House Study Bill 120 - Introduced HOUSE FILE _____ BY (PROPOSED COMMITTEE ON STATE GOVERNMENT BILL BY CHAIRPERSON BLOOMINGDALE) A BILL FOR An Act enacting the respiratory care interstate compact. 1 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 2 TLSB 1867YC (2) 91 ss/ko
H.F. _____ Section 1. NEW SECTION . 147J.1 Respiratory care interstate 1 compact. 2 1. Title and purpose. 3 a. The purpose of this compact is to facilitate the 4 interstate practice of respiratory therapy with the goal of 5 improving public access to respiratory therapy services by 6 providing respiratory therapists licensed in a member state 7 the ability to practice in other member states. The compact 8 preserves the regulatory authority of states to protect 9 public health and safety through the current system of state 10 licensure. 11 b. This compact is designed to achieve the following 12 objectives: 13 (1) Increase public access to respiratory therapy services 14 by creating a responsible, streamlined pathway for licensees to 15 practice in member states with the goal of improving outcomes 16 for patients. 17 (2) Enhance states ability to protect the publics health 18 and safety. 19 (3) Promote the cooperation of member states in regulating 20 the practice of respiratory therapy within those member states. 21 (4) Ease administrative burdens on states by encouraging 22 the cooperation of member states in regulating multistate 23 respiratory therapy practice. 24 (5) Support relocating active military members and their 25 spouses. 26 (6) Promote mobility and address workforce shortages. 27 2. Definitions. As used in this compact, unless the context 28 otherwise requires, the following definitions shall apply: 29 a. Active military member means a person with a full-time 30 duty status in the armed forces of the United States, including 31 a member of the national guard and reserve. 32 b. Adverse action means an administrative, civil, 33 equitable, or criminal action permitted by a states laws which 34 is imposed by a state authority with regulatory authority 35 -1- LSB 1867YC (2) 91 ss/ko 1/ 30
H.F. _____ over respiratory therapists, such as license denial, censure, 1 revocation, suspension, probation, monitoring of a licensee, 2 or restriction on a licensees practice, not including 3 participation in an alternative program. 4 c. Alternative program means a nondisciplinary monitoring 5 or practice remediation process applicable to a respiratory 6 therapist approved by a state authority with regulatory 7 authority over respiratory therapists. This includes but is 8 not limited to programs to which licensees with substance abuse 9 or addiction issues are referred in lieu of adverse action. 10 d. Charter member states means those member states that 11 were the first seven states to enact the compact into the laws 12 of their state. 13 e. Commission or respiratory care interstate compact 14 commission means the government instrumentality and body 15 politic whose membership consists of all member states that 16 have enacted the compact. 17 f. Commissioner means the individual appointed by a member 18 state to serve as the member of the commission for that member 19 state. 20 g. Compact means the respiratory care interstate compact. 21 h. Compact privilege means the authorization granted by a 22 remote state to allow a licensee from another member state to 23 practice as a respiratory therapist in the remote state under 24 the remote states laws and rules. The practice of respiratory 25 therapy occurs in the member state where the patient is located 26 at the time of the patient encounter. 27 i. Criminal background check means the submission by 28 the member state of fingerprints or other biometric-based 29 information on license applicants at the time of initial 30 licensing for the purpose of obtaining that applicants 31 criminal history record information, as defined in 28 C.F.R. 32 20.3(d) or successor provision, from the federal bureau 33 of investigation and the states criminal history record 34 repository, as defined in 28 C.F.R. 20.3(f) or successor 35 -2- LSB 1867YC (2) 91 ss/ko 2/ 30
H.F. _____ provision. 1 j. Data system means the commissions repository of 2 information about licensees as further set forth in subsection 3 8. 4 k. Domicile means the jurisdiction which is the licensees 5 principal home for legal purposes. 6 l. Encumbered license means a license that a states 7 respiratory therapy licensing authority has limited in any way. 8 m. Executive committee means a group of directors elected 9 or appointed to act on behalf of, and within the powers granted 10 to the directors by, the commission. 11 n. Home state means the member that is the licensees 12 primary domicile, except as set forth in subsection 5. 13 o. Home state license means an active license to practice 14 respiratory therapy in a home state that is not an encumbered 15 license. 16 p. Jurisprudence requirement means an assessment of an 17 individuals knowledge of the state laws and regulations 18 governing the practice of respiratory therapy in such state. 19 q. Licensee means an individual who currently holds an 20 authorization from the state to practice as a respiratory 21 therapist. 22 r. Member state means a state that has enacted the compact 23 and been admitted to the commission in accordance with the 24 provisions of this compact and commission rules. 25 s. Model compact means the model for the respiratory 26 care interstate compact on file with the council of state 27 governments or other entity as designated by the commission. 28 t. Remote state means a member state where a licensee is 29 exercising or seeking to exercise the compact privilege. 30 u. Respiratory therapist or respiratory care practitioner 31 means an individual who holds a credential issued by the 32 national board for respiratory care or its successor and holds 33 a license in a state to practice respiratory therapy. For 34 purposes of this compact, any other title or status adopted 35 -3- LSB 1867YC (2) 91 ss/ko 3/ 30
H.F. _____ by a state to replace the term respiratory therapist or 1 respiratory care practitioner shall be deemed synonymous with 2 respiratory therapist and shall confer the same rights and 3 responsibilities to the licensee under the provisions of this 4 compact at the time of its enactment. 5 v. Respiratory therapy , respiratory therapy practice , 6 respiratory care , the practice of respiratory care , and the 7 practice of respiratory therapy mean the care and services 8 provided by or under the direction and supervision of a 9 respiratory therapist or respiratory care practitioner. 10 w. Respiratory therapy licensing authority means the 11 agency, board, or other body of a state that is responsible for 12 licensing and regulation of respiratory therapists. 13 x. Rule means a regulation promulgated by an entity that 14 has the force and effect of law. 15 y. Scope of practice means the procedures, actions, 16 and processes a respiratory therapist licensed in a state or 17 practicing under a compact privilege in a state is permitted 18 to undertake in that state and the circumstances under which 19 the respiratory therapist is permitted to undertake those 20 procedures, actions, and processes. Such procedures, actions, 21 and processes, and the circumstances under which they may be 22 undertaken, may be established through means including but not 23 limited to statute, regulations, case law, and other processes 24 available to the state respiratory therapy licensing authority 25 or other government agency. 26 z. Significant investigative information means information, 27 records, and documents received or generated by a state 28 respiratory licensing authority pursuant to an investigation 29 for which a determination has been made that there is probable 30 cause to believe that the licensee has violated a statute or 31 regulation that is considered more than a minor infraction for 32 which the state respiratory therapy licensing authority could 33 pursue adverse action against the licensee. 34 aa. State means a state, commonwealth, district, or 35 -4- LSB 1867YC (2) 91 ss/ko 4/ 30
H.F. _____ territory of the United States. 1 3. State participation in this compact. 2 a. In order to participate in this compact and thereafter 3 continue as a member state, a member state shall do all of the 4 following: 5 (1) Enact a compact that is not materially different from 6 the model compact. 7 (2) License respiratory therapists. 8 (3) Participate in the commissions data system. 9 (4) Have a mechanism in place for receiving and 10 investigating complaints against licensees and compact 11 privilege holders. 12 (5) Notify the commission, in compliance with the terms 13 of this compact and commission rules, of any adverse action 14 against a licensee, a compact privilege holder, or a license 15 applicant. 16 (6) Notify the commission, in compliance with the terms 17 of this compact and commission rules, of the existence of 18 significant investigative information. 19 (7) Comply with the rules of the commission. 20 (8) Grant the compact privilege to a holder of an 21 active home state license and otherwise meet the applicable 22 requirements of subsection 4 in a member state. 23 (9) Complete a criminal background check for each new 24 licensee at the time of initial licensure. Where expressly 25 authorized or permitted by federal law, whether such federal 26 law is in effect prior to, at, or after the time of a member 27 states enactment of this compact, a member states enactment 28 of this compact shall hereby authorize the member states 29 respiratory therapy licensing authority to perform criminal 30 background checks as defined in this compact. The absence of 31 such a federal law as described in this subsection shall not 32 prevent or preclude such authorization where it may be derived 33 or granted through means other than the enactment of this 34 compact. 35 -5- LSB 1867YC (2) 91 ss/ko 5/ 30
H.F. _____ b. Nothing in this compact prohibits a member state from 1 charging a fee for granting and renewing the compact privilege. 2 4. Compact privilege. 3 a. To exercise the compact privilege under the terms and 4 provisions of the compact, the licensee shall meet all of the 5 following requirements: 6 (1) Hold and maintain an active home state license as a 7 respiratory therapist. 8 (2) Hold and maintain an active credential from the national 9 board for respiratory care or its successor that would qualify 10 the licensee for licensure in the remote state in which the 11 licensee is seeking the privilege. 12 (3) Have not had any adverse action against a license within 13 the previous two years. 14 (4) Notify the commission that the licensee is seeking the 15 compact privilege within a remote state. 16 (5) Pay any applicable fee, including any state and 17 commission fees and renewal fees, for the compact privilege. 18 (6) Meet any jurisprudence requirement established by 19 the remote state in which the licensee is seeking a compact 20 privilege. 21 (7) Report to the commission adverse action taken by a 22 nonmember state within thirty days from the date that adverse 23 action is taken. 24 (8) Report to the commission, when applying for a compact 25 privilege, the address of the licensees domicile and 26 thereafter promptly report to the commission any change in the 27 address of the licensees domicile within thirty days of the 28 effective date of the change in address. 29 (9) Consent to accept service of process by mail at the 30 licensees domicile on record with the commission with respect 31 to any action brought against the licensee by the commission or 32 a member state, and consent to accept service of a subpoena by 33 mail at the licensees domicile on record with the commission 34 with respect to any action brought or investigation conducted 35 -6- LSB 1867YC (2) 91 ss/ko 6/ 30
H.F. _____ by the commission or a member state. 1 b. The compact privilege is valid until the expiration 2 date or revocation of the home state license unless terminated 3 pursuant to adverse action. The licensee must comply with 4 all the requirements of paragraph a to maintain the compact 5 privilege in a remote state. If those requirements are met, 6 no adverse actions are taken, and the licensee has paid any 7 applicable compact privilege renewal fees, then the licensee 8 will maintain the licensees compact privilege. 9 c. A licensee providing respiratory therapy in a remote 10 state under the compact privilege shall function within the 11 scope of practice authorized by the remote state for the type 12 of respiratory therapist license the licensee holds. Such 13 procedures, actions, processes, and the circumstances under 14 which they may be undertaken, may be established through means 15 including but not limited to statute, regulations, case law, 16 and other processes available to the state respiratory therapy 17 licensing authority or other government agency. 18 d. If a licensees compact privilege in a remote state is 19 removed by the remote state, the individual shall lose or be 20 ineligible for the compact privilege in that remote state until 21 the compact privilege is no longer limited or restricted by 22 that state. 23 e. If a home state license is encumbered, the licensee shall 24 lose the compact privilege in all remote states until all of 25 the following occur: 26 (1) The home state license is no longer encumbered. 27 (2) Two years have elapsed from the date on which the 28 license is no longer encumbered due to the adverse action. 29 f. Once a licensee with a restricted or limited license 30 meets the requirements of paragraph e , the licensee must also 31 meet the requirements of paragraph a to obtain a compact 32 privilege in a remote state. 33 5. Active military members and spouses. 34 a. An active military member or a spouse of an active 35 -7- LSB 1867YC (2) 91 ss/ko 7/ 30
H.F. _____ military member shall designate a home state where the 1 individual has a current license in good standing. The 2 individual may retain the home state designation during the 3 period the service member is on active duty. 4 b. An active military member or a spouse of an active 5 military member shall not be required to pay to the commission 6 for a compact privilege any fee that may otherwise be charged 7 by the commission. If a remote state chooses to charge a fee 8 for a compact privilege, it may choose to charge a reduced fee 9 or no fee to an active military member or a spouse of an active 10 military member for a compact privilege. 11 6. Adverse actions. 12 a. A member state in which a licensee is licensed shall have 13 authority to impose adverse action against the license issued 14 by that member state. 15 b. A member state may take adverse action based on 16 significant investigative information of a remote state or 17 the home state, so long as the member state follows its own 18 procedures for imposing adverse action. 19 c. Nothing in this compact shall override a member states 20 decision that participation in an alternative program may be 21 used in lieu of adverse action and that such participation 22 shall remain nonpublic if required by the member states laws. 23 d. A remote state shall have the authority to do all of the 24 following: 25 (1) Take adverse actions as set forth in this compact 26 against a licensees compact privilege in that state. 27 (2) Issue subpoenas for both hearings and investigations 28 that require the attendance and testimony of witnesses and the 29 production of evidence. 30 (a) Subpoenas may be issued by a respiratory therapy 31 licensing authority in a member state for the attendance and 32 testimony of witnesses and the production of evidence. 33 (b) Subpoenas issued by a respiratory therapy licensing 34 authority in a member state for the attendance and testimony of 35 -8- LSB 1867YC (2) 91 ss/ko 8/ 30
H.F. _____ witnesses shall be enforced in the latter state by any court of 1 competent jurisdiction in the latter state, according to the 2 practice and procedure of that court applicable to subpoenas 3 issued by the proceedings pending before it. 4 (c) Subpoenas issued by a respiratory therapy licensing 5 authority in a member state for production of evidence 6 from another member state shall be enforced in the latter 7 state, according to the practice and procedure of that court 8 applicable to subpoenas issued in the proceedings pending 9 before it. 10 (d) The issuing authority shall pay witness fees, travel 11 expenses, mileage, and other fees required by the service 12 statutes of the state where the witness or evidence is located. 13 (3) Unless otherwise prohibited by state law, recover from 14 the licensee the costs of investigations and disposition of 15 cases resulting from any adverse action taken against that 16 licensee. 17 (4) Notwithstanding paragraph d , subparagraph (2), a 18 member state shall not issue a subpoena to gather evidence of 19 conduct in another member state that is lawful in such other 20 member state for the purpose of taking adverse action against 21 a licensees compact privilege or application for a compact 22 privilege in that member state. 23 (5) Nothing in this compact authorizes a member state to 24 impose discipline against a respiratory therapists compact 25 privilege in that member state for the individuals otherwise 26 lawful practice in another state. 27 e. Joint investigations. 28 (1) In addition to the authority granted to a member state 29 by its respective respiratory therapy practice act or other 30 applicable state law, a member state may participate with other 31 member states in joint investigations of licensees, provided, 32 however, that a member state receiving such a request has no 33 obligation to respond to any subpoena issued regarding an 34 investigation of conduct or practice that was lawful in a 35 -9- LSB 1867YC (2) 91 ss/ko 9/ 30
H.F. _____ member state at the time it was undertaken. 1 (2) Member states shall share any significant investigative 2 information, litigation, or compliance materials in furtherance 3 of any joint or individual investigation initiated under the 4 compact. In sharing such information between member state 5 respiratory therapy licensing authorities, all information 6 obtained shall be kept confidential, except as otherwise 7 mutually agreed upon by the sharing and receiving member 8 states. 9 f. Nothing in this compact permits a member state to take 10 any adverse action against a licensee or holder of a compact 11 privilege for conduct or a practice that was legal in the 12 member state at the time it was undertaken. 13 g. Nothing in this compact permits a member state to take 14 disciplinary action against a licensee or holder of a compact 15 privilege for conduct or a practice that was legal in the 16 member state at the time it was undertaken. 17 7. Establishment of the respiratory care interstate compact 18 commission. 19 a. The compact member states hereby create and establish a 20 joint government agency whose membership consists of all member 21 states that have enacted the compact, known as the respiratory 22 care interstate compact commission. The commission is an 23 instrumentality of the compact member states acting jointly 24 and not an instrumentality of any one state. The commission 25 shall come into existence on or after the effective date of the 26 compact as set forth in subsection 11. 27 b. Membership, voting, and meetings. 28 (1) Each member state shall have and be limited to one 29 commissioner, selected by that member states respiratory 30 therapy licensing authority. 31 (2) The commissioner shall be an administrator of the member 32 states respiratory therapy licensing authority or a staff 33 member designated by the administrator. 34 (3) The commission shall by rule or bylaw establish a term 35 -10- LSB 1867YC (2) 91 ss/ko 10/ 30
H.F. _____ of office for commissioners and may by rule or bylaw establish 1 term limits. 2 (4) The commission may recommend to a member state the 3 removal or suspension of a commissioner from office. 4 (5) A member states respiratory therapy licensing 5 authority shall fill any vacancy of its commissioner occurring 6 on the commission within sixty days of the vacancy. 7 (6) Each commissioner shall be entitled to one vote 8 on all matters before the commission requiring a vote by 9 commissioners. 10 (7) A commissioner shall vote in person or by such other 11 means as provided in the bylaws. The bylaws may provide for 12 commissioners to meet by telecommunication, videoconference, or 13 other means of communication. 14 (8) The commission shall meet at least once during each 15 calendar year. Additional meetings may be held as set forth 16 in the bylaws. 17 c. The commission shall have all of the following powers: 18 (1) Establish and amend the fiscal year of the commission. 19 (2) Establish and amend bylaws and policies, including but 20 not limited to a code of conduct and conflict of interest. 21 (3) Establish and amend rules, which shall be binding in all 22 member states. 23 (4) Maintain its financial records in accordance with the 24 bylaws. 25 (5) Meet and take such actions as are consistent with the 26 provisions of this compact, the commissions rules, and the 27 bylaws. 28 (6) Initiate and conduct legal proceedings or actions in 29 the name of the commission, provided that the standing of any 30 respiratory therapy licensing authority to sue or be sued under 31 applicable law shall not be affected. 32 (7) Maintain and certify records and information provided 33 to a member state as the authenticated business records of the 34 commission, and designate an agent to do so on the commissions 35 -11- LSB 1867YC (2) 91 ss/ko 11/ 30
H.F. _____ behalf. 1 (8) Purchase and maintain insurance and bonds. 2 (9) Accept or contract for services of personnel, including 3 but not limited to employees of a member state. 4 (10) Conduct an annual financial review. 5 (11) Hire employees, elect or appoint officers, fix 6 compensation, define duties, grant such individuals appropriate 7 authority to carry out the purposes of the compact, and 8 establish the commissions personnel policies and programs 9 relating to conflicts of interest, qualifications of personnel, 10 and other related personnel matters. 11 (12) Assess and collect fees. 12 (13) Accept any and all appropriate gifts, donations, 13 grants of money, other sources of revenue, equipment, supplies, 14 materials, and services, and receive, utilize, and dispose of 15 the same, provided that at all times the commission does all 16 of the following: 17 (a) Avoid any appearance of impropriety. 18 (b) Avoid any appearance of conflict of interest. 19 (14) Lease, purchase, retain, own, hold, improve, or use any 20 property, real, personal, or mixed, or any undivided interest 21 therein. 22 (15) Sell, convey, mortgage, pledge, lease, exchange, 23 abandon, or otherwise dispose of any property, real, personal, 24 or mixed. 25 (16) Establish a budget and make expenditures. 26 (17) Borrow money in a fiscally responsible manner. 27 (18) Appoint committees, including standing committees, 28 composed of commissioners, state regulators, state legislators 29 or their representatives, and consumer representatives, and 30 such other interested persons as may be designated in this 31 compact and the bylaws. 32 (19) Provide and receive information from, and cooperate 33 with, law enforcement agencies. 34 (20) Establish and elect an executive committee, including 35 -12- LSB 1867YC (2) 91 ss/ko 12/ 30
H.F. _____ a chair, vice chair, secretary, treasurer, and such other 1 offices as the commission shall establish by rule or bylaw. 2 (21) Enter into contracts or arrangements for the 3 management of the affairs of the commission. 4 (22) Determine whether a states adopted language is 5 materially different from the model compact language such that 6 the state would not qualify for participation in the compact. 7 (23) Perform such other functions as may be necessary or 8 appropriate to achieve the purposes of this compact. 9 d. The executive committee. 10 (1) The executive committee shall have the power to act 11 on behalf of the commission according to the terms of this 12 compact. The powers, duties, and responsibilities of the 13 executive committee shall include all of the following: 14 (a) Overseeing the day-to-day activities of the 15 administration of the compact, including enforcement and 16 compliance with the provisions of the compact, its rules and 17 bylaws, and other such duties as deemed necessary. 18 (b) Recommending to the commission changes to the rules or 19 bylaws, changes to this compact legislation, fees charged to 20 compact member states, fees charged to licensees, and other 21 fees. 22 (c) Ensuring compact administration services are 23 appropriately provided, including by contract. 24 (d) Preparing and recommending the budget. 25 (e) Maintaining financial records on behalf of the 26 commission. 27 (f) Monitoring compact compliance of member states and 28 providing compliance reports to the commission. 29 (g) Establishing additional committees as necessary. 30 (h) Exercising the powers and duties of the commission 31 during the interim between commission meetings, except for 32 adopting or amending rules, adopting or amending bylaws, and 33 exercising any other powers and duties expressly reserved to 34 the commission by rule or bylaw. 35 -13- LSB 1867YC (2) 91 ss/ko 13/ 30
H.F. _____ (i) Performing other duties as provided in the rules or 1 bylaws of the commission. 2 (2) The executive committee shall be composed of up to nine 3 of the following members, as further set forth in the bylaws 4 of the commission: 5 (a) Seven voting members who are elected by the commission 6 from the current membership of the commission. 7 (b) Two ex officio, nonvoting members. 8 (3) The commission may remove any member of the executive 9 committee as provided in the commissions bylaws. 10 (4) The executive committee shall meet at least annually. 11 (a) Executive committee meetings shall be open to the 12 public, except that the executive committee may meet in 13 a closed, nonpublic meeting as provided in paragraph f , 14 subparagraph (4). 15 (b) The executive committee shall give advance notice of 16 its meetings, posted on its internet site and as determined to 17 provide notice to persons with an interest in the business of 18 the commission. 19 (c) The executive committee may hold a special meeting in 20 accordance with paragraph f , subparagraph (2). 21 e. The commission shall adopt and provide to the member 22 states an annual report. 23 f. Meetings of the commission. 24 (1) All meetings of the commission that are not closed 25 pursuant to subparagraph (4) shall be open to the public. 26 Notice of public meetings shall be posted on the commissions 27 internet site at least thirty days prior to the public meeting. 28 (2) Notwithstanding subparagraph (1), the commission may 29 convene an emergency public meeting by providing at least 30 twenty-four hours prior notice on the commissions internet 31 site, and any other means as provided in the commissions 32 rules, for any of the reasons it may dispense with notice 33 of proposed rulemaking under subsection 9, paragraph g . 34 The commissions legal counsel shall certify that one of the 35 -14- LSB 1867YC (2) 91 ss/ko 14/ 30
H.F. _____ reasons justifying an emergency public meeting has been met. 1 (3) Notice of all commission meetings shall provide 2 the time, date, and location of the meeting, and if the 3 meeting is to be held or accessible via telecommunication, 4 videoconference, or other electronic means, the notice shall 5 include the mechanism for access to the meeting. 6 (4) The commission or the executive committee may convene 7 in a closed, nonpublic meeting for the commission or executive 8 committee to receive or solicit legal advice or to discuss any 9 of the following: 10 (a) Noncompliance of a member state with its obligations 11 under the compact. 12 (b) The employment, compensation, discipline, or other 13 matters, practices, or procedures related to specific 14 employees. 15 (c) Current or threatened discipline of a licensee or 16 compact privilege holder by the commission or by a member 17 states respiratory therapy licensing authority. 18 (d) Current, threatened, or reasonably anticipated 19 litigation. 20 (e) Negotiation of contracts for the purchase, lease, or 21 sale of goods, services, or real estate. 22 (f) Accusing any person of a crime or formally censuring any 23 person. 24 (g) Trade secrets or commercial or financial information 25 that is privileged or confidential. 26 (h) Information of a personal nature where disclosure would 27 constitute a clearly unwarranted invasion of personal privacy. 28 (i) Investigative records compiled for law enforcement 29 purposes. 30 (j) Information related to any investigative reports 31 prepared by or on behalf of or for use of the commission or 32 other committee charged with responsibility of investigation or 33 determination of compliance issues pursuant to this compact. 34 (k) Legal advice. 35 -15- LSB 1867YC (2) 91 ss/ko 15/ 30
H.F. _____ (l) Matters specifically exempted from disclosure by 1 federal or member state law. 2 (m) Other matters as promulgated by the commission by rule. 3 (5) If a meeting or portion of a meeting is closed, the 4 presiding officer shall state that the meeting will be closed 5 and reference each relevant exempting provision, and such 6 reference shall be recorded in the minutes. 7 (6) The commission shall keep minutes in accordance with 8 commission rules and bylaws. All documents considered in 9 connection with an action shall be identified in such minutes. 10 All minutes and documents of a closed meeting shall remain 11 under seal, subject to release only by a majority vote of the 12 commission or order of a court of competent jurisdiction. 13 g. Financing the commission. 14 (1) The commission shall pay, or provide for the payment of, 15 the reasonable expenses of its establishment, organization, and 16 ongoing activities. 17 (2) The commission may accept any and all appropriate 18 revenue sources as provided in this compact. 19 (3) The commission may levy on and collect an annual 20 assessment from each member state and impose fees on licensees 21 of member states to whom it grants a compact privilege to cover 22 the cost of the operations and activities of the commission and 23 its staff. The aggregate annual assessment amount for member 24 states, if any, shall be allocated based upon a formula that 25 the commission shall promulgate by rule. 26 (4) The commission shall not incur obligations of any kind 27 prior to securing the funds or a loan adequate to meet the 28 same; nor shall the commission pledge the credit of any of the 29 member states, except by and with the authority of the member 30 state. 31 (5) The commission shall keep accurate accounts of all 32 receipts and disbursements. The receipts and disbursements 33 of the commission shall be subject to the financial review 34 and accounting procedures established under its bylaws. 35 -16- LSB 1867YC (2) 91 ss/ko 16/ 30
H.F. _____ However, all receipts and disbursements of funds handled by the 1 commission shall be subject to an annual financial review by a 2 certified or licensed public accountant, and the report of the 3 financial review shall be included in and become part of the 4 annual report of the commission. 5 h. Qualified immunity, defense, and indemnification. 6 (1) Nothing in this paragraph shall be construed as a 7 limitation on the liability of any licensee for professional 8 malpractice or misconduct, which shall be governed solely by 9 any other applicable state laws. 10 (2) The member states, commissioners, officers, executive 11 directors, employees, and agents of the commission shall be 12 immune from suit and liability, both personally and in their 13 official capacity, for any claim for damage to or loss of 14 property or personal injury or other civil liability caused by 15 or arising out of any actual or alleged act, error, or omission 16 that occurred, or that the person against whom the claim is 17 made had a reasonable basis for believing occurred within the 18 scope of commission employment, duties, or responsibilities, 19 provided that nothing in this subparagraph shall be construed 20 to protect any such person from suit or liability for any 21 damage, loss, injury, or liability caused by the intentional or 22 willful or wanton misconduct of that person. The procurement 23 of insurance of any type by the commission shall not in any way 24 compromise or limit the immunity granted in this subparagraph. 25 (3) The commission shall defend any commissioner, officer, 26 executive director, employee, or agent of the commission 27 in any civil action seeking to impose liability arising 28 out of any actual or alleged act, error, or omission that 29 occurred within the scope of commission employment, duties, 30 or responsibilities, or as determined by the commission that 31 the person against whom the claim is made had a reasonable 32 basis for believing occurred within the scope of commission 33 employment, duties, or responsibilities, provided that nothing 34 in this subparagraph shall be construed to prohibit that 35 -17- LSB 1867YC (2) 91 ss/ko 17/ 30
H.F. _____ person from retaining counsel at that persons own expense, 1 and provided further that the actual or alleged act, error, 2 or omission did not result from that persons intentional or 3 willful or wanton misconduct. 4 (4) The commission shall indemnify and hold harmless any 5 commissioner, member, officer, executive director, employee, 6 and agent of the commission for the amount of any settlement or 7 judgment obtained against that person arising out of any actual 8 or alleged act, error, or omission that occurred within the 9 scope of commission employment, duties, or responsibilities, 10 or that such person had a reasonable basis for believing 11 occurred within the scope of commission employment, duties, 12 or responsibilities, provided that the actual or alleged act, 13 error, or omission did not result from the intentional or 14 willful or wanton misconduct of that person. 15 (5) Nothing in this compact shall be interpreted to waive 16 or otherwise abrogate a member states state action immunity 17 or state action affirmative defense with respect to antitrust 18 claims under the Sherman Act, Clayton Act, or any other state 19 or federal antitrust or anticompetitive law or regulation. 20 (6) Nothing in this compact shall be construed to be a 21 waiver of sovereign immunity by the member states or by the 22 commission. 23 8. Data system. 24 a. The commission shall provide for the development, 25 maintenance, operation, and utilization of a coordinated 26 database and reporting system containing licensure, adverse 27 action, and the presence of significant investigative 28 information. 29 b. Notwithstanding any other provision of state law to the 30 contrary, a member state shall submit a uniform data set to 31 the data system as required by the rules of the commission, 32 including but not limited to all of the following: 33 (1) Identifying information. 34 (2) Licensure data. 35 -18- LSB 1867YC (2) 91 ss/ko 18/ 30
H.F. _____ (3) Adverse actions against a licensee, license applicant, 1 or compact privilege holder and information related thereto. 2 (4) Nonconfidential information related to alternative 3 program participation, the beginning and ending dates of 4 such participation, and other information related to such 5 participation not made confidential under member state law. 6 (5) Any denial of application for licensure, and the reason 7 for such denial. 8 (6) The presence of current significant investigative 9 information. 10 (7) Other information that may facilitate the 11 administration of this compact or the protection of the public, 12 as determined by the rules of the commission. 13 c. No member state shall submit any information which 14 constitutes criminal history record information, as defined by 15 applicable federal law, to the data system established in this 16 subsection. 17 d. The records and information provided to a member 18 state pursuant to this compact or through the data system, 19 when certified by the commission or an agent thereof, 20 shall constitute the authenticated business records of the 21 commission, and shall be entitled to any associated hearsay 22 exception in any relevant judicial, quasi-judicial, or 23 administrative proceedings in a member state. 24 e. Significant investigative information pertaining to a 25 licensee in any member state will only be available to other 26 member states. 27 f. It is the responsibility of the member states to report 28 any adverse action against a licensee and to monitor the 29 database to determine whether adverse action has been taken 30 against a licensee. Adverse action information pertaining to 31 a licensee in any member state will be available to any other 32 member state. 33 g. Member states contributing information to the data 34 system may designate information that may not be shared with 35 -19- LSB 1867YC (2) 91 ss/ko 19/ 30
H.F. _____ the public without the express permission of the contributing 1 state. 2 h. Any information submitted to the data system that is 3 subsequently expunged pursuant to federal law or the laws of 4 the member state contributing the information shall be removed 5 from the data system. 6 9. Rulemaking. 7 a. The commission shall promulgate reasonable rules in 8 order to effectively and efficiently implement and administer 9 the purposes and provisions of the compact. A rule shall 10 be invalid and have no force and effect only if a court of 11 competent jurisdiction holds that the rule is invalid because 12 the commission exercised its rulemaking authority in a manner 13 that is beyond the scope and purposes of the compact, or the 14 powers granted under this subsection, or based upon another 15 applicable standard of review. 16 b. For purposes of the compact, the rules of the commission 17 shall have the force of law in each member state. 18 c. The commission shall exercise its rulemaking powers 19 pursuant to the criteria set forth in this subsection and the 20 rules adopted pursuant to this subsection. Rules shall become 21 binding as of the date specified in each rule. 22 d. If a majority of the legislatures of the member states 23 rejects a rule or portion of a rule, by enactment of a statute 24 or resolution in the same manner used to adopt the compact, 25 within four years of the date of application of the rule, then 26 such rule shall have no further force and effect in any member 27 state. 28 e. Rules shall be adopted at a regular or special meeting 29 of the commission. 30 f. Prior to adoption of a proposed rule, the commission 31 shall hold a public hearing and allow persons to provide oral 32 and written comments, data, facts, opinions, and arguments. 33 g. Prior to adoption of a proposed rule by the commission, 34 and at least thirty days in advance of the meeting at which the 35 -20- LSB 1867YC (2) 91 ss/ko 20/ 30
H.F. _____ commission will hold a public hearing on the proposed rule, the 1 commission shall provide a notice of proposed rulemaking by all 2 of the following methods: 3 (1) On the internet site of the commission or other publicly 4 accessible platform. 5 (2) To persons who have requested notice of the commissions 6 notices of proposed rulemaking. 7 (3) In such other way as the commission may by rule specify. 8 h. The notice of proposed rulemaking shall include all of 9 the following: 10 (1) The time, date, and location of the public hearing at 11 which the commission will hear public comments on the proposed 12 rule and, if different, the time, date, and location of the 13 meeting where the commission will consider and vote on the 14 proposed rule. 15 (2) If the hearing is held via telecommunication, 16 videoconference, or other electronic means, the commission 17 shall include the mechanism for access to the hearing in the 18 notice of proposed rulemaking. 19 (3) The text of the proposed rule and the reason therefor. 20 (4) A request for comments on the proposed rule from any 21 interested person. 22 (5) The manner in which interested persons may submit 23 written comments. 24 i. All hearings shall be recorded. A copy of the recording 25 and all written comments and documents received by the 26 commission in response to the proposed rule shall be available 27 to the public. 28 j. Nothing in this subsection shall be construed as 29 requiring a separate hearing on each rule. Rules may be 30 grouped for the convenience of the commission at hearings 31 required by this subsection. 32 k. The commission shall, by majority vote of all 33 commissioners, take final action on the proposed rule based on 34 the rulemaking record and the full text of the rule. 35 -21- LSB 1867YC (2) 91 ss/ko 21/ 30
H.F. _____ (1) The commission may adopt changes to the proposed rule, 1 provided that the changes are consistent with the original 2 purpose of the proposed rule. 3 (2) The commission shall provide an explanation of the 4 reasons for substantive changes made to the proposed rule as 5 well as reasons for substantive changes not made that were 6 recommended by commenters. 7 (3) The commission shall determine a reasonable effective 8 date for the rule. Except for an emergency as provided in 9 paragraph l , the effective date of the rule shall be no sooner 10 than thirty days after issuing the notice that it adopted or 11 amended the rule. 12 l. Upon determination that an emergency exists, the 13 commission may consider and adopt an emergency rule with 14 twenty-four hours notice, and with opportunity to comment, 15 provided that the usual rulemaking procedures provided in the 16 compact and in this subsection shall be retroactively applied 17 to the rule as soon as reasonably possible, in no event later 18 than ninety days after the effective date of the rule. For the 19 purposes of this provision, an emergency rule is one that must 20 be adopted immediately in order to do one of the following: 21 (1) Meet an imminent threat to public health, safety, or 22 welfare. 23 (2) Prevent a loss of commission or member state funds. 24 (3) Meet a deadline for the promulgation of a rule that is 25 established by federal law or rule. 26 (4) Protect public health and safety. 27 m. The commission or an authorized committee of the 28 commission may direct revisions to a previously adopted rule 29 for purposes of correcting typographical errors, errors in 30 format, errors in consistency, or grammatical errors. Public 31 notice of any revisions shall be posted on the internet site 32 of the commission. The revision shall be subject to challenge 33 by any person for a period of thirty days after posting. The 34 revision may be challenged only on grounds that the revision 35 -22- LSB 1867YC (2) 91 ss/ko 22/ 30
H.F. _____ results in a material change to a rule. A challenge shall 1 be made in writing and delivered to the commission prior to 2 the end of the notice period. If no challenge is made, the 3 revision will take effect without further action. If the 4 revision is challenged, the revision may not take effect 5 without the approval of the commission. 6 n. No member states rulemaking process or procedural 7 requirements shall apply to the commission. The commission 8 shall have no authority over any member states rulemaking 9 process or procedural requirements that do not pertain to the 10 compact. 11 o. Nothing in this compact, nor any rule or regulation 12 of the commission, shall be construed to limit, restrict, 13 or in any way reduce the ability of a member state to enact 14 and enforce laws, regulations, or other rules related to the 15 practice of respiratory therapy in that state where those laws, 16 regulations, or other rules are not inconsistent with the 17 provisions of this compact. 18 10. Oversight, dispute resolution, and enforcement. 19 a. Oversight. 20 (1) The executive and judicial branches of state government 21 in each member state shall enforce this compact and take all 22 actions necessary and appropriate to implement the compact. 23 (2) Venue is proper and judicial proceedings by or against 24 the commission shall be brought solely and exclusively in a 25 court of competent jurisdiction where the principal office 26 of the commission is located. The commission may waive 27 venue and jurisdictional defenses to the extent it adopts or 28 consents to participate in alternative dispute resolution 29 proceedings. Nothing in this subparagraph shall affect or 30 limit the selection or propriety of venue in any action against 31 a licensee for professional malpractice, misconduct, or any 32 such similar matter. 33 (3) The commission shall be entitled to receive service 34 of process in any proceeding regarding the enforcement or 35 -23- LSB 1867YC (2) 91 ss/ko 23/ 30
H.F. _____ interpretation of the compact and shall have standing to 1 intervene in such a proceeding for all purposes. Failure 2 to provide the commission service of process shall render a 3 judgment or order void as to the commission, this compact, or 4 promulgated rules. 5 b. Default, technical assistance, and termination. 6 (1) If the commission determines that a member state 7 has defaulted in the performance of its obligations or 8 responsibilities under this compact or the promulgated rules, 9 the commission shall provide written notice to the defaulting 10 state. The notice of default shall describe the default, the 11 proposed means of curing the default, and any other action that 12 the commission may take, and shall offer training and specific 13 technical assistance regarding the default. 14 (2) The commission shall provide a copy of the notice of 15 default to the other member states. 16 c. If a state in default fails to cure the default, the 17 defaulting state may be terminated from the compact upon 18 an affirmative vote of a majority of the commissioners of 19 the member states, and all rights, privileges, and benefits 20 conferred on that state by this compact may be terminated on 21 the effective date of termination. A cure of the default does 22 not relieve the offending state of obligations or liabilities 23 incurred during the period of default. 24 d. Termination of membership in the compact shall be imposed 25 only after all other means of securing compliance have been 26 exhausted. Notice of intent to suspend or terminate shall 27 be given by the commission to the governor, the majority and 28 minority leaders of the defaulting states legislature, the 29 defaulting states respiratory therapy licensing authority, 30 and each of the member states respiratory therapy licensing 31 authorities. 32 e. A state that has been terminated is responsible for all 33 assessments, obligations, and liabilities incurred through 34 the effective date of termination, including obligations that 35 -24- LSB 1867YC (2) 91 ss/ko 24/ 30
H.F. _____ extend beyond the effective date of termination, if necessary. 1 f. Upon termination of a states membership from this 2 compact, that state shall immediately provide notice to all 3 licensees and compact privilege holders of which the commission 4 has a record within that state of such termination. The 5 terminated state shall continue to recognize all licenses 6 granted pursuant to this compact for a minimum of one hundred 7 eighty days after the date of said notice of termination. 8 g. The commission shall not bear any costs related to 9 a state that is found to be in default or that has been 10 terminated from the compact, unless agreed upon in writing 11 between the commission and the defaulting state. 12 h. The defaulting state may appeal the action of the 13 commission by petitioning the United States district court 14 for the District of Columbia or the federal district where 15 the commission has its principal offices. The prevailing 16 party shall be awarded all costs of such litigation, including 17 reasonable attorney fees. 18 i. Dispute resolution. 19 (1) Upon request by a member state, the commission shall 20 attempt to resolve disputes related to the compact that arise 21 among member states and between member and nonmember states. 22 (2) The commission shall promulgate a rule providing for 23 both mediation and binding dispute resolution for disputes, as 24 appropriate. 25 j. Enforcement. 26 (1) By majority vote, as may be further provided by rule, 27 the commission may initiate legal action against a member state 28 in default in the United States district court for the District 29 of Columbia or the federal district where the commission has 30 its principal offices to enforce compliance with the provisions 31 of the compact and its promulgated rules. A member state by 32 enactment of this compact consents to venue and jurisdiction 33 in such court for the purposes set forth in this subparagraph. 34 The relief sought may include both injunctive relief and 35 -25- LSB 1867YC (2) 91 ss/ko 25/ 30
H.F. _____ damages. In the event judicial enforcement is necessary, 1 the prevailing party shall be awarded all costs of such 2 litigation, including reasonable attorney fees. The remedies 3 in this subparagraph shall not be the exclusive remedies of the 4 commission. The commission may pursue other remedies available 5 under federal or the defaulting member states law. 6 (2) A member state may initiate legal action against the 7 commission in the United States district court for the District 8 of Columbia or the federal district where the commission has 9 its principal offices to enforce compliance with the provisions 10 of the compact and its promulgated rules. The relief sought 11 may include both injunctive relief and damages. In the event 12 judicial enforcement is necessary, the prevailing party shall 13 be awarded all costs of such litigation, including reasonable 14 attorney fees. 15 (3) No person other than a member state shall enforce this 16 compact against the commission. 17 11. Effective date, withdrawal, and amendment. 18 a. The compact shall come into effect on the date on which 19 the compact statute is enacted into law in the seventh member 20 state. 21 (1) On or after the effective date of the compact, the 22 commission shall convene and review the enactment of each of 23 the first seven member states to determine if the statute 24 enacted by each such charter member state is materially 25 different than the model compact. 26 (a) A charter member state whose enactment is found to be 27 materially different from the model compact shall be entitled 28 to the default process set forth in subsection 10. 29 (b) If any member state is later found to be in default or 30 is terminated or withdraws from the compact, the commission 31 shall remain in existence and the compact shall remain in 32 effect even if the number of member states should be less than 33 seven. 34 (2) Member states enacting the compact subsequent to the 35 -26- LSB 1867YC (2) 91 ss/ko 26/ 30
H.F. _____ seven initial charter member states shall be subject to the 1 process set forth herein and commission rule to determine 2 if their enactments are materially different from the model 3 compact and whether they qualify for participation in the 4 compact. 5 (3) All actions taken for the benefit of the commission 6 or in furtherance of the purposes of the administration of 7 the compact prior to the effective date of the compact or the 8 commission coming into existence shall be considered to be the 9 actions of the commission unless specifically repudiated by the 10 commission. The commission shall own and have all rights to 11 any intellectual property developed on behalf or in furtherance 12 of the commission by individuals or entities involved in 13 organizing or establishing the commission, as may be further 14 set forth in rules of the commission. 15 (4) Any state that joins the compact subsequent to the 16 commissions initial adoption of the rules and bylaws shall be 17 subject to the rules and bylaws as they exist on the date on 18 which the compact becomes law in that state. Any rule that has 19 been previously adopted by the commission shall have the full 20 force and effect of law on the date the compact becomes law in 21 that state. 22 b. Any member state may withdraw from this compact by 23 enacting a statute repealing the same. 24 (1) A member states withdrawal shall not take effect 25 until one hundred eighty days after enactment of the repealing 26 statute. 27 (2) Withdrawal shall not affect the continuing requirements 28 of the withdrawing states respiratory therapy licensing 29 authority to comply with the investigative and adverse action 30 reporting requirements of this compact prior to the effective 31 date of withdrawal. 32 (3) Upon the enactment of a statute withdrawing from this 33 compact, a state shall immediately provide notice of such 34 withdrawal to all licensees and compact privilege holders 35 -27- LSB 1867YC (2) 91 ss/ko 27/ 30
H.F. _____ of which the commission has a record within that state. 1 Notwithstanding any subsequent statutory enactment to the 2 contrary, such withdrawing state shall continue to recognize 3 all licenses granted pursuant to this compact for a minimum 4 of one hundred eighty days after the date of such notice of 5 withdrawal. 6 c. Nothing contained in this compact shall be construed 7 to invalidate or prevent any licensure agreement or other 8 cooperative arrangement between a member state and a nonmember 9 state that does not conflict with the provisions of this 10 compact. 11 d. This compact may be amended by the member states. No 12 amendment to this compact shall become effective and binding 13 upon any member state until it is enacted into the laws of all 14 member states. 15 12. Construction and severability. 16 a. This compact and the commissions rulemaking authority 17 shall be liberally construed so as to effectuate the purposes 18 and the implementation and administration of the compact. 19 Provisions of the compact expressly authorizing or requiring 20 the promulgation of rules shall not be construed to limit the 21 commissions rulemaking authority solely for those purposes. 22 b. The provisions of this compact shall be severable, and 23 if any phrase, clause, sentence, or provision of this compact 24 is held by a court of competent jurisdiction to be contrary 25 to the constitution of any member state, a state seeking 26 participation in the compact, or of the United States, or 27 the applicability thereof to any government, agency, person, 28 or circumstance is held to be unconstitutional by a court of 29 competent jurisdiction, the validity of the remainder of this 30 compact and the applicability thereof to any other government, 31 agency, person, or circumstance shall not be affected thereby. 32 c. Notwithstanding paragraph b , the commission may deny 33 a states participation in the compact or, in accordance 34 with the requirements of subsection 10, terminate a member 35 -28- LSB 1867YC (2) 91 ss/ko 28/ 30
H.F. _____ states participation in the compact if it determines that a 1 constitutional requirement of a member state is a material 2 departure from the compact. Otherwise, if this compact shall 3 be held to be contrary to the constitution of any member state, 4 the compact shall remain in full force and effect as to the 5 remaining member states and in full force and effect as to the 6 member state affected as to all severable matters. 7 13. Consistent effect and conflict with other state laws. 8 a. Nothing in this subsection shall prevent or inhibit the 9 enforcement of any other law of a member state that is not 10 inconsistent with the compact. 11 b. Any laws, statutes, regulations, or other legal 12 requirements in a member state in conflict with the compact 13 are superseded to the extent of the conflict, including any 14 subsequently enacted state laws. 15 c. All permissible agreements between the commission and the 16 member states are binding in accordance with their terms. 17 d. Other than as expressly set forth herein, nothing in this 18 compact impacts initial licensure. 19 EXPLANATION 20 The inclusion of this explanation does not constitute agreement with 21 the explanations substance by the members of the general assembly. 22 This bill establishes the respiratory care interstate 23 compact. 24 The compact establishes a system whereby a respiratory 25 therapist licensed to practice in one participating state 26 may practice in another participating state under a compact 27 privilege without applying for a license in that state. The 28 compact imposes certain minimum requirements on the licensure 29 of respiratory therapists in participating states. 30 The compact creates a commission to administer the operation 31 of the compact. The commission is an instrumentality of the 32 participating states. The compact includes provisions relating 33 to the establishment and membership of the commission; powers 34 of the commission; meetings and voting requirements of the 35 -29- LSB 1867YC (2) 91 ss/ko 29/ 30
H.F. _____ commission; commission bylaws and rules; commission committees; 1 commission finances; the establishment of a data system; 2 compacting state compliance; venue for judicial proceedings; 3 defense and indemnification; effective dates and amendments to 4 the compact; withdrawal, default, and expulsion; severability 5 and construction; and the binding effect of the compact and 6 other laws. 7 The compact becomes effective upon the adoption of the 8 compact by the seventh participating state. 9 -30- LSB 1867YC (2) 91 ss/ko 30/ 30