notice period. If no challenge is made, the revision will
take effect without further action. If the revision is
challenged, the revision may not take effect without the
approval of the commission.
(n)(1) No member state's rulemaking process or
procedural requirements shall apply to the commission.
(2) The commission shall have no authority over any
member state's rulemaking process or procedural requirements
that do not pertain to the compact.
(o) Nothing in this compact, nor any rule of the
commission, shall be construed to limit, restrict, or in any
way reduce the ability of a member state to enact and enforce
laws or other rules related to the practice of respiratory
therapy in that state, where those laws, regulations, or other
rules are not inconsistent with the provisions of this
compact.
§34-27B-59. Oversight, Dispute Resolution, and
Enforcement.
(a) Oversight.
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(a) Oversight.
(1) The executive and judicial branches of state
government in each member state shall enforce this compact and
take all actions necessary and appropriate to implement the
compact.
(2) Venue is proper and judicial proceedings by or
against the commission shall be brought solely and exclusively
in a court of competent jurisdiction, including, but not
limited to, where the principal office of the commission is
located. The commission may waive venue and jurisdictional
defenses to the extent it adopts or consents to participate in
alternative dispute resolution proceedings. Nothing herein
shall affect or limit the selection or propriety of venue in
any action against a licensee for professional malpractice,
misconduct, or any such similar matter.
(3) The commission shall be entitled to receive service
of process in any proceeding regarding the enforcement or
interpretation of the compact and shall have standing to
intervene in such a proceeding for all purposes. Failure to
provide the commission service of process shall render a
judgment or order void as to the commission, this compact, or
adopted rules.
(b) Default, technical assistance, and termination.
(1) If the commission determines that a member state
has defaulted in the performance of its obligations or
responsibilities under this compact or the adopted rules, the
commission shall provide written notice to the defaulting
state. The notice of default shall describe the default, the
proposed means of curing the default, and any other action
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proposed means of curing the default, and any other action
that the commission may take, and shall offer training and
specific technical assistance regarding the default.
(2) The commission shall provide a copy of the notice
of default to the other member states.
(c) If a state in default fails to cure the default,
the defaulting state may be terminated from the compact upon
an affirmative vote of a majority of the commissioners of the
member states, and all rights, privileges, and benefits
conferred on that state by this compact may be terminated on
the effective date of termination. A cure of the default does
not relieve the offending state of obligations or liabilities
incurred during the period of default.
(d) Termination of membership in the compact shall be
imposed only after all other means of securing compliance have
been exhausted. Notice of intent to suspend or terminate shall
be given by the commission to the governor, the majority and
minority leaders of the defaulting state's legislature, the
defaulting state's respiratory therapy licensing authority,
and each of the member states' respiratory therapy licensing
authorities.
(e) A state that has been terminated is responsible for
all assessments, obligations, and liabilities incurred through
the effective date of termination, including obligations that
extend beyond the effective date of termination, if necessary.
(f) Upon the termination of a state's membership from
this compact, that state shall immediately provide notice to
all licensees and compact privilege holders, of which the
commission has a record, within that state of such
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commission has a record, within that state of such
termination. The terminated state shall continue to recognize
all licenses granted pursuant to this compact for a minimum of
180 days after the date of the notice of termination.
(g) The commission shall not bear any costs related to
a state that is found to be in default or that has been
terminated from the compact, unless agreed upon in writing
between the commission and the defaulting state.
(h) The defaulting state may appeal the action of the
commission by petitioning the U.S. District Court for the
District of Columbia or the federal district where the
commission has its principal offices. The prevailing party
shall be awarded all costs of such litigation, including
reasonable attorney fees.
(i) Dispute resolution.
(1) Upon request by a member state, the commission
shall attempt to resolve disputes related to the compact that
arise among member states and between member and nonmember
states.
(2) The commission shall adopt a rule providing for
both mediation and binding dispute resolution for disputes, as
appropriate.
(j) Enforcement.
(1) By majority vote, as may be further provided by
rule, the commission may initiate legal action against a
member state in default in the United States District Court
for the District of Columbia or the federal district where the
commission has its principal offices to enforce compliance
with the provisions of the compact and its adopted rules. A
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with the provisions of the compact and its adopted rules. A
member state by enactment of this compact consents to venue
and jurisdiction in such court for the purposes set forth
herein. The relief sought may include both injunctive relief
and damages. In the event judicial enforcement is necessary,
the prevailing party shall be awarded all costs of such
litigation, including reasonable attorney fees. The remedies
herein shall not be the exclusive remedies of the commission.
The commission may pursue any other remedies available under
federal or the defaulting member state's law.
(2) A member state may initiate legal action against
the commission in the U.S. 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 adopted rules. The relief sought may
include both injunctive relief and damages. In the event
judicial enforcement is necessary, the prevailing party shall
be awarded all costs of such litigation, including reasonable
attorney fees.
(3) No person other than a member state shall enforce
this compact against the commission.
§34-27B-60. Effective Date, Withdrawal, and Amendment.
(a) The compact shall come into effect on the date on
which the compact statute is enacted into law in the seventh
member state.
(1) On or after the effective date of the compact, the
commission shall convene and review the enactment of each of
the first seven member states referred to as "charter member
states," to determine if the statute enacted by each charter
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states," to determine if the statute enacted by each charter
member state is materially different than the model compact.
a. A charter member state whose enactment is found to
be materially different from the model compact shall be
entitled to the default process set forth in Section
34-27B-59.
b. If any member state is later found to be in default,
or is terminated or withdraws from the compact, the commission
shall remain in existence and the compact shall remain in
effect even if the number of member states should be less than
seven.
(2) Member states enacting the compact subsequent to
the seven initial charter member states shall be subject to
the process set forth herein and commission rule to determine
if their enactments are materially different from the model
compact and whether they qualify for participation in the
compact.
(3) All actions taken for the benefit of the commission
or in furtherance of the purposes of the administration of the
compact prior to the effective date of the compact or the
commission coming into existence shall be considered to be
actions of the commission unless specifically repudiated by
the commission. The commission shall own and have all rights
to any intellectual property developed on behalf or in
furtherance of the commission by individuals or entities
involved in organizing or establishing the commission, as may
be further set forth in rules of the commission.
(4) Any state that joins the compact subsequent to the
commission's initial adoption of the rules and bylaws shall be
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commission's initial adoption of the rules and bylaws shall be
subject to the rules and bylaws as they exist on the date on
which the compact becomes law in that state. Any rule that has
been previously adopted by the commission shall have the full
force and effect of law on the date the compact becomes law in
that state.
(b) Any member state may withdraw from this compact by
enacting a statute repealing the same.
(1) A member state's withdrawal shall not take effect
until 180 days after enactment of the repealing statute.
(2) Withdrawal shall not affect the continuing
requirement of the withdrawing state's respiratory therapy
licensing authority to comply with the investigative and
adverse action reporting requirements of this compact prior to
the effective date of withdrawal.
(3) Upon the enactment of a statute withdrawing from
this compact, a state shall immediately provide notice of such
withdrawal to all licensees and compact privilege holders, of
which the commission has a record, within that state.
Notwithstanding any subsequent statutory enactment to the
contrary, such withdrawing state shall continue to recognize
all licenses granted pursuant to this compact for a minimum of
180 days after the date of such notice of withdrawal.
(c) Nothing contained in this compact shall be
construed to invalidate or prevent any licensure agreement or
other cooperative arrangement between a member state and a
nonmember state that does not conflict with the provisions of
this compact.
(d) This compact may be amended by the member states.
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(d) This compact may be amended by the member states.
No amendment to this compact shall become effective and
binding upon any member state until it is enacted into the
laws of all member states.
§34-27B-61. Construction and Severability.
(a) This compact and the commission's rulemaking
authority shall be liberally construed so as to effectuate the
purposes and the implementation and administration of the
compact. Provisions of the compact expressly authorizing or
requiring the adoption of rules shall not be construed to
limit the commission's rulemaking authority solely for those
purposes.
(b) The provisions of this compact shall be severable,
and if any phrase, clause, sentence, or provision of this
compact is held by a court of competent jurisdiction to be
contrary to the constitution of any member state, a state
seeking participation in the compact, or of the United States,
or the applicability thereof to any government, agency,
person, or circumstance is held to be unconstitutional by a
court of competent jurisdiction, the validity of the remainder
of this compact and the applicability thereof to any other
government, agency, person, or circumstance shall not be
affected thereby.
(c) Notwithstanding subsection (b), the commission may
deny a state's participation in the compact or, in accordance
with the requirements of Section 34-27B-59, terminate a member
state's participation in the compact, if it determines that a
constitutional requirement of a member state is a material
departure from the compact. Otherwise, if this compact shall
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departure from the compact. Otherwise, if this compact shall
be held to be contrary to the constitution of any member
state, the compact shall remain in full force and effect as to
the remaining member states and in full force and effect as to
the member state affected as to all severable matters.
§34-27B-62. Consistent Effect and Conflict With Other
State Laws.
(a) Nothing herein shall prevent or inhibit the
enforcement of any other law of a member state that is not
inconsistent with the compact.
(b) Any laws, statutes, rules, or other legal
requirements in a member state in conflict with the compact
are superseded to the extent of the conflict, including any
subsequently enacted state laws.
(c) All permissible agreements between the commission
and the member states are binding in accordance with their
terms.
(d) Other than as expressly set forth herein, nothing
in this compact will impact initial licensure.
(d) Nothing in this compact shall be interpreted to
modify, amend, repeal, or supersede any state criminal or
civil liability laws.
(e) In the event the commission adopts rules to
coordinate the implementation or administration of this
compact which conflict with Alabama law, Alabama law shall
supersede those rules, and Alabama state courts shall retain
sole jurisdiction to determine any conflicts.
(f) Alabama state courts shall retain sole jurisdiction
to determine whether provisions of this compact are in
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to determine whether provisions of this compact are in
conflict with state laws or the Constitution of Alabama of
2022.
(g) Except as to judicial proceedings for the
enforcement of this compact among member states, individuals
may pursue judicial proceedings related to this compact in any
Alabama state or federal court that would otherwise have
competent jurisdiction.
Section 3. This act shall become effective on October
1, 2025.
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1, 2025.
Senate
Read for the first time and referred
to the Senate committee on Veterans,
Military Affairs and Public Safety
................20-Feb-25
Read for the second time and placed
on the calendar:
1 amendment
................27-Feb-25
Read for the third time and passed
as amended
Yeas 28
Nays 0
Abstains 0
................06-Mar-25
Patrick Harris,
Secretary.
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