North Dakota 2025 2025-2026 Regular Session

North Dakota Senate Bill SB2146 Introduced / Bill

Filed 01/08/2025

                    25.0274.02000
Sixty-ninth
Legislative Assembly
of North Dakota
Introduced by
Senators Roers, Barta
Representatives Frelich, Holle, M. Ruby, O'Brien
A BILL for an Act to create and enact chapter 43-40.1 of the North Dakota Century Code, 
relating to the occupational therapy licensure compact.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
SECTION 1. Chapter 43-40.1 of the North Dakota Century Code is created and enacted as 
follows:
43 - 40.1 - 01. Purpose. 
1.The purpose of this compact is to facilitate interstate practice of occupational therapy 
with the goal of improving public access to occupational therapy services. The practice 
of occupational therapy occurs in the state where the patient is located at the time of 
the patient encounter. The compact preserves the regulatory authority of states to 
protect public health and safety through the current system of state licensure.
2.This compact is designed to:
a.Increase public access to occupational therapy services by providing for the 
mutual recognition of other member state licenses;
b.Enhance the states' ability to protect the public's health and safety;
c.Encourage the cooperation of member states in regulating multistate 
occupational therapy practice;
d.Support spouses of relocating military members;
e.Enhance the exchange of licensure, investigative, and disciplinary information 
between member states;
f.Allow a remote state to hold a provider of services with a compact privilege in 
that state accountable to that state's practice standards; and
g.Facilitate the use of telehealth technology to increase access to occupational 
therapy services.
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43 - 40.1 - 02. Definitions. 
As used in this compact:
1."Active duty military" means full-time duty status in the active uniformed service of the 
United States, including members of the national guard and reserve on active duty 
orders under 10 U.S.C. chapter 1209 and 10 U.S.C. chapter 1211.
2."Adverse action" means any administrative, civil, equitable, or criminal action 
permitted by a state's laws which is imposed by a licensing board or other authority 
against an occupational therapist or occupational therapy assistant, including actions 
against an individual's license or compact privilege, including censure, revocation, 
suspension, probation, monitoring of the licensee, or restriction on the licensee's 
practice.
3."Alternative program" means a nondisciplinary monitoring process approved by an 
occupational therapy licensing board.
4."Compact privilege" means the authorization, which is equivalent to a license, granted 
by a remote state to allow a licensee from another member state to practice as an 
occupational therapist or practice as an occupational therapy assistant in the remote 
state under its laws and rules. The practice of occupational therapy occurs in the 
member state where the patient is located at the time of the patient encounter.
5."Continuing education" means a requirement, as a condition of license renewal, to 
provide evidence of participation in, or completion of, educational and professional 
activities relevant to practice or area of work.
6."Current significant investigative information" means investigative information a 
licensing board, after an inquiry or investigation that includes notification and an 
opportunity for the occupational therapist or occupational therapy assistant to respond, 
if required by state law, has reason to believe is not groundless and, if proved true, 
would indicate more than a minor infraction.
7."Data system" means a repository of information about licensees, including license 
status, investigative information, compact privileges, and adverse actions.
8."Encumbered license" means a license in which an adverse action restricts the 
practice of occupational therapy by the licensee or the adverse action has been 
reported to the national practitioner data bank.
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9."Executive committee" means a group of directors elected or appointed to act on 
behalf of, and within the powers granted to them by, the commission.
10."Home state" means the member state that is the licensee's primary state of 
residence.
11."Impaired practitioner" means an individual whose professional practice is adversely 
affected by substance abuse, addiction, or other health-related condition.
12."Investigative information" means information, records, or documents received or 
generated by an occupational therapy licensing board pursuant to an investigation.
13."Jurisprudence requirement" means the assessment of an individual's knowledge of 
the laws and rules governing the practice of occupational therapy in a state.
14."Licensee" means an individual who currently holds an authorization from the state to 
practice as an occupational therapist or as an occupational therapy assistant.
15."Member state" means a state that has enacted this compact.
16."Occupational therapist" means an individual who is licensed by a state to practice 
occupational therapy.
17."Occupational therapy", "occupational therapy practice", and the "practice of 
occupational therapy" mean the care and services provided by an occupational 
therapist or an occupational therapy assistant as provided under the member state's 
statutes and regulations.
18."Occupational therapy assistant" means an individual who is licensed by a state to 
assist in the practice of occupational therapy.
19."Occupational therapy compact commission" or "commission" means the national 
administrative body whose membership consists of all states that have enacted this 
compact.
20."Occupational therapy licensing board" or "licensing board" means the agency of a 
state that is authorized to license and regulate occupational therapists and 
occupational therapy assistants.
21."Primary state of residence" means the state in which an occupational therapist or 
occupational therapy assistant who is not active duty military declares a primary 
residence for legal purposes as verified by a driver's license, federal income tax 
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return, lease, deed, mortgage, or voter registration, or other verifying documentation 
as provided under commission rules.
22."Remote state" means a member state other than the home state, where a licensee is 
exercising or seeking to exercise the compact privilege.
23."Rule" means a regulation adopted by the commission which has the force of law.
24."Single-state license" means an occupational therapist or occupational therapy 
assistant license issued by a member state that authorizes practice only within the 
issuing state and does not include a compact privilege in any other member state.
25."State" means any state, commonwealth, district, or territory of the United States of 
America that regulates the practice of occupational therapy.
26."Telehealth" means the application of telecommunication technology to deliver 
occupational therapy services for assessment, intervention, or consultation.
43 - 40.1 - 03. State participation in the compact. 
1.To participate in the compact, a member state shall:
a.License occupational therapists and occupational therapy assistants;
b.Participate fully in the commission's data system, including using the 
commission's unique identifier as defined in rules of the commission;
c.Have a mechanism in place for receiving and investigating complaints about 
licensees;
d.Notify the commission, in compliance with the terms of the compact and rules, of 
any adverse action or the availability of investigative information regarding a 
licensee;
e.Implement or use procedures for considering the criminal history records of 
applicants for an initial compact privilege. The procedures shall include the 
submission of fingerprints or other biometric-based information by applicants for 
the purpose of obtaining an applicant's criminal history record information from 
the federal bureau of investigation and the agency responsible for retaining that 
state's criminal records.
(1)A member state shall, within a time frame established by the commission, 
require a criminal background check for a licensee applying for a compact 
privilege whose primary state of residence is that member state, by 
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receiving the results of the federal bureau of investigation criminal record 
search, and shall use the results in making licensure decisions.
(2)Communication between a member state, the commission, and among 
member states regarding the verification of eligibility for licensure through 
the compact may not include any information received from the federal 
bureau of investigation relating to a federal criminal records check 
performed by a member state under Public Law 92 	- 544; 
f.Comply with the rules of the commission;
g.Use only a recognized national examination as a requirement for licensure 
pursuant to the rules of the commission; and
h.Have continuing education requirements as a condition for license renewal.
2.A member state shall grant the compact privilege to a licensee holding a valid 
unencumbered license in another member state in accordance with the terms of the 
compact and rules.
3.Member states may charge a fee for granting a compact privilege.
4.A member state shall provide for the state's delegate to attend all occupational therapy 
compact commission meetings.
5.An individual not residing in a member state shall continue to be able to apply for a 
member state's single-state license as provided under the laws of each member state. 
The single-state license granted to the individual may not be recognized as granting 
the compact privilege in any other member state.
6.This compact does not affect the requirements established by a member state for the 
issuance of a single-state license.
43 - 40.1 - 04. Compact privilege. 
1.To exercise the compact privilege under the terms and provisions of the compact, the 
licensee shall:
a.Hold a license in the home state;
b.Have a valid United States social security number or national practitioner 
identification number;
c.Have no encumbrance on any state license;
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d.Be eligible for a compact privilege in any member state in accordance with 
subsections  4, 6, 7, and 8; 
e.Have paid all fines and completed all requirements resulting from any adverse 
action against any license or compact privilege, and two years have elapsed from 
the date of completing the requirements;
f.Notify the commission that the licensee is seeking the compact privilege within a 
remote state;
g.Pay any applicable fee, including any state fee, for the compact privilege;
h.Complete a criminal background check in accordance with subdivision   e of  
subsection  1 of section 43 - 40.1 - 03. The licensee shall be responsible for the  
payment of any fee associated with the completion of a criminal background 
check.
i.Meet any jurisprudence requirement established by the remote state in which the 
licensee is seeking a compact privilege; and
jReport adverse action taken by any nonmember state to the commission within 
thirty days from the date the adverse action is taken.
2.The compact privilege is valid until the expiration date of the home state license. The 
licensee must comply with the requirements of subsection   1 to maintain the compact  
privilege in the remote state.
3.A licensee providing occupational therapy in a remote state under the compact 
privilege shall function within the laws and regulations of the remote state.
4.Occupational therapy assistants practicing in a remote state must be supervised by an 
occupational therapist licensed or holding a compact privilege in that remote state.
5.A licensee providing occupational therapy in a remote state is subject to that state's 
regulatory authority. A remote state may, in accordance with due process and that 
state's laws, remove a licensee's compact privilege in the remote state for a specific 
period of time, impose fines, and take any other necessary actions to protect the 
health and safety of the remote state's citizens. The licensee may be ineligible for a 
compact privilege in any state until the specific time for removal has passed and all 
fines are paid.
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6.If a home state license is encumbered, the licensee loses the compact privilege in any 
remote state until:
a.The home state license is no longer encumbered; and
b.Two years have elapsed from the date on which the home state license is no 
longer encumbered in accordance with subdivision   a. 
7.If an encumbered license in the home state is restored to good standing, the licensee 
must meet the requirements of subsection   1 to obtain a compact privilege in any  
remote state.
8.If a licensee's compact privilege in any remote state is removed, the licensee may lose 
the compact privilege in any other remote state until:
a.The specific period of time for which the compact privilege was removed has 
ended;
b.All fines have been paid and all conditions have been met;
c.Two years have elapsed from the date of completing the requirements under 
subdivisions  a and b; and 
d.The compact privileges are reinstated by the commission, and the compact data 
system is updated to reflect reinstatement.
9.If a licensee's compact privilege in any remote state is removed due to an erroneous 
charge, privileges must be restored through the compact data system.
10.If the requirements of subsection   8 have been met, the licensee must meet the  
requirements in subsection   1 to obtain a compact privilege in a remote state. 
43 - 40.1 - 05. Obtaining a new home state license by virtue of compact privilege. 
1.An occupational therapist or occupational therapy assistant may hold a home state 
license, which allows for compact privileges in member states, in only one member 
state at a time.
2.If an occupational therapist or occupational therapy assistant changes primary state of 
residence by moving between two member states:
a.The occupational therapist or occupational therapy assistant shall file an 
application for obtaining a new home state license by virtue of a compact 
privilege, pay all applicable fees, and notify the current and new home state in 
accordance with applicable rules adopted by the commission.
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b.Upon receipt of an application for obtaining a new home state license by virtue of 
compact privilege, the new home state shall verify the occupational therapist or 
occupational therapy assistant meets the pertinent criteria outlined in section 
43 - 40.1 - 04 through the data system, without need for primary source verification  
except for:
(1)A federal bureau of investigation fingerprint-based criminal background 
check if not previously performed or updated pursuant to applicable rules 
adopted by the commission in accordance with Public Law 92 	- 544; 
(2)Any other criminal background check as required by the new home state; 
and
(3)Submission of any requisite jurisprudence requirements of the new home 
state.
c.The former home state shall convert the former home state license into a 
compact privilege once the new home state has activated the new home state 
license in accordance with applicable rules adopted by the commission.
d.Notwithstanding any other provision of this compact, if the occupational therapist 
or occupational therapy assistant cannot meet the criteria in section 43 	- 40.1 - 04,  
the new home state shall apply its requirements for issuing a new single-state 
license.
e.The occupational therapist or the occupational therapy assistant shall pay all 
applicable fees to the new home state in order to be issued a new home state 
license.
3.If an occupational therapist or occupational therapy assistant changes primary state of 
residence by moving from a member state to a nonmember state, or from a 
nonmember state to a member state, the state criteria applies for issuance of a single-
state license in the new state.
4.Nothing in this compact shall interfere with a licensee's ability to hold a single-state 
license in multiple states. For the purposes of this compact, a licensee only may have 
one home state license.
5.This compact does not affect the requirements established by a member state for the 
issuance of a single-state license.
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43 - 40.1 - 06. Active duty military personnel or their spouses. 
Active duty military personnel, or their spouses, shall designate a home state where the 
individual has a current license in good standing. The individual may retain the home state 
designation during the period the service member is on active duty. Subsequent to designating 
a home state, the individual only shall change their home state through application for licensure 
in the new state or through the process described in section 43 	- 40.1 - 05. 
43 - 40.1 - 07. Adverse actions. 
1.A home state has exclusive power to impose adverse action against an occupational 
therapist's or occupational therapy assistant's license issued by the home state.
2.In addition to the other powers conferred by state law, a remote state may:
a.Take adverse action against an occupational therapist's or occupational therapy 
assistant's compact privilege within that member state.
b.Issue a subpoena for hearings and investigations that require the attendance and 
testimony of witnesses as well as the production of evidence. A subpoena issued 
by a licensing board in a member state for the attendance and testimony of 
witnesses or the production of evidence from another member state must 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 the court. The issuing authority shall pay any witness 
fees, travel expenses, mileage, and other fees required by the service statutes of 
the state in which the witnesses or evidence are located.
3.For purposes of taking adverse action, the home state shall give the same priority and 
effect to reported conduct received from a member state as it would if the conduct had 
occurred within the home state. In so doing, the home state shall apply its own state 
laws to determine appropriate action.
4.The home state shall complete any pending investigation of an occupational therapist 
or occupational therapy assistant who changes primary state of residence during the 
course of the investigation. The home state, where the investigation was initiated may 
take appropriate action and shall promptly report the conclusion of the investigation to 
the occupational therapy compact commission data system. The occupational therapy 
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compact commission data system administrator shall promptly notify the new home 
state of any adverse action.
5.A member state, if otherwise permitted by state law, may recover from the affected 
occupational therapist or occupational therapy assistant the cost of an investigation 
and disposition of a case resulting from any adverse action taken against that 
occupational therapist or occupational therapy assistant.
6.A member state may take adverse action based on the factual findings of the remote 
state, provided the member state follows its own procedures for taking the adverse 
action.
7.Joint investigations:
a.In addition to the authority granted to a member state by its respective state 
occupational therapy laws and regulations or other applicable state law, any 
member state may participate with other member states in joint investigations of 
licensees.
b.Member states shall share any investigative, litigation, or compliance materials in 
furtherance of any joint or individual investigation initiated under the compact.
8.If an adverse action is taken by the home state against an occupational therapist's or 
occupational therapy assistant's license, the occupational therapist's or occupational 
therapy assistant's compact privilege in all other member states must be deactivated 
until all encumbrances have been removed from the state license. All home state 
disciplinary orders that impose adverse action against an occupational therapist's or 
occupational therapy assistant's license must include a statement that the 
occupational therapist's or occupational therapy assistant's compact privilege is 
deactivated in all member states during the pendency of the order.
9.If a member state takes adverse action, the member state shall promptly notify the 
administrator of the data system. The administrator of the data system shall promptly 
notify the home state of any adverse action by a remote state.
10.This compact does not override a member state's decision that participation in an 
alternative program may be used in lieu of adverse action.
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43 - 40.1 - 08. Establishment of the occupational therapy compact commission. 
1.The compact member states hereby create and establish a joint public agency known 
as the occupational therapy compact commission.
a.The commission is an instrumentality of the compact states.
b.Venue is proper and judicial proceedings by or against the commission must be 
brought exclusively in a court of competent jurisdiction where the principal office 
of the commission is located. The commission may waive venue and 
jurisdictional defenses to the extent the commission adopts or consents to 
participate in alternative dispute resolution proceedings.
c.This compact may not be construed to be a waiver of sovereign immunity.
2.Membership, voting, and meetings.
a.Each member state has and is limited to one delegate selected by that member 
state's licensing board.
b.The delegate must be:
(1)A current member of the licensing board, who is an occupational therapist, 
occupational therapy assistant, or public member; or
(2)An administrator of the licensing board.
c.A delegate may be removed or suspended from office as provided by the law of 
the state from which the delegate is appointed.
d.The member state board shall fill any vacancy occurring in the commission within 
ninety days.
e.Each delegate is entitled to one vote with regard to the adoption of rules and 
creation of bylaws and must have an opportunity to participate in the business 
and affairs of the commission. A delegate shall vote in person or by any other 
means provided in the bylaws. The bylaws may provide for delegates' 
participation in meetings by telephone or other means of communication.
f.The commission shall meet at least once during each calendar year. Additional 
meetings must be held as provided in the bylaws.
g.The commission shall establish by rule a term of office for delegates.
3.The commission has the power and duty to:
a.Establish a code of ethics for the commission.
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b.Establish the fiscal year of the commission.
c.Establish bylaws.
d.Maintain financial records in accordance with the bylaws.
e.Meet and take actions consistent with the provisions of this compact and the 
bylaws.
f.Adopt uniform rules to facilitate and coordinate implementation and 
administration of this compact. The rules have the force and effect of law and are 
binding in all member states.
g.Bring and prosecute legal proceedings or actions in the name of the commission, 
provided the standing of any state occupational therapy licensing board to sue or 
be sued under applicable law is not affected.
h.Purchase and maintain insurance and bonds.
i.Borrow, accept, or contract for services of personnel, including employees of a 
member state.
j.Hire employees, elect or appoint officers, fix compensation, define duties, grant 
the 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.
k.Accept any and all appropriate donations and grants of money, equipment, 
supplies, materials and services, and receive, use and dispose of the same; 
provided that at all times the commission avoids any appearance of impropriety 
and conflict of interest.
l.Lease, purchase, accept appropriate gifts or donations of, or otherwise own, 
hold, improve, or use any property; real, personal, or mixed; provided the 
commission avoids any appearance of impropriety;
m.Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose 
of any property; real, personal, or mixed.
n.Establish a budget and make expenditures.
o.Borrow money.
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p.Appoint committees, including standing committees composed of members, state 
regulators, state legislators or their representatives, and consumer 
representatives, and other interested persons as designated in this compact and 
the bylaws.
q.Provide and receive information from, and cooperate with, law enforcement 
agencies.
r.Establish and elect an executive committee.
s.Perform other functions as necessary or appropriate to achieve the purposes of 
this compact consistent with the state regulation of occupational therapy 
licensure and practice.
4.The executive committee.
a.The executive committee has the power to act on behalf of the commission 
according to the terms of this compact.
b.The executive committee is composed of nine members:
(1)Seven voting members who are elected by the commission from the current 
membership of the commission;
(2)One ex-officio, nonvoting member from a recognized national occupational 
therapy professional association; and
(3)One ex-officio, nonvoting member from a recognized national occupational 
therapy certification organization.
c.The ex-officio members will be selected by their respective organizations.
d.The commission may remove any member of the executive committee as 
provided in bylaws.
e.The executive committee shall:
(1)Meet at least annually;
(2)Recommend to the entire commission changes to the rules or bylaws, 
changes to this compact legislation, fees paid by compact member states 
including, annual dues, and any commission compact fee charged to 
licensees for the compact privilege;
(3)Ensure compact administration services are appropriately provided, 
contractual or otherwise;
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(4)Prepare and recommend the budget;
(5)Maintain financial records on behalf of the commission;
(6)Monitor compact compliance of member states and provide compliance 
reports to the commission;
(7)Establish additional committees as necessary; and
(8)Perform other duties as provided in rules or bylaws.
5.Meetings of the commission.
a.All meetings must be open to the public, and public notice of meetings must be 
given in the same manner as required under the rulemaking provisions in section 
43 - 40.1 - 10. 
b.The commission or the executive committee or other committees of the 
commission may convene in a closed, nonpublic meeting if the commission or 
executive committee or other committees of the commission must discuss:
(1)Noncompliance of a member state with its obligations under the compact;
(2)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;
(3)Current, threatened, or reasonably anticipated litigation;
(4)Negotiation of contracts for the purchase, lease, or sale of goods, services, 
or real estate;
(5)Accusing any individual of a crime or formally censuring any individual;
(6)Disclosure of trade secrets or commercial or financial information that is 
privileged or confidential;
(7)Disclosure of information of a personal nature if disclosure would constitute 
a clearly unwarranted invasion of personal privacy;
(8)Disclosure of investigative records compiled for law enforcement purposes;
(9)Disclosure of information related to any investigative reports prepared by or 
on behalf of or for use of the commission or other committee charged with 
responsibility of investigation or determination of compliance issues 
pursuant to the compact; or
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(10)Matters specifically exempted from disclosure by federal or member state 
statute.
c.If a meeting, or portion of a meeting, is closed pursuant to this provision, the 
commission's legal counsel or designee shall certify that the meeting may be 
closed and shall reference each relevant exempting provision.
d.The commission shall keep minutes that fully and clearly describe all matters 
discussed in a meeting and shall provide a full and accurate summary of actions 
taken, and the reasons for taking the actions, including a description of the views 
expressed. All documents considered in connection with an action must be 
identified in the minutes. All minutes and documents of a closed meeting must 
remain under seal, subject to release by a majority vote of the commission or 
order of a court of competent jurisdiction.
6.Financing of the commission.
a.The commission shall pay, or provide for the payment of, the reasonable 
expenses of its establishment, organization, and ongoing activities.
b.The commission may accept any and all appropriate revenue sources, donations, 
and grants of money, equipment, supplies, materials, and services.
c.The commission may levy on and collect an annual assessment from each 
member state or impose fees on other parties to cover the cost of the operations 
and activities of the commission and its staff, which must be in a total amount 
sufficient to cover its annual budget as approved by the commission each year 
for which revenue is not provided by other sources. The aggregate annual 
assessment amount must be allocated based on a formula determined by the 
commission, which shall adopt a rule binding on all member states.
d.The commission may not incur obligations before securing adequate funds to 
meet the obligations or pledge the credit of any of the member states, except by 
and with the authority of the member state.
e.The commission shall keep accurate accounts of all receipts and disbursements. 
The receipts and disbursements of the commission are subject to the audit and 
accounting procedures established under its bylaws. All receipts and 
disbursements of funds handled by the commission must be audited yearly by a 
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certified or licensed public accountant, and the report of the audit must be 
included in and become part of the annual report of the commission.
7.Qualified immunity, defense, and indemnification.
a.The members, officers, executive director, employees, and representatives of the 
commission are immune from suit and liability, either personally or 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 individual against whom the claim is made had 
a reasonable basis for believing occurred within the scope of commission 
employment, duties, or responsibilities. This subdivision may not be construed to 
protect any such individual from suit or liability for any damage, loss, injury, or 
liability caused by the intentional, willful, or wanton misconduct of that individual.
b.The commission shall defend any member, officer, executive director, employee, 
or 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 that the 
individual against whom the claim is made had a reasonable basis for believing 
occurred within the scope of commission employment, duties, or responsibilities. 
This subdivision may not be construed to prohibit that individual from retaining 
counsel or that the actual or alleged act, error, or omission did not result from that 
individual's intentional, willful, or wanton misconduct.
c.The commission shall indemnify and hold harmless any member, officer, 
executive director, employee, or representative of the commission for the amount 
of any settlement or judgment obtained against that individual arising out of any 
actual or alleged act, error, or omission that occurred within the scope of 
commission employment, duties, or responsibilities, or that the individual had a 
reasonable basis for believing occurred within the scope of commission 
employment, duties, or responsibilities, provided the actual or alleged act, error, 
or omission did not result from the intentional, willful, or wanton misconduct of 
that individual.
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43 - 40.1 - 09. Data system. 
1.The commission shall provide for the development, maintenance, and use of a 
coordinated database and reporting system containing licensure, adverse action, and 
investigative information on all licensed individuals in member states.
2.A member state shall submit a uniform data set to the data system on all individuals to 
whom this compact applies, as required by the rules of the commission using a unique 
identifier that includes:
a.Identifying information;
b.Licensure data;
c.Adverse actions against a license or compact privilege;
d.Nonconfidential information related to alternative program participation;
e.Any denial of application for licensure, and the reason for the denial;
f.Other information that may facilitate the administration of this compact, as 
determined by the rules of the commission; and
g.Current significant investigative information.
3.Current significant investigative information and other investigative information 
pertaining to a licensee in any member state only will be available to other member 
states.
4.The commission shall promptly notify all member states of any adverse action taken 
against a licensee or an individual applying for a license. Adverse action information 
pertaining to a licensee in any member state will be available to any other member 
state.
5.Member states contributing information to the data system may designate information 
that may not be shared with the public without the express permission of the 
contributing state.
6.Any information submitted to the data system that is subsequently required to be 
expunged by the laws of the member state contributing the information must be 
removed from the data system.
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43 - 40.1 - 10. Rulemaking. 
1.The commission shall exercise its rulemaking powers pursuant to the criteria set forth 
in this section and the rules adopted thereunder. Rules and amendments become 
binding as of the date specified in each rule or amendment.
2.The commission shall adopt rules in order to effectively and efficiently achieve the 
purposes of the compact. Notwithstanding the foregoing, if the commission exercises 
its rulemaking authority in a manner beyond the scope of the purposes of the compact, 
or the powers granted under the compact, then the action by the commission is invalid 
and has no force and effect.
3.If a majority of the legislatures of the member states rejects a rule, by enactment of a 
statute or resolution in the same manner used to adopt the compact within four years 
of the date of adoption of the rule, the rule has no further force and effect in any 
member state.
4.Rules or amendments to the rules must be adopted at a regular or special meeting of 
the commission.
5.Before adoption of a final rule by the commission, and at least thirty days in advance 
of the meeting at which the rule will be considered and voted upon, the commission 
shall file a notice of proposed rulemaking:
a.On the website of the commission or other publicly accessible platform; and
b.On the website of each member state occupational therapy licensing board or 
other publicly accessible platform or the publication in which each state would 
otherwise publish proposed rules.
6.The notice of proposed rulemaking must include:
a.The proposed time, date, and location of the meeting in which the rule will be 
considered and voted on;
b.The text of the proposed rule or amendment and the reason for the proposed 
rule;
c.A request for comments on the proposed rule from any interested person; and
d.The manner in which interested persons may submit notice to the commission of 
their intention to attend the public hearing and any written comments.
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7.Before adoption of a proposed rule, the commission shall allow an individual to submit 
written data, facts, opinions, and arguments, which must be made available to the 
public.
8.The commission shall grant an opportunity for a public hearing before the commission 
adopts a rule or amendment if a hearing is requested by:
a.At least twenty-five individuals;
b.A state or federal governmental subdivision or agency; or
c.An association or organization having at least twenty-five members.
9.If a hearing is held on the proposed rule or amendment, the commission shall publish 
the place, time, and date of the scheduled public hearing. If the hearing is held 
through electronic means, the commission shall publish the mechanism for access to 
the electronic hearing.
a.Any individual wishing to be heard at the hearing shall notify the executive 
director of the commission or other designated member in writing of their desire 
to appear and testify at the hearing not less than five business days before the 
scheduled date of the hearing.
b.Hearings must be conducted in a manner providing an individual who wishes to 
comment a fair and reasonable opportunity to comment orally or in writing.
c.All hearings must be recorded. A copy of the recording must be made available 
on request.
d.This section may not be construed to require a separate hearing on each rule. 
Rules may be grouped for the convenience of the commission at hearings 
required by this section.
10.Following the scheduled hearing date, or by the close of business on the scheduled 
hearing date if the hearing was not held, the commission shall consider all written and 
oral comments received.
11.If written notice of intent to attend the public hearing by interested parties is not 
received, the commission may proceed with adoption of the proposed rule without a 
public hearing.
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12.The commission shall, by majority vote of all members, take final action on the 
proposed rule and determine the effective date of the rule, if any, based on the 
rulemaking record and the full text of the rule.
13.Upon determination that an emergency exists, the commission may consider and 
adopt an emergency rule without prior notice, opportunity for comment, or hearing, 
provided the usual rulemaking procedures provided in the compact and in this section 
must be retroactively applied to the rule as soon as reasonably possible, in no event 
later than ninety days after the effective date of the rule. For purposes of this 
provision, an emergency rule is one that must be adopted immediately in order to:
a.Meet an imminent threat to public health, safety, or welfare;
b.Prevent a loss of commission or member state funds;
c.Meet a deadline for the promulgation of an administrative rule that is established 
by federal law or rule; or
d.Protect public health and safety.
14.The commission or an authorized committee of the commission may direct revisions to 
a previously adopted rule or amendment for purposes of correcting typographical 
errors, errors in format, errors in consistency, or grammatical errors. Public notice of 
any revisions must be posted on the website of the commission. The revision is 
subject to challenge by any individual for a period of thirty days after posting. The 
revision may be challenged only on grounds that the revision results in a material 
change to a rule. A challenge must be made in writing and delivered to the chair of the 
commission before the end of the notice period. If a challenge is not made, the 
revision will take effect without further action. If the revision is challenged, the revision 
may not take effect without the approval of the commission.
43 - 40.1 - 11. Oversight, dispute resolution, and enforcement. 
1.Oversight.
a.The executive, legislative, and judicial branches of state government in each 
member state shall enforce this compact and take all actions necessary and 
appropriate to effectuate the compact's purposes and intent. The provisions of 
this compact and the rules adopted hereunder have standing as statutory law.
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b.All courts shall take judicial notice of the compact and the rules in any judicial or 
administrative proceeding in a member state pertaining to the subject matter of 
this compact which may affect the powers, responsibilities, or actions of the 
commission.
c.The commission is entitled to receive service of process in any such proceeding, 
and has standing to intervene in such a proceeding for all purposes. Failure to 
provide service of process to the commission renders a judgment or order void 
as to the commission, this compact, or adopted rules.
2.Default, technical assistance, and termination.
a.If the commission determines a member state has defaulted in the performance 
of its obligations or responsibilities under this compact or the adopted rules, the 
commission shall:
(1)Provide written notice to the defaulting state and other member states of the 
nature of the default, the proposed means of curing the default, and any 
other action to be taken by the commission; and
(2)Provide remedial training and specific technical assistance regarding the 
default.
b.If a state in default fails to cure the default, the defaulting state may be 
terminated from the compact upon an affirmative vote of a majority of the 
member states, and all rights, privileges, and benefits conferred by this compact 
may be terminated on the effective date of termination. A cure of the default does 
not relieve the offending state of obligations or liabilities incurred during the 
period of default.
c.Termination of membership in the compact must be imposed only after all other 
means of securing compliance have been exhausted. Notice of intent to suspend 
or terminate must be given by the commission to the governor, the majority and 
minority leaders of the defaulting state's legislature, and each of the member 
states.
d.A state that has been terminated is responsible for all assessments, obligations, 
and liabilities incurred through the effective date of termination, including 
obligations that extend beyond the effective date of termination.
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e.The commission may not incur any costs related to a state that is found to be in 
default or has been terminated from the compact, unless agreed on in writing 
between the commission and the defaulting state.
f.The defaulting state may appeal the action of the commission by petitioning the 
United States district court for the District of Columbia or the federal district 
where the commission has its principal offices. The prevailing member must be 
awarded all costs of litigation, including reasonable attorney's fees.
3.Dispute resolution.
a.Upon request by a member state, the commission shall attempt to resolve 
disputes related to the compact that arise among member states and between 
member and nonmember states.
b.The commission shall adopt a rule providing for both mediation and binding 
dispute resolution for disputes as appropriate.
4.Enforcement.
a.The commission, in the reasonable exercise of its discretion, shall enforce the 
provisions and rules of this compact.
b.By majority vote, the commission may initiate legal action in the United States 
district court for the District of Columbia, or the federal district where the 
commission has its principal offices, against a member state in default to enforce 
compliance with the provisions of the compact and its rules and bylaws. The relief 
sought may include injunctive relief and damages. If judicial enforcement is 
necessary, the prevailing member must be awarded all costs of litigation, 
including reasonable attorney's fees.
c.The remedies herein are not the exclusive remedies of the commission. The 
commission may pursue any other remedies available under federal or state law.
43 - 40.1 - 12. Date of implementation of the interstate compact for occupational therapy  
practice and associated rules, withdrawal, and amendment.
1.The compact becomes effective on the date the compact statute is enacted into law in 
the tenth member state. The provisions, which become effective at that time, are 
limited to the powers granted to the commission relating to assembly and the adoption 
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of rules. Thereafter, the commission shall meet and exercise rulemaking powers 
necessary to the implementation and administration of the compact.
2.Any state that joins the compact subsequent to the commission's initial adoption of the 
rules is subject to the rules as they exist on the date the compact becomes law in that 
state. Any rule that has been previously adopted by the commission has the full force 
and effect of law on the day the compact becomes law in that state.
3.Any member state may withdraw from this compact by enacting a statute repealing the 
compact.
a.A member state's withdrawal may not take effect until six months after enactment 
of the repealing statute.
b.Withdrawal may not affect the continuing requirement of the withdrawing state's 
occupational therapy licensing board to comply with the investigative and 
adverse action reporting requirements of this compact before the effective date of 
withdrawal.
4.The compact may not be construed to invalidate or prevent any occupational therapy 
licensure agreement or other cooperative arrangement between a member state and a 
nonmember state which does not conflict with the provisions of this compact.
5.This compact may be amended by the member states. An amendment to this compact 
may not become effective and binding on any member state until the amendment is 
enacted into the laws of all member states.
43 - 40.1 - 13. Construction and severability. 
This compact must be liberally construed to effectuate the purposes of the compact. The 
provisions of this compact are severable and if any phrase, clause, sentence, or provision of 
this compact is declared to be contrary to the constitution of any member state or of the United 
States or the applicability thereof to any government, agency, individual, or circumstance is held 
invalid, the validity of the remainder of this compact and the applicability of this compact to any 
government, agency, individual, or circumstance are not affected thereby. If this compact is held 
contrary to the constitution of any member state, the compact remains in full force and effect as 
to the remaining member states and in full force and effect as to the member state affected as 
to all severable matters.
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43 - 40.1 - 14. Binding effect of compact and other laws. 
1.A licensee providing occupational therapy in a remote state under the compact 
privilege shall function within the laws and regulations of the remote state.
2.This compact does not prevent the enforcement of any other law of a member state 
which is not inconsistent with the compact.
3.A law in a member state in conflict with the compact is superseded to the extent of the 
conflict.
4.Any lawful actions of the commission, including all rules and bylaws adopted by the 
commission, are binding on the member states.
5.All agreements between the commission and the member states are binding in 
accordance with the terms of the agreement.
6.If a provision of the compact exceeds the constitutional limits imposed on the 
legislature of any member state, the provision is ineffective to the extent of the conflict 
with the constitutional provision in question in that member state.
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