Bill Text: NY A08172 | 2023-2024 | General Assembly | Introduced
Bill Title: Adopts the PA licensure compact to enhance the portability of a physician assistant license between participating states while safeguarding the safety of patients.
Spectrum: Partisan Bill (Republican 8-0)
Status: (Introduced) 2024-01-03 - referred to higher education [A08172 Detail]
Download: New_York-2023-A08172-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 8172 2023-2024 Regular Sessions IN ASSEMBLY October 27, 2023 ___________ Introduced by M. of A. MILLER -- read once and referred to the Committee on Higher Education AN ACT to amend the education law, in relation to adopting the PA licen- sure compact The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The education law is amended by adding a new section 6546-a 2 to read as follows: 3 § 6546-a. PA licensure compact. The PA licensure compact is hereby 4 entered into and enacted into law with all jurisdictions legal joining 5 therein, in the form substantially as follows: 6 PA LICENSURE COMPACT 7 Section 1. Purpose. In order to strengthen access to medical services, 8 and in recognition of the advances in the delivery of medical services, 9 the participating states of the PA licensure compact have allied in 10 common purpose to develop a comprehensive process that complements the 11 existing authority of state licensing boards to license and discipline 12 PAs and seeks to enhance the portability of a License to practice as a 13 PA while safeguarding the safety of patients. This compact allows 14 medical services to be provided by PAs, via the mutual recognition of 15 the licensee's qualifying license by other compact participating states. 16 This compact also adopts the prevailing standard for PA licensure and 17 affirms that the practice and delivery of medical services by the PA 18 occurs where the patient is located at the time of the patient encount- 19 er, and therefore requires the PA to be under the jurisdiction of the 20 state licensing board where the patient is located. State licensing 21 boards that participate in this compact retain the jurisdiction to 22 impose adverse action against a compact privilege in that state issued 23 to a PA through the procedures of this compact. The PA licensure compact 24 will alleviate burdens for military families by allowing active duty 25 military personnel and their spouses to obtain a compact privilege based EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD11355-02-3A. 8172 2 1 on having an unrestricted license in good standing from a participating 2 state. 3 Section 2. Definitions. In this compact: 4 A. "Adverse Action" means any administrative, civil, equitable, or 5 criminal action permitted by a state's laws which is imposed by a 6 licensing board or other authority against a PA license or license 7 application or compact privilege such as license denial, censure, revo- 8 cation, suspension, probation, monitoring of the licensee, or 9 restriction on the licensee's practice. 10 B. "Compact Privilege" means the authorization granted by a remote 11 state to allow a licensee from another participating state to practice 12 as a PA to provide medical services and other licensed activity to a 13 patient located in the remote state under the remote state's laws and 14 regulations. 15 C. "Conviction" means a finding by a court that an individual is guil- 16 ty of a felony or misdemeanor offense through adjudication or entry of a 17 plea of guilt or no contest to the charge by the offender. 18 D. "Criminal Background Check" means the submission of fingerprints or 19 other biometric based information for a License applicant for the 20 purpose of obtaining that applicant's criminal history record informa- 21 tion, as defined in 28 C.F.R. § 20.3(d), from the state's criminal 22 history record repository as defined in 28 C.F.R. § 20.3(f). 23 E. "Data System" means the repository of information about licensees, 24 including but not limited to license status and adverse actions, which 25 is created and administered under the terms of this compact. 26 F. "Executive Committee" means a group of directors and ex-officio 27 individuals elected or appointed pursuant to section 7.F.2. 28 G. "Impaired Practitioner" means a PA whose practice is adversely 29 affected by a health related condition that impact their ability to 30 practice. 31 H. "Investigative Information" means information, records, or docu- 32 ments received or generated by a Licensing Board pursuant to an investi- 33 gation. 34 I. "Jurisprudence Requirement" means the assessment of an individual's 35 knowledge of the laws and Rules governing the practice of a PA in a 36 state. 37 J. "License" means current authorization by a state, other than 38 authorization pursuant to a compact privilege, for a PA to provide 39 medical services, which would be unlawful without current authorization. 40 K. "Licensee" means an individual who holds a License from a state to 41 provide medical services as a PA. 42 L. "Licensing Board" means any state entity authorized to license and 43 otherwise regulate PAs. 44 M. "Medical Services" means health care services provided for the 45 diagnosis, prevention, treatment, cure or relief of a health condition, 46 injury, or disease, as defined by a state's laws and regulations. 47 N. "Model Compact" means the model for the PA licensure compact on 48 file with the council of state governments or other entity as designated 49 by the commission. 50 O. "Participating State" means a state that has enacted this compact. 51 P. "PA" means an individual who is licensed as a physician assistant 52 in a state. For purposes of this compact, any other title or status 53 adopted by a state to replace the term "physician assistant" shall be 54 deemed synonymous with "physician assistant" and shall confer the same 55 rights and responsibilities to the licensee under the provisions of this 56 compact at the time of its enactment.A. 8172 3 1 Q. "PA Licensure Compact Commission," "Compact Commission," or 2 "Commission" mean the national administrative body created pursuant to 3 section 7.A of this compact. 4 R. "Qualifying License" means an unrestricted license issued by a 5 participating state to provide medical services as a PA. 6 S. "Remote State" means a participating state where a Licensee who is 7 not licensed as a PA is exercising or seeking to exercise the compact 8 privilege. 9 T. "Rule" means a regulation promulgated by an entity that has the 10 force and effect of law. 11 U. "Significant Investigative Information" means Investigative Infor- 12 mation that a Licensing Board, after an inquiry or investigation that 13 includes notification and an opportunity for the PA to respond if 14 required by state law, has reason to believe is not groundless and, if 15 proven true, would indicate more than a minor infraction. 16 V. "State" means any state, commonwealth, district, or territory of 17 the United States. 18 Section 3. State participation in this compact. 19 A. To participate in this compact, a participating state shall: 20 1. License PAs. 21 2. Participate in the compact commission's data system. 22 3. Have a mechanism in place for receiving and investigating 23 complaints against licensees and license applicants. 24 4. Notify the commission, in compliance with the terms of this compact 25 and commission rules, of any adverse action against a licensee or 26 license applicant and the existence of significant investigative infor- 27 mation regarding a licensee or license applicant. 28 5. Fully implement a criminal background check requirement, within a 29 time frame established by commission rule, by its licensing board 30 receiving the results of a criminal background check and reporting to 31 the commission whether the license applicant has been granted a license. 32 6. Comply with the rules of the compact commission. 33 7. Utilize passage of a recognized national exam such as the NCCPA 34 PANCE as a requirement for PA licensure. 35 8. Grant the compact privilege to a holder of a qualifying license in 36 a participating state. 37 B. Nothing in this compact prohibits a participating state from charg- 38 ing a fee for granting the compact privilege. 39 Section 4. Compact privilege. 40 A. To exercise the compact privilege, a licensee must: 41 1. Have graduated from a PA program accredited by the accreditation 42 review commission on education for the physician assistant, inc. or 43 other programs authorized by commission rule. 44 2. Hold current NCCPA certification. 45 3. Have no felony or misdemeanor conviction. 46 4. Have never had a controlled substance license, permit, or registra- 47 tion suspended or revoked by a state or by the United States Drug 48 Enforcement Administration. 49 5. Have a unique identifier as determined by commission rule. 50 6. Hold a qualifying license. 51 7. Have had no revocation of a License or limitation or restriction on 52 any License currently held due to an adverse action. 53 8. If a licensee has had a limitation or restriction on a license or 54 compact privilege due to an adverse action, two years must have elapsed 55 from the date on which the license or compact privilege is no longer 56 limited or restricted due to the adverse action.A. 8172 4 1 9. If a compact privilege has been revoked or is limited or restricted 2 in a participating state for conduct that would not be a basis for 3 disciplinary action in a participating state in which the licensee is 4 practicing or applying to practice under a compact privilege, that 5 participating state shall have the discretion not to consider such 6 action as an adverse action requiring the denial or removal of a compact 7 privilege in that state. 8 10. Notify the compact commission that the licensee is seeking the 9 compact privilege in a remote state. 10 11. Meet any jurisprudence requirement of a remote state in which the 11 licensee is seeking to practice under the compact privilege and pay any 12 fees applicable to satisfying the jurisprudence requirement. 13 12. Report to the commission any adverse action taken by a non-parti- 14 cipating state within thirty (30) days after the action is taken. 15 B. The compact privilege is valid until the expiration or revocation 16 of the qualifying license unless terminated pursuant to an adverse 17 action. The licensee must also comply with all of the requirements of 18 subsection A above to maintain the compact privilege in a remote state. 19 If the participating state takes adverse action against a qualifying 20 license, the licensee shall lose the compact privilege in any remote 21 state in which the licensee has a compact privilege until all of the 22 following occur: 23 1. The license is no longer limited or restricted; and 24 2. Two (2) years have elapsed from the date on which the license is no 25 longer limited or restricted due to the adverse action. 26 C. Once a restricted or limited License satisfies the requirements of 27 subsection B.1 and 2, the licensee must meet the requirements of 28 subsection A to obtain a compact privilege in any remote state. 29 D. For each remote state in which a PA seeks authority to prescribe 30 controlled substances, the PA shall satisfy all requirements imposed by 31 such state in granting or renewing such authority. 32 Section 5. Designation of the state from which licensee is applying 33 for a compact privilege. 34 A. Upon a licensee's application for a compact privilege, the licensee 35 shall identify to the commission the participating state from which the 36 licensee is applying, in accordance with applicable rules adopted by the 37 commission, and subject to the following requirements: 38 1. When applying for a compact privilege, the licensee shall provide 39 the commission with the address of the licensee's primary residence and 40 thereafter shall immediately report to the commission any change in the 41 address of the licensee's primary residence. 42 2. When applying for a compact privilege, the licensee is required to 43 consent to accept service of process by mail at the licensee's primary 44 residence on file with the commission with respect to any action brought 45 against the licensee by the commission or a participating state, includ- 46 ing a subpoena, with respect to any action brought or investigation 47 conducted by the commission or a participating state. 48 Section 6. Adverse actions. 49 A. A participating state in which a licensee is licensed shall have 50 exclusive power to impose adverse action against the qualifying license 51 issued by that participating state. 52 B. In addition to the other powers conferred by state law, a remote 53 state shall have the authority, in accordance with existing state due 54 process law, to do all of the following: 55 1. Take adverse action against a PA's compact privilege within that 56 state to remove a licensee's compact privilege or take other actionA. 8172 5 1 necessary under applicable law to protect the health and safety of its 2 citizens. 3 2. Issue subpoenas for both hearings and investigations that require 4 the attendance and testimony of witnesses as well as the production of 5 evidence. Subpoenas issued by a licensing board in a participating state 6 for the attendance and testimony of witnesses or the production of 7 evidence from another participating state shall be enforced in the 8 latter state by any court of competent jurisdiction, according to the 9 practice and procedure of that court applicable to subpoenas issued in 10 proceedings pending before it. The issuing authority shall pay any 11 witness fees, travel expenses, mileage and other fees required by the 12 service statutes of the state in which the witnesses or evidence are 13 located. 14 3. Notwithstanding paragraph 2, subpoenas may not be issued by a 15 participating state to gather evidence of conduct in another state that 16 is lawful in that other state for the purpose of taking adverse action 17 against a licensee's compact privilege or application for a compact 18 privilege in that participating state. 19 4. Nothing in this compact authorizes a participating state to impose 20 discipline against a PA's compact privilege or to deny an application 21 for a compact privilege in that participating state for the individual's 22 otherwise lawful practice in another state. 23 C. For purposes of taking adverse action, the participating state 24 which issued the qualifying license shall give the same priority and 25 effect to reported conduct received from any other participating state 26 as it would if the conduct had occurred within the participating state 27 which issued the qualifying license. In so doing, that participating 28 state shall apply its own state laws to determine appropriate action. 29 D. A participating state, if otherwise permitted by state law, may 30 recover from the affected PA the costs of investigations and disposition 31 of cases resulting from any adverse action taken against that PA. 32 E. A participating state may take adverse action based on the factual 33 findings of a remote state, provided that the participating state 34 follows its own procedures for taking the adverse action. 35 F. Joint investigations: 36 1. In addition to the authority granted to a participating state by 37 its respective state PA laws and regulations or other applicable state 38 law, any participating state may participate with other participating 39 states in joint investigations of licensees. 40 2. Participating states shall share any investigative, litigation, or 41 compliance materials in furtherance of any joint or individual investi- 42 gation initiated under this compact. 43 G. If an adverse action is taken against a PA's qualifying license, 44 the PA's compact privilege in all remote states shall be deactivated 45 until two (2) years have elapsed after all restrictions have been 46 removed from the state license. All disciplinary orders by the partic- 47 ipating state which issued the qualifying license that impose adverse 48 action against a PA's license shall include a statement that the PA's 49 compact privilege is deactivated in all participating states during the 50 pendency of the order. 51 H. If any participating state takes adverse action, it promptly shall 52 notify the administrator of the data system. 53 Section 7. Establishment of the PA licensure compact commission. 54 A. The participating states hereby create and establish a joint 55 government agency and national administrative body known as the PA 56 licensure compact commission. The commission is an instrumentality ofA. 8172 6 1 the compact states acting jointly and not an instrumentality of any one 2 state. The commission shall come into existence on or after the effec- 3 tive date of the compact as set forth in section 11.A. 4 B. Membership, voting, and meetings: 5 1. Each participating state shall have and be limited to one (1) dele- 6 gate selected by that participating state's licensing board or, if the 7 state has more than one licensing board, selected collectively by the 8 participating state's licensing boards. 9 2. The delegate shall be either: 10 a. A current PA, physician or public member of a licensing board or PA 11 council/committee; or 12 b. An administrator of a licensing board. 13 3. Any delegate may be removed or suspended from office as provided by 14 the laws of the state from which the delegate is appointed. 15 4. The participating state licensing board shall fill any vacancy 16 occurring in the commission within sixty (60) days. 17 5. Each delegate shall be entitled to one (1) vote on all matters 18 voted on by the commission and shall otherwise have an opportunity to 19 participate in the business and affairs of the commission. A delegate 20 shall vote in person or by such other means as provided in the bylaws. 21 The bylaws may provide for delegates' participation in meetings by tele- 22 communications, video conference, or other means of communication. 23 6. The commission shall meet at least once during each calendar year. 24 Additional meetings shall be held as set forth in this compact and the 25 bylaws. 26 7. The commission shall establish by rule a term of office for deleg- 27 ates. 28 C. The commission shall have the following powers and duties: 29 1. Establish a code of ethics for the commission; 30 2. Establish the fiscal year of the commission; 31 3. Establish fees; 32 4. Establish bylaws; 33 5. Maintain its financial records in accordance with the bylaws; 34 6. Meet and take such actions as are consistent with the provisions of 35 this compact and the bylaws; 36 7. Promulgate rules to facilitate and coordinate implementation and 37 administration of this compact. The rules shall have the force and 38 effect of law and shall be binding in all participating states; 39 8. Bring and prosecute legal proceedings or actions in the name of the 40 commission, provided that the standing of any State Licensing Board to 41 sue or be sued under applicable law shall not be affected; 42 9. Purchase and maintain insurance and bonds; 43 10. Borrow, accept, or contract for services of personnel, including, 44 but not limited to, employees of a participating state; 45 11. Hire employees and engage contractors, elect or appoint officers, 46 fix compensation, define duties, grant such individuals appropriate 47 authority to carry out the purposes of this compact, and establish the 48 commission's personnel policies and programs relating to conflicts of 49 interest, qualifications of personnel, and other related personnel 50 matters; 51 12. Accept any and all appropriate donations and grants of money, 52 equipment, supplies, materials and services, and receive, utilize and 53 dispose of the same; provided that at all times the commission shall 54 avoid any appearance of impropriety or conflict of interest; 55 13. Lease, purchase, accept appropriate gifts or donations of, or 56 otherwise own, hold, improve or use, any property, real, personal orA. 8172 7 1 mixed; provided that at all times the commission shall avoid any appear- 2 ance of impropriety; 3 14. Sell, convey, mortgage, pledge, lease, exchange, abandon, or 4 otherwise dispose of any property real, personal, or mixed; 5 15. Establish a budget and make expenditures; 6 16. Borrow money; 7 17. Appoint committees, including standing committees composed of 8 members, state regulators, state legislators or their representatives, 9 and consumer representatives, and such other interested persons as may 10 be designated in this compact and the bylaws; 11 18. Provide and receive information from, and cooperate with, law 12 enforcement agencies; 13 19. Elect a chair, vice chair, secretary and treasurer and such other 14 officers of the commission as provided in the commission's bylaws. 15 20. Reserve for itself, in addition to those reserved exclusively to 16 the commission under the compact, powers that the executive committee 17 may not exercise; 18 21. Approve or disapprove a state's participation in the compact based 19 upon its determination as to whether the state's compact legislation 20 departs in a material manner from the model compact language; 21 22. Prepare and provide to the participating states an annual report; 22 and 23 23. Perform such other functions as may be necessary or appropriate to 24 achieve the purposes of this compact consistent with the state regu- 25 lation of PA licensure and practice. 26 D. Meetings of the commission: 27 1. All meetings of the commission that are not closed pursuant to this 28 subsection shall be open to the public. Notice of public meetings shall 29 be posted on the commission's website at least thirty (30) days prior to 30 the public meeting. 31 2. Notwithstanding subsection D.1, the commission may convene a public 32 meeting by providing at least twenty-four (24) hours prior notice on the 33 commission's website, and any other means as provided in the commis- 34 sion's rules, for any of the reasons it may dispense with notice of 35 proposed rulemaking under section 9.L. 36 3. The commission may convene in a closed, non-public meeting or 37 nonpublic part of a public meeting to receive legal advice or to 38 discuss: 39 a. Non-compliance of a participating state with its obligations under 40 this compact; 41 b. The employment, compensation, discipline or other matters, prac- 42 tices or procedures related to specific employees or other matters 43 related to the commission's internal personnel practices and procedures; 44 c. Current, threatened, or reasonably anticipated litigation; 45 d. Negotiation of contracts for the purchase, lease, or sale of goods, 46 services, or real estate; 47 e. Accusing any person of a crime or formally censuring any person; 48 f. Disclosure of trade secrets or commercial or financial information 49 that is privileged or confidential; 50 g. Disclosure of information of a personal nature where disclosure 51 would constitute a clearly unwarranted invasion of personal privacy; 52 h. Disclosure of investigative records compiled for law enforcement 53 purposes; 54 i. Disclosure of information related to any investigative reports 55 prepared by or on behalf of or for use of the commission or otherA. 8172 8 1 committee charged with responsibility of investigation or determination 2 of compliance issues pursuant to this compact; 3 j. Legal advice; or 4 k. Matters specifically exempted from disclosure by federal or partic- 5 ipating states' statutes. 6 4. If a meeting, or portion of a meeting, is closed pursuant to this 7 provision, the chair of the meeting or the chair's designee shall certi- 8 fy that the meeting or portion of the meeting may be closed and shall 9 reference each relevant exempting provision. 10 5. The commission shall keep minutes that fully and clearly describe 11 all matters discussed in a meeting and shall provide a full and accurate 12 summary of actions taken, including a description of the views 13 expressed. All documents considered in connection with an action shall 14 be identified in such minutes. All minutes and documents of a closed 15 meeting shall remain under seal, subject to release by a majority vote 16 of the commission or order of a court of competent jurisdiction. 17 E. Financing of the commission: 18 1. The commission shall pay, or provide for the payment of, the 19 reasonable expenses of its establishment, organization, and ongoing 20 activities. 21 2. The commission may accept any and all appropriate revenue sources, 22 donations, and grants of money, equipment, supplies, materials, and 23 services. 24 3. The commission may levy on and collect an annual assessment from 25 each participating state and may impose compact privilege fees on licen- 26 sees of participating states to whom a compact privilege is granted to 27 cover the cost of the operations and activities of the commission and 28 its staff, which must be in a total amount sufficient to cover its annu- 29 al budget as approved by the commission each year for which revenue is 30 not provided by other sources. The aggregate annual assessment amount 31 levied on participating states shall be allocated based upon a formula 32 to be determined by commission rule. 33 a. A compact privilege expires when the licensee's qualifying license 34 in the participating state from which the licensee applied for the 35 compact privilege expires. 36 b. If the licensee terminates the qualifying license through which the 37 licensee applied for the compact privilege before its scheduled expira- 38 tion, and the licensee has a qualifying license in another participating 39 state, the licensee shall inform the commission that it is changing to 40 that participating state the participating state through which it 41 applies for a compact privilege and pay to the commission any compact 42 privilege fee required by commission rule. 43 4. The commission shall not incur obligations of any kind prior to 44 securing the funds adequate to meet the same; nor shall the commission 45 pledge the credit of any of the participating states, except by and with 46 the authority of the participating state. 47 5. The commission shall keep accurate accounts of all receipts and 48 disbursements. The receipts and disbursements of the commission shall be 49 subject to the financial review and accounting procedures established 50 under its bylaws. All receipts and disbursements of funds handled by the 51 commission shall be subject to an annual financial review by a certified 52 or licensed public accountant, and the report of the financial review 53 shall be included in and become part of the annual report of the commis- 54 sion. 55 F. The executive committee:A. 8172 9 1 1. The executive committee shall have the power to act on behalf of 2 the commission according to the terms of this compact and commission 3 rules. 4 2. The executive committee shall be composed of nine (9) members: 5 a. Seven voting members who are elected by the commission from the 6 current membership of the commission; 7 b. One ex-officio, nonvoting member from a recognized national PA 8 professional association; and 9 c. One ex-officio, nonvoting member from a recognized national PA 10 certification organization. 11 3. The ex-officio members will be selected by their respective organ- 12 izations. 13 4. The commission may remove any member of the executive committee as 14 provided in its bylaws. 15 5. The executive committee shall meet at least annually. 16 6. The executive committee shall have the following duties and respon- 17 sibilities: 18 a. Recommend to the commission changes to the commission's rules or 19 bylaws, changes to this compact legislation, fees to be paid by compact 20 participating states such as annual dues, and any commission compact fee 21 charged to licensees for the compact privilege; 22 b. Ensure compact administration services are appropriately provided, 23 contractual or otherwise; 24 c. Prepare and recommend the budget; 25 d. Maintain financial records on behalf of the commission; 26 e. Monitor compact compliance of participating states and provide 27 compliance reports to the commission; 28 f. Establish additional committees as necessary; 29 g. Exercise the powers and duties of the commission during the interim 30 between commission meetings, except for issuing proposed rulemaking or 31 adopting commission rules or bylaws, or exercising any other powers and 32 duties exclusively reserved to the commission by the commission's rules; 33 and 34 h. Perform other duties as provided in the commission's rules or 35 bylaws. 36 7. All meeting of the executive committee at which it votes or plans 37 to vote on matters in exercising the powers and duties of the commission 38 shall be open to the public and public notice of such meetings shall be 39 given as public meetings of the commission are given. 40 8. The executive committee may convene in a closed, non-public meeting 41 for the same reasons that the commission may convene in a non-public 42 meeting as set forth in section 7.D.3 and shall announce the closed 43 meeting as the commission is required to under section 7.D.4 and keep 44 minutes of the closed meeting as the commission is required to under 45 section 7.D.5. 46 G. Qualified immunity, defense, and indemnification: 47 1. The members, officers, executive director, employees and represen- 48 tatives of the commission shall be immune from suit and liability, both 49 personally and in their official capacity, for any claim for damage to 50 or loss of property or personal injury or other civil liability caused 51 by or arising out of any actual or alleged act, error, or omission that 52 occurred, or that the person against whom the claim is made had a 53 reasonable basis for believing occurred within the scope of commission 54 employment, duties or responsibilities; provided that nothing in this 55 paragraph shall be construed to protect any such person from suit or 56 liability for any damage, loss, injury, or liability caused by theA. 8172 10 1 intentional or willful or wanton misconduct of that person. The procure- 2 ment of insurance of any type by the commission shall not in any way 3 compromise or limit the immunity granted hereunder. 4 2. The commission shall defend any member, officer, executive direc- 5 tor, employee, and representative of the commission in any civil action 6 seeking to impose liability arising out of any actual or alleged act, 7 error, or omission that occurred within the scope of commission employ- 8 ment, duties, or responsibilities, or as determined by the commission 9 that the person against whom the claim is made had a reasonable basis 10 for believing occurred within the scope of commission employment, 11 duties, or responsibilities; provided that nothing herein shall be 12 construed to prohibit that person from retaining their own counsel at 13 their own expense; and provided further, that the actual or alleged act, 14 error, or omission did not result from that person's intentional or 15 willful or wanton misconduct. 16 3. The commission shall indemnify and hold harmless any member, offi- 17 cer, executive director, employee, and representative of the commission 18 for the amount of any settlement or judgment obtained against that 19 person arising out of any actual or alleged act, error, or omission that 20 occurred within the scope of commission employment, duties, or responsi- 21 bilities, or that such person had a reasonable basis for believing 22 occurred within the scope of commission employment, duties, or responsi- 23 bilities, provided that the actual or alleged act, error, or omission 24 did not result from the intentional or willful or wanton misconduct of 25 that person. 26 4. Venue is proper and judicial proceedings by or against the commis- 27 sion shall be brought solely and exclusively in a court of competent 28 jurisdiction where the principal office of the commission is located. 29 The commission may waive venue and jurisdictional defenses in any 30 proceedings as authorized by commission rules. 31 5. Nothing herein shall be construed as a limitation on the liability 32 of any Licensee for professional malpractice or misconduct, which shall 33 be governed solely by any other applicable state laws. 34 6. Nothing herein shall be construed to designate the venue or juris- 35 diction to bring actions for alleged acts of malpractice, professional 36 misconduct, negligence, or other such civil action pertaining to the 37 practice of a PA. All such matters shall be determined exclusively by 38 state law other than this compact. 39 7. Nothing in this compact shall be interpreted to waive or otherwise 40 abrogate a participating state's state action immunity or state action 41 affirmative defense with respect to antitrust claims under the Sherman 42 Act, Clayton Act, or any other state or federal antitrust or anticompet- 43 itive law or regulation. 44 8. Nothing in this compact shall be construed to be a waiver of sover- 45 eign immunity by the participating states or by the commission. 46 Section 8. Data system. 47 A. The commission shall provide for the development, maintenance, 48 operation, and utilization of a coordinated data and reporting system 49 containing licensure, adverse action, and the reporting of the existence 50 of significant investigative Information on all licensed PAs and appli- 51 cants denied a license in participating states. 52 B. Notwithstanding any other state law to the contrary, a participat- 53 ing state shall submit a uniform data set to the data system on all PAs 54 to whom this compact is applicable (utilizing a unique identifier) as 55 required by the rules of the commission, including: 56 1. Identifying information;A. 8172 11 1 2. Licensure data; 2 3. Adverse actions against a license or compact privilege; 3 4. Any denial of application for licensure, and the reason(s) for such 4 denial (excluding the reporting of any criminal history record informa- 5 tion where prohibited by law); 6 5. The existence of significant investigative information; and 7 6. Other information that may facilitate the administration of this 8 compact, as determined by the rules of the commission. 9 C. Significant investigative information pertaining to a licensee in 10 any participating state shall only be available to other participating 11 states. 12 D. The commission shall promptly notify all participating states of 13 any adverse action taken against a licensee or an individual applying 14 for a license that has been reported to it. This adverse action informa- 15 tion shall be available to any other participating state. 16 E. Participating states contributing information to the data system 17 may, in accordance with state or federal law, designate information that 18 may not be shared with the public without the express permission of the 19 contributing state. Notwithstanding any such designation, such informa- 20 tion shall be reported to the commission through the data system. 21 F. Any information submitted to the data system that is subsequently 22 expunged pursuant to federal law or the laws of the participating state 23 contributing the information shall be removed from the data system upon 24 reporting of such by the participating state to the commission. 25 G. The records and information provided to a participating state 26 pursuant to this compact or through the data system, when certified by 27 the commission or an agent thereof, shall constitute the authenticated 28 business records of the commission, and shall be entitled to any associ- 29 ated hearsay exception in any relevant judicial, quasi-judicial or 30 administrative proceedings in a participating state. 31 Section 9. Rulemaking. 32 A. The commission shall exercise its rulemaking powers pursuant to the 33 criteria set forth in this section and the rules adopted thereunder. 34 Commission rules shall become binding as of the date specified by the 35 commission for each rule. 36 B. The commission shall promulgate reasonable rules in order to effec- 37 tively and efficiently implement and administer this compact and achieve 38 its purposes. A commission rule shall be invalid and have not force or 39 effect only if a court of competent jurisdiction holds that the rule is 40 invalid because the commission exercised its rulemaking authority in a 41 manner that is beyond the scope of the purposes of this compact, or the 42 powers granted hereunder, or based upon another applicable standard of 43 review. 44 C. The rules of the commission shall have the force of law in each 45 participating state, provided however that where the rules of the 46 commission conflict with the laws of the participating state that estab- 47 lish the medical services a PA may perform in the participating state, 48 as held by a court of competent jurisdiction, the rules of the commis- 49 sion shall be ineffective in that state to the extent of the conflict. 50 D. If a majority of the legislatures of the participating states 51 rejects a commission rule, by enactment of a statute or resolution in 52 the same manner used to adopt this compact within four (4) years of the 53 date of adoption of the rule, then such rule shall have no further force 54 and effect in any participating state or to any state applying to 55 participate in the compact.A. 8172 12 1 E. Commission rules shall be adopted at a regular or special meeting 2 of the commission. 3 F. Prior to promulgation and adoption of a final rule or rules by the 4 commission, and at least thirty (30) days in advance of the meeting at 5 which the rule will be considered and voted upon, the commission shall 6 file a notice of proposed rulemaking: 7 1. On the website of the commission or other publicly accessible plat- 8 form; and 9 2. To persons who have requested notice of the commission's notices of 10 proposed rulemaking, and 11 3. In such other way(s) as the commission may by rule specify. 12 G. The notice of proposed rulemaking shall include: 13 1. The time, date, and location of the public hearing on the proposed 14 rule and the proposed time, date and location of the meeting in which 15 the proposed rule will be considered and voted upon; 16 2. The text of the proposed rule and the reason for the proposed rule; 17 3. A request for comments on the proposed rule from any interested 18 person and the date by which written comments must be received; and 19 4. The manner in which interested persons may submit notice to the 20 commission of their intention to attend the public hearing or provide 21 any written comments. 22 H. Prior to adoption of a proposed rule, the commission shall allow 23 persons to submit written data, facts, opinions, and arguments, which 24 shall be made available to the public. 25 I. If the hearing is to be held via electronic means, the commission 26 shall publish the mechanism for access to the electronic hearing. 27 1. All persons wishing to be heard at the hearing shall as directed in 28 the notice of proposed rulemaking, not less than five (5) business days 29 before the scheduled date of the hearing, notify the commission of their 30 desire to appear and testify at the hearing. 31 2. Hearings shall be conducted in a manner providing each person who 32 wishes to comment a fair and reasonable opportunity to comment orally or 33 in writing. 34 3. All hearings shall be recorded. A copy of the recording and the 35 written comments, data, facts, opinions, and arguments received in 36 response to the proposed rulemaking shall be made available to a person 37 upon request. 38 4. Nothing in this section shall be construed as requiring a separate 39 hearing on each proposed rule. Proposed rules may be grouped for the 40 convenience of the commission at hearings required by this section. 41 J. Following the public hearing the commission shall consider all 42 written and oral comments timely received. 43 K. The commission shall, by majority vote of all delegates, take final 44 action on the proposed rule and shall determine the effective date of 45 the rule, if adopted, based on the rulemaking record and the full text 46 of the rule. 47 1. If adopted, the rule shall be posted on the commission's website. 48 2. The commission may adopt changes to the proposed rule provided the 49 changes do not enlarge the original purpose of the proposed rule. 50 3. The commission shall provide on its website an explanation of the 51 reasons for substantive changes made to the proposed rule as well as 52 reasons for substantive changes not made that were recommended by 53 commenters. 54 4. The commission shall determine a reasonable effective date for the 55 rule. Except for an emergency as provided in subsection L, the effectiveA. 8172 13 1 date of the rule shall be no sooner than thirty (30) days after the 2 commission issued the notice that it adopted the rule. 3 L. Upon determination that an emergency exists, the commission may 4 consider and adopt an emergency rule with twenty-four (24) hours prior 5 notice, without the opportunity for comment, or hearing, provided that 6 the usual rulemaking procedures provided in this compact and in this 7 section shall be retroactively applied to the rule as soon as reasonably 8 possible, in no event later than ninety (90) days after the effective 9 date of the rule. For the purposes of this provision, an emergency rule 10 is one that must be adopted immediately by the commission in order to: 11 1. Meet an imminent threat to public health, safety, or welfare; 12 2. Prevent a loss of commission or participating state funds; 13 3. Meet a deadline for the promulgation of a commission rule that is 14 established by federal law or rule; or 15 4. Protect public health and safety. 16 M. The commission or an authorized committee of the commission may 17 direct revisions to a previously adopted commission rule for purposes of 18 correcting typographical errors, errors in format, errors in consisten- 19 cy, or grammatical errors. Public notice of any revisions shall be post- 20 ed on the website of the commission. The revision shall be subject to 21 challenge by any person for a period of thirty (30) days after posting. 22 The revision may be challenged only on grounds that the revision results 23 in a material change to a rule. A challenge shall be made as set forth 24 in the notice of revisions and delivered to the commission prior to the 25 end of the notice period. If no challenge is made, the revision will 26 take effect without further action. If the revision is challenged, the 27 revision may not take effect without the approval of the commission. 28 N. No participating state's rulemaking requirements shall apply under 29 this compact. 30 Section 10. Oversight, dispute resolution, and enforcement. 31 A. Oversight: 32 1. The executive and judicial branches of state government in each 33 participating state shall enforce this compact and take all actions 34 necessary and appropriate to implement the compact. 35 2. Venue is proper and judicial proceedings by or against the commis- 36 sion shall be brought solely and exclusively in a court of competent 37 jurisdiction where the principal office of the commission is located. 38 The commission may waive venue and jurisdictional defenses to the extent 39 it adopts or consents to participate in alternative dispute resolution 40 proceedings. Nothing herein shall affect or limit the selection or 41 propriety of venue in any action against a licensee for professional 42 malpractice, misconduct or any such similar matter. 43 3. The commission shall be entitled to receive service of process in 44 any proceeding regarding the enforcement or interpretation of the 45 compact or the commission's rules and shall have standing to intervene 46 in such a proceeding for all purposes. Failure to provide the commission 47 with service of process shall render a judgment or order in such 48 proceeding void as to the commission, this compact, or commission rules. 49 B. Default, technical assistance, and termination: 50 1. If the commission determines that a participating state has 51 defaulted in the performance of its obligations or responsibilities 52 under this compact or the commission rules, the commission shall provide 53 written notice to the defaulting state and other participating states. 54 The notice shall describe the default, the proposed means of curing the 55 default and any other action that the commission may take and shallA. 8172 14 1 offer remedial training and specific technical assistance regarding the 2 default. 3 2. If a state in default fails to cure the default, the defaulting 4 state may be terminated from this compact upon an affirmative vote of a 5 majority of the delegates of the participating states, and all rights, 6 privileges and benefits conferred by this compact upon such state may be 7 terminated on the effective date of termination. A cure of the default 8 does not relieve the offending state of obligations or liabilities 9 incurred during the period of default. 10 3. Termination of participation in this compact shall be imposed only 11 after all other means of securing compliance have been exhausted. Notice 12 of intent to suspend or terminate shall be given by the Commission to 13 the governor, the majority and minority leaders of the defaulting 14 state's legislature, and to the licensing board(s) of each of the 15 participating states. 16 4. A state that has been terminated is responsible for all assess- 17 ments, obligations, and liabilities incurred through the effective date 18 of termination, including obligations that extend beyond the effective 19 date of termination. 20 5. The commission shall not bear any costs related to a state that is 21 found to be in default or that has been terminated from this compact, 22 unless agreed upon in writing between the commission and the defaulting 23 state. 24 6. The defaulting state may appeal its termination from the compact by 25 the commission by petitioning the United States District Court for the 26 District of Columbia or the federal district where the commission has 27 its principal offices. The prevailing member shall be awarded all costs 28 of such litigation, including reasonable attorney's fees. 29 7. Upon the termination of a state's participation in the compact, the 30 state shall immediately provide notice to all licensees within that 31 state of such termination: 32 a. Licensees who have been granted a compact privilege in that state 33 shall retain the compact privilege for one hundred eighty (180) days 34 following the effective date of such termination. 35 b. Licensees who are licensed in that state who have been granted a 36 compact privilege in a participating state shall retain the compact 37 privilege for one hundred eighty (180) days unless the licensee also has 38 a qualifying license in a participating state or obtains a qualifying 39 license in a participating state before the one hundred eighty (180)-day 40 period ends, in which case the compact privilege shall continue. 41 C. Dispute resolution: 42 1. Upon request by a participating state, the commission shall attempt 43 to resolve disputes related to this compact that arise among participat- 44 ing states and between participating and non-participating states. 45 2. The commission shall promulgate a Rule providing for both mediation 46 and binding dispute resolution for disputes as appropriate. 47 D. Enforcement: 48 1. The commission, in the reasonable exercise of its discretion, shall 49 enforce the provisions of this compact and rules of the commission. 50 2. If compliance is not secured after all means to secure compliance 51 have been exhausted, by majority vote, the commission may initiate legal 52 action in the United States District Court for the District of Columbia 53 or the federal district where the commission has its principal offices, 54 against a participating state in default to enforce compliance with the 55 provisions of this compact and the commission's promulgated rules and 56 bylaws. The relief sought may include both injunctive relief andA. 8172 15 1 damages. In the event judicial enforcement is necessary, the prevailing 2 party shall be awarded all costs of such litigation, including reason- 3 able attorney's fees. 4 3. The remedies herein shall not be the exclusive remedies of the 5 commission. The commission may pursue any other remedies available under 6 federal or state law. 7 E. Legal action against the commission: 8 1. A participating state may initiate legal action against the commis- 9 sion in the United States District Court for the District of Columbia or 10 the federal district where the commission has its principal offices to 11 enforce compliance with the provisions of the compact and its rules. The 12 relief sought may include both injunctive relief and damages. In the 13 event judicial enforcement is necessary, the prevailing party shall be 14 awarded all costs of such litigation, including reasonable attorney's 15 fees. 16 2. No person other than a participating state shall enforce this 17 compact against the commission. 18 Section 11. Date of implementation of the PA licensure compact commis- 19 sion. 20 A. This compact shall come into effect on the date on which this 21 compact statute is enacted into law in the seventh participating state. 22 1. On or after the effective date of the compact, the commission shall 23 convene and review the enactment of each of the states that enacted the 24 compact prior to the commission convening ("charter participating 25 states") to determine if the statute enacted by each such charter 26 participating state is materially different than the model compact. 27 a. A charter participating state whose enactment is found to be mate- 28 rially different from the model compact shall be entitled to the default 29 process set forth in section 10.B. 30 b. If any participating state later withdraws from the compact or its 31 participation is terminated, the commission shall remain in existence 32 and the compact shall remain in effect even if the number of participat- 33 ing states should be less than seven. Participating states enacting the 34 compact subsequent to the commission convening shall be subject to the 35 process set forth in section 7.C.21 to determine if their enactments are 36 materially different from the model compact and whether they qualify for 37 participation in the compact. 38 2. Participating states enacting the compact subsequent to the seven 39 initial charter participating states shall be subject to the process set 40 forth in section 7.C.21 to determine if their enactments are materially 41 different from the model compact and whether they qualify for partic- 42 ipation in the compact. 43 3. All actions taken for the benefit of the commission or in further- 44 ance of the purposes of the administration of the compact prior to the 45 effective date of the compact or the commission coming into existence 46 shall be considered to be actions of the commission unless specifically 47 repudiated by the commission. 48 B. Any state that joins this compact shall be subject to the commis- 49 sion's rules and bylaws as they exist on the date on which this compact 50 becomes law in that state. Any rule that has been previously adopted by 51 the commission shall have the full force and effect of law on the day 52 this compact becomes law in that state. 53 C. Any participating state may withdraw from this compact by enacting 54 a statute repealing the same. 55 1. A participating state's withdrawal shall not take effect until one 56 hundred eighty (180) days after enactment of the repealing statute.A. 8172 16 1 during this one hundred eighty (180)-day period, all compact privileges 2 that were in effect in the withdrawing state and were granted to licen- 3 sees licensed in the withdrawing state shall remain in effect. If any 4 licensee licensed in the withdrawing state is also licensed in another 5 participating state or obtains a license in another participating state 6 within the one hundred eighty (180) days, the licensee's compact privi- 7 leges in other participating states shall not be affected by the passage 8 of the one hundred eighty (180) days. 9 2. Withdrawal shall not affect the continuing requirement of the state 10 licensing board(s) of the withdrawing state to comply with the investi- 11 gative, and adverse action reporting requirements of this compact prior 12 to the effective date of withdrawal. 13 3. Upon the enactment of a statute withdrawing a state from this 14 compact, the state shall immediately provide notice of such withdrawal 15 to all licensees within that state. Such withdrawing state shall contin- 16 ue to recognize all licenses granted pursuant to this compact for a 17 minimum of one hundred eighty (180) days after the date of such notice 18 of withdrawal. 19 D. Nothing contained in this compact shall be construed to invalidate 20 or prevent any PA licensure agreement or other cooperative arrangement 21 between participating states and between a participating state and non- 22 participating state that does not conflict with the provisions of this 23 compact. 24 E. This compact may be amended by the participating states. No amend- 25 ment to this compact shall become effective and binding upon any partic- 26 ipating state until it is enacted materially in the same manner into the 27 laws of all participating states as determined by the commission. 28 Section 12. Construction and severability. 29 A. This compact and the commission's rulemaking authority shall be 30 liberally construed so as to effectuate the purposes, and the implemen- 31 tation and administration of the compact. Provisions of the compact 32 expressly authorizing or requiring the promulgation of rules shall not 33 be construed to limit the commission's rulemaking authority solely for 34 those purposes. 35 B. The provisions of this compact shall be severable and if any 36 phrase, clause, sentence or provision of this compact is held by a court 37 of competent jurisdiction to be contrary to the constitution of any 38 participating state, a state seeking participation in the compact, or of 39 the United States, or the applicability thereof to any government, agen- 40 cy, person or circumstance is held to be unconstitutional by a court of 41 competent jurisdiction, the validity of the remainder of this compact 42 and the applicability thereof to any other government, agency, person or 43 circumstance shall not be affected thereby. 44 C. Notwithstanding subsection B or this section, the commission may 45 deny a state's participation in the compact or, in accordance with the 46 requirements of section 10.B, terminate a participating state's partic- 47 ipation in the compact, if it determines that a constitutional require- 48 ment of a participating state is, or would be with respect to a state 49 seeking to participate in the compact, a material departure from the 50 compact. Otherwise, if this compact shall be held to be contrary to the 51 constitution of any participating state, the compact shall remain in 52 full force and effect as to the remaining participating states and in 53 full force and effect as to the participating state affected as to all 54 severable matters. 55 Section 13. Binding effect of compact.A. 8172 17 1 A. Nothing herein prevents the enforcement of any other law of a 2 participating state that is not inconsistent with this compact. 3 B. Any laws in a participating state in conflict with this compact are 4 superseded to the extent of the conflict. 5 C. All agreements between the commission and the participating states 6 are binding in accordance with their terms. 7 § 2. Severability clause. If any clause, sentence, paragraph, subdivi- 8 sion, section or part of this act shall be adjudged by any court of 9 competent jurisdiction to be invalid, such judgment shall not affect, 10 impair, or invalidate the remainder thereof, but shall be confined in 11 its operation to the clause, sentence, paragraph, subdivision, section 12 or part thereof directly involved in the controversy in which such judg- 13 ment shall have been rendered. It is hereby declared to be the intent of 14 the legislature that this act would have been enacted even if such 15 invalid provisions had not been included herein. 16 § 3. This act shall take effect immediately.
