SESSION OF 2024
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2453
As Recommended by House Committee on
Health and Human Services
Brief*
HB 2453 would enact the Dentist and Dental Hygienist
Compact (Compact) to provide interstate practice privileges
for dentists and dental hygienists. The bill contains uniform
language that would enact the Compact in Kansas.
Purpose (Section 1)
The bill would state the purposes of the Compact are to
facilitate the interstate practice of dentistry and dental
hygiene and improve public access to dentistry and dental
hygiene services. The Compact would establish a pathway
for dentists and dental hygienists licensed in a participating
state to obtain privilege to practice in other participating
states where they are not licensed, while states would be
able to protect public health and safety through the State’s
authority to regulate the practice of dentistry and dental
hygiene. The Compact would:
●Enable dentists and dental hygienists who qualify
for Compact privilege to practice in other
participating states without satisfying burdensome
and duplicative requirements associated with
securing a license to practice in those states;
●Promote mobility and address workforce shortages
through each participating state’s acceptance of a
Compact privilege to practice in that state;
____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org ●Increase public access to qualified, licensed
dentists and dental hygienists by creating a
responsible, streamlined pathway for licensees to
practice in participating states;
●Enhance the ability of participating states to protect
the public’s health and safety;
●Not interfere with licensure requirements
established by a participating state;
●Facilitate the sharing of licensure and disciplinary
information among participating states;
●Require dentists and dental hygienists who
practice in a participating state pursuant to a
Compact privilege to practice within the scope of
practice authorized in that state;
●Extend the authority of a participating state to
regulate the practice of dentistry and dental
hygiene within its borders to dentists and dental
hygienists who practice in the state through a
Compact privilege;
●Promote the cooperation of a participating state in
regulating the practice of dentistry and dental
hygiene within those states; and
●Facilitate the relocation of military members and
their spouses who are licensed to practice dentistry
or dental hygiene.
Definitions (Section 2)
The Compact would define various terms used
throughout the Compact. Key terms would include the
following:
2- 2453 ●“Compact privilege,” defined as the authorization
granted by a remote state to allow a licensee from
a participating state to practice as a dentist or
dental hygienist in a remote state; and
●“Dentist and Dental Hygienist Compact
Commission,” (Commission) defined as a joint
government agency established by the Compact
comprised of each state that has enacted the
Compact and a national administrative body
comprised of a Commissioner from each state that
has enacted the Compact.
State Participation in the Compact (Section 3)
In order to join the Compact and continue as a
participating state, states would be required to:
●Enact a Compact that is not materially different
from the model compact as determined in
accordance with Commission rules;
●Participate fully in the Commission’s data system;
●Have a mechanism in place for receiving and
investigating complaints about its licensees and
license applicants;
●Notify the Commission, in compliance with the
terms of the Compact and Commission rules, of
any adverse action or the availability of significant
investigative information regarding a licensee and
license applicant;
●Fully implement a criminal background check
requirement, within a time frame established by
Commission rule, by receiving the results of a
qualifying criminal background check;
3- 2453 ●Comply with the Commission rules applicable to a
participating state;
●Accept the National Board Examinations of the
Joint Commission on National Dental Examinations
or another examination accepted by Commission
rule as a licensure examination;
●Accept for licensure that applicants for a dental
license graduate from a predoctoral dental
education program accredited by the Commission
on Dental Accreditation, or another accrediting
agency recognized by the U.S. Department of
Education for the accreditation of dentistry and
dental hygiene education programs, leading to a
doctor of dental surgery (DDS) or doctor of dental
medicine (DMD) degree;
●Accept for licensure that applicants for a dental
hygienist license graduate from a dental hygiene
education program accredited by the Commission
on Dental Accreditation or another accrediting
agency recognized by the U.S. Department of
Education for the accreditation of dentistry and
dental hygiene education programs;
●Require for licensure that applicants successfully
complete a clinical assessment;
●Have continuing professional development
requirements as a condition for license renewal;
and
●Pay a participation fee to the Commission as
established by Commission rule.
The Compact would state that providing alternative
pathways for an individual to receive an unrestricted license
would not disqualify a state from participating in the Compact.
4- 2453 Criminal Background Check
When conducting a criminal background check, the
Compact would require the state licensing authority to:
●Consider that information in making a licensure
decision;
●Maintain documentation of completion of the
criminal background check and background check
information to the extent allowed by state and
federal law; and
●Report to the Commission whether it has
completed the criminal background check and
whether the individual was granted or denied a
license.
Compact Licensure
The Compact would state a licensee of a participating
state who has a qualifying license in that state and does not
hold an encumbered license in any other participating state
would be issued a Compact privilege in a remote state in
accordance with the terms of the Compact and Commission
rules. If a remote state has a jurisprudence requirement, a
Compact privilege would not be issued to the licensee unless
the licensee has satisfied the jurisprudence requirement.
Compact Privilege (Section 4)
The Compact would require a licensee to do the
following in order to obtain and exercise the Compact
privilege:
●Have a qualifying license as a dentist or dental
hygienist in a participating state;
5- 2453 ●Be eligible for Compact privilege in any remote
state in accordance with the Compact;
●Submit to an application process whenever the
licensee is seeking a Compact privilege;
●Pay any applicable Commission and remote state
fees for a Compact privilege in the remote state;
●Meet any jurisprudence requirement established by
a remote state in which the licensee is seeking a
Compact privilege;
●Have passed a national board examination of the
Joint Commission on National Dental Examinations
or another examination accepted by Commission
rule;
●For a dentist, have graduated from a predoctoral
dental education program accredited by the
Commission on Dental Accreditation, or another
accrediting agency recognized by the U.S.
Department of Education for the accreditation of
dentistry and dental hygiene education programs,
leading to the DDS or DMD degree;
●For a dental hygienist, have graduated from a
dental hygiene education program accredited by
the Commission on Dental Accreditation or another
accrediting agency recognized by the U.S.
Department of Education for the accreditation of
dentistry and dental hygiene education programs;
●Have successfully completed a clinical assessment
for licensure;
●Report to the Commission any adverse action
taken by any non-participating state when applying
for a Compact privilege and, otherwise, within 30
days after the date the adverse action is taken;
6- 2453 ●Report to the Commission, when applying for a
Compact privilege, the address of the licensee’s
primary residence and thereafter immediately
report to the Commission any change in address of
the licensee’s primary residence; and
●Consent to accept service of process by mail at the
licensee’s primary residence on record with the
Commission with respect to any action brought
against the licensee by the Commission or a
participating state and consent to accept service of
a subpoena by mail at the licensee’s primary
residence on record with the Commission with
respect to any action brought on investigation
conducted by the Commission or a participating
state.
Compact Privilege
Licensees would be required to comply with the
requirements of the Compact to maintain Compact privilege
in the remote state. If those requirements are met, the
Compact privilege would continue if the licensee maintains a
qualifying license in the state through which the licensee
applied for the Compact privilege and pays any applicable
Compact privilege renewal fees.
A licensee providing dentistry or dental hygiene in a
remote state under the Compact privilege would be required
to function within the scope of practice authorized by the
remote state for a dentist or dental hygienist licensed in that
state.
A licensee providing dentistry or dental hygiene pursuant
to a Compact privilege in a remote state would be subject to
that state’s regulatory authority. A remote state would be able
to, in accordance with due process and that state’s laws, by
adverse action revoke or remove a licensee’s Compact
privilege in the remote state for a specific period of time and
7- 2453 impose fines or take any other necessary actions to protect
the health and safety of its citizens. If a remote state imposes
an adverse action against a Compact privilege that limits the
Compact privilege, that adverse action would apply to all
Compact privileges in all remote states. A licensee whose
Compact privilege in a remote state is removed for a
specified period of time would not be eligible for a Compact
privilege in any other remote state until the specific time for
removal of the Compact privilege has passed, and all
encumbrance requirements are satisfied.
If a license in a participating state is an encumbered
license, the licensee would lose the Compact privilege in a
remote state and would not be eligible for a Compact
privilege in any remote state until the license is
unencumbered.
Once an encumbered license in a participating state is
restored to good standing, the licensee would need to meet
the requirements for licensees under the Compact to obtain
privilege in a remote state.
If a licensee’s Compact privilege in a remote state is
removed by the remote state, the individual would lose or be
ineligible for the Compact privilege in any remote state until:
●The specific period for which the Compact privilege
was removed has ended; and
●All conditions for removal of the Compact privilege
have been satisfied.
Once these requirements have been met, the licensee
would also need to meet the requirements for licensees under
the Compact to obtain privilege in a remote state.
8- 2453 Active Military Member or Their Spouses (Section 5)
An active military member and their spouse would not
be required to pay the fee charged by the Commission for a
Compact privilege. If a remote state chooses to charge a fee
for a Compact privilege, it would be able to charge a reduced
fee or no fee to an active military member and their spouse
for a Compact privilege.
Adverse Actions (Section 6)
A participating state in which a licensee is licensed
would have exclusive authority to impose adverse action
against the qualifying license issued by that participating
state.
A participating state would be able to take adverse
action based on the significant investigative information of a
remote state, if the participating state follows its own
procedures for imposing adverse action.
Nothing in the Compact would override a participating
state’s decision that participation in an alternative program
may be used in lieu of adverse action and that participation
would remain non-public if required by the participating
state’s laws. Participating states would be required to require
licensees who enter any alternative program in lieu of
discipline to agree not to practice pursuant to a Compact
privilege in any other participating state during the term of the
alternative program without prior authorization from the other
participating state.
Any participating state in which a licensee is applying to
practice or is practicing pursuant to a Compact privilege
would be able to investigate actual or alleged violations of the
statutes and regulations authorizing the practice of dentistry
or dental hygiene in any other participating state in which the
dentist or dental hygienist holds a license or Compact
privilege.
9- 2453 A remote state would have the authority to:
●Take adverse actions as set forth in the Compact
against a licensee’s compact privilege in the state;
●In furtherance of its rights and responsibilities
under the Compact and the Commission’s rules,
issue subpoenas for both hearings and
investigations that require the attendance and
testimony of witnesses and the production of
evidence. Subpoenas issued by a state licensing
authority in a participating state for the attendance
and testimony of witnesses, or the production of
evidence from another participating state, would be
enforced in the latter state by any court of
competent jurisdiction, according to the practice
and procedure of that court applicable to
subpoenas issued in proceedings pending before
it. The issuing authority would be required to pay
any witness fees, travel expenses, mileage, and
other fees required by the service statutes of the
state where the witnesses or evidence is located;
and
●If otherwise permitted by state law, recover from
the licensee the costs of investigations and
disposition of cases resulting from any adverse
action taken against that licensee.
In addition to the authority granted to a participating
state by its dentist or dental hygienist licensure act or other
applicable state law, a participating state would be able to
jointly investigate licensees with other participating states.
Participating states would be required to share any
significant investigative information, litigation, or compliance
materials in furtherance of any joint or individual investigation
initiated under the Compact.
10- 2453 After a licensee’s Compact privilege in a remote state is
terminated, the remote state could continue an investigation
of the licensee that began when the licensee had a Compact
privilege in that remote state.
If the investigation yields what would be a significant
investigative information had the licensee continued to have a
Compact privilege in that remote state, the remote state
would report the presence of the information to the data
system as required by the Compact as if it was significant
investigative information.
Establishment and Operation of the Commission
(Section 7)
The Compact would provide for participating states to
create and establish a joint government agency whose
membership would consist of all participating states that have
enacted the Compact. The Commission would be an
instrumentality of the participating states acting jointly and not
an instrumentality of any one state. The Commission would
come into existence on or after the effective date of Compact.
Each participating state would have and be limited to
one Commissioner selected by that state’s licensing authority
or, if the state has more one state licensing authority, selected
collectively by the state licensing authorities.
The Commissioner would be a member or designee of
such authority or authorities.
The Commission would, by rule or bylaw, establish a
term of office for commissioners and could establish term
limits.
The Commission could recommend to a state licensing
authority or authorities, as applicable, removal or suspension
of an individual as the state’s commissioner.
11- 2453 A participating state’s state licensing authority or
authorities, as applicable, would fill any vacancy of its
commissioner or the Commission within 60 days after the
vacancy.
Each commissioner would be entitled to one vote on all
matters voted upon by the Commission.
The Commission would meet at least once during each
calendar year. Additional meetings could be held as set forth
in the bylaws. The Commission would be able to meet by
telecommunication, video conference, or other similar
electronic means.
Commission Powers
The Commission would have the following powers:
●Establish the fiscal year of the Commission;
●Establish a code of conduct and conflict of interest
policies;
●Adopt rules and bylaws;
●Maintain its financial records in accordance with
the bylaws;
●Meet and take actions as are consistent with the
provisions of the Compact and the Commission’s
rules and bylaws;
●Initiate and conclude legal proceedings or actions
in the name of the Commission, provided the
standing of any state licensing authority to sue or
be sued under applicable law would not be
affected;
●Maintain and certify records and information
provided to a participating state as the
12- 2453 authenticated business records of the Commission
and designate a person to do so on the
Commission’s behalf;
●Purchase and maintain insurance and bonds;
●Borrow, accept, or contract for services of
personnel, including, but not limited to, employees
of a participating state;
●Conduct an annual financial review;
●Hire employees, elect or appoint officers, fix
compensation, define duties, grant 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;
●As set forth in Commission rules, charge a fee to a
licensee for the grant of a Compact privilege in a
remote state and charge the licensee a Compact
privilege renewal fee for each renewal period in
which that licensee exercises or intends to exercise
the Compact privilege in that remote state. A
remote state would not be prevented from charging
a licensee a fee for a Compact privilege or
renewals of a Compact privilege, or a fee for the
jurisprudence requirement, if the remote state
imposes a requirement for the grant of a Compact
privilege;
●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, and at all
times the Commission would avoid any
appearance of impropriety or conflict of interest;
13- 2453 ●Lease, purchase, retain, own, hold, improve, or use
any property, real, personal, or mixed, or any
undivided interest in property;
●Sell, convey, mortgage, pledge, lease, exchange,
abandon, or otherwise dispose of any property
real, personal, or mixed;
●Establish a budget and make expenditures;
●Borrow money;
●Appoint committees, including standing
committees, which may be composed of members,
state regulators, state legislators or their
representatives, consumer representatives, and
other interested persons as may be designated in
this Compact and the bylaws;
●Provide and receive information from, and
cooperate with, law enforcement agencies;
●Elect a chairperson, vice-chairperson, secretary,
and treasurer and other officers of the Commission
as provided in the Commission’s bylaws;
●Establish and elect an executive board;
●Adopt and provide to the participating states an
annual report;
●Determine whether a state’s enacted Compact is
materially different from the model Compact
language such that the state would not qualify for
participation in the Compact; and
●Perform other functions as may be necessary or
appropriate to achieve the purposes of the
Compact.
14- 2453 Meeting Notice
All meetings of the Commission not closed pursuant to
the Compact would be open to the public. Notice of public
meetings would be posted on the Commission’s website at
least 30 days prior to the public meeting.
Notice of all Commission meetings would 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 would
include the mechanism for access to the meeting through
those means.
Notwithstanding the above, the Commission could
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.
Emergency meetings would be permissible in order to:
●Meet an imminent threat to public health, safety, or
welfare;
●Prevent a loss of Commission or participating state
funds;
●Meet a deadline for the promulgation of a rule that
is established by federal law or rule; or
●Protect public health and safety.
The Commission’s legal counsel would certify that one
of the reasons justifying an emergency public meeting has
been met.
15- 2453 Closed Meetings
The Commission could convene in a closed, non-public
meeting for the Commission to receive legal advice to
discuss:
●Non-compliance of a participating state with its
obligations under the Compact;
●The employment, compensation, discipline, or
other matters, practices, or procedures related to
specific employees or other matters related to the
Commission’s internal personnel practices and
procedures;
●Current or threatened discipline of a licensee or
Compact privilege holder by the Commission or by
a participating state’s licensing authority;
●Current, threatened, or reasonably anticipated
litigation;
●Negotiation of contracts for the purchase, lease, or
sale of goods, services, or real estate;
●Accusing any person of a crime or formally
censuring any person;
●Trade secrets or commercial or financial
information that is privileged or confidential;
●Information of a personal nature where disclosure
would constitute a clearly unwarranted invasion of
personal privacy;
●Investigative records compiled for law enforcement
purposes;
●Information related to any investigative reports
prepared by, on behalf of, or for use of the
Commission or any other committee charged with
16- 2453 responsibility of investigation or determination of
compliance issues pursuant to the Compact;
●Legal advice;
●Matters specifically exempted from disclosure to
the public by federal or participating state law; and
●Other matters as promulgated by the Commission
by rule.
If a meeting, or portion of a meeting, is closed, the
presiding officer would state the meeting will be closed and
reference each relevant exempting provision, and this
reference would be recorded in the minutes.
The Commission would keep minutes that fully and
clearly describe all matters discussed in a meeting and would
provide a full and accurate summary of actions taken, and the
reasons therefor, including a description of the views
expressed. All documents considered in connection with an
action would be identified in the minutes. All minutes and
documents of a closed meeting would remain under seal,
subject to release only by a majority vote of the Commission
or order of a court of competent jurisdiction.
Commission Finances
The Commission would pay, or provide for the payment
of, the reasonable expenses of its establishment,
organization, and ongoing activities.
The Commission could accept any and all appropriate
sources of revenue, donations, and grants of money,
equipment, supplies, materials, and services.
The Commission could levy on and collect an annual
assessment from each participating state and impose fees on
licensees of participating states when a Compact privilege is
granted to cover the cost of the operations and activities of
17- 2453 the Commission and its staff, which would be in a total
amount sufficient to cover its annual budget as approved
each fiscal year for which sufficient revenue is not provided
by other sources. The aggregate annual assessment amount
for participating states would be allocated based upon a
formula that the Commission would promulgate by rule.
The Commission would not incur obligations of any kind
prior to securing the funds adequate to meet the same nor
would the Commission pledge the credit of any participating
state except by and with the authority of the participating
state.
The Commission would keep accurate accounts of all
receipts and disbursements. The receipts and disbursements
of the Commission would be subject to the financial review
and accounting procedures established under its bylaws. All
receipts and disbursements of funds handled by the
Commission would be subject to an annual financial review
by a certified or licensed public accountant, and the report of
the financial review would be included in and become part of
the annual report of the Commission.
Executive Board
The Executive Board would have the power to act on
behalf of the Commission according to the terms of the
Compact. The powers, duties, and responsibilities of the
Executive Board would include:
●Overseeing the day-to-day activities of the
administration of the Compact, including
compliance with the provisions of the Compact, the
Commission’s rules, and bylaws;
●Recommending the Commission changes to the
rules or bylaws, changes to this Compact
legislation, fees charged to Compact participating
states, fees charged to licensees, and other fees;
18- 2453 ●Ensuring Compact administration services are
appropriately provided, including by contract;
●Preparing and recommending the budget;
●Maintaining financial records on behalf of the
Commission;
●Monitoring Compact compliance of participating
states and providing compliance reports to the
Commission;
●Establishing additional committees as necessary;
●Exercising 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; and
●Other duties as provided in the rules and bylaws of
the Commission.
Executive Board Membership
The Executive Board would be composed of up to seven
members. The chairperson, vice-chairperson, secretary, and
treasurer of the Commission and any other members of the
Commission who serve on the Executive Board would be
voting members of the Executive Board. Other than the
chairperson, vice chairperson, secretary, and treasurer, the
Commission could elect up to three voting members from the
current membership of the Commission.
The Commission could remove any member of the
Executive Board as provided in the Commission’s bylaws.
19- 2453 Executive Board Meetings
The Executive Board would meet at least annually.
An Executive Board meeting at which it takes or intends
to take formal action on a matter would be open to the public,
except the Executive Board could meet in a closed, non-
public session of a public meeting when dealing with:
●Non-compliance of a participating state with its
obligations under the Compact;
●The employment, compensation, discipline, or
other matters, practices, or procedures related to
specific employees or other matters related to the
Commission’s internal personnel practices and
procedures;
●Current or threatened discipline of a licensee or
Compact privilege holder by the Commission or by
a participating state’s licensing authority;
●Current, threatened, or reasonably anticipated
litigation;
●Negotiation of contracts for the purchase, lease, or
sale of goods, services, or real estate;
●Accusing any person of a crime or formally
censuring any person;
●Trade secrets or commercial or financial
information that is privileged or confidential;
●Information of a personal nature where disclosure
would constitute a clearly unwarranted invasion of
personal privacy;
●Investigative records compiled for law enforcement
purposes;
20- 2453 ●Information related to any investigative reports
prepared by, on behalf of, or for use of the
Commission or any other committee charged with
responsibility of investigation or determination of
compliance issues pursuant to the Compact;
●Legal advice;
●Matters specifically exempted from disclosure to
the public by federal or participating state law; and
●Other matters as promulgated by the Commission
by rule.
The Executive Board would provide five business days’
notice of its public meetings, published on its website, and as
it may otherwise determine, to provide notice to persons with
an interest in the public matters the Executive Board intends
to address at those meetings.
The Executive Board could hold an emergency meeting
when acting for the Commission to:
●Meet an imminent threat to public health, safety, or
welfare;
●Prevent a loss of Commission or participating state
funds; or
●Protect public health and safety.
Commission Liability and Protections
The members, officers, executive director, employees,
and representatives of the Commission would 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
21- 2453 reasonable basis for believing occurred within the scope of
Commission employment, duties, or responsibilities. Nothing
in this section would 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 would not in any way compromise or limit this
immunity.
The Commission would defend any member, officer,
executive director, employee, and representative 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 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 paragraph would be construed to prohibit
that person from retaining their own counsel at their own
expense, and provided further, the actual or alleged act, error,
or omission did not result in that person’s intentional, willful,
or wanton misconduct.
Should any member, officer, executive director,
employee, or representative of the Commission be held liable
for the amount of any settlement or judgment arising out of
any actual or alleged act, error, or omission that occurred
within the scope of that individual’s employment, duties, or
responsibilities for the Commission, the Commission would
indemnify and hold harmless the individual, provided the
actual or alleged act, error, or omission did not result from the
intentional, willful, or wanton misconduct of the individual.
Nothing in this subsection would be construed as a
limitation on the liability of any licensee for professional
malpractice or misconduct, which would be governed solely
by any other applicable state laws.
22- 2453 Nothing in the Compact would be interpreted to waive or
otherwise abrogate a participating state’s state action
immunity or state action affirmative defense with respect to
antitrust claims under the Sherman Act, Clayton Act, or any
other state or federal antitrust or anti-competitive law or
regulation.
[Note: The Sherman Act and Clayton Act are federal
antitrust laws.]
Nothing in the Compact would be construed to be a
waiver of sovereign immunity by the participating states or by
the Commission.
Data System (Section 8)
The bill would require the Commission to 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 on all licensees and applicants for a
license in participating states.
The bill would require, notwithstanding any provision of
state law to the contrary, a participating state to submit a
uniform data set to the data system on all individuals to whom
the Compact is applicable, as required by the rules of the
Commission, including:
●Identifying information;
●Licensure data;
●Adverse actions against a licensee, license
applicant, or Compact privilege;
●Non-confidential information related to alternative
program participation, the beginning and ending
23- 2453 dates of the participation, and other related
information;
●Any denial of an application for licensure and the
reasons for denial;
●The presence of significant investigative
information; and
●Other information that may facilitate the
administration of the Compact or the protection of
the public, as determined by the rules of the
Commission.
Records and information provided to a participating state
pursuant to the Compact through the data system would
constitute the authenticated business records of the
Commission and would be entitled to any associated hearsay
exception in any relevant judicial, quasi-judicial, or
administrative proceedings in a participating state. Significant
investigative information pertaining to a licensee in any
participating state would be only available to other
participating states.
Participating states would be responsible for monitoring
the database to determine whether adverse action has been
taken against a licensee or license applicant. Adverse action
information pertaining to a license or license applicant in any
participating state would be available to any other
participating state. Participating states would be able to
designate information that may not be shared with the public
without the express permission of the contributing state. Any
information submitted to the data system and subsequently
expunged pursuant to federal law or the laws of the
participating state would be removed from the data system.
Rulemaking (Section 9)
The bill would provide for the Commission to promulgate
reasonable rules in order to effectively and efficiently
24- 2453 implement and administer the Compact. A Commission rule
would be invalid and have no force or effect only if a court of
competent jurisdiction holds the rule is invalid because the
Commission exercised its rulemaking authority in a manner
beyond the scope and purposes of the Compact or based on
another applicable standard of review.
The rules of the Commission would have the force of
law in each participating state unless the rules conflict with
the laws of the participating state that establish the
participating state’s scope of practice, as held by a court of
competent jurisdiction; the rules of the Commission would be
ineffective in that state to the extent of the conflict.
The bill would state the Commission could exercise its
rulemaking powers pursuant to the Compact and the rules
adopted thereunder. Rules would become binding as of the
date specified by the Commission for each rule.
If a majority of legislatures of the participating states
reject a Commission rule or portion of a Commission 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 would have no further force
and effect in any participating state or to any state applying to
participate in the Compact.
Rules would be adopted at regular or special meetings
of the Commission. Prior to adoption of a proposed rule, the
Commission would hold a public hearing and allow persons to
provide oral and written comments, data, facts, opinions, and
arguments.
Notice of Public Hearing
At least 30 days in advance of the meeting at which the
Commission would hold a public hearing on the proposed
rule, the Commission would provide a notice of proposed
rulemaking:
25- 2453 ●On the website of the Commission or other publicly
available platform;
●To persons who have requested notice of the
Commission’s notices of proposed rulemaking; and
●In other ways as the Commission may specify by
rule.
The notice of proposed rulemaking would include:
●The time, date, and location of the public hearing at
which the Commission would hear public
comments on the proposed rule and, if different,
the time, date, and location of the meeting where
the Commission would consider and vote on the
proposed rule;
●If the hearing is held via telecommunication, video
conference, or other electronic means, the
Commission would include the mechanism for
access to the hearing in the notice of proposed
rulemaking;
●The text of the proposed rule and the reason
therefor;
●A request for comments on the proposed rule from
any interested person; and
●The manner in which interested persons may
submit written comments.
Public Hearings
All hearings would be recorded. A copy of the recording
and all written comments and documents received by the
Commission in response to the proposed rule would be
available to the public.
26- 2453 Nothing in the Compact would be construed as requiring
a separate hearing on each Commission rule. Rules would be
grouped for the convenience of the Commission at hearings
required by this section.
The Commission would, by majority vote of all
Commissioners, take final action on the proposed rule based
on the rulemaking record.
The Commission could adopt changes to the proposed
rule if the changes would not enlarge the original purpose of
the proposed rule.
The Commission would 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.
The Commission would determine a reasonable
effective date for the rule. Except for an emergency, the
effective date of the rule would be no sooner than 30 days
after the Commission issuing the notice that it adopted or
amended the rule.
Emergency Rulemaking
Upon determination that an emergency exists, the
Commission could consider and adopt an emergency rule
with 24 hours’ notice, with opportunity to comment, and the
usual rulemaking procedures provided in the Compact would
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 subsection, an
emergency rule would be one that must be adopted
immediately in order to:
●Meet an imminent threat to public health, safety, or
welfare;
27- 2453 ●Prevent a loss of Commission or participating state
funds;
●Meet a deadline for the promulgation of a rule that
is established by federal law or rule; or
●Protect public health and safety.
The Commission or an authorized committee of the
Commission could 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 would be posted on the website of the
Commission. The revision would be subject to challenge by
any person for a period of 30 days after posting. The revision
could be challenged only on grounds the revision results in a
material change to a rule. A challenge would be made in
writing and delivered to the Commission prior to the end of
the notice period. If no challenge is made, the revision would
take effect without further action. If the revision is challenged,
the revision would not take effect without the approval or the
Commission.
No participating state’s rulemaking requirements would
apply under the Compact.
Oversight, Dispute Resolution, and Enforcement
(Section 10)
The Compact would provide for the executive and
judicial branches of state government in each participating
state to enforce the Compact and take all actions necessary
and appropriate to implement the Compact.
The Compact would establish proper venue for judicial
proceedings by or against the Commission to be solely and
exclusively a court of competent jurisdiction where the
principal office of the Commission is located. The
Commission could waive venue and jurisdictional defenses to
28- 2453 the extent it would adopt or consent to participate in
alternative dispute resolution proceedings. These provisions
would not affect or limit the selection or propriety of venue in
any action against a licensee for professional malpractice,
misconduct, or any similar matter.
The Commission would be entitled to receive service of
process in any proceeding regarding the enforcement or
interpretation of the Compact or Commission rule and would
have standing to intervene in such a proceeding for all
purposes. Failure to provide the Commission service of
process would render a judgment or order void as to the
Commission, the Compact, or promulgated rules.
Defaulting States
If the Commission determines that a participating state
has defaulted in the performance of its obligations or
responsibilities under the Compact or the promulgated rules,
the Commission would provide written notice to the defaulting
state. The notice of default would describe the default, the
proposed means of curing the default, and any other action
the Commission could take and would offer training and
specific technical assistance regarding the default.
The Commission would provide a copy of the notice of
default to the other participating state.
If a state in default fails to cure the default, the
defaulting state would be terminated from the Compact upon
an affirmative vote of a majority of the Commissioners, and all
rights, privileges, and benefits conferred on that state by the
Compact would be terminated on the effective date of
termination. A cure of the default would not relieve the
offending state of obligations or liabilities incurred during the
period of default.
Termination of participation in the Compact would be
imposed only after all other means of securing compliance
29- 2453 were exhausted. Notice of intent to suspend or terminate
would be given by the Commission to:
●The governor;
●The majority and minority leaders of the defaulting
state’s legislature;
●The defaulting state’s state licensing authority or
authorities, as applicable; and
●Each of the participating states’ state licensing
authority or authorities, as applicable.
A state that has been terminated would be responsible
for all assessments, obligations, and liabilities incurred
through the effective date of termination, including obligations
that extend beyond the effective date of termination.
Upon the termination of a state’s participation in the
Compact, that state would immediately provide notice to all
licensees of the state, including licensees of other
participating states issued a Compact privilege to practice
within that state of termination. The terminated state would
continue to recognize all Compact privileges then in effect in
that state for a minimum of 180 days after the date of said
notice of termination.
The Commission would 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.
The defaulting state could 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
would be awarded all costs of litigation, including reasonable
attorney fees.
30- 2453 Upon request by a participating state, the Commission
would attempt to resolve disputes related to the Compact that
arise among participating states and between participating
states and non-participating states.
The Compact would require the Commission to
promulgate a rule providing for both mediation and binding
dispute resolution for disputes as appropriate.
The Commission, in the reasonable exercise of its
discretion, would enforce the provisions of the Compact and
the Commission’s rules.
By majority vote, the Commission could initiate legal
action against a participating state in default 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
promulgated rules. The relief sought could include both
injunctive relief and damages. In the event judicial
enforcement is necessary, the prevailing party would be
awarded all costs of litigation, including reasonable attorney
fees. The remedies included in this section would not be the
exclusive remedies of the Commission, and the Commission
could pursue any other remedies available under federal or
the defaulting participating state’s law.
A participating state could 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 promulgated rules. The relief sought
could include both injunctive relief and damages. In the event
judicial enforcement is necessary, the prevailing party would
be awarded all costs of litigation, including reasonable
attorney fees.
No individual or entity other than a participating state
could enforce this Compact against the Commission.
31- 2453 Effective Date, Withdrawal, and Amendment (Section 11)
The Compact would come into effect on the date on
which the Compact statute is enacted into law in the seventh
participating state. [Note: As of February 6, 2024, four states
have enacted the Compact: Iowa, Tennessee, Washington,
and Wisconsin. Legislation is pending in 12 states, including
Kansas.]
On or after the effective date of the Compact, the
Commission would convene and review the enactment of
each of the states that enacted the Compact prior to the
Commission convening, the charter participating states, to
determine if the statute enacted by each charter participating
state is materially different than the model Compact.
A charter participating state whose enactment is found
to be materially different from the model Compact would be
entitled to the default process described in Section 10 of the
bill.
If any participating state is later found to be in default, or
is terminated or withdraws from the Compact, the
Commission would remain in existence, and the Compact
would remain in effect even if the number of participating
states would be fewer than seven.
Participating states enacting the Compact after the
charter participating states would be subject to evaluation by
the Commission to determine if their enactments are
materially different from the model Compact and whether they
qualify for participation in the Compact.
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 would be actions of the
Commission unless specifically repudiated by the
Commission.
32- 2453 Any state that joins the Compact after the Commission’s
initial adoption of the rules and bylaws would be subject to
the Commission’s rules and bylaws as they exist on the date
on which the Compact becomes law in that state. Any rules
previously adopted by the Commission would have the full
force and effect of law on the day the Compact becomes law
in that state.
State Withdrawal
Any participating state would be able to withdraw from
the Compact by enacting a statute repealing that state’s
enactment of the Compact. A participating state’s withdrawal
would not take effect until 180 days after enactment of the
repealing statute.
Withdrawal would not affect the continuing requirement
of the withdrawing state’s licensing authority or authorities to
comply with the investigative and adverse action reporting
requirements of this Compact prior to the effective date of
withdrawal.
Upon the enactment of a statute withdrawing from this
Compact, the state would immediately provide notice of
withdrawal to all licensees within that state. Notwithstanding
any subsequent statutory enactment to the contrary, the
withdrawing state would continue to recognize all Compact
privileges to practice within that state granted pursuant to this
Compact for a minimum of 180 days after the date of notice
of withdrawal.
Nothing contained in the Compact would be construed
to invalidate or prevent any licensure agreement or other
cooperative arrangement between a participating state and a
non-participating state that does not conflict with the
provisions of this Compact.
This Compact would be amendable by the participating
states. No amendment to the Compact would become
33- 2453 effective and binding upon any participating state until it is
enacted into the laws of all participating states.
Construction and Severability (Section 12)
The Compact and the Commission’s rulemaking
authority would be liberally construed so as to effectuate the
purposes and the implementation and administration of the
Compact. Provisions of the Compact expressly authorizing or
requiring the promulgation of rules would not be construed to
limit the Commission’s rulemaking authority solely for those
purposes.
The provisions of this Compact would be severable, and
if any phrase, clause, sentence, or provision of this Compact
is held by a court of competent jurisdiction to be contrary to
the constitution of any participating state, a state seeking
participation in the Compact or of the United States, or the
applicability thereof to any government, agency, person, or
circumstance is held to be unconstitutional by a court of
competent jurisdiction, the validity of the remainder of this
Compact and the applicability thereof to any other
government, agency, person, or circumstance would not be
affected by such holding.
The Commission would be able to deny a state’s
participation in the Compact or terminate a participating state
if it determines a constitutional requirement of a participating
state is a material departure from the Compact. If the
Compact would be held to be contrary to the constitution of
any participating state, the Compact would remain in full force
and effect as to the remaining participating states and in full
force and effect as to the participating state affected as to all
severable matters.
34- 2453 Consistent Effect and Conflict with Other State Laws
(Section 13)
The Compact would state that nothing within it would
prevent or inhibit the enforcement of any other law of a
participating state that is not consistent with the Compact.
Laws, statutes, regulations, and other legal requirements in a
participating state in conflict with the Compact would be
superseded to the extent of the conflict. Permissible
agreements between the Commission and participating states
would be binding.
Background
The bill was introduced by the House Committee on
Appropriations at the request of a representative of the
Association of Dental Support Organizations.
House Committee on Health and Human Services
In the House Committee hearing, proponent testimony
was provided by representatives of the Association of Dental
Support Organizations, Council of State Governments,
Kansas Dental Association, and Oral Health Kansas. The
proponents generally stated dental licensing is complex, and
the Compact can help bridge the patchwork of licensing
requirements in various states. The conferees stated that
areas of the state suffer from a lack of dental providers, and
enacting the Compact could help ensure more Kansans have
access to consistent, comprehensive oral health care.
Written-only proponent testimony was provided by a
practicing dentist and representatives of the U.S. Department
of Defense and Kansas Dental Hygienists Association.
The Executive Director of the Kansas Dental Board
(Board), when questioned, stated the Board had a neutral
position and made themselves available for questions.
35- 2453 No other testimony was provided.
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on the bill, the Board states that enactment of the
bill would increase fee fund expenditures by approximately
$200,000 beginning in FY 2024. While exact costs are
unknown, the estimate includes the Compact participation
fee, participation in and use of the coordinated database, and
compliance with other Compact requirements. The Board
notes enactment of the Compact should be revenue neutral
as the Compact allows the same fee structure for remote
state applicants as what is established for originating state
applicants. Any fiscal effect associated with the bill is not
reflected in The FY 2025 Governor’s Budget Report.
Dentists; dental hygienists; Dentist and Dental Hygienist Compact; interstate practice
privileges; licensure
36- 2453