Wisconsin 2025-2026 Regular Session

Wisconsin Senate Bill SB190 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	2025 - 2026 LEGISLATURE
2	2	LRB-2628/1
3	3	MED:emw
4	4	2025 SENATE BILL 190
5	5	April 14, 2025 - Introduced by Senators CABRAL-GUEVARA and TESTIN, cosponsored
6	6	by Representatives RODRIGUEZ, SNYDER, DITTRICH, GUNDRUM, KNODL,
7	7	MELOTIK, MURPHY, O'CONNOR, WICHGERS and DUCHOW. Referred to
8	8	Committee on Health.
9	9	AN ACT to renumber 448.05 (5r); to amend 146.81 (1) (d), 146.997 (1) (d) 5.,
10	10	256.15 (4) (a) 3., 440.03 (9) (a) (intro.) and 2., 440.03 (13) (b) (intro.), 440.15,
11	11	448.01 (9s), 448.01 (12), 448.02 (3) (a) to (c), (e), (f) and (h), 448.02 (4) (a) and
12	12	(b), 448.02 (5), 448.02 (6), 448.02 (8) (a), 448.02 (8) (c), 448.03 (1m), 448.05 (5r)
13	13	(title), 448.07 (1) (b), 448.07 (1) (c), 448.07 (1) (d), 448.07 (2), 448.08 (1m),
14	14	448.08 (4), 448.12, 448.13 (1) (a), 448.13 (2), 448.13 (3) and 990.01 (28); to
15	15	repeal and recreate 448.02 (3) (a), 448.07 (title), 448.07 (1) (title) and 448.07
16	16	(1) (a); to create 14.832, 440.03 (11m) (c) 2rm., 440.03 (13) (c) 1. m., 448.015
17	17	(2m), 448.04 (1) (im), 448.04 (2m), 448.05 (1) (e), 448.05 (5r) (b), 448.05 (6) (av),
18	18	448.06 (3) and subchapter XIV of chapter 448 [precedes 448.9886] of the
19	19	statutes; relating to: ratification of the Respiratory Care Interstate Compact.
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31	31	SENATE BILL 190
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34	34	Analysis by the Legislative Reference Bureau
35	35	RESPIRATORY CARE INTERSTATE COMPACT
36	36	This bill ratifies and enters Wisconsin into the Respiratory Care Interstate
37	37	Compact, which provides for the ability of a respiratory care practitioner to become
38	38	eligible to practice in other compact states. Significant provisions of the compact
39	39	include the following:
40	40	1. The creation of a Respiratory Care Interstate Compact Commission, which
41	41	includes one administrator or staff member of the licensure authorities of each
42	42	member state. The commission has various powers and duties granted in the
43	43	compact, including establishing bylaws, promulgating binding rules for the
44	44	compact, hiring officers, electing or appointing employees, and establishing and
45	45	electing an executive committee. The commission may levy on and collect an
46	46	annual assessment from each member state or impose fees on licensees of member
47	47	states to cover the cost of the operations and activities of the commission and its
48	48	staff.
49	49	2. A process whereby a respiratory care practitioner may obtain a compact
50	50	privilege to practice in another member state. A licensee's primary state of
51	51	residence is considered to be his or her home state, and any other member state in
52	52	which the licensee wishes to practice is considered a remote state. A licensee
53	53	providing respiratory therapy in a remote state under the compact privilege is
54	54	required under the compact to function within the scope of practice authorized by
55	55	the remote state.
56	56	A remote state may take actions against a respiratory care practitioner[s
57	57	compact privilege within that remote state, and if a respiratory care practitioner[s
58	58	home state license is encumbered, the respiratory care practitioner loses his or her
59	59	compact privilege in all remote states until the home state license is no longer
60	60	encumbered and two years have elapsed from the date on which the license is no
61	61	longer encumbered.
62	62	3. The ability of member states to issue subpoenas that are enforceable in
63	63	other states.
64	64	4. The creation of a coordinated database and reporting system containing
65	65	licensure and disciplinary action information on respiratory care practitioners. The
66	66	compact provides that member states are responsible for reporting any adverse
67	67	action against a licensee and for monitoring the database to determine whether
68	68	adverse action has been taken against a licensee. A member state must submit a
69	69	uniform data set to the data system with certain information specified in the
70	70	compact, as required by the rules of the commission.
71	71	5. Provisions regarding resolutions of disputes among member states and
72	72	between member and nonmember states, including a process for termination of a
73	73	state[s membership in the compact if the state defaults on its obligations under the
74	74	compact.
75	75	The compact becomes effective in this state upon enactment in seven states.
76	76	The compact provides that it may be amended upon enactment of an amendment by 2025 - 2026 Legislature
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80	80	SECTION 1
81	81	all member states. A state may withdraw from the compact by repealing the statute
82	82	authorizing the compact, but the compact provides that a withdrawal does not take
83	83	effect until 180 days after the effective date of that repeal.
84	84	STATUTES AND RULES EXAMINATION FOR RESPIRATORY CARE PRACTITIONERS
85	85	The bill prohibits the Medical Examining Board from requiring an applicant
86	86	to pass a statutes and rules examination as a condition of certification as a
87	87	respiratory care practitioner. The bill allows the board to require an applicant to
88	88	affirm that the applicant has read and understands the statutes and rules that
89	89	apply to the applicant's practice as a respiratory care practitioner.
90	90	For further information see the state fiscal estimate, which will be printed as
91	91	an appendix to this bill.
92	92	The people of the state of Wisconsin, represented in senate and assembly, do
93	93	enact as follows:
94	94	SECTION 1. 14.832 of the statutes is created to read:
95	95	14.832 Respiratory care interstate compact. There is created a
96	96	respiratory care interstate compact commission as specified in s. 448.9886. The
97	97	commissioner on the commission representing this state shall be appointed by the
98	98	medical examining board as provided in s. 448.9886 (7) (b) 1., with the advice of the
99	99	respiratory care practitioners examining council, and shall be an individual
100	100	described in s. 448.9886 (7) (b) 2. The commission has the powers and duties
101	101	granted and imposed under s. 448.9886.
102	102	SECTION 2. 146.81 (1) (d) of the statutes is amended to read:
103	103	146.81 (1) (d) A physician, perfusionist, or respiratory care practitioner
104	104	licensed or certified under subch. II of ch. 448 or a respiratory care practitioner who
105	105	holds a compact privilege under subch. XIV of ch. 448.
106	106	SECTION 3. 146.997 (1) (d) 5. of the statutes is amended to read:
107	107	146.997 (1) (d) 5. A respiratory care practitioner licensed or who is certified
108	108	under ch. 448 or who holds a compact privilege under subch. XIV of ch. 448.
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128	128	SECTION 4. 256.15 (4) (a) 3. of the statutes is amended to read:
129	129	256.15 (4) (a) 3. If the ambulance is an aircraft and the sick, disabled, or
130	130	injured individual is a pediatric patient who is being transferred from one hospital
131	131	to another hospital, one individual specified in subd. 1. plus one respiratory care
132	132	practitioner who is certified under subch. II of ch. 448 or who holds a compact
133	133	privilege under subch. XIV of ch. 448.
134	134	SECTION 5. 440.03 (9) (a) (intro.) and 2. of the statutes are amended to read:
135	135	440.03 (9) (a) (intro.) Subject to pars. (b) and (c) and s. 458.33 (2) (b) and (5),
136	136	the department shall, biennially, determine each fee for an initial credential for
137	137	which no examination is required, for a reciprocal credential, and for a credential
138	138	renewal and any fees imposed under ss. 447.51 (2), 448.986 (2), 448.9875 (2),
139	139	448.9885 (2), 448.9887 (2), 457.51 (2), and 459.71 (2) by doing all of the following:
140	140	2. Not later than January 31 of each odd-numbered year, adjusting for the
141	141	succeeding fiscal biennium each fee for an initial credential for which an
142	142	examination is not required, for a reciprocal credential, and, subject to s. 440.08 (2)
143	143	(a), for a credential renewal, and any fees imposed under ss. 447.51 (2), 448.986 (2),
144	144	448.9875 (2), 448.9885 (2), 448.9887 (2), 457.51 (2), and 459.71 (2), if an adjustment
145	145	is necessary to reflect the approximate administrative and enforcement costs of the
146	146	department that are attributable to the regulation of the particular occupation or
147	147	business during the period in which the initial or reciprocal credential, credential
148	148	renewal, or compact privilege is in effect and, for purposes of each fee for a
149	149	credential renewal, to reflect an estimate of any additional moneys available for the
150	150	department[s general program operations as a result of appropriation transfers
151	151	that have been or are estimated to be made under s. 20.165 (1) (i) during the fiscal
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179	179	SECTION 5
180	180	biennium in progress at the time of the deadline for an adjustment under this
181	181	subdivision or during the fiscal biennium beginning on the July 1 immediately
182	182	following the deadline for an adjustment under this subdivision.
183	183	SECTION 6. 440.03 (11m) (c) 2rm. of the statutes is created to read:
184	184	440.03 (11m) (c) 2rm. The coordinated data system under s. 448.9886 (8), if
185	185	such disclosure is required under the respiratory care interstate compact under s.
186	186	448.9886.
187	187	SECTION 7. 440.03 (13) (b) (intro.) of the statutes is amended to read:
188	188	440.03 (13) (b) (intro.) The department may investigate whether an applicant
189	189	for or holder of any of the following credentials has been charged with or convicted
190	190	of a crime only pursuant to rules promulgated by the department under this
191	191	paragraph, including rules that establish the criteria that the department will use
192	192	to determine whether an investigation under this paragraph is necessary, except as
193	193	provided in par. (c) and ss. 441.51 (5) (a) 5., 447.50 (3) (a) 5., 448.980 (5) (b) 3.,
194	194	448.985 (3) (a) 4., 448.987 (3) (a) 5. a. and (5) (b) 2. a., 448.988 (3) (a) 5., 448.9886 (3)
195	195	(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)
196	196	2.:
197	197	SECTION 8. 440.03 (13) (c) 1. m. of the statutes is created to read:
198	198	440.03 (13) (c) 1. m. An applicant for a respiratory care practitioner certificate
199	199	under s. 448.04 (1) (i).
200	200	SECTION 9. 440.15 of the statutes is amended to read:
201	201	440.15 No fingerprinting. Except as provided under ss. 440.03 (13) (c),
202	202	441.51 (5) (a) 5., 447.50 (3) (a) 5., 448.980 (5) (b) 3., 448.985 (3) (a) 4., 448.987 (3) (a)
203	203	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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231	231	SECTION 9
232	232	(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)
233	233	(b) 1., the department or a credentialing board may not require that an applicant for
234	234	a credential or a credential holder be fingerprinted or submit fingerprints in
235	235	connection with the department[s or the credentialing board[s credentialing.
236	236	SECTION 10. 448.01 (9s) of the statutes is amended to read:
237	237	448.01 (9s) XScene of an emergencyY means an area not within the confines of
238	238	a hospital or other institution which has hospital facilities or the office of a person
239	239	licensed, certified or holding a compact privilege or limited permit under this
240	240	chapter.
241	241	SECTION 11. 448.01 (12) of the statutes is amended to read:
242	242	448.01 (12) XWarnY means to privately apprise the holder of a license or,
243	243	certificate, or compact privilege of the unprofessional nature of the holder[s conduct
244	244	and admonish the holder that continued or repeated conduct of such nature may
245	245	give the medical examining board or an attached affiliated credentialing board
246	246	cause to reprimand the holder or to limit, suspend or revoke such license or,
247	247	certificate, or compact privilege.
248	248	SECTION 12. 448.015 (2m) of the statutes is created to read:
249	249	448.015 (2m) XRespiratory care compact privilegeY means a compact
250	250	privilege, as defined in s. 448.9886 (2) (h), that is granted under the respiratory
251	251	care interstate compact to an individual to practice in this state.
252	252	SECTION 13. 448.02 (3) (a) to (c), (e), (f) and (h) of the statutes are amended to
253	253	read:
254	254	448.02 (3) (a) The board shall investigate allegations of unprofessional
255	255	conduct and negligence in treatment by persons holding a license or, certificate, or
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283	283	SECTION 13
284	284	respiratory care compact privilege granted by the board. An allegation that a
285	285	physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to mail or
286	286	present a medical certification required under s. 69.18 (2) within 21 days after the
287	287	pronouncement of death of the person who is the subject of the required certificate
288	288	or that a physician has failed at least 6 times within a 6-month period to mail or
289	289	present a medical certificate required under s. 69.18 (2) within 6 days after the
290	290	pronouncement of death of the person who is the subject of the required certificate
291	291	is an allegation of unprofessional conduct. Information contained in reports filed
292	292	with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under
293	293	42 CFR 1001.2005, shall be investigated by the board. Information contained in a
294	294	report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act
295	295	29, which is not a finding of negligence or in a report filed with the board under s.
296	296	50.36 (3) (c) may, within the discretion of the board, be used as the basis of an
297	297	investigation of a person named in the report. The board may require a person
298	298	holding a license or, certificate, or respiratory care compact privilege to undergo
299	299	and may consider the results of one or more physical, mental or professional
300	300	competency examinations if the board believes that the results of any such
301	301	examinations may be useful to the board in conducting its investigation.
302	302	(b) After an investigation, if the board finds that there is probable cause to
303	303	believe that the person is guilty of unprofessional conduct or negligence in
304	304	treatment, the board shall hold a hearing on such conduct. The board may use any
305	305	information obtained by the board or the department under s. 655.17 (7) (b), as
306	306	created by 1985 Wisconsin Act 29, in an investigation or a disciplinary proceeding,
307	307	including a public disciplinary proceeding, conducted under this subsection and the
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335	335	SECTION 13
336	336	board may require a person holding a license or, certificate, or respiratory care
337	337	compact privilege to undergo and may consider the results of one or more physical,
338	338	mental or professional competency examinations if the board believes that the
339	339	results of any such examinations may be useful to the board in conducting its
340	340	hearing. A unanimous finding by a panel established under s. 655.02, 1983 stats.,
341	341	or a finding by a court that a physician has acted negligently in treating a patient is
342	342	conclusive evidence that the physician is guilty of negligence in treatment. A
343	343	finding that is not a unanimous finding by a panel established under s. 655.02, 1983
344	344	stats., that a physician has acted negligently in treating a patient is presumptive
345	345	evidence that the physician is guilty of negligence in treatment. A certified copy of
346	346	the findings of fact, conclusions of law and order of the panel or the order of a court
347	347	is presumptive evidence that the finding of negligence in treatment was made. The
348	348	board shall render a decision within 90 days after the date on which the hearing is
349	349	held or, if subsequent proceedings are conducted under s. 227.46 (2), within 90 days
350	350	after the date on which those proceedings are completed.
351	351	(c) Subject to par. (cm), after a disciplinary hearing, the board may, when it
352	352	determines that a panel established under s. 655.02, 1983 stats., has unanimously
353	353	found or a court has found that a person has been negligent in treating a patient or
354	354	when it finds a person guilty of unprofessional conduct or negligence in treatment,
355	355	do one or more of the following: warn or reprimand that person, or limit, suspend or
356	356	revoke any license or, certificate, or respiratory care compact privilege granted by
357	357	the board to that person. The board may condition the removal of limitations on a
358	358	license or, certificate, or respiratory care compact privilege or the restoration of a
359	359	suspended or revoked license or, certificate, or respiratory care compact privilege
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388	388	upon obtaining minimum results specified by the board on one or more physical,
389	389	mental or professional competency examinations if the board believes that
390	390	obtaining the minimum results is related to correcting one or more of the bases
391	391	upon which the limitation, suspension or revocation was imposed.
392	392	(e) A person whose license or, certificate, or respiratory care compact privilege
393	393	is limited under this subchapter shall be permitted to continue practice upon
394	394	condition that the person will refrain from engaging in unprofessional conduct; that
395	395	the person will appear before the board or its officers or agents at such times and
396	396	places as may be designated by the board from time to time; that the person will
397	397	fully disclose to the board or its officers or agents the nature of the person[s practice
398	398	and conduct; that the person will fully comply with the limits placed on his or her
399	399	practice and conduct by the board; that the person will obtain additional training,
400	400	education or supervision required by the board; and that the person will cooperate
401	401	with the board.
402	402	(f) Unless a suspended license or, certificate, or respiratory care compact
403	403	privilege is revoked during the period of suspension, upon the expiration of the
404	404	period of suspension the license or, certificate, or respiratory care compact privilege
405	405	shall again become operative and effective. However, the board may require the
406	406	holder of any such suspended license or, certificate, or respiratory care compact
407	407	privilege to pass the examinations required for the original grant of the license or,
408	408	certificate, or respiratory care compact privilege before allowing such suspended
409	409	license or, certificate, or respiratory care compact privilege again to become
410	410	operative and effective.
411	411	(h) Nothing in this subsection prohibits the board, in its discretion, from
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439	439	SECTION 13
440	440	investigating and conducting disciplinary proceedings on allegations of
441	441	unprofessional conduct by persons holding a license or, certificate, or respiratory
442	442	care compact privilege granted by the board when the allegations of unprofessional
443	443	conduct may also constitute allegations of negligence in treatment.
444	444	SECTION 14. 448.02 (3) (a) of the statutes, as affected by 2023 Wisconsin Act
445	445	172 and 2025 Wisconsin Act .... (this act), is repealed and recreated to read:
446	446	448.02 (3) (a) The board shall investigate allegations of unprofessional
447	447	conduct and negligence in treatment by persons holding a license, certificate, or
448	448	respiratory care compact privilege granted by the board. An allegation that a
449	449	physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to present a
450	450	medical certification required under s. 69.18 (2) within 21 days after the
451	451	pronouncement of death of the person who is the subject of the required certificate
452	452	or that a physician has failed at least 6 times within a 6-month period to present a
453	453	medical certificate required under s. 69.18 (2) within 6 days after the
454	454	pronouncement of death of the person who is the subject of the required certificate
455	455	is an allegation of unprofessional conduct. Information contained in reports filed
456	456	with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under
457	457	42 CFR 1001.2005, shall be investigated by the board. Information contained in a
458	458	report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act
459	459	29, which is not a finding of negligence or in a report filed with the board under s.
460	460	50.36 (3) (c) may, within the discretion of the board, be used as the basis of an
461	461	investigation of a person named in the report. The board may require a person
462	462	holding a license, certificate, or respiratory care compact privilege to undergo and
463	463	may consider the results of one or more physical, mental or professional competency
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491	491	SECTION 14
492	492	examinations if the board believes that the results of any such examinations may be
493	493	useful to the board in conducting its investigation.
494	494	SECTION 15. 448.02 (4) (a) and (b) of the statutes are amended to read:
495	495	448.02 (4) (a) The board may summarily suspend or limit any license or,
496	496	certificate, or respiratory care compact privilege granted by the board when the
497	497	board has in its possession evidence establishing probable cause to believe that the
498	498	holder of the license or, certificate, or respiratory care compact privilege has
499	499	violated the provisions of this subchapter and that it is necessary to suspend or
500	500	limit the license or, certificate, or respiratory care compact privilege immediately to
501	501	protect the public health, safety, or welfare. The holder of the license or, certificate,
502	502	or respiratory care compact privilege shall be granted an opportunity to be heard
503	503	during the determination of probable cause. The board chair and 2 board members
504	504	designated by the chair or, if the board chair is not available, the board vice-chair
505	505	and 2 board members designated by the vice-chair, shall exercise the authority
506	506	granted by this paragraph to summarily suspend or limit a license or, certificate, or
507	507	respiratory care compact privilege in the manner provided under par. (b).
508	508	(b) An order of summary suspension or limitation shall be served upon the
509	509	holder of the license or, certificate, or respiratory care compact privilege in the
510	510	manner provided in s. 801.11 for service of summons. The order of summary
511	511	suspension or limitation shall be effective upon service or upon actual notice of the
512	512	summary suspension or limitation given to the holder of the license or, certificate,
513	513	or respiratory care compact privilege or to the attorney of the license or, certificate,
514	514	or respiratory care compact privilege holder, whichever is sooner. A notice of
515	515	hearing commencing a disciplinary proceeding shall be issued no more than 10 days
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543	543	SECTION 15
544	544	following the issuance of the order of summary suspension or limitation. The order
545	545	of summary suspension or limitation remains in effect until the effective date of a
546	546	final decision and order in the disciplinary proceeding against the holder or until
547	547	the order of summary suspension or limitation is discontinued by the board
548	548	following a hearing to show cause. The holder of the license or, certificate, or
549	549	respiratory care compact privilege shall have the right to request a hearing to show
550	550	cause why the order of summary suspension or limitation should not be continued
551	551	and the order of summary suspension or limitation shall notify the holder of the
552	552	license or, certificate, or respiratory care compact privilege of that right. If a
553	553	hearing to show cause is requested by the holder of the license or, certificate, or
554	554	respiratory care compact privilege, the hearing shall be scheduled on a date within
555	555	20 days of receipt by the board of the request for the hearing to show cause.
556	556	SECTION 16. 448.02 (5) of the statutes is amended to read:
557	557	448.02 (5) VOLUNTARY SURRENDER. The holder of any license or, certificate, or
558	558	respiratory care compact privilege granted by the board may voluntarily surrender
559	559	the license or, certificate, or respiratory care compact privilege to the secretary of
560	560	the board, but the secretary may refuse to accept the surrender if the board has
561	561	received allegations of unprofessional conduct against the holder of the license or,
562	562	certificate, or respiratory care compact privilege. The board may negotiate
563	563	stipulations in consideration for accepting the surrender of licenses.
564	564	SECTION 17. 448.02 (6) of the statutes is amended to read:
565	565	448.02 (6) RESTORATION OF LICENSE OR CERTIFICATE CREDENTIAL. The board
566	566	may restore any license or, certificate, or respiratory care compact privilege that has
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593	593	SECTION 17
594	594	been voluntarily surrendered or revoked under any of the provisions of this
595	595	subchapter, on such terms and conditions as it may deem appropriate.
596	596	SECTION 18. 448.02 (8) (a) of the statutes is amended to read:
597	597	448.02 (8) (a) After an investigation by the board under sub. (3) (a) or by the
598	598	department under s. 440.03 (3m) or (5), the board may issue a private and
599	599	confidential administrative warning to a holder of a license or, certificate, or
600	600	respiratory care compact privilege if the board determines that there is evidence of
601	601	misconduct by him or her. The board may issue an administrative warning under
602	602	this paragraph only if the board determines that no further action is warranted
603	603	because the matter involves minor misconduct and the issuance of an
604	604	administrative warning adequately protects the public by putting the holder of the
605	605	license or, certificate, or respiratory care compact privilege on notice that any
606	606	subsequent misconduct may result in disciplinary action. The board shall review
607	607	the determination if the holder of the license or, certificate, or respiratory care
608	608	compact privilege makes a personal appearance before the board. Following the
609	609	review, the board may affirm, rescind or modify the administrative warning. A
610	610	holder of a license or, certificate, or respiratory care compact privilege may seek
611	611	judicial review under ch. 227 of an affirmation or modification of an administrative
612	612	warning by the board.
613	613	SECTION 19. 448.02 (8) (c) of the statutes is amended to read:
614	614	448.02 (8) (c) Notwithstanding par. (b), if the board receives a subsequent
615	615	allegation of misconduct about a holder of a license or, certificate, or respiratory
616	616	care compact privilege to whom the board issued an administrative warning under
617	617	par. (a), the board may reopen the matter that resulted in the issuance of the
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644	644	MED:emw
645	645	SECTION 19
646	646	administrative warning or use the administrative warning in any subsequent
647	647	disciplinary hearing under sub. (3) (b) as evidence that he or she had actual
648	648	knowledge that the misconduct that was the basis for the administrative warning
649	649	was contrary to law.
650	650	SECTION 20. 448.03 (1m) of the statutes is amended to read:
651	651	448.03 (1m) CERTIFICATE REQUIRED TO PRACTICE. No person may practice
652	652	respiratory care, or attempt to do so or make a representation as authorized to do
653	653	so, without unless the person holds a certificate as a respiratory care practitioner
654	654	granted by the board or holds a respiratory care compact privilege.
655	655	SECTION 21. 448.04 (1) (im) of the statutes is created to read:
656	656	448.04 (1) (im) Respiratory care compact privilege. The board may grant a
657	657	respiratory care compact privilege pursuant to the respiratory care interstate
658	658	compact under s. 448.9886.
659	659	SECTION 22. 448.04 (2m) of the statutes is created to read:
660	660	448.04 (2m) DISPLAY OF CREDENTIAL. Each individual who holds a license,
661	661	certificate, or respiratory care compact privilege under this subchapter shall
662	662	display his or her credential in a conspicuous place in the individual[s office or place
663	663	of practice or business.
664	664	SECTION 23. 448.05 (1) (e) of the statutes is created to read:
665	665	448.05 (1) (e) Pay the fee specified in s. 440.05 (1).
666	666	SECTION 24. 448.05 (5r) (title) of the statutes is amended to read:
667	667	448.05 (5r) (title) CERTIFICATE AS RESPIRATORY CARE PRACTITIONER; COMPACT
668	668	PRIVILEGE.
669	669	SECTION 25. 448.05 (5r) of the statutes is renumbered 448.05 (5r) (a).
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697	697	SECTION 26
698	698	SECTION 26. 448.05 (5r) (b) of the statutes is created to read:
699	699	448.05 (5r) (b) An applicant for a respiratory care compact privilege shall
700	700	submit evidence satisfactory to the board that the applicant satisfies the
701	701	requirements under s. 448.9886 (4).
702	702	SECTION 27. 448.05 (6) (av) of the statutes is created to read:
703	703	448.05 (6) (av) 1. The board may not require an applicant for certification as a
704	704	respiratory care practitioner under s. 448.04 (1) (i) to pass a statutes and rules
705	705	examination as a condition of receiving an initial certification or a certification
706	706	renewal.
707	707	2. The board may require an applicant described under subd. 1. to affirm that
708	708	the applicant has read and understands the statutes and rules that apply to the
709	709	applicant's practice.
710	710	SECTION 28. 448.06 (3) of the statutes is created to read:
711	711	448.06 (3) GRANT OF RESPIRATORY CARE COMPACT PRIVILEGE. The board shall
712	712	grant or deny a respiratory care compact privilege in accordance with subs. (1) to
713	713	(2), unless otherwise provided under the respiratory care interstate compact under
714	714	subch. XIV.
715	715	SECTION 29. 448.07 (title) of the statutes is repealed and recreated to read:
716	716	448.07 (title) Renewal.
717	717	SECTION 30. 448.07 (1) (title) of the statutes is repealed and recreated to read:
718	718	448.07 (1) (title) RENEWAL.
719	719	SECTION 31. 448.07 (1) (a) of the statutes is repealed and recreated to read:
720	720	448.07 (1) (a) Renewal applications for a license, certificate, or respiratory
721	721	care compact privilege issued under this subchapter shall be submitted to the
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749	749	SECTION 31
750	750	department on a form provided by the department on or before the applicable
751	751	renewal date specified under s. 440.08 (2) (a), except that renewal of a compact
752	752	license shall be governed by the renewal provisions in s. 448.980 (7), and renewal of
753	753	a respiratory care compact privilege shall be governed by s. 448.9886 (4).
754	754	SECTION 32. 448.07 (1) (b) of the statutes is amended to read:
755	755	448.07 (1) (b) The board shall maintain the register required by s. 440.035
756	756	(1m) (d), which shall be divided according to the activity for which the registrant is
757	757	licensed or certified individual holds the license, certificate, or respiratory care
758	758	compact privilege. The board shall make copies available for purchase at cost.
759	759	SECTION 33. 448.07 (1) (c) of the statutes is amended to read:
760	760	448.07 (1) (c) Every registration renewal made as provided in this section
761	761	shall be presumptive evidence in all courts and other places that the person named
762	762	therein is legally registered holds the license, certificate, or respiratory care
763	763	compact privilege for the period covered by such registration the renewal, and shall
764	764	be deemed to fulfill any statutory requirement for renewal of that license or,
765	765	certificate, or compact privilege.
766	766	SECTION 34. 448.07 (1) (d) of the statutes is amended to read:
767	767	448.07 (1) (d) No registration renewal may be permitted by the secretary of
768	768	the board in the case of any physician or, perfusionist, or anesthesiologist assistant
769	769	who has failed to meet the requirements of s. 448.13 or any person whose license or,
770	770	certificate, or respiratory care compact privilege has been suspended or revoked
771	771	and the registration of any such person shall be deemed automatically annulled
772	772	upon receipt by the secretary of the board of a verified report of such suspension or
773	773	revocation, subject to the person[s right of appeal. A person whose license or
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801	801	SECTION 34
802	802	certificate has been suspended or revoked and subsequently restored shall be
803	803	registered by the board upon tendering a verified report of such restoration of the
804	804	license or certificate, together with an application for registration and the
805	805	registration fee.
806	806	SECTION 35. 448.07 (2) of the statutes is amended to read:
807	807	448.07 (2) FEES. Except as otherwise provided in s. 448.980, the fees for
808	808	examination and licenses granted under this subchapter are specified in s. 440.05,
809	809	and the renewal fee for such licenses a license, certificate, or respiratory care
810	810	compact privilege is determined by the department under s. 440.03 (9) (a). Compact
811	811	licenses shall be subject to additional fees and assessments, as established by the
812	812	department, the board, or the interstate medical licensure compact commission, to
813	813	cover any costs incurred by the department or the board for this state [s
814	814	participation in the interstate medical licensure compact under s. 448.980 and costs
815	815	incurred by the interstate medical licensure compact commission for its
816	816	administration of the renewal process for the interstate medical licensure compact
817	817	under s. 448.980.
818	818	SECTION 36. 448.08 (1m) of the statutes is amended to read:
819	819	448.08 (1m) FEE SPLITTING. Except as otherwise provided in this section, no
820	820	person licensed or certified who holds a license, certificate, or respiratory care
821	821	compact privilege under this subchapter may give or receive, directly or indirectly,
822	822	to or from any person, firm or corporation any fee, commission, rebate or other form
823	823	of compensation or anything of value for sending, referring or otherwise inducing a
824	824	person to communicate with a licensee in a professional capacity, or for any
825	825	professional services not actually rendered personally or at his or her direction.
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853	853	SECTION 37
854	854	SECTION 37. 448.08 (4) of the statutes is amended to read:
855	855	448.08 (4) PROFESSIONAL PARTNERSHIPS AND CORPORATIONS PERMITTED.
856	856	Notwithstanding any other provision in this section, it is lawful for 2 or more
857	857	physicians, who have entered into a bona fide partnership for the practice of
858	858	medicine, to render a single bill for such services in the name of such partnership,
859	859	and it also is lawful for a service corporation to render a single bill for services in
860	860	the name of the corporation, provided that each individual licensed, registered or
861	861	certified who holds a license, certificate, or respiratory care compact privilege
862	862	under this chapter, subch. I of ch. 457, or ch. 446, 449, 450, 455, or 459 that renders
863	863	billed services is individually identified as having rendered such services.
864	864	SECTION 38. 448.12 of the statutes is amended to read:
865	865	448.12 Malpractice. Anyone practicing medicine, surgery, osteopathy, or
866	866	any other form or system of treating the sick without having a valid license or a
867	867	certificate of registration shall be liable to the penalties and liabilities for
868	868	malpractice; and ignorance shall not lessen such liability for failing to perform or
869	869	for negligently or unskillfully performing or attempting to perform any duty
870	870	assumed, and which is ordinarily performed by authorized practitioners.
871	871	SECTION 39. 448.13 (1) (a) of the statutes is amended to read:
872	872	448.13 (1) (a) Except as provided in par. (b), each physician shall include with
873	873	his or her application for a certificate of registration renewal under s. 448.07 proof
874	874	of attendance at and completion of all of the following:
875	875	1. Continuing education programs or courses of study approved for at least 30
876	876	hours of credit by the board within the 2 calendar years preceding the calendar year
877	877	for which the registration renewal is effective.
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904	904	MED:emw
905	905	SECTION 39
906	906	2. Professional development and maintenance of certification or performance
907	907	improvement or continuing medical education programs or courses of study
908	908	required by the board by rule under s. 448.40 (1) and completed within the 2
909	909	calendar years preceding the calendar year for which the registration renewal is
910	910	effective.
911	911	SECTION 40. 448.13 (2) of the statutes is amended to read:
912	912	448.13 (2) Each person licensed as a perfusionist shall include with his or her
913	913	application for a certificate of registration renewal under s. 448.07 proof of
914	914	completion of continuing education requirements promulgated by rule by the board.
915	915	SECTION 41. 448.13 (3) of the statutes is amended to read:
916	916	448.13 (3) Each person licensed as an anesthesiologist assistant shall include
917	917	with his or her application for a certificate of registration renewal under s. 448.07
918	918	proof of meeting the criteria for recertification by the National Commission on
919	919	Certification of Anesthesiologist Assistants or by a successor entity, including any
920	920	continuing education requirements.
921	921	SECTION 42. Subchapter XIV of chapter 448 [precedes 448.9886] of the
922	922	statutes is created to read:
923	923	CHAPTER 448
924	924	SUBCHAPTER XIV
925	925	RESPIRATORY CARE
926	926	INTERSTATE COMPACT
927	927	448.9886 Respiratory care interstate compact. (1) TITLE AND PURPOSE.
928	928	(a) The purpose of this compact is to facilitate the interstate practice of respiratory
929	929	therapy with the goal of improving public access to respiratory therapy services by
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957	957	SECTION 42
958	958	providing respiratory therapists licensed in a member state the ability to practice in
959	959	other member states. The compact preserves the regulatory authority of states to
960	960	protect public health and safety through the current system of state licensure.
961	961	(b) This compact is designed to achieve the following objectives:
962	962	1. Increase public access to respiratory therapy services by creating a
963	963	responsible, streamlined pathway for licensees to practice in member states with
964	964	the goal of improving outcomes for patients;
965	965	2. Enhance states[ ability to protect the public[s health and safety;
966	966	3. Promote the cooperation of member states in regulating the practice of
967	967	respiratory therapy within those member states;
968	968	4. Ease administrative burdens on states by encouraging the cooperation of
969	969	member states in regulating multi-state respiratory therapy practice;
970	970	5. Support relocating active military members and their spouses; and
971	971	6. Promote mobility and address workforce shortages.
972	972	(2) DEFINITIONS. As used in this compact, unless the context requires
973	973	otherwise, the following definitions shall apply:
974	974	(a) XActive military memberY means any person with a full-time duty status
975	975	in the armed forces of the United States, including members of the national guard
976	976	and reserve.
977	977	(b) XAdverse actionY means any administrative, civil, equitable, or criminal
978	978	action permitted by a state[s laws which is imposed by any state authority with
979	979	regulatory authority over respiratory therapists, such as license denial, censure,
980	980	revocation, suspension, probation, monitoring of the licensee, or restriction on the
981	981	licensee[s practice, not including participation in an alternative program.
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1009	1009	SECTION 42
1010	1010	(c) XAlternative programY means a nondisciplinary monitoring or practice
1011	1011	remediation process applicable to a respiratory therapist approved by any state
1012	1012	authority with regulatory authority over respiratory therapists. This includes, but
1013	1013	is not limited to, programs to which licensees with substance abuse or addiction
1014	1014	issues are referred in lieu of adverse action.
1015	1015	(d) XCharter member statesY means those member states who were the first 7
1016	1016	states to enact the compact into the laws of their state.
1017	1017	(e) XCommissionY or Xrespiratory care interstate compact commissionY means
1018	1018	the government instrumentality and body politic whose membership consists of all
1019	1019	member states that have enacted the compact.
1020	1020	(f) XCommissionerY means the individual appointed by a member state to
1021	1021	serve as the member of the commission for that member state.
1022	1022	(g) XCompactY means the respiratory care interstate compact.
1023	1023	(h) XCompact privilegeY means the authorization granted by a remote state to
1024	1024	allow a licensee from another member state to practice as a respiratory therapist in
1025	1025	the remote state under the remote state[s laws and rules. The practice of
1026	1026	respiratory therapy occurs in the member state where the patient is located at the
1027	1027	time of the patient encounter.
1028	1028	(i) XCriminal background checkY means the submission by the member state
1029	1029	of fingerprints or other biometric-based information on license applicants at the
1030	1030	time of initial licensing for the purpose of obtaining that applicant[s criminal
1031	1031	history record information, as defined in 28 CFR 20.3 (d) or successor provision,
1032	1032	from the federal bureau of investigation and the state[s criminal history record
1033	1033	repository, as defined in 28 CFR 20.3 (f) or successor provision.
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1053	1053	20
1054	1054	21
1055	1055	22
1056	1056	23
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1058	1058	SENATE BILL 190
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1060	1060	MED:emw
1061	1061	SECTION 42
1062	1062	(j) XData systemY means the commission[s repository of information about
1063	1063	licensees as further set forth in sub. (8).
1064	1064	(k) XDomicileY means the jurisdiction which is the licensee[s principal home
1065	1065	for legal purposes.
1066	1066	(L) XEncumbered licenseY means a license that a state[s respiratory therapy
1067	1067	licensing authority has limited in any way.
1068	1068	(m) XExecutive committeeY means a group of directors elected or appointed to
1069	1069	act on behalf of, and within the powers granted to them by the commission.
1070	1070	(n) XHome stateY except as set forth in sub. (5), means the member state that
1071	1071	is the licensee[s primary domicile.
1072	1072	(o) XHome state licenseY means an active license to practice respiratory
1073	1073	therapy in a home state that is not an encumbered license.
1074	1074	(p) XJurisprudence requirementY means an assessment of an individual[s
1075	1075	knowledge of the state laws and regulations governing the practice of respiratory
1076	1076	therapy in such state.
1077	1077	(q) XLicenseeY means an individual who currently holds an authorization
1078	1078	from the state to practice as a respiratory therapist.
1079	1079	(r) XMember stateY means a state that has enacted the compact and been
1080	1080	admitted to the commission in accordance with the provisions herein and
1081	1081	commission rules.
1082	1082	(s) XModel compactY means the model for the respiratory care interstate
1083	1083	compact on file with the Council of State Governments or other entity as designated
1084	1084	by the commission.
1085	1085	1
1086	1086	2
1087	1087	3
1088	1088	4
1089	1089	5
1090	1090	6
1091	1091	7
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1093	1093	9
1094	1094	10
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1098	1098	14
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1103	1103	19
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1108	1108	SENATE BILL 190
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1110	1110	MED:emw
1111	1111	SECTION 42
1112	1112	(t) XRemote stateY means a member state where a licensee is exercising or
1113	1113	seeking to exercise the compact privilege.
1114	1114	(u) XRespiratory therapistY or Xrespiratory care practitionerY means an
1115	1115	individual who holds a credential issued by the National Board for Respiratory Care
1116	1116	(or its successor) and holds a license in a state to practice respiratory therapy. For
1117	1117	purposes of this compact, any other title or status adopted by a state to replace the
1118	1118	term Xrespiratory therapistY or Xrespiratory care practitionerY shall be deemed
1119	1119	synonymous with Xrespiratory therapistY and shall confer the same rights and
1120	1120	responsibilities to the licensee under the provisions of this compact at the time of its
1121	1121	enactment.
1122	1122	(v) XRespiratory therapy,Y Xrespiratory therapy practice,Y Xrespiratory care,Y
1123	1123	Xthe practice of respiratory care,Y and Xthe practice of respiratory therapyY means
1124	1124	the care and services provided by or under the direction and supervision of a
1125	1125	respiratory therapist or respiratory care practitioner.
1126	1126	(w) XRespiratory therapy licensing authorityY means the agency, board, or
1127	1127	other body of a state that is responsible for licensing and regulation of respiratory
1128	1128	therapists.
1129	1129	(x) XRuleY means a regulation promulgated by an entity that has the force and
1130	1130	effect of law.
1131	1131	(y) XScope of practiceY means the procedures, actions, and processes a
1132	1132	respiratory therapist licensed in a state or practicing under a compact privilege in a
1133	1133	state is permitted to undertake in that state and the circumstances under which
1134	1134	the respiratory therapist is permitted to undertake those procedures, actions, and
1135	1135	processes. Such procedures, actions, and processes, and the circumstances under
1136	1136	1
1137	1137	2
1138	1138	3
1139	1139	4
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1160	1160	SENATE BILL 190
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1162	1162	MED:emw
1163	1163	SECTION 42
1164	1164	which they may be undertaken may be established through means, including, but
1165	1165	not limited to, statute, regulations, case law, and other processes available to the
1166	1166	state respiratory therapy licensing authority or other government agency.
1167	1167	(z) XSignificant investigative informationY means information, records, and
1168	1168	documents received or generated by a state respiratory therapy licensing authority
1169	1169	pursuant to an investigation for which a determination has been made that there is
1170	1170	probable cause to believe that the licensee has violated a statute or regulation that
1171	1171	is considered more than a minor infraction for which the state respiratory therapy
1172	1172	licensing authority could pursue adverse action against the licensee.
1173	1173	(zm) XStateY means any state, commonwealth, district, or territory of the
1174	1174	United States.
1175	1175	(3) STATE PARTICIPATION IN THIS COMPACT. (a) In order to participate in this
1176	1176	compact and thereafter continue as a member state, a member state shall:
1177	1177	1. Enact a compact that is not materially different from the model compact;
1178	1178	2. License respiratory therapists;
1179	1179	3. Participate in the commission[s data system;
1180	1180	4. Have a mechanism in place for receiving and investigating complaints
1181	1181	against licensees and compact privilege holders;
1182	1182	5. Notify the commission, in compliance with the terms of this compact and
1183	1183	commission rules, of any adverse action against a licensee, a compact privilege
1184	1184	holder, or a license applicant;
1185	1185	6. Notify the commission, in compliance with the terms of this compact and
1186	1186	commission rules, of the existence of significant investigative information;
1187	1187	7. Comply with the rules of the commission;
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1189	1189	2
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1212	1212	SENATE BILL 190
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1214	1214	MED:emw
1215	1215	SECTION 42
1216	1216	8. Grant the compact privilege to a holder of an active home state license and
1217	1217	otherwise meet the applicable requirements of sub. (4) in a member state; and
1218	1218	9. Complete a criminal background check for each new licensee at the time of
1219	1219	initial licensure.
1220	1220	a. Where expressly authorized or permitted by federal law, whether such
1221	1221	federal law is in effect prior to, at, or after the time of a member state[s enactment
1222	1222	of this compact, a member state[s enactment of this compact shall hereby authorize
1223	1223	the member state[s respiratory therapy licensing authority to perform criminal
1224	1224	background checks as defined herein. The absence of such a federal law as
1225	1225	described in this subd. 9. a. shall not prevent or preclude such authorization where
1226	1226	it may be derived or granted through means other than the enactment of this
1227	1227	compact.
1228	1228	(b) Nothing in this compact prohibits a member state from charging a fee for
1229	1229	granting and renewing the compact privilege.
1230	1230	(4) COMPACT PRIVILEGE. (a) To exercise the compact privilege under the
1231	1231	terms and provisions of the compact, the licensee shall:
1232	1232	1. Hold and maintain an active home state license as a respiratory therapist;
1233	1233	2. Hold and maintain an active credential from the National Board for
1234	1234	Respiratory Care (or its successor) that would qualify them for licensure in the
1235	1235	remote state in which they are seeking the privilege;
1236	1236	3. Have not had any adverse action against a license within the previous 2
1237	1237	years;
1238	1238	4. Notify the commission that the licensee is seeking the compact privilege
1239	1239	within a remote state(s);
1240	1240	1
1241	1241	2
1242	1242	3
1243	1243	4
1244	1244	5
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1246	1246	7
1247	1247	8
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1252	1252	13
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1264	1264	SENATE BILL 190
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1266	1266	MED:emw
1267	1267	SECTION 42
1268	1268	5. Pay any applicable fees, including any state and commission fees and
1269	1269	renewal fees, for the compact privilege;
1270	1270	6. Meet any jurisprudence requirements established by the remote state in
1271	1271	which the licensee is seeking a compact privilege;
1272	1272	7. Report to the commission adverse action taken by any nonmember state
1273	1273	within 30 days from the date the adverse action is taken;
1274	1274	8. Report to the commission, when applying for a compact privilege, the
1275	1275	address of the licensee[s domicile and thereafter promptly report to the commission
1276	1276	any change in the address of the licensee[s domicile within 30 days of the effective
1277	1277	date of the change in address; and
1278	1278	9. Consent to accept service of process by mail at the licensee[s domicile on
1279	1279	record with the commission with respect to any action brought against the licensee
1280	1280	by the commission or a member state, and consent to accept service of a subpoena
1281	1281	by mail at the licensee[s domicile on record with the commission with respect to any
1282	1282	action brought or investigation conducted by the commission or a member state.
1283	1283	(b) The compact privilege is valid until the expiration date or revocation of the
1284	1284	home state license unless terminated pursuant to adverse action. The licensee
1285	1285	must comply with all of the requirements of par. (a), above, to maintain the compact
1286	1286	privilege in a remote state. If those requirements are met, no adverse actions are
1287	1287	taken, and the licensee has paid any applicable compact privilege renewal fees, then
1288	1288	the licensee will maintain the licensee[s compact privilege.
1289	1289	(c) A licensee providing respiratory therapy in a remote state under the
1290	1290	compact privilege shall function within the scope of practice authorized by the
1291	1291	remote state for the type of respiratory therapist license the licensee holds. Such
1292	1292	1
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1315	1315	24 2025 - 2026 Legislature
1316	1316	SENATE BILL 190
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1318	1318	MED:emw
1319	1319	SECTION 42
1320	1320	procedures, actions, processes, and the circumstances under which they may be
1321	1321	undertaken may be established through means, including, but not limited to,
1322	1322	statute, regulations, case law, and other processes available to the state respiratory
1323	1323	therapy licensing authority or other government agency.
1324	1324	(d) If a licensee[s compact privilege in a remote state is removed by the remote
1325	1325	state, the individual shall lose or be ineligible for the compact privilege in that
1326	1326	remote state until the compact privilege is no longer limited or restricted by that
1327	1327	state.
1328	1328	(e) If a home state license is encumbered, the licensee shall lose the compact
1329	1329	privilege in all remote states until the following occur:
1330	1330	1. The home state license is no longer encumbered; and
1331	1331	2. Two years have elapsed from the date on which the license is no longer
1332	1332	encumbered due to the adverse action.
1333	1333	(f) Once a licensee with a restricted or limited license meets the requirements
1334	1334	of par. (e) 1. and 2., the licensee must also meet the requirements of par. (a) to
1335	1335	obtain a compact privilege in a remote state.
1336	1336	(5) ACTIVE MILITARY MEMBER OR THEIR SPOUSE. (a) An active military
1337	1337	member, or their spouse, shall designate a home state where the individual has a
1338	1338	current license in good standing. The individual may retain the home state
1339	1339	designation during the period the service member is on active duty.
1340	1340	(b) An active military member and their spouse shall not be required to pay to
1341	1341	the commission for a compact privilege any fee that may otherwise be charged by
1342	1342	the commission. If a remote state chooses to charge a fee for a compact privilege, it
1343	1343	1
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1366	1366	SENATE BILL 190
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1368	1368	MED:emw
1369	1369	SECTION 42
1370	1370	may choose to charge a reduced fee or no fee to an active military member and their
1371	1371	spouse for a compact privilege.
1372	1372	(6) ADVERSE ACTIONS. (a) A member state in which a licensee is licensed
1373	1373	shall have authority to impose adverse action against the license issued by that
1374	1374	member state.
1375	1375	(b) A member state may take adverse action based on significant investigative
1376	1376	information of a remote state or the home state, so long as the member state follows
1377	1377	its own procedures for imposing adverse action.
1378	1378	(c) Nothing in this compact shall override a member state[s decision that
1379	1379	participation in an alternative program may be used in lieu of adverse action and
1380	1380	that such participation shall remain nonpublic if required by the member state[s
1381	1381	laws.
1382	1382	(d) A remote state shall have the authority to:
1383	1383	1. Take adverse actions as set forth herein against a licensee[s compact
1384	1384	privilege in that state;
1385	1385	2. Issue subpoenas for both hearings and investigations that require the
1386	1386	attendance and testimony of witnesses, and the production of evidence.
1387	1387	a. Subpoenas may be issued by a respiratory therapy licensing authority in a
1388	1388	member state for the attendance and testimony of witnesses and the production of
1389	1389	evidence.
1390	1390	b. Subpoenas issued by a respiratory therapy licensing authority in a member
1391	1391	state for the attendance and testimony of witnesses shall be enforced in the latter
1392	1392	state by any court of competent jurisdiction in the latter state, according to the
1393	1393	1
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1395	1395	3
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1415	1415	23 2025 - 2026 Legislature
1416	1416	SENATE BILL 190
1417	1417	- 29 - LRB-2628/1
1418	1418	MED:emw
1419	1419	SECTION 42
1420	1420	practice and procedure of that court applicable to subpoenas issued in proceedings
1421	1421	pending before it.
1422	1422	c. Subpoenas issued by a respiratory therapy licensing authority in a member
1423	1423	state for production of evidence from another member state shall be enforced in the
1424	1424	latter state, according to the practice and procedure of that court applicable to
1425	1425	subpoenas issued in the proceedings pending before it.
1426	1426	d. The issuing authority shall pay any witness fees, travel expenses, mileage,
1427	1427	and other fees required by the service statutes of the state where the witnesses or
1428	1428	evidence are located;
1429	1429	3. Unless otherwise prohibited by state law, recover from the licensee the costs
1430	1430	of investigations and disposition of cases resulting from any adverse action taken
1431	1431	against that licensee;
1432	1432	4. Notwithstanding subd. 2., a member state may not issue a subpoena to
1433	1433	gather evidence of conduct in another member state that is lawful in such other
1434	1434	member state for the purpose of taking adverse action against a licensee[s compact
1435	1435	privilege or application for a compact privilege in that member state; and
1436	1436	5. Nothing in this compact authorizes a member state to impose discipline
1437	1437	against a respiratory therapist[s compact privilege in that member state for the
1438	1438	individual[s otherwise lawful practice in another state.
1439	1439	(e) Joint investigations. 1. In addition to the authority granted to a member
1440	1440	state by its respective respiratory therapy practice act or other applicable state law,
1441	1441	a member state may participate with other member states in joint investigations of
1442	1442	licensees, provided, however, that a member state receiving such a request has no
1443	1443	1
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1466	1466	SENATE BILL 190
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1468	1468	MED:emw
1469	1469	SECTION 42
1470	1470	obligation to respond to any subpoena issued regarding an investigation of conduct
1471	1471	or practice that was lawful in a member state at the time it was undertaken.
1472	1472	2. Member states shall share any significant investigative information,
1473	1473	litigation, or compliance materials in furtherance of any joint or individual
1474	1474	investigation initiated under the compact. In sharing such information between
1475	1475	member state respiratory therapy licensing authorities, all information obtained
1476	1476	shall be kept confidential, except as otherwise mutually agreed upon by the sharing
1477	1477	and receiving member state(s).
1478	1478	(f) Nothing in this compact may permit a member state to take any adverse
1479	1479	action against a licensee or holder of a compact privilege for conduct or practice that
1480	1480	was legal in the member state at the time it was undertaken.
1481	1481	(g) Nothing in this compact may permit a member state to take disciplinary
1482	1482	action against a licensee or holder of a compact privilege for conduct or practice that
1483	1483	was legal in the member state at the time it was undertaken.
1484	1484	(7) ESTABLISHMENT OF THE RESPIRATORY CARE INTERSTATE COMPACT
1485	1485	COMMISSION. (a) The compact member states hereby create and establish a joint
1486	1486	government agency whose membership consists of all member states that have
1487	1487	enacted the compact known as the respiratory care interstate compact commission.
1488	1488	The commission is an instrumentality of the compact member states acting jointly
1489	1489	and not an instrumentality of any one state. The commission shall come into
1490	1490	existence on or after the effective date of the compact, as set forth in sub. (11).
1491	1491	(b) Membership, voting, and meetings. 1. Each member state shall have and
1492	1492	be limited to one commissioner selected by that member state[s respiratory therapy
1493	1493	licensing authority.
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1518	1518	SENATE BILL 190
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1520	1520	MED:emw
1521	1521	SECTION 42
1522	1522	2. The commissioner shall be an administrator or their designated staff
1523	1523	member of the member state[s respiratory therapy licensing authority.
1524	1524	3. The commission shall by rule or bylaw establish a term of office for
1525	1525	commissioners and may by rule or bylaw establish term limits.
1526	1526	4. The commission may recommend to a member state the removal or
1527	1527	suspension of any commissioner from office.
1528	1528	5. A member state[s respiratory therapy licensing authority shall fill any
1529	1529	vacancy of its commissioner occurring on the commission within 60 days of the
1530	1530	vacancy.
1531	1531	6. Each commissioner shall be entitled to one vote on all matters before the
1532	1532	commission requiring a vote by commissioners.
1533	1533	7. A commissioner shall vote in person or by such other means as provided in
1534	1534	the bylaws. The bylaws may provide for commissioners to meet by
1535	1535	telecommunication, videoconference, or other means of communication.
1536	1536	8. The commission shall meet at least once during each calendar year.
1537	1537	Additional meetings may be held as set forth in the bylaws.
1538	1538	(c) The commission shall have the following powers:
1539	1539	1. Establish and amend the fiscal year of the commission;
1540	1540	2. Establish and amend bylaws and policies, including but not limited to, a
1541	1541	code of conduct and conflict of interest;
1542	1542	3. Establish and amend rules, which shall be binding in all member states;
1543	1543	4. Maintain its financial records in accordance with the bylaws;
1544	1544	5. Meet and take such actions as are consistent with the provisions of this
1545	1545	compact, the commission[s rules, and the bylaws;
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1570	1570	SENATE BILL 190
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1572	1572	MED:emw
1573	1573	SECTION 42
1574	1574	6. Initiate and conduct legal proceedings or actions in the name of the
1575	1575	commission, provided that the standing of any respiratory therapy licensing
1576	1576	authority to sue or be sued under applicable law shall not be affected;
1577	1577	7. Maintain and certify records and information provided to a member state
1578	1578	as the authenticated business records of the commission, and designate an agent to
1579	1579	do so on the commission[s behalf;
1580	1580	8. Purchase and maintain insurance and bonds;
1581	1581	9. Accept or contract for services of personnel, including, but not limited to,
1582	1582	employees of a member state;
1583	1583	10. Conduct an annual financial review;
1584	1584	11. Hire employees, elect or appoint officers, fix compensation, define duties,
1585	1585	grant such individuals appropriate authority to carry out the purposes of the
1586	1586	compact, and establish the commission[s personnel policies and programs relating
1587	1587	to conflicts of interest, qualifications of personnel, and other related personnel
1588	1588	matters;
1589	1589	12. Assess and collect fees;
1590	1590	13. Accept any and all appropriate gifts, donations, grants of money, other
1591	1591	sources of revenue, equipment, supplies, materials, and services, and receive,
1592	1592	utilize, and dispose of the same, provided that at all times:
1593	1593	a. The commission shall avoid any appearance of impropriety; and
1594	1594	b. The commission shall avoid any appearance of conflict of interest;
1595	1595	14. Lease, purchase, retain, own, hold, improve, or use any property, real,
1596	1596	personal, or mixed, or any undivided interest therein;
1597	1597	1
1598	1598	2
1599	1599	3
1600	1600	4
1601	1601	5
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1616	1616	20
1617	1617	21
1618	1618	22
1619	1619	23 2025 - 2026 Legislature
1620	1620	SENATE BILL 190
1621	1621	- 33 - LRB-2628/1
1622	1622	MED:emw
1623	1623	SECTION 42
1624	1624	15. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise
1625	1625	dispose of any property real, personal, or mixed;
1626	1626	16. Establish a budget and make expenditures;
1627	1627	17. Borrow money in a fiscally responsible manner;
1628	1628	18. Appoint committees, including standing committees, composed of
1629	1629	commissioners state regulators, state legislators or their representatives, and
1630	1630	consumer representatives, and such other interested persons as may be designated
1631	1631	in this compact and the bylaws;
1632	1632	19. Provide and receive information from, and cooperate with, law
1633	1633	enforcement agencies;
1634	1634	20. Establish and elect an executive committee, including a chair, vice-chair,
1635	1635	secretary, treasurer, and such other offices as the commission shall establish by
1636	1636	rule or bylaw;
1637	1637	21. Enter into contracts or arrangements for the management of the affairs of
1638	1638	the commission;
1639	1639	22. Determine whether a state[s adopted language is materially different from
1640	1640	the model compact language such that the state would not qualify for participation
1641	1641	in the compact; and
1642	1642	23. Perform such other functions as may be necessary or appropriate to
1643	1643	achieve the purposes of this compact.
1644	1644	(d) The executive committee. 1. The executive committee shall have the power
1645	1645	to act on behalf of the commission according to the terms of this compact. The
1646	1646	powers, duties, and responsibilities of the executive committee shall include:
1647	1647	a. Overseeing the day-to-day activities of the administration of the compact,
1648	1648	1
1649	1649	2
1650	1650	3
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1652	1652	5
1653	1653	6
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1670	1670	23
1671	1671	24 2025 - 2026 Legislature
1672	1672	SENATE BILL 190
1673	1673	- 34 - LRB-2628/1
1674	1674	MED:emw
1675	1675	SECTION 42
1676	1676	including enforcement and compliance with the provisions of the compact, its rules
1677	1677	and bylaws, and other such duties as deemed necessary;
1678	1678	b. Recommending to the commission changes to the rules or bylaws, changes
1679	1679	to this compact legislation, fees charged to compact member states, fees charged to
1680	1680	licensees, and other fees;
1681	1681	c. Ensuring compact administration services are appropriately provided,
1682	1682	including by contract;
1683	1683	d. Preparing and recommending the budget;
1684	1684	e. Maintaining financial records on behalf of the commission;
1685	1685	f. Monitoring compact compliance of member states and providing compliance
1686	1686	reports to the commission;
1687	1687	g. Establishing additional committees as necessary;
1688	1688	h. Exercising the powers and duties of the commission during the interim
1689	1689	between commission meetings, except for adopting or amending rules, adopting or
1690	1690	amending bylaws, and exercising any other powers and duties expressly reserved to
1691	1691	the commission by rule or bylaw; and
1692	1692	i. Performing other duties as provided in the rules or bylaws of the
1693	1693	commission.
1694	1694	2. The executive committee shall be composed of up to 9 members, as further
1695	1695	set forth in the bylaws of the commission:
1696	1696	a. Seven voting members who are elected by the commission from the current
1697	1697	membership of the commission; and
1698	1698	b. Two ex-officio, nonvoting members.
1699	1699	1
1700	1700	2
1701	1701	3
1702	1702	4
1703	1703	5
1704	1704	6
1705	1705	7
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1718	1718	20
1719	1719	21
1720	1720	22
1721	1721	23 2025 - 2026 Legislature
1722	1722	SENATE BILL 190
1723	1723	- 35 - LRB-2628/1
1724	1724	MED:emw
1725	1725	SECTION 42
1726	1726	3. The commission may remove any member of the executive committee as
1727	1727	provided in the commission[s bylaws.
1728	1728	4. The executive committee shall meet at least annually.
1729	1729	a. Executive committee meetings shall be open to the public, except that the
1730	1730	executive committee may meet in a closed, nonpublic meeting as provided in par. (f)
1731	1731	4. below;
1732	1732	b. The executive committee shall give advance notice of its meetings, posted
1733	1733	on its website and as determined to provide notice to persons with an interest in the
1734	1734	business of the commission; and
1735	1735	c. The executive committee may hold a special meeting in accordance with
1736	1736	par. (f) 2. below.
1737	1737	(e) The commission shall adopt and provide to the member states an annual
1738	1738	report.
1739	1739	(f) Meetings of the commission. 1. All meetings of the commission that are not
1740	1740	closed pursuant to subd. 4. shall be open to the public. Notice of public meetings
1741	1741	shall be posted on the commission[s website at least 30 days prior to the public
1742	1742	meeting.
1743	1743	2. Notwithstanding subd. 1., the commission may convene an emergency
1744	1744	public meeting by providing at least 24 hours prior notice on the commission[s
1745	1745	website, and any other means as provided in the commission[s rules, for any of the
1746	1746	reasons it may dispense with notice of proposed rule making under sub. (9) (g). The
1747	1747	commission[s legal counsel shall certify that one of the reasons justifying an
1748	1748	emergency public meeting has been met.
1749	1749	3. Notice of all commission meetings shall provide the time, date, and location
1750	1750	1
1751	1751	2
1752	1752	3
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1754	1754	5
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1770	1770	21
1771	1771	22
1772	1772	23
1773	1773	24 2025 - 2026 Legislature
1774	1774	SENATE BILL 190
1775	1775	- 36 - LRB-2628/1
1776	1776	MED:emw
1777	1777	SECTION 42
1778	1778	of the meeting, and if the meeting is to be held or accessible via telecommunication,
1779	1779	video conference, or other electronic means, the notice shall include the mechanism
1780	1780	for access to the meeting.
1781	1781	4. The commission or the executive committee may convene in a closed,
1782	1782	nonpublic meeting for the commission or executive committee to receive or solicit
1783	1783	legal advice or to discuss:
1784	1784	a. Noncompliance of a member state with its obligations under the compact;
1785	1785	b. The employment, compensation, discipline or other matters, practices or
1786	1786	procedures related to specific employees;
1787	1787	c. Current or threatened discipline of a licensee or compact privilege holder by
1788	1788	the commission or by a member state[s respiratory therapy licensing authority;
1789	1789	d. Current, threatened, or reasonably anticipated litigation;
1790	1790	e. Negotiation of contracts for the purchase, lease, or sale of goods, services, or
1791	1791	real estate;
1792	1792	f. Accusing any person of a crime or formally censuring any person;
1793	1793	g. Trade secrets or commercial or financial information that is privileged or
1794	1794	confidential;
1795	1795	h. Information of a personal nature where disclosure would constitute a
1796	1796	clearly unwarranted invasion of personal privacy;
1797	1797	i. Investigative records compiled for law enforcement purposes;
1798	1798	j. Information related to any investigative reports prepared by or on behalf of
1799	1799	or for use of the commission or other committee charged with responsibility of
1800	1800	investigation or determination of compliance issues pursuant to the compact;
1801	1801	k. Legal advice;
1802	1802	1
1803	1803	2
1804	1804	3
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1806	1806	5
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1821	1821	20
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1823	1823	22
1824	1824	23
1825	1825	24 2025 - 2026 Legislature
1826	1826	SENATE BILL 190
1827	1827	- 37 - LRB-2628/1
1828	1828	MED:emw
1829	1829	SECTION 42
1830	1830	L. Matters specifically exempted from disclosure by federal or member state
1831	1831	law; or
1832	1832	m. Other matters as promulgated by the commission by rule.
1833	1833	5. If a meeting, or portion of a meeting, is closed, the presiding officer shall
1834	1834	state that the meeting will be closed and reference each relevant exempting
1835	1835	provision, and such reference shall be recorded in the minutes.
1836	1836	6. The commission shall keep minutes in accordance with commission rules
1837	1837	and bylaws. All documents considered in connection with an action shall be
1838	1838	identified in such minutes. All minutes and documents of a closed meeting shall
1839	1839	remain under seal, subject to release only by a majority vote of the commission or
1840	1840	order of a court of competent jurisdiction.
1841	1841	(g) Financing of the commission. 1. The commission shall pay, or provide for
1842	1842	the payment of, the reasonable expenses of its establishment, organization, and
1843	1843	ongoing activities.
1844	1844	2. The commission may accept any and all appropriate revenue sources as
1845	1845	provided herein.
1846	1846	3. The commission may levy on and collect an annual assessment from each
1847	1847	member state and impose fees on licensees of member states to whom it grants a
1848	1848	compact privilege to cover the cost of the operations and activities of the commission
1849	1849	and its staff. The aggregate annual assessment amount for member states, if any,
1850	1850	shall be allocated based upon a formula that the commission shall promulgate by
1851	1851	rule.
1852	1852	4. The commission shall not incur obligations of any kind prior to securing the
1853	1853	funds or a loan adequate to meet the same; nor shall the commission pledge the
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1875	1875	22
1876	1876	23
1877	1877	24 2025 - 2026 Legislature
1878	1878	SENATE BILL 190
1879	1879	- 38 - LRB-2628/1
1880	1880	MED:emw
1881	1881	SECTION 42
1882	1882	credit of any of the member states, except by and with the authority of the member
1883	1883	state.
1884	1884	5. The commission shall keep accurate accounts of all receipts and
1885	1885	disbursements. The receipts and disbursements of the commission shall be subject
1886	1886	to the financial review and accounting procedures established under its bylaws.
1887	1887	However, all receipts and disbursements of funds handled by the commission shall
1888	1888	be subject to an annual financial review by a certified or licensed public accountant,
1889	1889	and the report of the financial review shall be included in and become part of the
1890	1890	annual report of the commission.
1891	1891	(h) Qualified immunity, defense, and indemnification. 1. Nothing herein
1892	1892	shall be construed as a limitation on the liability of any licensee for professional
1893	1893	malpractice or misconduct, which shall be governed solely by any other applicable
1894	1894	state laws.
1895	1895	2. The member states, commissioners, officers, executive directors, employees,
1896	1896	and agents of the commission shall be immune from suit and liability, both
1897	1897	personally and in their official capacity, for any claim for damage to or loss of
1898	1898	property or personal injury or other civil liability caused by or arising out of any
1899	1899	actual or alleged act, error, or omission that occurred, or that the person against
1900	1900	whom the claim is made had a reasonable basis for believing occurred within the
1901	1901	scope of commission employment, duties or responsibilities; provided that nothing
1902	1902	in this subdivision shall be construed to protect any such person from suit or
1903	1903	liability for any damage, loss, injury, or liability caused by the intentional or willful
1904	1904	or wanton misconduct of that person. The procurement of insurance of any type by
1905	1905	1
1906	1906	2
1907	1907	3
1908	1908	4
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1910	1910	6
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1925	1925	21
1926	1926	22
1927	1927	23 2025 - 2026 Legislature
1928	1928	SENATE BILL 190
1929	1929	- 39 - LRB-2628/1
1930	1930	MED:emw
1931	1931	SECTION 42
1932	1932	the commission shall not in any way compromise or limit the immunity granted
1933	1933	hereunder.
1934	1934	3. The commission shall defend any commissioner, officer, executive director,
1935	1935	employee, and agent of the commission in any civil action seeking to impose liability
1936	1936	arising out of any actual or alleged act, error, or omission that occurred within the
1937	1937	scope of commission employment, duties, or responsibilities, or as determined by
1938	1938	the commission that the person against whom the claim is made had a reasonable
1939	1939	basis for believing occurred within the scope of commission employment, duties, or
1940	1940	responsibilities; provided that nothing herein shall be construed to prohibit that
1941	1941	person from retaining their own counsel at their own expense; and provided further,
1942	1942	that the actual or alleged act, error, or omission did not result from that person[s
1943	1943	intentional or willful or wanton misconduct.
1944	1944	4. The commission shall indemnify and hold harmless any commissioner,
1945	1945	member, officer, executive director, employee, and agent of the commission for the
1946	1946	amount of any settlement or judgment obtained against that person arising out of
1947	1947	any actual or alleged act, error, or omission that occurred within the scope of
1948	1948	commission employment, duties, or responsibilities, or that such person had a
1949	1949	reasonable basis for believing occurred within the scope of commission
1950	1950	employment, duties, or responsibilities, provided that the actual or alleged act,
1951	1951	error, or omission did not result from the intentional or willful or wanton
1952	1952	misconduct of that person.
1953	1953	5. Nothing in this compact shall be interpreted to waive or otherwise abrogate
1954	1954	a member state[s state action immunity or state action affirmative defense with
1955	1955	1
1956	1956	2
1957	1957	3
1958	1958	4
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1976	1976	22
1977	1977	23 2025 - 2026 Legislature
1978	1978	SENATE BILL 190
1979	1979	- 40 - LRB-2628/1
1980	1980	MED:emw
1981	1981	SECTION 42
1982	1982	respect to antitrust claims under the Sherman Act, Clayton Act, or any other state
1983	1983	or federal antitrust or anticompetitive law or regulation.
1984	1984	6. Nothing in this compact shall be construed to be a waiver of sovereign
1985	1985	immunity by the member states or by the commission.
1986	1986	(8) DATA SYSTEM. (a) The commission shall provide for the development,
1987	1987	maintenance, operation, and utilization of a coordinated database and reporting
1988	1988	system containing licensure, adverse action, and the presence of significant
1989	1989	investigative information.
1990	1990	(b) Notwithstanding any other provision of state law to the contrary, a
1991	1991	member state shall submit a uniform data set to the data system as required by the
1992	1992	rules of the commission, including but not limited to:
1993	1993	1. Identifying information;
1994	1994	2. Licensure data;
1995	1995	3 Adverse actions against a licensee, license applicant, or compact privilege
1996	1996	holder and information related thereto;
1997	1997	4. Nonconfidential information related to alternative program participation,
1998	1998	the beginning and ending dates of such participation, and other information related
1999	1999	to such participation not made confidential under member state law;
2000	2000	5. Any denial of application for licensure, and the reason(s) for such denial;
2001	2001	6. The presence of current significant investigative information; and
2002	2002	7. Other information that may facilitate the administration of this compact or
2003	2003	the protection of the public, as determined by the rules of the commission.
2004	2004	(c) No member state shall submit any information which constitutes criminal
2005	2005	1
2006	2006	2
2007	2007	3
2008	2008	4
2009	2009	5
2010	2010	6
2011	2011	7
2012	2012	8
2013	2013	9
2014	2014	10
2015	2015	11
2016	2016	12
2017	2017	13
2018	2018	14
2019	2019	15
2020	2020	16
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2026	2026	22
2027	2027	23 2025 - 2026 Legislature
2028	2028	SENATE BILL 190
2029	2029	- 41 - LRB-2628/1
2030	2030	MED:emw
2031	2031	SECTION 42
2032	2032	history record information, as defined by applicable federal law, to the data system
2033	2033	established hereunder.
2034	2034	(d) The records and information provided to a member state pursuant to this
2035	2035	compact or through the data system, when certified by the commission or an agent
2036	2036	thereof, shall constitute the authenticated business records of the commission, and
2037	2037	shall be entitled to any associated hearsay exception in any relevant judicial, quasi-
2038	2038	judicial or administrative proceedings in a member state.
2039	2039	(e) Significant investigative information pertaining to a licensee in any
2040	2040	member state will only be available to other member states.
2041	2041	(f) It is the responsibility of the member states to report any adverse action
2042	2042	against a licensee and to monitor the database to determine whether adverse action
2043	2043	has been taken against a licensee. Adverse action information pertaining to a
2044	2044	licensee in any member state will be available to any other member state.
2045	2045	(g) Member states contributing information to the data system may designate
2046	2046	information that may not be shared with the public without the express permission
2047	2047	of the contributing state.
2048	2048	(h) Any information submitted to the data system that is subsequently
2049	2049	expunged pursuant to federal law or the laws of the member state contributing the
2050	2050	information shall be removed from the data system.
2051	2051	(9) RULE MAKING. (a) The commission shall promulgate reasonable rules in
2052	2052	order to effectively and efficiently implement and administer the purposes and
2053	2053	provisions of the compact. A rule shall be invalid and have no force or effect only if
2054	2054	a court of competent jurisdiction holds that the rule is invalid because the
2055	2055	commission exercised its rule-making authority in a manner that is beyond the
2056	2056	1
2057	2057	2
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2078	2078	23
2079	2079	24 2025 - 2026 Legislature
2080	2080	SENATE BILL 190
2081	2081	- 42 - LRB-2628/1
2082	2082	MED:emw
2083	2083	SECTION 42
2084	2084	scope and purposes of the compact, or the powers granted hereunder, or based upon
2085	2085	another applicable standard of review.
2086	2086	(b) For purposes of the compact, the rules of the commission shall have the
2087	2087	force of law in each member state.
2088	2088	(c) The commission shall exercise its rule-making powers pursuant to the
2089	2089	criteria set forth in this subsection and the rules adopted thereunder. Rules shall
2090	2090	become binding as of the date specified in each rule.
2091	2091	(d) If a majority of the legislatures of the member states rejects a rule or
2092	2092	portion of a rule, by enactment of a statute or resolution in the same manner used
2093	2093	to adopt the compact within 4 years of the date of adoption of the rule, then such
2094	2094	rule shall have no further force and effect in any member state.
2095	2095	(e) Rules shall be adopted at a regular or special meeting of the commission.
2096	2096	(f) Prior to adoption of a proposed rule, the commission shall hold a public
2097	2097	hearing and allow persons to provide oral and written comments, data, facts,
2098	2098	opinions, and arguments.
2099	2099	(g) Prior to adoption of a proposed rule by the commission, and at least 30
2100	2100	days in advance of the meeting at which the commission will hold a public hearing
2101	2101	on the proposed rule, the commission shall provide a notice of proposed rule
2102	2102	making:
2103	2103	1. On the website of the commission or other publicly accessible platform;
2104	2104	2. To persons who have requested notice of the commission[s notices of
2105	2105	proposed rule making, and
2106	2106	3. In such other way(s) as the commission may by rule specify.
2107	2107	(h) The notice of proposed rule making shall include:
2108	2108	1
2109	2109	2
2110	2110	3
2111	2111	4
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2129	2129	22
2130	2130	23
2131	2131	24 2025 - 2026 Legislature
2132	2132	SENATE BILL 190
2133	2133	- 43 - LRB-2628/1
2134	2134	MED:emw
2135	2135	SECTION 42
2136	2136	1. The time, date, and location of the public hearing at which the commission
2137	2137	will hear public comments on the proposed rule and, if different, the time, date, and
2138	2138	location of the meeting where the commission will consider and vote on the
2139	2139	proposed rule;
2140	2140	2. If the hearing is held via telecommunication, video conference, or other
2141	2141	electronic means, the commission shall include the mechanism for access to the
2142	2142	hearing in the notice of proposed rule making;
2143	2143	3. The text of the proposed rule and the reason therefor;
2144	2144	4. A request for comments on the proposed rule from any interested person;
2145	2145	and
2146	2146	5. The manner in which interested persons may submit written comments.
2147	2147	(i) All hearings will be recorded. A copy of the recording and all written
2148	2148	comments and documents received by the commission in response to the proposed
2149	2149	rule shall be available to the public.
2150	2150	(j) Nothing in this subsection shall be construed as requiring a separate
2151	2151	hearing on each rule. Rules may be grouped for the convenience of the commission
2152	2152	at hearings required by this subsection.
2153	2153	(k) The commission shall, by majority vote of all commissioners, take final
2154	2154	action on the proposed rule based on the rule-making record and the full text of the
2155	2155	rule.
2156	2156	1. The commission may adopt changes to the proposed rule provided the
2157	2157	changes are consistent with the original purpose of the proposed rule.
2158	2158	2. The commission shall provide an explanation of the reasons for substantive
2159	2159	1
2160	2160	2
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2179	2179	21
2180	2180	22
2181	2181	23 2025 - 2026 Legislature
2182	2182	SENATE BILL 190
2183	2183	- 44 - LRB-2628/1
2184	2184	MED:emw
2185	2185	SECTION 42
2186	2186	changes made to the proposed rule as well as reasons for substantive changes not
2187	2187	made that were recommended by commenters.
2188	2188	3. The commission shall determine a reasonable effective date for the rule.
2189	2189	Except for an emergency as provided in par. (L), the effective date of the rule shall
2190	2190	be no sooner than 30 days after issuing the notice that it adopted or amended the
2191	2191	rule.
2192	2192	(L) Upon determination that an emergency exists, the commission may
2193	2193	consider and adopt an emergency rule with 24 hours[ notice, and with opportunity
2194	2194	to comment, provided that the usual rule-making procedures provided in the
2195	2195	compact and in this subsection shall be retroactively applied to the rule as soon as
2196	2196	reasonably possible, in no event later than 90 days after the effective date of the
2197	2197	rule. For the purposes of this provision, an emergency rule is one that must be
2198	2198	adopted immediately in order to:
2199	2199	1. Meet an imminent threat to public health, safety, or welfare;
2200	2200	2. Prevent a loss of commission or member state funds;
2201	2201	3. Meet a deadline for the promulgation of a rule that is established by federal
2202	2202	law or rule; or
2203	2203	4. Protect public health and safety.
2204	2204	(m) The commission or an authorized committee of the commission may direct
2205	2205	revisions to a previously adopted rule for purposes of correcting typographical
2206	2206	errors, errors in format, errors in consistency, or grammatical errors. Public notice
2207	2207	of any revisions shall be posted on the website of the commission. The revision shall
2208	2208	be subject to challenge by any person for a period of 30 days after posting. The
2209	2209	revision may be challenged only on grounds that the revision results in a material
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2233	2233	24 2025 - 2026 Legislature
2234	2234	SENATE BILL 190
2235	2235	- 45 - LRB-2628/1
2236	2236	MED:emw
2237	2237	SECTION 42
2238	2238	change to a rule. A challenge shall be made in writing and delivered to the
2239	2239	commission prior to the end of the notice period. If no challenge is made, the
2240	2240	revision will take effect without further action. If the revision is challenged, the
2241	2241	revision may not take effect without the approval of the commission.
2242	2242	(n) No member state[s rule-making process or procedural requirements shall
2243	2243	apply to the commission.
2244	2244	1. The commission shall have no authority over any member state[s rule-
2245	2245	making process or procedural requirements that do not pertain to the compact.
2246	2246	(o) Nothing in this compact, nor any rule or regulation of the commission,
2247	2247	shall be construed to limit, restrict, or in any way reduce the ability of a member
2248	2248	state to enact and enforce laws, regulations, or other rules related to the practice of
2249	2249	respiratory therapy in that state, where those laws, regulations, or other rules are
2250	2250	not inconsistent with the provisions of this compact.
2251	2251	(10) OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT . (a) Oversight. 1.
2252	2252	The executive and judicial branches of state government in each member state shall
2253	2253	enforce this compact and take all actions necessary and appropriate to implement
2254	2254	the compact.
2255	2255	2. Venue is proper and judicial proceedings by or against the commission shall
2256	2256	be brought solely and exclusively in a court of competent jurisdiction where the
2257	2257	principal office of the commission is located. The commission may waive venue and
2258	2258	jurisdictional defenses to the extent it adopts or consents to participate in
2259	2259	alternative dispute resolution proceedings. Nothing herein shall affect or limit the
2260	2260	selection or propriety of venue in any action against a licensee for professional
2261	2261	malpractice, misconduct or any such similar matter.
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2263	2263	2
2264	2264	3
2265	2265	4
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2285	2285	24 2025 - 2026 Legislature
2286	2286	SENATE BILL 190
2287	2287	- 46 - LRB-2628/1
2288	2288	MED:emw
2289	2289	SECTION 42
2290	2290	3. The commission shall be entitled to receive service of process in any
2291	2291	proceeding regarding the enforcement or interpretation of the compact and shall
2292	2292	have standing to intervene in such a proceeding for all purposes. Failure to provide
2293	2293	the commission service of process shall render a judgment or order void as to the
2294	2294	commission, this compact, or promulgated rules.
2295	2295	(b) Default, technical assistance, and termination. 1. If the commission
2296	2296	determines that a member state has defaulted in the performance of its obligations
2297	2297	or responsibilities under this compact or the promulgated rules, the commission
2298	2298	shall provide written notice to the defaulting state. The notice of default shall
2299	2299	describe the default, the proposed means of curing the default, and any other action
2300	2300	that the commission may take, and shall offer training and specific technical
2301	2301	assistance regarding the default.
2302	2302	2. The commission shall provide a copy of the notice of default to the other
2303	2303	member states.
2304	2304	(c) If a state in default fails to cure the default, the defaulting state may be
2305	2305	terminated from the compact upon an affirmative vote of a majority of the
2306	2306	commissioners of the member states, and all rights, privileges and benefits
2307	2307	conferred on that state by this compact may be terminated on the effective date of
2308	2308	termination. A cure of the default does not relieve the offending state of obligations
2309	2309	or liabilities incurred during the period of default.
2310	2310	(d) Termination of membership in the compact shall be imposed only after all
2311	2311	other means of securing compliance have been exhausted. Notice of intent to
2312	2312	suspend or terminate shall be given by the commission to the governor, the majority
2313	2313	and minority leaders of the defaulting state[s legislature, the defaulting state[s
2314	2314	1
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2337	2337	24 2025 - 2026 Legislature
2338	2338	SENATE BILL 190
2339	2339	- 47 - LRB-2628/1
2340	2340	MED:emw
2341	2341	SECTION 42
2342	2342	respiratory therapy licensing authority and each of the member states[ respiratory
2343	2343	therapy licensing authorities.
2344	2344	(e) A state that has been terminated is responsible for all assessments,
2345	2345	obligations, and liabilities incurred through the effective date of termination,
2346	2346	including obligations that extend beyond the effective date of termination, if
2347	2347	necessary.
2348	2348	(f) Upon the termination of a state[s membership from this compact, that
2349	2349	state shall immediately provide notice to all licensees and compact privilege holders
2350	2350	(of which the commission has a record) within that state of such termination. The
2351	2351	terminated state shall continue to recognize all licenses granted pursuant to this
2352	2352	compact for a minimum of 180 days after the date of said notice of termination.
2353	2353	(g) The commission shall not bear any costs related to a state that is found to
2354	2354	be in default or that has been terminated from the compact, unless agreed upon in
2355	2355	writing between the commission and the defaulting state.
2356	2356	(h) The defaulting state may appeal the action of the commission by
2357	2357	petitioning the U.S. District Court for the District of Columbia or the federal
2358	2358	district where the commission has its principal offices. The prevailing party shall
2359	2359	be awarded all costs of such litigation, including reasonable attorney[s fees.
2360	2360	(i) Dispute resolution. 1. Upon request by a member state, the commission
2361	2361	shall attempt to resolve disputes related to the compact that arise among member
2362	2362	states and between member and nonmember states.
2363	2363	2. The commission shall promulgate a rule providing for both mediation and
2364	2364	binding dispute resolution for disputes, as appropriate.
2365	2365	(j) Enforcement. 1. By majority vote, as may be further provided by rule, the
2366	2366	1
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2368	2368	3
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2389	2389	24 2025 - 2026 Legislature
2390	2390	SENATE BILL 190
2391	2391	- 48 - LRB-2628/1
2392	2392	MED:emw
2393	2393	SECTION 42
2394	2394	commission may initiate legal action against a member state in default in the
2395	2395	United States District Court for the District of Columbia or the federal district
2396	2396	where the commission has its principal offices to enforce compliance with the
2397	2397	provisions of the compact and its promulgated rules. A member state by enactment
2398	2398	of this compact consents to venue and jurisdiction in such court for the purposes set
2399	2399	forth herein. The relief sought may include both injunctive relief and damages. In
2400	2400	the event judicial enforcement is necessary, the prevailing party shall be awarded
2401	2401	all costs of such litigation, including reasonable attorney[s fees. The remedies
2402	2402	herein shall not be the exclusive remedies of the commission. The commission may
2403	2403	pursue any other remedies available under federal or the defaulting member state[s
2404	2404	law.
2405	2405	2. A member state may initiate legal action against the commission in the
2406	2406	U.S. District Court for the District of Columbia or the federal district where the
2407	2407	commission has its principal offices to enforce compliance with the provisions of the
2408	2408	compact and its promulgated rules. The relief sought may include both injunctive
2409	2409	relief and damages. In the event judicial enforcement is necessary, the prevailing
2410	2410	party shall be awarded all costs of such litigation, including reasonable attorney[s
2411	2411	fees.
2412	2412	3. No person other than a member state shall enforce this compact against the
2413	2413	commission.
2414	2414	(11) EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT . (a) The compact shall
2415	2415	come into effect on the date on which the compact statute is enacted into law in the
2416	2416	7th member state (Xeffective dateY).
2417	2417	1. On or after the effective date of the compact, the commission shall convene
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2441	2441	24 2025 - 2026 Legislature
2442	2442	SENATE BILL 190
2443	2443	- 49 - LRB-2628/1
2444	2444	MED:emw
2445	2445	SECTION 42
2446	2446	and review the enactment of each of the first 7 member states (Xcharter member
2447	2447	statesY) to determine if the statute enacted by each such charter member state is
2448	2448	materially different than the model compact.
2449	2449	a. A charter member state whose enactment is found to be materially
2450	2450	different from the model compact shall be entitled to the default process set forth in
2451	2451	sub. (10).
2452	2452	b. If any member state is later found to be in default, or is terminated or
2453	2453	withdraws from the compact, the commission shall remain in existence and the
2454	2454	compact shall remain in effect even if the number of member states should be less
2455	2455	than 7.
2456	2456	2. Member states enacting the compact subsequent to the 7 initial charter
2457	2457	member states shall be subject to the process set forth herein and commission rule
2458	2458	to determine if their enactments are materially different from the model compact
2459	2459	and whether they qualify for participation in the compact.
2460	2460	3. All actions taken for the benefit of the commission or in furtherance of the
2461	2461	purposes of the administration of the compact prior to the effective date of the
2462	2462	compact or the commission coming into existence shall be considered to be actions
2463	2463	of the commission unless specifically repudiated by the commission. The
2464	2464	commission shall own and have all rights to any intellectual property developed on
2465	2465	behalf or in furtherance of the commission by individuals or entities involved in
2466	2466	organizing or establishing the commission, as may be further set forth in rules of
2467	2467	the commission.
2468	2468	4. Any state that joins the compact subsequent to the commission[s initial
2469	2469	adoption of the rules and bylaws shall be subject to the rules and bylaws as they
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2492	2492	23
2493	2493	24 2025 - 2026 Legislature
2494	2494	SENATE BILL 190
2495	2495	- 50 - LRB-2628/1
2496	2496	MED:emw
2497	2497	SECTION 42
2498	2498	exist on the date on which the compact becomes law in that state. Any rule that has
2499	2499	been previously adopted by the commission shall have the full force and effect of law
2500	2500	on the date the compact becomes law in that state.
2501	2501	(b) Any member state may withdraw from this compact by enacting a statute
2502	2502	repealing the same.
2503	2503	1. A member state[s withdrawal shall not take effect until 180 days after
2504	2504	enactment of the repealing statute.
2505	2505	2. Withdrawal shall not affect the continuing requirement of the withdrawing
2506	2506	state[s respiratory therapy licensing authority to comply with the investigative and
2507	2507	adverse action reporting requirements of this compact prior to the effective date of
2508	2508	withdrawal.
2509	2509	3. Upon the enactment of a statute withdrawing from this compact, a state
2510	2510	shall immediately provide notice of such withdrawal to all licensees and compact
2511	2511	privilege holders (of which the commission has a record) within that state.
2512	2512	Notwithstanding any subsequent statutory enactment to the contrary, such
2513	2513	withdrawing state shall continue to recognize all licenses granted pursuant to this
2514	2514	compact for a minimum of 180 days after the date of such notice of withdrawal.
2515	2515	(c) Nothing contained in this compact shall be construed to invalidate or
2516	2516	prevent any licensure agreement or other cooperative arrangement between a
2517	2517	member state and a nonmember state that does not conflict with the provisions of
2518	2518	this compact.
2519	2519	(d) This compact may be amended by the member states. No amendment to
2520	2520	this compact shall become effective and binding upon any member state until it is
2521	2521	enacted into the laws of all member states.
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2545	2545	24 2025 - 2026 Legislature
2546	2546	SENATE BILL 190
2547	2547	- 51 - LRB-2628/1
2548	2548	MED:emw
2549	2549	SECTION 42
2550	2550	(12) CONSTRUCTION AND SEVERABILITY. (a) This compact and the
2551	2551	commission[s rule-making authority shall be liberally construed so as to effectuate
2552	2552	the purposes and the implementation and administration of the compact.
2553	2553	Provisions of the compact expressly authorizing or requiring the promulgation of
2554	2554	rules shall not be construed to limit the commission[s rule-making authority solely
2555	2555	for those purposes.
2556	2556	(b) The provisions of this compact shall be severable, and if any phrase,
2557	2557	clause, sentence or provision of this compact is held by a court of competent
2558	2558	jurisdiction to be contrary to the constitution of any member state, a state seeking
2559	2559	participation in the compact, or of the United States, or the applicability thereof to
2560	2560	any government, agency, person or circumstance is held to be unconstitutional by a
2561	2561	court of competent jurisdiction, the validity of the remainder of this compact and
2562	2562	the applicability thereof to any other government, agency, person or circumstance
2563	2563	shall not be affected thereby.
2564	2564	(c) Notwithstanding par. (b), the commission may deny a state[s participation
2565	2565	in the compact or, in accordance with the requirements of sub. (10), terminate a
2566	2566	member state[s participation in the compact, if it determines that a constitutional
2567	2567	requirement of a member state is a material departure from the compact.
2568	2568	Otherwise, if this compact shall be held to be contrary to the constitution of any
2569	2569	member state, the compact shall remain in full force and effect as to the remaining
2570	2570	member states and in full force and effect as to the member state affected as to all
2571	2571	severable matters.
2572	2572	(13) CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS. (a) Nothing
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2595	2595	23 2025 - 2026 Legislature
2596	2596	SENATE BILL 190
2597	2597	- 52 - LRB-2628/1
2598	2598	MED:emw
2599	2599	SECTION 42
2600	2600	herein shall prevent or inhibit the enforcement of any other law of a member state
2601	2601	that is not inconsistent with the compact.
2602	2602	(b) Any laws, statutes, regulations, or other legal requirements in a member
2603	2603	state in conflict with the compact are superseded to the extent of the conflict,
2604	2604	including any subsequently enacted state laws.
2605	2605	(c) All permissible agreements between the commission and the member
2606	2606	states are binding in accordance with their terms.
2607	2607	(d) Other than as expressly set forth herein, nothing in this compact will
2608	2608	impact initial licensure.
2609	2609	448.9887 Implementation of the respiratory care interstate compact.
2610	2610	(1) In this section:
2611	2611	(a) XCompactY means the respiratory care interstate compact under s.
2612	2612	448.9886.
2613	2613	(b) XCompact privilegeY means a compact privilege, as defined in s. 448.9886
2614	2614	(2) (h), that is granted under the compact to an individual to practice in this state.
2615	2615	(2) The department may impose a fee for an individual to receive a compact
2616	2616	privilege as provided in s. 448.9886 (3) (b).
2617	2617	(3) (a) An individual who holds a compact privilege shall comply with s.
2618	2618	440.03 (13) (am).
2619	2619	(b) Subject to s. 448.9886 and any rules promulgated thereunder, ss. 440.20 to
2620	2620	440.22 and the rules promulgated under s. 440.03 (1) shall apply to an individual
2621	2621	who holds a compact privilege in the same manner that they apply to holders of
2622	2622	certificates issued under subch. II.
2623	2623	SECTION 43. 990.01 (28) of the statutes is amended to read:
2624	2624	1
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2647	2647	24 2025 - 2026 Legislature
2648	2648	SENATE BILL 190
2649	2649	- 53 - LRB-2628/1
2650	2650	MED:emw
2651	2651	SECTION 43
2652	2652	990.01 (28) PHYSICIAN, SURGEON OR OSTEOPATH. XPhysician,Y XsurgeonY or
2653	2653	XosteopathY means a person holding a license or certificate of registration to
2654	2654	practice medicine and surgery from the medical examining board.
2655	2655	SECTION 44. Effective dates. This act takes effect on the day after
2656	2656	publication, except as follows:
2657	2657	(1) The repeal and recreation of s. 448.02 (3) (a) takes effect on March 1, 2026.
2658	2658	(END)
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