Wisconsin Assembly Bill AB193 Latest Draft

                            2025 - 2026  LEGISLATURE
LRB-1851/2
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2025 ASSEMBLY BILL 193
April 15, 2025 - Introduced by Representatives RODRIGUEZ, SNYDER, DITTRICH, 
GUNDRUM, KNODL, MELOTIK, MURPHY, O'CONNOR, WICHGERS and DUCHOW, 
cosponsored by Senators CABRAL-GUEVARA and TESTIN. Referred to 
Committee on Health, Aging and Long-Term Care. 
 
 ***AUTHORS SUBJECT TO CHANGE***
AN ACT to renumber 448.05 (5r); to amend 146.81 (1) (d), 146.997 (1) (d) 5., 
256.15 (4) (a) 3., 440.03 (9) (a) (intro.) and 2., 440.03 (13) (b) (intro.), 440.15, 
448.01 (9s), 448.01 (12), 448.02 (3) (a) to (c), (e), (f) and (h), 448.02 (4) (a) and 
(b), 448.02 (5), 448.02 (6), 448.02 (8) (a), 448.02 (8) (c), 448.03 (1m), 448.05 (5r) 
(title), 448.07 (1) (b), 448.07 (1) (c), 448.07 (1) (d), 448.07 (2), 448.08 (1m), 
448.08 (4), 448.12, 448.13 (1) (a), 448.13 (2), 448.13 (3) and 990.01 (28); to 
repeal and recreate 448.02 (3) (a), 448.07 (title), 448.07 (1) (title) and 448.07 
(1) (a); to create 14.832, 440.03 (11m) (c) 2rm., 440.03 (13) (c) 1. m., 448.015 
(2m), 448.04 (1) (im), 448.04 (2m), 448.05 (1) (e), 448.05 (5r) (b), 448.05 (6) (av), 
448.06 (3) and subchapter XIV of chapter 448 [precedes 448.9886] of the 
statutes; relating to: ratification of the Respiratory Care Interstate Compact.
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Analysis by the Legislative Reference Bureau
RESPIRATORY CARE INTERSTATE COMPACT
This bill ratifies and enters Wisconsin into the Respiratory Care Interstate 
Compact, which provides for the ability of a respiratory care practitioner to become 
eligible to practice in other compact states.  Significant provisions of the compact 
include the following:
1.  The creation of a Respiratory Care Interstate Compact Commission, which 
includes one administrator or staff member of the licensure authorities of each 
member state. The commission has various powers and duties granted in the 
compact, including establishing bylaws, promulgating binding rules for the 
compact, hiring officers, electing or appointing employees, and establishing and 
electing an executive committee. The commission may levy on and collect an 
annual assessment from each member state or impose fees on licensees of member 
states to cover the cost of the operations and activities of the commission and its 
staff.
2.  A process whereby a respiratory care practitioner may obtain a compact 
privilege to practice in another member state. A licensee's primary state of 
residence is considered to be his or her home state, and any other member state in 
which the licensee wishes to practice is considered a remote state. A licensee 
providing respiratory therapy in a remote state under the compact privilege is 
required under the compact to function within the scope of practice authorized by 
the remote state.
 A remote state may take actions against a respiratory care practitioner[s 
compact privilege within that remote state, and if a respiratory care practitioner[s 
home state license is encumbered, the respiratory care practitioner loses his or her 
compact privilege in all remote states until the home state license is no longer 
encumbered and two years have elapsed from the date on which the license is no 
longer encumbered.
3.  The ability of member states to issue subpoenas that are enforceable in 
other states.
4.  The creation of a coordinated database and reporting system containing 
licensure and disciplinary action information on respiratory care practitioners.  The 
compact provides that member states are responsible for reporting any adverse 
action against a licensee and for monitoring the database to determine whether 
adverse action has been taken against a licensee.  A member state must submit a 
uniform data set to the data system with certain information specified in the 
compact, as required by the rules of the commission.
5. Provisions regarding resolutions of disputes among member states and 
between member and nonmember states, including a process for termination of a 
state[s membership in the compact if the state defaults on its obligations under the 
compact.
The compact becomes effective in this state upon enactment in seven states.  
The compact provides that it may be amended upon enactment of an amendment by  2025 - 2026  Legislature
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SECTION 1
all member states.  A state may withdraw from the compact by repealing the statute 
authorizing the compact, but the compact provides that a withdrawal does not take 
effect until 180 days after the effective date of that repeal.
STATUTES AND RULES EXAMINATION FOR RESPIRATORY CARE PRACTITIONERS
The bill prohibits the Medical Examining Board from requiring an applicant 
to pass a statutes and rules examination as a condition of certification as a 
respiratory care practitioner.  The bill allows the board to require an applicant to 
affirm that the applicant has read and understands the statutes and rules that 
apply to the applicant's practice as a respiratory care practitioner.
For further information see the state fiscal estimate, which will be printed as 
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do 
enact as follows:
SECTION 1.  14.832 of the statutes is created to read:
14.832 Respiratory care interstate compact. There is created a 
respiratory care interstate compact commission as specified in s. 448.9886.  The 
commissioner on the commission representing this state shall be appointed by the 
medical examining board as provided in s. 448.9886 (7) (b) 1., with the advice of the 
respiratory care practitioners examining council, and shall be an individual 
described in s. 448.9886 (7) (b) 2. The commission has the powers and duties 
granted and imposed under s. 448.9886.
SECTION 2. 146.81 (1) (d) of the statutes is amended to read:
146.81 (1) (d) A physician, perfusionist, or respiratory care practitioner 
licensed or certified under subch. II of ch. 448 or a respiratory care practitioner who 
holds a compact privilege under subch. XIV of ch. 448.
SECTION 3. 146.997 (1) (d) 5. of the statutes is amended to read:
146.997 (1) (d) 5.  A respiratory care practitioner licensed or who is certified 
under ch. 448 or who holds a compact privilege under subch. XIV of ch. 448.
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SECTION 4. 256.15 (4) (a) 3. of the statutes is amended to read:
256.15 (4) (a) 3.  If the ambulance is an aircraft and the sick, disabled, or 
injured individual is a pediatric patient who is being transferred from one hospital 
to another hospital, one individual specified in subd. 1. plus one respiratory care 
practitioner who is certified under subch. II of ch. 448 or who holds a compact 
privilege under subch. XIV of ch. 448.
SECTION 5. 440.03 (9) (a) (intro.) and 2. of the statutes are amended to read:
440.03 (9) (a) (intro.)  Subject to pars. (b) and (c) and s. 458.33 (2) (b) and (5), 
the department shall, biennially, determine each fee for an initial credential for 
which no examination is required, for a reciprocal credential, and for a credential 
renewal and any fees imposed under ss. 447.51 (2), 448.986 (2), 448.9875 (2), 
448.9885 (2), 448.9887 (2), 457.51 (2), and 459.71 (2) by doing all of the following:
2.  Not later than January 31 of each odd-numbered year, adjusting for the 
succeeding fiscal biennium each fee for an initial credential for which an 
examination is not required, for a reciprocal credential, and, subject to s. 440.08 (2) 
(a), for a credential renewal, and any fees imposed under ss. 447.51 (2), 448.986 (2), 
448.9875 (2), 448.9885 (2), 448.9887 (2), 457.51 (2), and 459.71 (2), if an adjustment 
is necessary to reflect the approximate administrative and enforcement costs of the 
department that are attributable to the regulation of the particular occupation or 
business during the period in which the initial or reciprocal credential, credential 
renewal, or compact privilege is in effect and, for purposes of each fee for a 
credential renewal, to reflect an estimate of any additional moneys available for the 
department[s general program operations as a result of appropriation transfers 
that have been or are estimated to be made under s. 20.165 (1) (i) during the fiscal 
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biennium in progress at the time of the deadline for an adjustment under this 
subdivision or during the fiscal biennium beginning on the July 1 immediately 
following the deadline for an adjustment under this subdivision.
SECTION 6.  440.03 (11m) (c) 2rm. of the statutes is created to read:
440.03 (11m) (c) 2rm.  The coordinated data system under s. 448.9886 (8), if 
such disclosure is required under the respiratory care interstate compact under s. 
448.9886.
SECTION 7. 440.03 (13) (b) (intro.) of the statutes is amended to read:
440.03 (13) (b) (intro.)  The department may investigate whether an applicant 
for or holder of any of the following credentials has been charged with or convicted 
of a crime only pursuant to rules promulgated by the department under this 
paragraph, including rules that establish the criteria that the department will use 
to determine whether an investigation under this paragraph is necessary, except as 
provided in par. (c) and ss. 441.51 (5) (a) 5., 447.50 (3) (a) 5., 448.980 (5) (b) 3., 
448.985 (3) (a) 4., 448.987 (3) (a) 5. a. and (5) (b) 2. a., 448.988 (3) (a) 5., 448.9886 (3) 
(a) 9., 455.50 (3) (e) 4. and (f) 4., 457.50 (3) (b) 3. and (5) (b) 2. a., and 459.70 (3) (b) 
2.:
SECTION 8.  440.03 (13) (c) 1. m. of the statutes is created to read:
440.03 (13) (c) 1. m.  An applicant for a respiratory care practitioner certificate 
under s. 448.04 (1) (i).
SECTION 9. 440.15 of the statutes is amended to read:
440.15 No fingerprinting. Except as provided under ss. 440.03 (13) (c), 
441.51 (5) (a) 5., 447.50 (3) (a) 5., 448.980 (5) (b) 3., 448.985 (3) (a) 4., 448.987 (3) (a) 
5. a. and (5) (b) 2. a., 448.988 (3) (a) 5., 448.9886 (3) (a) 9., 450.071 (3) (c) 9., 450.075 
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(3) (c) 9., 455.50 (3) (e) 4. and (f) 4., 457.50 (3) (b) 3. and (5) (b) 2. a., and 459.70 (3) 
(b) 1., the department or a credentialing board may not require that an applicant for 
a credential or a credential holder be fingerprinted or submit fingerprints in 
connection with the department[s or the credentialing board[s credentialing.
SECTION 10. 448.01 (9s) of the statutes is amended to read:
448.01 (9s) XScene of an emergencyY means an area not within the confines of 
a hospital or other institution which has hospital facilities or the office of a person 
licensed, certified or holding a compact privilege or limited permit under this 
chapter.
SECTION 11. 448.01 (12) of the statutes is amended to read:
448.01 (12) XWarnY means to privately apprise the holder of a license or, 
certificate, or compact privilege of the unprofessional nature of the holder[s conduct 
and admonish the holder that continued or repeated conduct of such nature may 
give the medical examining board or an attached affiliated credentialing board 
cause to reprimand the holder or to limit, suspend or revoke such license or, 
certificate, or compact privilege.
SECTION 12. 448.015 (2m) of the statutes is created to read:
448.015 (2m) XRespiratory care compact privilegeY means a compact 
privilege, as defined in s. 448.9886 (2) (h), that is granted under the respiratory 
care interstate compact to an individual to practice in this state.
SECTION 13. 448.02 (3) (a) to (c), (e), (f) and (h) of the statutes are amended to 
read:
448.02 (3) (a) The board shall investigate allegations of unprofessional 
conduct and negligence in treatment by persons holding a license or, certificate, or 
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respiratory care compact privilege granted by the board. An allegation that a 
physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to mail or 
present a medical certification required under s. 69.18 (2) within 21 days after the 
pronouncement of death of the person who is the subject of the required certificate 
or that a physician has failed at least 6 times within a 6-month period to mail or 
present a medical certificate required under s. 69.18 (2) within 6 days after the 
pronouncement of death of the person who is the subject of the required certificate 
is an allegation of unprofessional conduct.  Information contained in reports filed 
with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under 
42 CFR 1001.2005, shall be investigated by the board.  Information contained in a 
report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 
29, which is not a finding of negligence or in a report filed with the board under s. 
50.36 (3) (c) may, within the discretion of the board, be used as the basis of an 
investigation of a person named in the report.  The board may require a person 
holding a license or, certificate, or respiratory care compact privilege to undergo 
and may consider the results of one or more physical, mental or professional 
competency examinations if the board believes that the results of any such 
examinations may be useful to the board in conducting its investigation.
(b)  After an investigation, if the board finds that there is probable cause to 
believe that the person is guilty of unprofessional conduct or negligence in 
treatment, the board shall hold a hearing on such conduct.  The board may use any 
information obtained by the board or the department under s. 655.17 (7) (b), as 
created by 1985 Wisconsin Act 29, in an investigation or a disciplinary proceeding, 
including a public disciplinary proceeding, conducted under this subsection and the 
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board may require a person holding a license or, certificate, or respiratory care 
compact privilege to undergo and may consider the results of one or more physical, 
mental or professional competency examinations if the board believes that the 
results of any such examinations may be useful to the board in conducting its 
hearing.  A unanimous finding by a panel established under s. 655.02, 1983 stats., 
or a finding by a court that a physician has acted negligently in treating a patient is 
conclusive evidence that the physician is guilty of negligence in treatment. A 
finding that is not a unanimous finding by a panel established under s. 655.02, 1983 
stats., that a physician has acted negligently in treating a patient is presumptive 
evidence that the physician is guilty of negligence in treatment.  A certified copy of 
the findings of fact, conclusions of law and order of the panel or the order of a court 
is presumptive evidence that the finding of negligence in treatment was made.  The 
board shall render a decision within 90 days after the date on which the hearing is 
held or, if subsequent proceedings are conducted under s. 227.46 (2), within 90 days 
after the date on which those proceedings are completed.
(c)  Subject to par. (cm), after a disciplinary hearing, the board may, when it 
determines that a panel established under s. 655.02, 1983 stats., has unanimously 
found or a court has found that a person has been negligent in treating a patient or 
when it finds a person guilty of unprofessional conduct or negligence in treatment, 
do one or more of the following:  warn or reprimand that person, or limit, suspend or 
revoke any license or, certificate, or respiratory care compact privilege granted by 
the board to that person.  The board may condition the removal of limitations on a 
license or, certificate, or respiratory care compact privilege or the restoration of a 
suspended or revoked license or, certificate, or respiratory care compact privilege 
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upon obtaining minimum results specified by the board on one or more physical, 
mental or professional competency examinations if the board believes that 
obtaining the minimum results is related to correcting one or more of the bases 
upon which the limitation, suspension or revocation was imposed.
(e)  A person whose license or, certificate, or respiratory care compact privilege 
is limited under this subchapter shall be permitted to continue practice upon 
condition that the person will refrain from engaging in unprofessional conduct; that 
the person will appear before the board or its officers or agents at such times and 
places as may be designated by the board from time to time; that the person will 
fully disclose to the board or its officers or agents the nature of the person[s practice 
and conduct; that the person will fully comply with the limits placed on his or her 
practice and conduct by the board; that the person will obtain additional training, 
education or supervision required by the board; and that the person will cooperate 
with the board.
(f) Unless a suspended license or, certificate, or respiratory care compact 
privilege is revoked during the period of suspension, upon the expiration of the 
period of suspension the license or, certificate, or respiratory care compact privilege 
shall again become operative and effective.  However, the board may require the 
holder of any such suspended license or, certificate, or respiratory care compact 
privilege to pass the examinations required for the original grant of the license or, 
certificate, or respiratory care compact privilege before allowing such suspended 
license or, certificate, or respiratory care compact privilege again to become 
operative and effective.
(h) Nothing in this subsection prohibits the board, in its discretion, from 
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investigating and conducting disciplinary proceedings on allegations of 
unprofessional conduct by persons holding a license or, certificate, or respiratory 
care compact privilege granted by the board when the allegations of unprofessional 
conduct may also constitute allegations of negligence in treatment.
SECTION 14. 448.02 (3) (a) of the statutes, as affected by 2023 Wisconsin Act 
172 and 2025 Wisconsin Act .... (this act), is repealed and recreated to read:
448.02 (3) (a) The board shall investigate allegations of unprofessional 
conduct and negligence in treatment by persons holding a license, certificate, or 
respiratory care compact privilege granted by the board. An allegation that a 
physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to present a 
medical certification required under s. 69.18 (2) within 21 days after the 
pronouncement of death of the person who is the subject of the required certificate 
or that a physician has failed at least 6 times within a 6-month period to present a 
medical certificate required under s. 69.18 (2) within 6 days after the 
pronouncement of death of the person who is the subject of the required certificate 
is an allegation of unprofessional conduct.  Information contained in reports filed 
with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under 
42 CFR 1001.2005, shall be investigated by the board.  Information contained in a 
report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 
29, which is not a finding of negligence or in a report filed with the board under s. 
50.36 (3) (c) may, within the discretion of the board, be used as the basis of an 
investigation of a person named in the report.  The board may require a person 
holding a license, certificate, or respiratory care compact privilege to undergo and 
may consider the results of one or more physical, mental or professional competency 
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examinations if the board believes that the results of any such examinations may be 
useful to the board in conducting its investigation.
SECTION 15. 448.02 (4) (a) and (b) of the statutes are amended to read:
448.02 (4) (a) The board may summarily suspend or limit any license or, 
certificate, or respiratory care compact privilege granted by the board when the 
board has in its possession evidence establishing probable cause to believe that the 
holder of the license or, certificate, or respiratory care compact privilege has 
violated the provisions of this subchapter and that it is necessary to suspend or 
limit the license or, certificate, or respiratory care compact privilege immediately to 
protect the public health, safety, or welfare.  The holder of the license or, certificate, 
or respiratory care compact privilege shall be granted an opportunity to be heard 
during the determination of probable cause.  The board chair and 2 board members 
designated by the chair or, if the board chair is not available, the board vice-chair 
and 2 board members designated by the vice-chair, shall exercise the authority 
granted by this paragraph to summarily suspend or limit a license or, certificate, or 
respiratory care compact privilege in the manner provided under par. (b).
(b)  An order of summary suspension or limitation shall be served upon the 
holder of the license or, certificate, or respiratory care compact privilege in the 
manner provided in s. 801.11 for service of summons. The order of summary 
suspension or limitation shall be effective upon service or upon actual notice of the 
summary suspension or limitation given to the holder of the license or, certificate, 
or respiratory care compact privilege or to the attorney of the license or, certificate, 
or respiratory care compact privilege holder, whichever is sooner. A notice of 
hearing commencing a disciplinary proceeding shall be issued no more than 10 days 
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following the issuance of the order of summary suspension or limitation.  The order 
of summary suspension or limitation remains in effect until the effective date of a 
final decision and order in the disciplinary proceeding against the holder or until 
the order of summary suspension or limitation is discontinued by the board 
following a hearing to show cause. The holder of the license or, certificate, or 
respiratory care compact privilege shall have the right to request a hearing to show 
cause why the order of summary suspension or limitation should not be continued 
and the order of summary suspension or limitation shall notify the holder of the 
license or, certificate, or respiratory care compact privilege of that right. If a 
hearing to show cause is requested by the holder of the license or, certificate, or 
respiratory care compact privilege, the hearing shall be scheduled on a date within 
20 days of receipt by the board of the request for the hearing to show cause.
SECTION 16. 448.02 (5) of the statutes is amended to read:
448.02 (5) VOLUNTARY SURRENDER.  The holder of any license or, certificate, or 
respiratory care compact privilege granted by the board may voluntarily surrender 
the license or, certificate, or respiratory care compact privilege to the secretary of 
the board, but the secretary may refuse to accept the surrender if the board has 
received allegations of unprofessional conduct against the holder of the license or, 
certificate, or respiratory care compact privilege. The board may negotiate 
stipulations in consideration for accepting the surrender of licenses.
SECTION 17. 448.02 (6) of the statutes is amended to read:
448.02 (6) RESTORATION OF LICENSE OR CERTIFICATE CREDENTIAL.  The board 
may restore any license or, certificate, or respiratory care compact privilege that has 
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been voluntarily surrendered or revoked under any of the provisions of this 
subchapter, on such terms and conditions as it may deem appropriate.
SECTION 18. 448.02 (8) (a) of the statutes is amended to read:
448.02 (8) (a)  After an investigation by the board under sub. (3) (a) or by the 
department under s. 440.03 (3m) or (5), the board may issue a private and 
confidential administrative warning to a holder of a license or, certificate, or 
respiratory care compact privilege if the board determines that there is evidence of 
misconduct by him or her.  The board may issue an administrative warning under 
this paragraph only if the board determines that no further action is warranted 
because the matter involves minor misconduct and the issuance of an 
administrative warning adequately protects the public by putting the holder of the 
license or, certificate, or respiratory care compact privilege on notice that any 
subsequent misconduct may result in disciplinary action.  The board shall review 
the determination if the holder of the license or, certificate, or respiratory care 
compact privilege makes a personal appearance before the board.  Following the 
review, the board may affirm, rescind or modify the administrative warning.  A 
holder of a license or, certificate, or respiratory care compact privilege may seek 
judicial review under ch. 227 of an affirmation or modification of an administrative 
warning by the board.
SECTION 19. 448.02 (8) (c) of the statutes is amended to read:
448.02 (8) (c)  Notwithstanding par. (b), if the board receives a subsequent 
allegation of misconduct about a holder of a license or, certificate, or respiratory 
care compact privilege to whom the board issued an administrative warning under 
par. (a), the board may reopen the matter that resulted in the issuance of the 
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administrative warning or use the administrative warning in any subsequent 
disciplinary hearing under sub. (3) (b) as evidence that he or she had actual 
knowledge that the misconduct that was the basis for the administrative warning 
was contrary to law.
SECTION 20. 448.03 (1m) of the statutes is amended to read:
448.03 (1m) CERTIFICATE REQUIRED TO PRACTICE.  No person may practice 
respiratory care, or attempt to do so or make a representation as authorized to do 
so, without unless the person holds a certificate as a respiratory care practitioner 
granted by the board or holds a respiratory care compact privilege.
SECTION 21. 448.04 (1) (im) of the statutes is created to read:
448.04 (1) (im)  Respiratory care compact privilege. The board may grant a 
respiratory care compact privilege pursuant to the respiratory care interstate 
compact under s. 448.9886.
SECTION 22. 448.04 (2m) of the statutes is created to read:
448.04 (2m) DISPLAY OF CREDENTIAL.  Each individual who holds a license, 
certificate, or respiratory care compact privilege under this subchapter shall 
display his or her credential in a conspicuous place in the individual[s office or place 
of practice or business.
SECTION 23. 448.05 (1) (e) of the statutes is created to read:
448.05 (1) (e)  Pay the fee specified in s. 440.05 (1).
SECTION 24. 448.05 (5r) (title) of the statutes is amended to read:
448.05 (5r) (title)  CERTIFICATE AS RESPIRATORY CARE PRACTITIONER; COMPACT 
PRIVILEGE.
SECTION 25. 448.05 (5r) of the statutes is renumbered 448.05 (5r) (a).
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SECTION 26. 448.05 (5r) (b) of the statutes is created to read:
448.05 (5r) (b)  An applicant for a respiratory care compact privilege shall 
submit evidence satisfactory to the board that the applicant satisfies the 
requirements under s. 448.9886 (4).
SECTION 27. 448.05 (6) (av) of the statutes is created to read:
448.05 (6) (av) 1.  The board may not require an applicant for certification as a 
respiratory care practitioner under s. 448.04 (1) (i) to pass a statutes and rules 
examination as a condition of receiving an initial certification or a certification 
renewal.
2.  The board may require an applicant described under subd. 1. to affirm that 
the applicant has read and understands the statutes and rules that apply to the 
applicant's practice.
SECTION 28. 448.06 (3) of the statutes is created to read:
448.06 (3) GRANT OF RESPIRATORY CARE COMPACT PRIVILEGE.  The board shall 
grant or deny a respiratory care compact privilege in accordance with subs. (1) to 
(2), unless otherwise provided under the respiratory care interstate compact under 
subch. XIV.
SECTION 29. 448.07 (title) of the statutes is repealed and recreated to read:
448.07 (title)  Renewal.
SECTION 30. 448.07 (1) (title) of the statutes is repealed and recreated to read:
448.07 (1) (title)  RENEWAL.
SECTION 31. 448.07 (1) (a) of the statutes is repealed and recreated to read:
448.07 (1) (a)  Renewal applications for a license, certificate, or respiratory 
care compact privilege issued under this subchapter shall be submitted to the 
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department on a form provided by the department on or before the applicable 
renewal date specified under s. 440.08 (2) (a), except that renewal of a compact 
license shall be governed by the renewal provisions in s. 448.980 (7), and renewal of 
a respiratory care compact privilege shall be governed by s. 448.9886 (4).
SECTION 32. 448.07 (1) (b) of the statutes is amended to read:
448.07 (1) (b)  The board shall maintain the register required by s. 440.035 
(1m) (d), which shall be divided according to the activity for which the registrant is 
licensed or certified individual holds the license, certificate, or respiratory care 
compact privilege.  The board shall make copies available for purchase at cost.
SECTION 33. 448.07 (1) (c) of the statutes is amended to read:
448.07 (1) (c)  Every registration renewal made as provided in this section 
shall be presumptive evidence in all courts and other places that the person named 
therein is legally registered holds the license, certificate, or respiratory care 
compact privilege for the period covered by such registration the renewal, and shall 
be deemed to fulfill any statutory requirement for renewal of that license or, 
certificate, or compact privilege.
SECTION 34. 448.07 (1) (d) of the statutes is amended to read:
448.07 (1) (d)  No registration renewal may be permitted by the secretary of 
the board in the case of any physician or, perfusionist, or anesthesiologist assistant 
who has failed to meet the requirements of s. 448.13 or any person whose license or, 
certificate, or respiratory care compact privilege has been suspended or revoked 
and the registration of any such person shall be deemed automatically annulled 
upon receipt by the secretary of the board of a verified report of such suspension or 
revocation, subject to the person[s right of appeal. A person whose license or 
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certificate has been suspended or revoked and subsequently restored shall be 
registered by the board upon tendering a verified report of such restoration of the 
license or certificate, together with an application for registration and the 
registration fee.
SECTION 35. 448.07 (2) of the statutes is amended to read:
448.07 (2) FEES.  Except as otherwise provided in s. 448.980, the fees for 
examination and licenses granted under this subchapter are specified in s. 440.05, 
and the renewal fee for such licenses a license, certificate, or respiratory care 
compact privilege is determined by the department under s. 440.03 (9) (a).  Compact 
licenses shall be subject to additional fees and assessments, as established by the 
department, the board, or the interstate medical licensure compact commission, to 
cover any costs incurred by the department or the board for this state [s 
participation in the interstate medical licensure compact under s. 448.980 and costs 
incurred by the interstate medical licensure compact commission for its 
administration of the renewal process for the interstate medical licensure compact 
under s. 448.980.
SECTION 36. 448.08 (1m) of the statutes is amended to read:
448.08 (1m) FEE SPLITTING.  Except as otherwise provided in this section, no 
person licensed or certified who holds a license, certificate, or respiratory care 
compact privilege under this subchapter may give or receive, directly or indirectly, 
to or from any person, firm or corporation any fee, commission, rebate or other form 
of compensation or anything of value for sending, referring or otherwise inducing a 
person to communicate with a licensee in a professional capacity, or for any 
professional services not actually rendered personally or at his or her direction.
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SECTION 37. 448.08 (4) of the statutes is amended to read:
448.08 (4) PROFESSIONAL PARTNERSHIPS AND CORPORATIONS PERMITTED.  
Notwithstanding any other provision in this section, it is lawful for 2 or more 
physicians, who have entered into a bona fide partnership for the practice of 
medicine, to render a single bill for such services in the name of such partnership, 
and it also is lawful for a service corporation to render a single bill for services in 
the name of the corporation, provided that each individual licensed, registered or 
certified who holds a license, certificate, or respiratory care compact privilege 
under this chapter, subch. I of ch. 457, or ch. 446, 449, 450, 455, or 459 that renders 
billed services is individually identified as having rendered such services.
SECTION 38. 448.12 of the statutes is amended to read:
448.12 Malpractice. Anyone practicing medicine, surgery, osteopathy, or 
any other form or system of treating the sick without having a valid license or a 
certificate of registration shall be liable to the penalties and liabilities for 
malpractice; and ignorance shall not lessen such liability for failing to perform or 
for negligently or unskillfully performing or attempting to perform any duty 
assumed, and which is ordinarily performed by authorized practitioners.
SECTION 39. 448.13 (1) (a) of the statutes is amended to read:
448.13 (1) (a)  Except as provided in par. (b), each physician shall include with 
his or her application for  a certificate of registration renewal under s. 448.07 proof 
of attendance at and completion of all of the following:
1.  Continuing education programs or courses of study approved for at least 30 
hours of credit by the board within the 2 calendar years preceding the calendar year 
for which the registration renewal is effective.
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2.  Professional development and maintenance of certification or performance 
improvement or continuing medical education programs or courses of study 
required by the board by rule under s. 448.40 (1) and completed within the 2 
calendar years preceding the calendar year for which the registration renewal is 
effective.
SECTION 40. 448.13 (2) of the statutes is amended to read:
448.13 (2) Each person licensed as a perfusionist shall include with his or her 
application for a certificate of registration renewal under s. 448.07 proof of 
completion of continuing education requirements promulgated by rule by the board.
SECTION 41. 448.13 (3) of the statutes is amended to read:
448.13 (3) Each person licensed as an anesthesiologist assistant shall include 
with his or her application for  a certificate of registration renewal under s. 448.07 
proof of meeting the criteria for recertification by the National Commission on 
Certification of Anesthesiologist Assistants or by a successor entity, including any 
continuing education requirements.
SECTION 42.  Subchapter XIV of chapter 448 [precedes 448.9886] of the 
statutes is created to read:
CHAPTER 448
SUBCHAPTER XIV
RESPIRATORY CARE  
INTERSTATE COMPACT
448.9886  Respiratory care interstate compact. (1) TITLE AND PURPOSE.  
(a)  The purpose of this compact is to facilitate the interstate practice of respiratory 
therapy with the goal of improving public access to respiratory therapy services by 
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providing respiratory therapists licensed in a member state the ability to practice in 
other member states.  The compact preserves the regulatory authority of states to 
protect public health and safety through the current system of state licensure.
(b)  This compact is designed to achieve the following objectives:
1. Increase public access to respiratory therapy services by creating a 
responsible, streamlined pathway for licensees to practice in member states with 
the goal of improving outcomes for patients;
2.  Enhance states[ ability to protect the public[s health and safety;
3. Promote the cooperation of member states in regulating the practice of 
respiratory therapy within those member states;
4.  Ease administrative burdens on states by encouraging the cooperation of 
member states in regulating multi-state respiratory therapy practice;
5.  Support relocating active military members and their spouses; and
6.  Promote mobility and address workforce shortages.
(2) DEFINITIONS. As used in this compact, unless the context requires 
otherwise, the following definitions shall apply:
(a)  XActive military memberY means any person with a full-time duty status 
in the armed forces of the United States, including members of the national guard 
and reserve.
(b)  XAdverse actionY means any administrative, civil, equitable, or criminal 
action permitted by a state[s laws which is imposed by any state authority with 
regulatory authority over respiratory therapists, such as license denial, censure, 
revocation, suspension, probation, monitoring of the licensee, or restriction on the 
licensee[s practice, not including participation in an alternative program.
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(c)  XAlternative programY means a nondisciplinary monitoring or practice 
remediation process applicable to a respiratory therapist approved by any state 
authority with regulatory authority over respiratory therapists.  This includes, but 
is not limited to, programs to which licensees with substance abuse or addiction 
issues are referred in lieu of adverse action.
(d)  XCharter member statesY means those member states who were the first 7 
states to enact the compact into the laws of their state.
(e)  XCommissionY or Xrespiratory care interstate compact commissionY means 
the government instrumentality and body politic whose membership consists of all 
member states that have enacted the compact.
(f)  XCommissionerY means the individual appointed by a member state to 
serve as the member of the commission for that member state.
(g)  XCompactY means the respiratory care interstate compact.
(h)  XCompact privilegeY means the authorization granted by a remote state to 
allow a licensee from another member state to practice as a respiratory therapist in 
the remote state under the remote state[s laws and rules. The practice of 
respiratory therapy occurs in the member state where the patient is located at the 
time of the patient encounter.
(i)  XCriminal background checkY means the submission by the member state 
of fingerprints or other biometric-based information on license applicants at the 
time of initial licensing for the purpose of obtaining that applicant[s criminal 
history record information, as defined in 28 CFR 20.3 (d) or successor provision, 
from the federal bureau of investigation and the state[s criminal history record 
repository, as defined in 28 CFR 20.3 (f) or successor provision.
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(j)  XData systemY means the commission[s repository of information about 
licensees as further set forth in sub. (8).
(k)  XDomicileY means the jurisdiction which is the licensee[s principal home 
for legal purposes.
(L)  XEncumbered licenseY means a license that a state[s respiratory therapy 
licensing authority has limited in any way.
(m)  XExecutive committeeY means a group of directors elected or appointed to 
act on behalf of, and within the powers granted to them by the commission.
(n)  XHome stateY except as set forth in sub. (5), means the member state that 
is the licensee[s primary domicile.
(o)  XHome state licenseY means an active license to practice respiratory 
therapy in a home state that is not an encumbered license.
(p)  XJurisprudence requirementY means an assessment of an individual[s 
knowledge of the state laws and regulations governing the practice of respiratory 
therapy in such state.
(q)  XLicenseeY means an individual who currently holds an authorization 
from the state to practice as a respiratory therapist.
(r)  XMember stateY means a state that has enacted the compact and been 
admitted to the commission in accordance with the provisions herein and 
commission rules.
(s)  XModel compactY means the model for the respiratory care interstate 
compact on file with the Council of State Governments or other entity as designated 
by the commission.
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(t)  XRemote stateY means a member state where a licensee is exercising or 
seeking to exercise the compact privilege.
(u)  XRespiratory therapistY or Xrespiratory care practitionerY means an 
individual who holds a credential issued by the National Board for Respiratory Care 
(or its successor) and holds a license in a state to practice respiratory therapy.  For 
purposes of this compact, any other title or status adopted by a state to replace the 
term Xrespiratory therapistY or Xrespiratory care practitionerY shall be deemed 
synonymous with Xrespiratory therapistY and shall confer the same rights and 
responsibilities to the licensee under the provisions of this compact at the time of its 
enactment.
(v)  XRespiratory therapy,Y Xrespiratory therapy practice,Y Xrespiratory care,Y 
Xthe practice of respiratory care,Y and Xthe practice of respiratory therapyY means 
the care and services provided by or under the direction and supervision of a 
respiratory therapist or respiratory care practitioner.
(w)  XRespiratory therapy licensing authorityY means the agency, board, or 
other body of a state that is responsible for licensing and regulation of respiratory 
therapists.
(x)  XRuleY means a regulation promulgated by an entity that has the force and 
effect of law.
(y)  XScope of practiceY means the procedures, actions, and processes a 
respiratory therapist licensed in a state or practicing under a compact privilege in a 
state is permitted to undertake in that state and the circumstances under which 
the respiratory therapist is permitted to undertake those procedures, actions, and 
processes.  Such procedures, actions, and processes, and the circumstances under 
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which they may be undertaken may be established through means, including, but 
not limited to, statute, regulations, case law, and other processes available to the 
state respiratory therapy licensing authority or other government agency.
(z)  XSignificant investigative informationY means information, records, and 
documents received or generated by a state respiratory therapy licensing authority 
pursuant to an investigation for which a determination has been made that there is 
probable cause to believe that the licensee has violated a statute or regulation that 
is considered more than a minor infraction for which the state respiratory therapy 
licensing authority could pursue adverse action against the licensee.
(zm)  XStateY means any state, commonwealth, district, or territory of the 
United States.
(3) STATE PARTICIPATION IN THIS COMPACT.  (a)  In order to participate in this 
compact and thereafter continue as a member state, a member state shall:
1.  Enact a compact that is not materially different from the model compact;
2.  License respiratory therapists;
3.  Participate in the commission[s data system;
4. Have a mechanism in place for receiving and investigating complaints 
against licensees and compact privilege holders;
5.  Notify the commission, in compliance with the terms of this compact and 
commission rules, of any adverse action against a licensee, a compact privilege 
holder, or a license applicant;
6.  Notify the commission, in compliance with the terms of this compact and 
commission rules, of the existence of significant investigative information;
7.  Comply with the rules of the commission;
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8.  Grant the compact privilege to a holder of an active home state license and 
otherwise meet the applicable requirements of sub. (4) in a member state; and
9.  Complete a criminal background check for each new licensee at the time of 
initial licensure.
a. Where expressly authorized or permitted by federal law, whether such 
federal law is in effect prior to, at, or after the time of a member state[s enactment 
of this compact, a member state[s enactment of this compact shall hereby authorize 
the member state[s respiratory therapy licensing authority to perform criminal 
background checks as defined herein. The absence of such a federal law as 
described in this subd. 9. a. shall not prevent or preclude such authorization where 
it may be derived or granted through means other than the enactment of this 
compact.
(b)  Nothing in this compact prohibits a member state from charging a fee for 
granting and renewing the compact privilege.
(4) COMPACT PRIVILEGE. (a) To exercise the compact privilege under the 
terms and provisions of the compact, the licensee shall:
1.  Hold and maintain an active home state license as a respiratory therapist;
2. Hold and maintain an active credential from the National Board for 
Respiratory Care (or its successor) that would qualify them for licensure in the 
remote state in which they are seeking the privilege;
3.  Have not had any adverse action against a license within the previous 2 
years;
4.  Notify the commission that the licensee is seeking the compact privilege 
within a remote state(s);
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5. Pay any applicable fees, including any state and commission fees and 
renewal fees, for the compact privilege;
6.  Meet any jurisprudence requirements established by the remote state in 
which the licensee is seeking a compact privilege;
7.  Report to the commission adverse action taken by any nonmember state 
within 30 days from the date the adverse action is taken;
8. Report to the commission, when applying for a compact privilege, the 
address of the licensee[s domicile and thereafter promptly report to the commission 
any change in the address of the licensee[s domicile within 30 days of the effective 
date of the change in address; and
9.  Consent to accept service of process by mail at the licensee[s domicile on 
record with the commission with respect to any action brought against the licensee 
by the commission or a member state, and consent to accept service of a subpoena 
by mail at the licensee[s domicile on record with the commission with respect to any 
action brought or investigation conducted by the commission or a member state.
(b)  The compact privilege is valid until the expiration date or revocation of the 
home state license unless terminated pursuant to adverse action. The licensee 
must comply with all of the requirements of par. (a), above, to maintain the compact 
privilege in a remote state.  If those requirements are met, no adverse actions are 
taken, and the licensee has paid any applicable compact privilege renewal fees, then 
the licensee will maintain the licensee[s compact privilege.
(c) A licensee providing respiratory therapy in a remote state under the 
compact privilege shall function within the scope of practice authorized by the 
remote state for the type of respiratory therapist license the licensee holds.  Such 
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procedures, actions, processes, and the circumstances under which they may be 
undertaken may be established through means, including, but not limited to, 
statute, regulations, case law, and other processes available to the state respiratory 
therapy licensing authority or other government agency.
(d)  If a licensee[s compact privilege in a remote state is removed by the remote 
state, the individual shall lose or be ineligible for the compact privilege in that 
remote state until the compact privilege is no longer limited or restricted by that 
state.
(e)  If a home state license is encumbered, the licensee shall lose the compact 
privilege in all remote states until the following occur:
1.  The home state license is no longer encumbered; and
2.  Two years have elapsed from the date on which the license is no longer 
encumbered due to the adverse action.
(f)  Once a licensee with a restricted or limited license meets the requirements 
of par. (e) 1. and 2., the licensee must also meet the requirements of par. (a) to 
obtain a compact privilege in a remote state.
(5) ACTIVE MILITARY MEMBER OR THEIR SPOUSE. (a) An active military 
member, or their spouse, shall designate a home state where the individual has a 
current license in good standing. The individual may retain the home state 
designation during the period the service member is on active duty.
(b)  An active military member and their spouse shall not be required to pay to 
the commission for a compact privilege any fee that may otherwise be charged by 
the commission.  If a remote state chooses to charge a fee for a compact privilege, it 
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may choose to charge a reduced fee or no fee to an active military member and their 
spouse for a compact privilege.
(6) ADVERSE ACTIONS.  (a)  A member state in which a licensee is licensed 
shall have authority to impose adverse action against the license issued by that 
member state.
(b)  A member state may take adverse action based on significant investigative 
information of a remote state or the home state, so long as the member state follows 
its own procedures for imposing adverse action.
(c) Nothing in this compact shall override a member state[s decision that 
participation in an alternative program may be used in lieu of adverse action and 
that such participation shall remain nonpublic if required by the member state[s 
laws.
(d)  A remote state shall have the authority to:
1. Take adverse actions as set forth herein against a licensee[s compact 
privilege in that state;
2. Issue subpoenas for both hearings and investigations that require the 
attendance and testimony of witnesses, and the production of evidence.
a.  Subpoenas may be issued by a respiratory therapy licensing authority in a 
member state for the attendance and testimony of witnesses and the production of 
evidence.
b.  Subpoenas issued by a respiratory therapy licensing authority in a member 
state for the attendance and testimony of witnesses shall be enforced in the latter 
state by any court of competent jurisdiction in the latter state, according to the 
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practice and procedure of that court applicable to subpoenas issued in proceedings 
pending before it.
c.  Subpoenas issued by a respiratory therapy licensing authority in a member 
state for production of evidence from another member state shall be enforced in the 
latter state, according to the practice and procedure of that court applicable to 
subpoenas issued in the proceedings pending before it.
d.  The issuing authority shall pay any witness fees, travel expenses, mileage, 
and other fees required by the service statutes of the state where the witnesses or 
evidence are located;
3.  Unless otherwise prohibited by state law, recover from the licensee the costs 
of investigations and disposition of cases resulting from any adverse action taken 
against that licensee;
4.  Notwithstanding subd. 2., a member state may not issue a subpoena to 
gather evidence of conduct in another member state that is lawful in such other 
member state for the purpose of taking adverse action against a licensee[s compact 
privilege or application for a compact privilege in that member state; and
5.  Nothing in this compact authorizes a member state to impose discipline 
against a respiratory therapist[s compact privilege in that member state for the 
individual[s otherwise lawful practice in another state.
(e)  Joint investigations. 1.  In addition to the authority granted to a member 
state by its respective respiratory therapy practice act or other applicable state law, 
a member state may participate with other member states in joint investigations of 
licensees, provided, however, that a member state receiving such a request has no 
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obligation to respond to any subpoena issued regarding an investigation of conduct 
or practice that was lawful in a member state at the time it was undertaken.
2. Member states shall share any significant investigative information, 
litigation, or compliance materials in furtherance of any joint or individual 
investigation initiated under the compact.  In sharing such information between 
member state respiratory therapy licensing authorities, all information obtained 
shall be kept confidential, except as otherwise mutually agreed upon by the sharing 
and receiving member state(s).
(f)  Nothing in this compact may permit a member state to take any adverse 
action against a licensee or holder of a compact privilege for conduct or practice that 
was legal in the member state at the time it was undertaken.
(g)  Nothing in this compact may permit a member state to take disciplinary 
action against a licensee or holder of a compact privilege for conduct or practice that 
was legal in the member state at the time it was undertaken.
(7) ESTABLISHMENT OF THE RESPIRATORY CARE INTERSTATE COMPACT 
COMMISSION.  (a)  The compact member states hereby create and establish a joint 
government agency whose membership consists of all member states that have 
enacted the compact known as the respiratory care interstate compact commission.  
The commission is an instrumentality of the compact member states acting jointly 
and not an instrumentality of any one state. The commission shall come into 
existence on or after the effective date of the compact, as set forth in sub. (11).
(b)  Membership, voting, and meetings. 1.  Each member state shall have and 
be limited to one commissioner selected by that member state[s respiratory therapy 
licensing authority.
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2. The commissioner shall be an administrator or their designated staff 
member of the member state[s respiratory therapy licensing authority.
3. The commission shall by rule or bylaw establish a term of office for 
commissioners and may by rule or bylaw establish term limits.
4. The commission may recommend to a member state the removal or 
suspension of any commissioner from office.
5. A member state[s respiratory therapy licensing authority shall fill any 
vacancy of its commissioner occurring on the commission within 60 days of the 
vacancy.
6.  Each commissioner shall be entitled to one vote on all matters before the 
commission requiring a vote by commissioners.
7.  A commissioner shall vote in person or by such other means as provided in 
the bylaws. The bylaws may provide for commissioners to meet by 
telecommunication, videoconference, or other means of communication.
8. The commission shall meet at least once during each calendar year.  
Additional meetings may be held as set forth in the bylaws.
(c)  The commission shall have the following powers:
1.  Establish and amend the fiscal year of the commission;
2.  Establish and amend bylaws and policies, including but not limited to, a 
code of conduct and conflict of interest;
3.  Establish and amend rules, which shall be binding in all member states;
4.  Maintain its financial records in accordance with the bylaws;
5.  Meet and take such actions as are consistent with the provisions of this 
compact, the commission[s rules, and the bylaws;
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6. Initiate and conduct legal proceedings or actions in the name of the 
commission, provided that the standing of any respiratory therapy licensing 
authority to sue or be sued under applicable law shall not be affected;
7.  Maintain and certify records and information provided to a member state 
as the authenticated business records of the commission, and designate an agent to 
do so on the commission[s behalf;
8.  Purchase and maintain insurance and bonds;
9.  Accept or contract for services of personnel, including, but not limited to, 
employees of a member state;
10.  Conduct an annual financial review;
11.  Hire employees, elect or appoint officers, fix compensation, define duties, 
grant such individuals appropriate authority to carry out the purposes of the 
compact, and establish the commission[s personnel policies and programs relating 
to conflicts of interest, qualifications of personnel, and other related personnel 
matters;
12.  Assess and collect fees;
13.  Accept any and all appropriate gifts, donations, grants of money, other 
sources of revenue, equipment, supplies, materials, and services, and receive, 
utilize, and dispose of the same, provided that at all times:
a.  The commission shall avoid any appearance of impropriety; and
b.  The commission shall avoid any appearance of conflict of interest;
14.  Lease, purchase, retain, own, hold, improve, or use any property, real, 
personal, or mixed, or any undivided interest therein;
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15. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise 
dispose of any property real, personal, or mixed;
16.  Establish a budget and make expenditures;
17.  Borrow money in a fiscally responsible manner;
18. Appoint committees, including standing committees, composed of 
commissioners state regulators, state legislators or their representatives, and 
consumer representatives, and such other interested persons as may be designated 
in this compact and the bylaws;
19. Provide and receive information from, and cooperate with, law 
enforcement agencies;
20.  Establish and elect an executive committee, including a chair, vice-chair, 
secretary, treasurer, and such other offices as the commission shall establish by 
rule or bylaw;
21.  Enter into contracts or arrangements for the management of the affairs of 
the commission;
22.  Determine whether a state[s adopted language is materially different from 
the model compact language such that the state would not qualify for participation 
in the compact; and
23. Perform such other functions as may be necessary or appropriate to 
achieve the purposes of this compact.
(d)  The executive committee. 1.  The executive committee shall have the power 
to act on behalf of the commission according to the terms of this compact.  The 
powers, duties, and responsibilities of the executive committee shall include:
a.  Overseeing the day-to-day activities of the administration of the compact, 
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including enforcement and compliance with the provisions of the compact, its rules 
and bylaws, and other such duties as deemed necessary;
b.  Recommending to the commission changes to the rules or bylaws, changes 
to this compact legislation, fees charged to compact member states, fees charged to 
licensees, and other fees;
c. Ensuring compact administration services are appropriately provided, 
including by contract;
d.  Preparing and recommending the budget;
e.  Maintaining financial records on behalf of the commission;
f.  Monitoring compact compliance of member states and providing compliance 
reports to the commission;
g.  Establishing additional committees as necessary;
h.  Exercising the powers and duties of the commission during the interim 
between commission meetings, except for adopting or amending rules, adopting or 
amending bylaws, and exercising any other powers and duties expressly reserved to 
the commission by rule or bylaw; and
i. Performing other duties as provided in the rules or bylaws of the 
commission.
2.  The executive committee shall be composed of up to 9 members, as further 
set forth in the bylaws of the commission: 
a.  Seven voting members who are elected by the commission from the current 
membership of the commission; and
b.  Two ex-officio, nonvoting members.
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3.  The commission may remove any member of the executive committee as 
provided in the commission[s bylaws.
4.  The executive committee shall meet at least annually.
a.  Executive committee meetings shall be open to the public, except that the 
executive committee may meet in a closed, nonpublic meeting as provided in par. (f) 
4. below;
b.  The executive committee shall give advance notice of its meetings, posted 
on its website and as determined to provide notice to persons with an interest in the 
business of the commission; and
c.  The executive committee may hold a special meeting in accordance with 
par. (f) 2. below.
(e)  The commission shall adopt and provide to the member states an annual 
report.
(f)  Meetings of the commission. 1.  All meetings of the commission that are not 
closed pursuant to subd. 4. shall be open to the public.  Notice of public meetings 
shall be posted on the commission[s website at least 30 days prior to the public 
meeting.
2. Notwithstanding subd. 1., the commission may convene an emergency 
public meeting by providing at least 24 hours prior notice on the commission[s 
website, and any other means as provided in the commission[s rules, for any of the 
reasons it may dispense with notice of proposed rule making under sub. (9) (g).  The 
commission[s legal counsel shall certify that one of the reasons justifying an 
emergency public meeting has been met.
3.  Notice of all commission meetings shall provide the time, date, and location 
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of the meeting, and if the meeting is to be held or accessible via telecommunication, 
video conference, or other electronic means, the notice shall include the mechanism 
for access to the meeting.
4. The commission or the executive committee may convene in a closed, 
nonpublic meeting for the commission or executive committee to receive or solicit 
legal advice or to discuss:
a.  Noncompliance of a member state with its obligations under the compact;
b.  The employment, compensation, discipline or other matters, practices or 
procedures related to specific employees;
c.  Current or threatened discipline of a licensee or compact privilege holder by 
the commission or by a member state[s respiratory therapy licensing authority;
d.  Current, threatened, or reasonably anticipated litigation;
e.  Negotiation of contracts for the purchase, lease, or sale of goods, services, or 
real estate;
f.  Accusing any person of a crime or formally censuring any person;
g.  Trade secrets or commercial or financial information that is privileged or 
confidential;
h. Information of a personal nature where disclosure would constitute a 
clearly unwarranted invasion of personal privacy;
i.  Investigative records compiled for law enforcement purposes;
j.  Information related to any investigative reports prepared by or on behalf of 
or for use of the commission or other committee charged with responsibility of 
investigation or determination of compliance issues pursuant to the compact;
k.  Legal advice;
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L.  Matters specifically exempted from disclosure by federal or member state 
law; or
m.  Other matters as promulgated by the commission by rule.
5.  If a meeting, or portion of a meeting, is closed, the presiding officer shall 
state that the meeting will be closed and reference each relevant exempting 
provision, and such reference shall be recorded in the minutes.
6.  The commission shall keep minutes in accordance with commission rules 
and bylaws. All documents considered in connection with an action shall be 
identified in such minutes.  All minutes and documents of a closed meeting shall 
remain under seal, subject to release only by a majority vote of the commission or 
order of a court of competent jurisdiction.
(g)  Financing of the commission. 1.  The commission shall pay, or provide for 
the payment of, the reasonable expenses of its establishment, organization, and 
ongoing activities.
2.  The commission may accept any and all appropriate revenue sources as 
provided herein. 
3.  The commission may levy on and collect an annual assessment from each 
member state and impose fees on licensees of member states to whom it grants a 
compact privilege to cover the cost of the operations and activities of the commission 
and its staff.  The aggregate annual assessment amount for member states, if any, 
shall be allocated based upon a formula that the commission shall promulgate by 
rule.
4.  The commission shall not incur obligations of any kind prior to securing the 
funds or a loan adequate to meet the same; nor shall the commission pledge the 
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credit of any of the member states, except by and with the authority of the member 
state.
5. The commission shall keep accurate accounts of all receipts and 
disbursements.  The receipts and disbursements of the commission shall be subject 
to the financial review and accounting procedures established under its bylaws.  
However, all receipts and disbursements of funds handled by the commission shall 
be subject to an annual financial review by a certified or licensed public accountant, 
and the report of the financial review shall be included in and become part of the 
annual report of the commission.
(h)  Qualified immunity, defense, and indemnification. 1. Nothing herein 
shall be construed as a limitation on the liability of any licensee for professional 
malpractice or misconduct, which shall be governed solely by any other applicable 
state laws.
2.  The member states, commissioners, officers, executive directors, employees, 
and agents of the commission shall be immune from suit and liability, both 
personally and in their official capacity, for any claim for damage to or loss of 
property or personal injury or other civil liability caused by or arising out of any 
actual or alleged act, error, or omission that occurred, or that the person against 
whom the claim is made had a reasonable basis for believing occurred within the 
scope of commission employment, duties or responsibilities; provided that nothing 
in this subdivision shall be construed to protect any such person from suit or 
liability for any damage, loss, injury, or liability caused by the intentional or willful 
or wanton misconduct of that person.  The procurement of insurance of any type by 
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the commission shall not in any way compromise or limit the immunity granted 
hereunder.
3.  The commission shall defend any commissioner, officer, executive director, 
employee, and agent of the commission in any civil action seeking to impose liability 
arising out of any actual or alleged act, error, or omission that occurred within the 
scope of commission employment, duties, or responsibilities, or as determined by 
the commission that the person against whom the claim is made had a reasonable 
basis for believing occurred within the scope of commission employment, duties, or 
responsibilities; provided that nothing herein shall be construed to prohibit that 
person from retaining their own counsel at their own expense; and provided further, 
that the actual or alleged act, error, or omission did not result from that person[s 
intentional or willful or wanton misconduct.
4. The commission shall indemnify and hold harmless any commissioner, 
member, officer, executive director, employee, and agent of the commission for the 
amount of any settlement or judgment obtained against that person arising out of 
any actual or alleged act, error, or omission that occurred within the scope of 
commission employment, duties, or responsibilities, or that such person had a 
reasonable basis for believing occurred within the scope of commission 
employment, duties, or responsibilities, provided that the actual or alleged act, 
error, or omission did not result from the intentional or willful or wanton 
misconduct of that person.
5.  Nothing in this compact shall be interpreted to waive or otherwise abrogate 
a member state[s state action immunity or state action affirmative defense with 
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respect to antitrust claims under the Sherman Act, Clayton Act, or any other state 
or federal antitrust or anticompetitive law or regulation.
6. Nothing in this compact shall be construed to be a waiver of sovereign 
immunity by the member states or by the commission.
(8) DATA SYSTEM.  (a)  The commission shall provide for the development, 
maintenance, operation, and utilization of a coordinated database and reporting 
system containing licensure, adverse action, and the presence of significant 
investigative information.
(b) Notwithstanding any other provision of state law to the contrary, a 
member state shall submit a uniform data set to the data system as required by the 
rules of the commission, including but not limited to:
1.  Identifying information;
2.  Licensure data;
3  Adverse actions against a licensee, license applicant, or compact privilege 
holder and information related thereto;
4.  Nonconfidential information related to alternative program participation, 
the beginning and ending dates of such participation, and other information related 
to such participation not made confidential under member state law;
5.  Any denial of application for licensure, and the reason(s) for such denial;
6.  The presence of current significant investigative information; and
7.  Other information that may facilitate the administration of this compact or 
the protection of the public, as determined by the rules of the commission.
(c)  No member state shall submit any information which constitutes criminal 
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history record information, as defined by applicable federal law, to the data system 
established hereunder.
(d)  The records and information provided to a member state pursuant to this 
compact or through the data system, when certified by the commission or an agent 
thereof, shall constitute the authenticated business records of the commission, and 
shall be entitled to any associated hearsay exception in any relevant judicial, quasi-
judicial or administrative proceedings in a member state.
(e) Significant investigative information pertaining to a licensee in any 
member state will only be available to other member states.
(f)  It is the responsibility of the member states to report any adverse action 
against a licensee and to monitor the database to determine whether adverse action 
has been taken against a licensee. Adverse action information pertaining to a 
licensee in any member state will be available to any other member state.
(g)  Member states contributing information to the data system may designate 
information that may not be shared with the public without the express permission 
of the contributing state.
(h) Any information submitted to the data system that is subsequently 
expunged pursuant to federal law or the laws of the member state contributing the 
information shall be removed from the data system.
(9) RULE MAKING.  (a)  The commission shall promulgate reasonable rules in 
order to effectively and efficiently implement and administer the purposes and 
provisions of the compact.  A rule shall be invalid and have no force or effect only if 
a court of competent jurisdiction holds that the rule is invalid because the 
commission exercised its rule-making authority in a manner that is beyond the 
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scope and purposes of the compact, or the powers granted hereunder, or based upon 
another applicable standard of review.
(b)  For purposes of the compact, the rules of the commission shall have the 
force of law in each member state.
(c) The commission shall exercise its rule-making powers pursuant to the 
criteria set forth in this subsection and the rules adopted thereunder.  Rules shall 
become binding as of the date specified in each rule.
(d)  If a majority of the legislatures of the member states rejects a rule or 
portion of a rule, by enactment of a statute or resolution in the same manner used 
to adopt the compact within 4 years of the date of adoption of the rule, then such 
rule shall have no further force and effect in any member state.
(e)  Rules shall be adopted at a regular or special meeting of the commission.
(f)  Prior to adoption of a proposed rule, the commission shall hold a public 
hearing and allow persons to provide oral and written comments, data, facts, 
opinions, and arguments.
(g)  Prior to adoption of a proposed rule by the commission, and at least 30 
days in advance of the meeting at which the commission will hold a public hearing 
on the proposed rule, the commission shall provide a notice of proposed rule 
making:
1.  On the website of the commission or other publicly accessible platform;
2. To persons who have requested notice of the commission[s notices of 
proposed rule making, and
3.  In such other way(s) as the commission may by rule specify.
(h)  The notice of proposed rule making shall include:
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1.  The time, date, and location of the public hearing at which the commission 
will hear public comments on the proposed rule and, if different, the time, date, and 
location of the meeting where the commission will consider and vote on the 
proposed rule;
2.  If the hearing is held via telecommunication, video conference, or other 
electronic means, the commission shall include the mechanism for access to the 
hearing in the notice of proposed rule making;
3.  The text of the proposed rule and the reason therefor;
4.  A request for comments on the proposed rule from any interested person; 
and
5.  The manner in which interested persons may submit written comments.
(i) All hearings will be recorded. A copy of the recording and all written 
comments and documents received by the commission in response to the proposed 
rule shall be available to the public.
(j) Nothing in this subsection shall be construed as requiring a separate 
hearing on each rule.  Rules may be grouped for the convenience of the commission 
at hearings required by this subsection.
(k)  The commission shall, by majority vote of all commissioners, take final 
action on the proposed rule based on the rule-making record and the full text of the 
rule.
1. The commission may adopt changes to the proposed rule provided the 
changes are consistent with the original purpose of the proposed rule.
2.  The commission shall provide an explanation of the reasons for substantive 
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changes made to the proposed rule as well as reasons for substantive changes not 
made that were recommended by commenters.
3.  The commission shall determine a reasonable effective date for the rule.  
Except for an emergency as provided in par. (L), the effective date of the rule shall 
be no sooner than 30 days after issuing the notice that it adopted or amended the 
rule.
(L) Upon determination that an emergency exists, the commission may 
consider and adopt an emergency rule with 24 hours[ notice, and with opportunity 
to comment, provided that the usual rule-making procedures provided in the 
compact and in this subsection shall be retroactively applied to the rule as soon as 
reasonably possible, in no event later than 90 days after the effective date of the 
rule.  For the purposes of this provision, an emergency rule is one that must be 
adopted immediately in order to:
1.  Meet an imminent threat to public health, safety, or welfare;
2.  Prevent a loss of commission or member state funds;
3.  Meet a deadline for the promulgation of a rule that is established by federal 
law or rule; or
4.  Protect public health and safety.
(m)  The commission or an authorized committee of the commission may direct 
revisions to a previously adopted rule for purposes of correcting typographical 
errors, errors in format, errors in consistency, or grammatical errors.  Public notice 
of any revisions shall be posted on the website of the commission.  The revision shall 
be subject to challenge by any person for a period of 30 days after posting.  The 
revision may be challenged only on grounds that the revision results in a material 
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change to a rule. A challenge shall be made in writing and delivered to the 
commission prior to the end of the notice period. If no challenge is made, the 
revision will take effect without further action.  If the revision is challenged, the 
revision may not take effect without the approval of the commission.
(n)  No member state[s rule-making process or procedural requirements shall 
apply to the commission.
1. The commission shall have no authority over any member state[s rule-
making process or procedural requirements that do not pertain to the compact.
(o)  Nothing in this compact, nor any rule or regulation of the commission, 
shall be construed to limit, restrict, or in any way reduce the ability of a member 
state to enact and enforce laws, regulations, or other rules related to the practice of 
respiratory therapy in that state, where those laws, regulations, or other rules are 
not inconsistent with the provisions of this compact.
(10) OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT .  (a)  Oversight. 1.  
The executive and judicial branches of state government in each member state shall 
enforce this compact and take all actions necessary and appropriate to implement 
the compact.
2.  Venue is proper and judicial proceedings by or against the commission shall 
be brought solely and exclusively in a court of competent jurisdiction where the 
principal office of the commission is located.  The commission may waive venue and 
jurisdictional defenses to the extent it adopts or consents to participate in 
alternative dispute resolution proceedings.  Nothing herein shall affect or limit the 
selection or propriety of venue in any action against a licensee for professional 
malpractice, misconduct or any such similar matter.
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3. The commission shall be entitled to receive service of process in any 
proceeding regarding the enforcement or interpretation of the compact and shall 
have standing to intervene in such a proceeding for all purposes.  Failure to provide 
the commission service of process shall render a judgment or order void as to the 
commission, this compact, or promulgated rules.
(b)  Default, technical assistance, and termination. 1. If the commission 
determines that a member state has defaulted in the performance of its obligations 
or responsibilities under this compact or the promulgated rules, the commission 
shall provide written notice to the defaulting state. The notice of default shall 
describe the default, the proposed means of curing the default, and any other action 
that the commission may take, and shall offer training and specific technical 
assistance regarding the default.
2.  The commission shall provide a copy of the notice of default to the other 
member states.
(c)  If a state in default fails to cure the default, the defaulting state may be 
terminated from the compact upon an affirmative vote of a majority of the 
commissioners of the member states, and all rights, privileges and benefits 
conferred on that state by this compact may be terminated on the effective date of 
termination.  A cure of the default does not relieve the offending state of obligations 
or liabilities incurred during the period of default.
(d)  Termination of membership in the compact shall be imposed only after all 
other means of securing compliance have been exhausted. Notice of intent to 
suspend or terminate shall be given by the commission to the governor, the majority 
and minority leaders of the defaulting state[s legislature, the defaulting state[s 
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respiratory therapy licensing authority and each of the member states[ respiratory 
therapy licensing authorities.
(e) A state that has been terminated is responsible for all assessments, 
obligations, and liabilities incurred through the effective date of termination, 
including obligations that extend beyond the effective date of termination, if 
necessary.
(f) Upon the termination of a state[s membership from this compact, that 
state shall immediately provide notice to all licensees and compact privilege holders 
(of which the commission has a record) within that state of such termination.  The 
terminated state shall continue to recognize all licenses granted pursuant to this 
compact for a minimum of 180 days after the date of said notice of termination.
(g)  The commission shall not bear any costs related to a state that is found to 
be in default or that has been terminated from the compact, unless agreed upon in 
writing between the commission and the defaulting state.
(h) The defaulting state may appeal the action of the commission by 
petitioning the U.S. District Court for the District of Columbia or the federal 
district where the commission has its principal offices.  The prevailing party shall 
be awarded all costs of such litigation, including reasonable attorney[s fees.
(i)  Dispute resolution. 1.  Upon request by a member state, the commission 
shall attempt to resolve disputes related to the compact that arise among member 
states and between member and nonmember states.
2.  The commission shall promulgate a rule providing for both mediation and 
binding dispute resolution for disputes, as appropriate.
(j)  Enforcement. 1.  By majority vote, as may be further provided by rule, the 
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commission may initiate legal action against a member state in default in the 
United States District Court for the District of Columbia or the federal district 
where the commission has its principal offices to enforce compliance with the 
provisions of the compact and its promulgated rules.  A member state by enactment 
of this compact consents to venue and jurisdiction in such court for the purposes set 
forth herein.  The relief sought may include both injunctive relief and damages.  In 
the event judicial enforcement is necessary, the prevailing party shall be awarded 
all costs of such litigation, including reasonable attorney[s fees. The remedies 
herein shall not be the exclusive remedies of the commission.  The commission may 
pursue any other remedies available under federal or the defaulting member state[s 
law.
2.  A member state may initiate legal action against the commission in the 
U.S. District Court for the District of Columbia or the federal district where the 
commission has its principal offices to enforce compliance with the provisions of the 
compact and its promulgated rules.  The relief sought may include both injunctive 
relief and damages.  In the event judicial enforcement is necessary, the prevailing 
party shall be awarded all costs of such litigation, including reasonable attorney[s 
fees.
3.  No person other than a member state shall enforce this compact against the 
commission.
(11) EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT .  (a)  The compact shall 
come into effect on the date on which the compact statute is enacted into law in the 
7th member state (Xeffective dateY).
1.  On or after the effective date of the compact, the commission shall convene 
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and review the enactment of each of the first 7 member states (Xcharter member 
statesY) to determine if the statute enacted by each such charter member state is 
materially different than the model compact.
a. A charter member state whose enactment is found to be materially 
different from the model compact shall be entitled to the default process set forth in 
sub. (10).
b.  If any member state is later found to be in default, or is terminated or 
withdraws from the compact, the commission shall remain in existence and the 
compact shall remain in effect even if the number of member states should be less 
than 7.
2.  Member states enacting the compact subsequent to the 7 initial charter 
member states shall be subject to the process set forth herein and commission rule 
to determine if their enactments are materially different from the model compact 
and whether they qualify for participation in the compact.
3.  All actions taken for the benefit of the commission or in furtherance of the 
purposes of the administration of the compact prior to the effective date of the 
compact or the commission coming into existence shall be considered to be actions 
of the commission unless specifically repudiated by the commission. The 
commission shall own and have all rights to any intellectual property developed on 
behalf or in furtherance of the commission by individuals or entities involved in 
organizing or establishing the commission, as may be further set forth in rules of 
the commission.
4.  Any state that joins the compact subsequent to the commission[s initial 
adoption of the rules and bylaws shall be subject to the rules and bylaws as they 
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exist on the date on which the compact becomes law in that state.  Any rule that has 
been previously adopted by the commission shall have the full force and effect of law 
on the date the compact becomes law in that state.
(b)  Any member state may withdraw from this compact by enacting a statute 
repealing the same.
1. A member state[s withdrawal shall not take effect until 180 days after 
enactment of the repealing statute.
2.  Withdrawal shall not affect the continuing requirement of the withdrawing 
state[s respiratory therapy licensing authority to comply with the investigative and 
adverse action reporting requirements of this compact prior to the effective date of 
withdrawal.
3.  Upon the enactment of a statute withdrawing from this compact, a state 
shall immediately provide notice of such withdrawal to all licensees and compact 
privilege holders (of which the commission has a record) within that state.  
Notwithstanding any subsequent statutory enactment to the contrary, such 
withdrawing state shall continue to recognize all licenses granted pursuant to this 
compact for a minimum of 180 days after the date of such notice of withdrawal.
(c) Nothing contained in this compact shall be construed to invalidate or 
prevent any licensure agreement or other cooperative arrangement between a 
member state and a nonmember state that does not conflict with the provisions of 
this compact.
(d)  This compact may be amended by the member states.  No amendment to 
this compact shall become effective and binding upon any member state until it is 
enacted into the laws of all member states.
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(12) CONSTRUCTION AND SEVERABILITY. (a) This compact and the 
commission[s rule-making authority shall be liberally construed so as to effectuate 
the purposes and the implementation and administration of the compact.  
Provisions of the compact expressly authorizing or requiring the promulgation of 
rules shall not be construed to limit the commission[s rule-making authority solely 
for those purposes.
(b) The provisions of this compact shall be severable, and if any phrase, 
clause, sentence or provision of this compact is held by a court of competent 
jurisdiction to be contrary to the constitution of any member state, a state seeking 
participation in the compact, or of the United States, or the applicability thereof to 
any government, agency, person or circumstance is held to be unconstitutional by a 
court of competent jurisdiction, the validity of the remainder of this compact and 
the applicability thereof to any other government, agency, person or circumstance 
shall not be affected thereby.
(c)  Notwithstanding par. (b), the commission may deny a state[s participation 
in the compact or, in accordance with the requirements of sub. (10), terminate a 
member state[s participation in the compact, if it determines that a constitutional 
requirement of a member state is a material departure from the compact.  
Otherwise, if this compact shall be held to be contrary to the constitution of any 
member state, the compact shall remain in full force and effect as to the remaining 
member states and in full force and effect as to the member state affected as to all 
severable matters.
(13) CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS.  (a)  Nothing 
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herein shall prevent or inhibit the enforcement of any other law of a member state 
that is not inconsistent with the compact.
(b)  Any laws, statutes, regulations, or other legal requirements in a member 
state in conflict with the compact are superseded to the extent of the conflict, 
including any subsequently enacted state laws.
(c) All permissible agreements between the commission and the member 
states are binding in accordance with their terms.
(d) Other than as expressly set forth herein, nothing in this compact will 
impact initial licensure.
448.9887 Implementation of the respiratory care interstate compact. 
(1) In this section:
(a)  XCompactY means the respiratory care interstate compact under s. 
448.9886.
(b)  XCompact privilegeY means a compact privilege, as defined in s. 448.9886 
(2) (h), that is granted under the compact to an individual to practice in this state.
(2) The department may impose a fee for an individual to receive a compact 
privilege as provided in s. 448.9886 (3) (b).
(3) (a) An individual who holds a compact privilege shall comply with s. 
440.03 (13) (am).
(b)  Subject to s. 448.9886 and any rules promulgated thereunder, ss. 440.20 to 
440.22 and the rules promulgated under s. 440.03 (1) shall apply to an individual 
who holds a compact privilege in the same manner that they apply to holders of 
certificates issued under subch. II.
SECTION 43. 990.01 (28) of the statutes is amended to read:
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990.01 (28) PHYSICIAN, SURGEON OR OSTEOPATH.  XPhysician,Y XsurgeonY or 
XosteopathY means a person holding a license or certificate of registration to 
practice medicine and surgery from the medical examining board.
SECTION 44. Effective dates. This act takes effect on the day after 
publication, except as follows:
(1)  The repeal and recreation of s. 448.02 (3) (a) takes effect on March 1, 2026.
(END)
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