84R7764 JSC-F
 
  By: Zerwas H.B. No. 2498
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a compact with other states regarding the licensure of
  emergency medical services personnel and the authority of those
  personnel to perform job duties in this state and other states.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle B, Title 9, Health and Safety Code, is
  amended by adding Chapter 778A to read as follows:
  CHAPTER 778A. RECOGNITION OF EMERGENCY MEDICAL SERVICES PERSONNEL
  LICENSURE INTERSTATE COMPACT ("REPLICA")
         Sec. 778A.001.  EXECUTION OF INTERSTATE COMPACT. This
  state enacts the EMS Personnel Licensure Interstate Compact and
  enters into the compact with all other states legally joining in the
  compact in substantially the following form:
  EMS PERSONNEL LICENSURE INTERSTATE COMPACT.
         Section 1.  PURPOSE.  In order to protect the public through
  verification of competency and ensure accountability for patient
  care related activities all states license emergency medical
  services (EMS) personnel, such as emergency medical technicians
  (EMTs), advanced EMTs and paramedics. This compact is intended to
  facilitate the day to day movement of EMS personnel across state
  boundaries in the performance of their EMS duties as assigned by an
  appropriate authority and authorize state EMS offices to afford
  immediate legal recognition to EMS personnel licensed in a member
  state. This compact recognizes that states have a vested interest
  in protecting the public's health and safety through their
  licensing and regulation of EMS personnel and that such state
  regulation shared among the member states will best protect public
  health and safety. This compact is designed to achieve the
  following purposes and objectives:
         1.  increase public access to EMS personnel;
         2.  enhance the states' ability to protect the public's
  health and safety, especially patient safety;
         3.  encourage the cooperation of member states in the areas
  of EMS personnel licensure and regulation;
         4.  support licensing of military members who are separating
  from an active duty tour and their spouses;
         5.  facilitate the exchange of information between member
  states regarding EMS personnel licensure, adverse action and
  significant investigatory information;
         6.  promote compliance with the laws governing EMS personnel
  practice in each member state; and
         7.  invest all member states with the authority to hold EMS
  personnel accountable through the mutual recognition of member
  state licenses.
         Section 2.  DEFINITIONS. In this compact:
         A.  "Advanced emergency medical technician (AEMT)" means: an
  individual licensed with cognitive knowledge and a scope of
  practice that corresponds to that level in the National EMS
  Education Standards and National EMS Scope of Practice Model.
         B.  "Adverse action" means: any administrative, civil,
  equitable or criminal action permitted by a state's laws which may
  be imposed against licensed EMS personnel by a state EMS authority
  or state court, including, but not limited to, actions against an
  individual's license such as revocation, suspension, probation,
  consent agreement, monitoring or other limitation or encumbrance on
  the individual's practice, letters of reprimand or admonition,
  fines, criminal convictions and state court judgments enforcing
  adverse actions by the state EMS authority.
         C.  "Alternative program" means: a voluntary,
  non-disciplinary substance abuse recovery program approved by a
  state EMS authority.
         D.  "Certification" means: the successful verification of
  entry-level cognitive and psychomotor competency using a reliable,
  validated, and legally defensible examination.
         E.  "Commission" means: the national administrative body of
  which all states that have enacted the compact are members.
         F.  "Emergency medical technician (EMT)" means: an
  individual licensed with cognitive knowledge and a scope of
  practice that corresponds to that level in the National EMS
  Education Standards and National EMS Scope of Practice Model.
         G.  "Home state" means: a member state where an individual is
  licensed to practice emergency medical services.
         H.  "License" means: the authorization by a state for an
  individual to practice as an EMT, AEMT, paramedic, or a level in
  between EMT and paramedic.
         I.  "Medical director" means: a physician licensed in a
  member state who is accountable for the care delivered by EMS
  personnel.
         J.  "Member state" means: a state that has enacted this
  compact.
         K.  "Privilege to practice" means: an individual's authority
  to deliver emergency medical services in remote states as
  authorized under this compact.
         L.  "Paramedic" means: an individual licensed with cognitive
  knowledge and a scope of practice that corresponds to that level in
  the National EMS Education Standards and National EMS Scope of
  Practice Model.
         M.  "Remote state" means: a member state in which an
  individual is not licensed.
         N.  "Restricted" means: the outcome of an adverse action that
  limits a license or the privilege to practice.
         O.  "Rule" means: a written statement by the interstate
  commission promulgated pursuant to Section 12 of this compact that
  is of general applicability; implements, interprets, or prescribes
  a policy or provision of the compact; or is an organizational,
  procedural, or practice requirement of the commission and has the
  force and effect of statutory law in a member state and includes the
  amendment, repeal, or suspension of an existing rule.
         P.  "Scope of practice" means: defined parameters of various
  duties or services that may be provided by an individual with
  specific credentials. Whether regulated by rule, statute, or court
  decision, it tends to represent the limits of services an
  individual may perform.
         Q.  "Significant investigatory information" means:
               1.  investigative information that a state EMS
  authority, after a preliminary inquiry that includes notification
  and an opportunity to respond if required by state law, has reason
  to believe, if proved true, would result in the imposition of an
  adverse action on a license or privilege to practice; or
               2.  investigative information that indicates that the
  individual represents an immediate threat to public health and
  safety regardless of whether the individual has been notified and
  had an opportunity to respond.
         R.  "State" means: any state, commonwealth, district, or
  territory of the United States.
         S.  "State EMS authority" means: the board, office, or other
  agency with the legislative mandate to license EMS personnel.
         Section 3.  HOME STATE LICENSURE.  A. Any member state in
  which an individual holds a current license shall be deemed a home
  state for purposes of this compact.
         B.  Any member state may require an individual to obtain and
  retain a license to be authorized to practice in the member state
  under circumstances not authorized by the privilege to practice
  under the terms of this compact.
         C.  A home state's license authorizes an individual to
  practice in a remote state under the privilege to practice only if
  the home state:
               1.  currently requires the use of the National Registry
  of Emergency Medical Technicians (NREMT) examination as a condition
  of issuing initial licenses at the EMT and paramedic levels;
               2.  has a mechanism in place for receiving and
  investigating complaints about individuals;
               3.  notifies the commission, in compliance with the
  terms herein, of any adverse action or significant investigatory
  information regarding an individual;
               4.  no later than five years after activation of the
  compact, requires a criminal background check of all applicants for
  initial licensure, including the use of the results of fingerprint
  or other biometric data checks compliant with the requirements of
  the Federal Bureau of Investigation with the exception of federal
  employees who have suitability determination in accordance with 5
  C.F.R. Section 731.202 and submit documentation of such as
  promulgated in the rules of the commission; and
               5.  complies with the rules of the commission.
         Section 4.  COMPACT PRIVILEGE TO PRACTICE.  A. Member states
  shall recognize the privilege to practice of an individual licensed
  in another member state that is in conformance with Section 3.
         B.  To exercise the privilege to practice under the terms and
  provisions of this compact, an individual must:
               1.  be at least 18 years of age;
               2.  possess a current unrestricted license in a member
  state as an EMT, AEMT, paramedic, or state recognized and licensed
  level with a scope of practice and authority between EMT and
  paramedic; and
               3.  practice under the supervision of a medical
  director.
         C.  An individual providing patient care in a remote state
  under the privilege to practice shall function within the scope of
  practice authorized by the home state unless and until modified by
  an appropriate authority in the remote state as may be defined in
  the rules of the commission.
         D.  Except as provided in Section 4.C. of this compact, an
  individual practicing in a remote state will be subject to the
  remote state's authority and laws. A remote state may, in
  accordance with due process and that state's laws, restrict,
  suspend, or revoke an individual's privilege to practice in the
  remote state and may take any other necessary actions to protect the
  health and safety of its citizens. If a remote state takes action it
  shall promptly notify the home state and the commission.
         E.  If an individual's license in any home state is
  restricted or suspended, the individual shall not be eligible to
  practice in a remote state under the privilege to practice until the
  individual's home state license is restored.
         F.  If an individual's privilege to practice in any remote
  state is restricted, suspended, or revoked the individual shall not
  be eligible to practice in any remote state until the individual's
  privilege to practice is restored.
         Section 5.  CONDITIONS OF PRACTICE IN A REMOTE STATE. An
  individual may practice in a remote state under a privilege to
  practice only in the performance of the individual's EMS duties as
  assigned by an appropriate authority, as defined in the rules of the
  commission, and under the following circumstances:
         1.  the individual originates a patient transport in a home
  state and transports the patient to a remote state;
         2.  the individual originates in the home state and enters a
  remote state to pick up a patient and provide care and transport of
  the patient to the home state;
         3.  the individual enters a remote state to provide patient
  care and/or transport within that remote state;
         4.  the individual enters a remote state to pick up a patient
  and provide care and transport to a third member state; or
         5.  other conditions as determined by rules promulgated by
  the commission.
         Section 6.  RELATIONSHIP TO EMERGENCY MANAGEMENT ASSISTANCE
  COMPACT. Upon a member state's governor's declaration of a state of
  emergency or disaster that activates the Emergency Management
  Assistance Compact (EMAC), all relevant terms and provisions of
  EMAC shall apply and to the extent any terms or provisions of this
  compact conflicts with EMAC, the terms of EMAC shall prevail with
  respect to any individual practicing in the remote state in
  response to such declaration.
         Section 7.  VETERANS, SERVICE MEMBERS SEPARATING FROM ACTIVE
  DUTY MILITARY, AND THEIR SPOUSES.  A. Member states shall consider
  a veteran, active military service member, and member of the
  National Guard and Reserves separating from an active duty tour,
  and a spouse thereof, who holds a current valid and unrestricted
  NREMT certification at or above the level of the state license being
  sought as satisfying the minimum training and examination
  requirements for such licensure.
         B.  Member states shall expedite the processing of licensure
  applications submitted by veterans, active military service
  members, and members of the National Guard and Reserves separating
  from an active duty tour, and their spouses.
         C.  All individuals functioning with a privilege to practice
  under this section remain subject to the adverse actions provisions
  of Section 8 of this compact.
         Section 8.  ADVERSE ACTIONS.  A. A home state shall have
  exclusive power to impose adverse action against an individual's
  license issued by the home state.
         B.  If an individual's license in any home state is
  restricted or suspended, the individual shall not be eligible to
  practice in a remote state under the privilege to practice until the
  individual's home state license is restored.
               1.  All home state adverse action orders shall include
  a statement that the individual's compact privileges are inactive.
  The order may allow the individual to practice in remote states with
  prior written authorization from both the home state and remote
  state's EMS authority.
               2.  An individual currently subject to adverse action
  in the home state shall not practice in any remote state without
  prior written authorization from both the home state and remote
  state's EMS authority.
         C.  A member state shall report adverse actions and any
  occurrences that the individual's compact privileges are
  restricted, suspended, or revoked to the commission in accordance
  with the rules of the commission.
         D.  A remote state may take adverse action on an individual's
  privilege to practice within that state.
         E.  Any member state may take adverse action against an
  individual's privilege to practice in that state based on the
  factual findings of another member state, so long as each state
  follows its own procedures for imposing such adverse action.
         F.  A home state's EMS authority shall investigate and take
  appropriate action with respect to reported conduct in a remote
  state as it would if such conduct had occurred within the home
  state. In such cases, the home state's law shall control in
  determining the appropriate adverse action.
         G.  Nothing in this compact shall override a member state's
  decision that participation in an alternative program may be used
  in lieu of adverse action and that such participation shall remain
  non-public if required by the member state's laws. Member states
  must require individuals who enter any alternative programs to
  agree not to practice in any other member state during the term of
  the alternative program without prior authorization from such other
  member state.
         Section 9.  ADDITIONAL POWERS INVESTED IN A MEMBER STATE'S
  EMS AUTHORITY. A member state's EMS authority, in addition to any
  other powers granted under state law, is authorized under this
  compact to:
         1.  issue subpoenas for both hearings and investigations
  that require the attendance and testimony of witnesses and the
  production of evidence; subpoenas issued by a member state's EMS
  authority for the attendance and testimony of witnesses, and/or the
  production of evidence from another member state, shall be enforced
  in the remote state by any court of competent jurisdiction,
  according to that court's practice and procedure in considering
  subpoenas issued in its own proceedings; the issuing state EMS
  authority shall pay any witness fees, travel expenses, mileage, and
  other fees required by the service statutes of the state where the
  witnesses and/or evidence are located; and
         2.  issue cease and desist orders to restrict, suspend, or
  revoke an individual's privilege to practice in the state.
         Section 10.  ESTABLISHMENT OF THE INTERSTATE COMMISSION FOR
  EMS PERSONNEL PRACTICE.  A. The compact states hereby create and
  establish a joint public agency known as the Interstate Commission
  for EMS Personnel Practice.
               1.  The commission is a body politic and an
  instrumentality of the compact states.
               2.  Venue is proper and judicial proceedings by or
  against the commission shall be brought solely and exclusively in a
  court of competent jurisdiction where the principal office of the
  commission is located. The commission may waive venue and
  jurisdictional defenses to the extent it adopts or consents to
  participate in alternative dispute resolution proceedings.
               3.  Nothing in this compact shall be construed to be a
  waiver of sovereign immunity.
         B.  Membership, Voting, and Meetings.  1. Each member state
  shall have and be limited to one delegate. The responsible official
  of the state EMS authority or his designee shall be the delegate to
  this compact for each member state. Any delegate may be removed or
  suspended from office as provided by the law of the state from which
  the delegate is appointed. Any vacancy occurring in the commission
  shall be filled in accordance with the laws of the member state in
  which the vacancy exists. In the event that more than one board,
  office, or other agency with the legislative mandate to license EMS
  personnel at and above the level of EMT exists, the governor of the
  state will determine which entity will be responsible for assigning
  the delegate.
               2.  Each delegate shall be entitled to one vote with
  regard to the promulgation of rules and creation of bylaws and shall
  otherwise have an opportunity to participate in the business and
  affairs of the commission. A delegate shall vote in person or by
  such other means as provided in the bylaws. The bylaws may provide
  for delegates' participation in meetings by telephone or other
  means of communication.
               3.  The commission shall meet at least once during each
  calendar year. Additional meetings shall be held as set forth in the
  bylaws.
               4.  All meetings shall be open to the public, and public
  notice of meetings shall be given in the same manner as required
  under the rulemaking provisions in Section 12 of this compact.
               5.  The commission may convene in a closed, non-public
  meeting if the commission must discuss:
                     a.  non-compliance of a member state with its
  obligations under the compact;
                     b.  the employment, compensation, discipline or
  other personnel matters, practices or procedures related to
  specific employees or other matters related to the commission's
  internal personnel practices and procedures;
                     c.  current, threatened, or reasonably
  anticipated litigation;
                     d.  negotiation of contracts for the purchase or
  sale of goods, services, or real estate;
                     e.  accusing any person of a crime or formally
  censuring any person;
                     f.  disclosure of trade secrets or commercial or
  financial information that is privileged or confidential;
                     g.  disclosure of information of a personal nature
  where disclosure would constitute a clearly unwarranted invasion of
  personal privacy;
                     h.  disclosure of investigatory records compiled
  for law enforcement purposes;
                     i.  disclosure of information related to any
  investigatory reports prepared by or on behalf of or for use of the
  commission or other committee charged with responsibility of
  investigation or determination of compliance issues pursuant to the
  compact; or
                     j.  matters specifically exempted from disclosure
  by federal or member state statute.
               6.  If a meeting, or portion of a meeting, is closed
  pursuant to this section, the commission's legal counsel or
  designee shall certify that the meeting may be closed and shall
  reference each relevant exempting provision. The commission shall
  keep minutes that fully and clearly describe all matters discussed
  in a meeting and shall provide a full and accurate summary of
  actions taken, and the reasons therefore, including a description
  of the views expressed. All documents considered in connection with
  an action shall be identified in such minutes. All minutes and
  documents of a closed meeting shall remain under seal, subject to
  release by a majority vote of the commission or order of a court of
  competent jurisdiction.
         C.  The commission shall, by a majority vote of the
  delegates, prescribe bylaws and/or rules to govern its conduct as
  may be necessary or appropriate to carry out the purposes and
  exercise the powers of the compact, including but not limited to:
               1.  establishing the fiscal year of the commission;
               2.  providing reasonable standards and procedures:
                     a.  for the establishment and meetings of other
  committees; and
                     b.  governing any general or specific delegation
  of any authority or function of the commission;
               3.  providing reasonable procedures for calling and
  conducting meetings of the commission, ensuring reasonable advance
  notice of all meetings, and providing an opportunity for attendance
  of such meetings by interested parties, with enumerated exceptions
  designed to protect the public's interest, the privacy of
  individuals, and proprietary information, including trade secrets.
  The commission may meet in closed session only after a majority of
  the membership votes to close a meeting in whole or in part. As soon
  as practicable, the commission must make public a copy of the vote
  to close the meeting revealing the vote of each member with no proxy
  votes allowed;
               4.  establishing the titles, duties and authority, and
  reasonable procedures for the election of the officers of the
  commission;
               5.  providing reasonable standards and procedures for
  the establishment of the personnel policies and programs of the
  commission; notwithstanding any civil service or other similar laws
  of any member state, the bylaws shall exclusively govern the
  personnel policies and programs of the commission;
               6.  promulgating a code of ethics to address
  permissible and prohibited activities of commission members and
  employees;
               7.  providing a mechanism for winding up the operations
  of the commission and the equitable disposition of any surplus
  funds that may exist after the termination of the compact after the
  payment and/or reserving of all of its debts and obligations;
               8.  the commission shall publish its bylaws and file a
  copy thereof, and a copy of any amendment thereto, with the
  appropriate agency or officer in each of the member states, if any;
               9.  the commission shall maintain its financial records
  in accordance with the bylaws; and
               10.  the commission shall meet and take such actions as
  are consistent with the provisions of this compact and the bylaws.
         D.  The commission shall have the following powers:
               1.  the authority to promulgate uniform rules to
  facilitate and coordinate implementation and administration of
  this compact; the rules shall have the force and effect of law and
  shall be binding in all member states;
               2.  to bring and prosecute legal proceedings or actions
  in the name of the commission, provided that the standing of any
  state EMS authority or other regulatory body responsible for EMS
  personnel licensure to sue or be sued under applicable law shall not
  be affected;
               3.  to purchase and maintain insurance and bonds;
               4.  to borrow, accept, or contract for services of
  personnel, including, but not limited to, employees of a member
  state;
               5.  to hire employees, elect or appoint officers, fix
  compensation, define duties, grant such individuals appropriate
  authority to carry out the purposes of the compact, and to establish
  the commission's personnel policies and programs relating to
  conflicts of interest, qualifications of personnel, and other
  related personnel matters;
               6.  to accept any and all appropriate donations and
  grants of money, equipment, supplies, materials and services, and
  to receive, utilize and dispose of the same; provided that at all
  times the commission shall strive to avoid any appearance of
  impropriety and/or conflict of interest;
               7.  to lease, purchase, accept appropriate gifts or
  donations of, or otherwise to own, hold, improve or use, any
  property, real, personal or mixed; provided that at all times the
  commission shall strive to avoid any appearance of impropriety;
               8.  to sell convey, mortgage, pledge, lease, exchange,
  abandon, or otherwise dispose of any property real, personal, or
  mixed;
               9.  to establish a budget and make expenditures;
               10.  to borrow money;
               11.  to appoint committees, including advisory
  committees comprised of members, state regulators, state
  legislators or their representatives, and consumer
  representatives, and such other interested persons as may be
  designated in this compact and the bylaws;
               12.  to provide and receive information from, and to
  cooperate with, law enforcement agencies;
               13.  to adopt and use an official seal; and
               14.  to perform such other functions as may be
  necessary or appropriate to achieve the purposes of this compact
  consistent with the state regulation of EMS personnel licensure and
  practice.
         E.  Financing of the Commission.  1. The commission shall
  pay, or provide for the payment of, the reasonable expenses of its
  establishment, organization, and ongoing activities.
               2.  The commission may accept any and all appropriate
  revenue sources, donations, and grants of money, equipment,
  supplies, materials, and services.
               3.  The commission may levy on and collect an annual
  assessment from each member state or impose fees on other parties to
  cover the cost of the operations and activities of the commission
  and its staff, which must be in a total amount sufficient to cover
  its annual budget as approved each year for which revenue is not
  provided by other sources. The aggregate annual assessment amount
  shall be allocated based upon a formula to be determined by the
  commission, which shall promulgate a rule binding upon all member
  states.
               4.  The commission shall not incur obligations of any
  kind prior to securing the funds adequate to meet the same; nor
  shall the commission pledge the credit of any of the member states,
  except by and with the authority of the member state.
               5.  The commission shall keep accurate accounts of all
  receipts and disbursements. The receipts and disbursements of the
  commission shall be subject to the audit and accounting procedures
  established under its bylaws. However, all receipts and
  disbursements of funds handled by the commission shall be audited
  yearly by a certified or licensed public accountant, and the report
  of the audit shall be included in and become part of the annual
  report of the commission.
         F.  Qualified Immunity, Defense, and Indemnification.  1.
  The members, officers, executive director, employees and
  representatives of the commission shall be immune from suit and
  liability, either personally or in their official capacity, for any
  claim for damage to or loss of property or personal injury or other
  civil liability caused by or arising out of any actual or alleged
  act, error, or omission that occurred, or that the person against
  whom the claim is made had a reasonable basis for believing occurred
  within the scope of commission employment, duties, or
  responsibilities; provided that nothing in this paragraph shall be
  construed to protect any such person from suit and/or liability for
  any damage, loss, injury, or liability caused by the intentional or
  willful or wanton misconduct of that person.
               2.  The commission shall defend any member, officer,
  executive director, employee or representative of the commission in
  any civil action seeking to impose liability arising out of any
  actual or alleged act, error, or omission that occurred within the
  scope of commission employment, duties, or responsibilities, or
  that the person against whom the claim is made had a reasonable
  basis for believing occurred within the scope of commission
  employment, duties, or responsibilities; provided that nothing
  herein shall be construed to prohibit that person from retaining
  his or her own counsel; and provided further, that the actual or
  alleged act, error, or omission did not result from that person's
  intentional or willful or wanton misconduct.
               3.  The commission shall indemnify and hold harmless
  any member, officer, executive director, employee, or
  representative of the commission for the amount of any settlement
  or judgment obtained against that person arising out of any actual
  or alleged act, error or omission that occurred within the scope of
  commission employment, duties, or responsibilities, or that such
  person had a reasonable basis for believing occurred within the
  scope of commission employment, duties, or responsibilities,
  provided that the actual or alleged act, error, or omission did not
  result from the intentional or willful or wanton misconduct of that
  person.
         Section 11.  COORDINATED DATABASE.  A. The commission shall
  provide for the development and maintenance of a coordinated
  database and reporting system containing licensure, adverse
  action, and significant investigatory information on all licensed
  individuals in member states.
         B.  Notwithstanding any other provision of state law to the
  contrary, a member state shall submit a uniform data set to the
  coordinated database on all individuals to whom this compact is
  applicable as required by the rules of the commission, including:
               1.  identifying information;
               2.  licensure data;
               3.  significant investigatory information;
               4.  adverse actions against an individual's license;
               5.  an indicator that an individual's privilege to
  practice is restricted, suspended or revoked;
               6.  non-confidential information related to
  alternative program participation;
               7.  any denial of application for licensure, and the
  reason or reasons for such denial; and
               8.  other information that may facilitate the
  administration of this compact, as determined by the rules of the
  commission.
         C.  The coordinated database administrator shall promptly
  notify all member states of any adverse action taken against, or
  significant investigative information on, any individual in a
  member state.
         D.  Member states contributing information to the
  coordinated database may designate information that may not be
  shared with the public without the express permission of the
  contributing state.
         E.  Any information submitted to the coordinated database
  that is subsequently required to be expunged by the laws of the
  member state contributing the information shall be removed from the
  coordinated database.
         Section 12.  RULEMAKING.  A. The commission shall exercise
  its rulemaking powers pursuant to the criteria set forth in this
  section and the rules adopted thereunder. Rules and amendments
  shall become binding as of the date specified in each rule or
  amendment.
         B.  If a majority of the legislatures of the member states
  rejects a rule, by enactment of a statute or resolution in the same
  manner used to adopt the compact, then such rule shall have no
  further force and effect in any member state.
         C.  Rules or amendments to the rules shall be adopted at a
  regular or special meeting of the commission.
         D.  Prior to promulgation and adoption of a final rule or
  rules by the commission, and at least 60 days in advance of the
  meeting at which the rule will be considered and voted upon, the
  commission shall file a notice of proposed rulemaking:
               1.  on the website of the commission; and
               2.  on the website of each member state EMS authority or
  the publication in which each state would otherwise publish
  proposed rules.
         E.  The notice of proposed rulemaking shall include:
               1.  the proposed time, date, and location of the
  meeting in which the rule will be considered and voted upon;
               2.  the text of the proposed rule or amendment and the
  reason for the proposed rule;
               3.  a request for comments on the proposed rule from any
  interested person; and
               4.  the manner in which interested persons may submit
  notice to the commission of their intention to attend the public
  hearing and any written comments.
         F.  Prior to adoption of a proposed rule, the commission
  shall allow persons to submit written data, facts, opinions, and
  arguments, which shall be made available to the public.
         G.  The commission shall grant an opportunity for a public
  hearing before it adopts a rule or amendment if a hearing is
  requested by:
               1.  at least 25 persons;
               2.  a governmental subdivision or agency; or
               3.  an association having at least 25 members.
         H.  If a hearing is held on the proposed rule or amendment,
  the commission shall publish the place, time, and date of the
  scheduled public hearing.
               1.  All persons wishing to be heard at the hearing shall
  notify the executive director of the commission or other designated
  member in writing of their desire to appear and testify at the
  hearing not less than 5 business days before the scheduled date of
  the hearing.
               2.  Hearings shall be conducted in a manner providing
  each person who wishes to comment a fair and reasonable opportunity
  to comment orally or in writing.
               3.  No transcript of the hearing is required, unless a
  written request for a transcript is made, in which case the person
  requesting the transcript shall bear the cost of producing the
  transcript. A recording may be made in lieu of a transcript under
  the same terms and conditions as a transcript. This subsection
  shall not preclude the commission from making a transcript or
  recording of the hearing if it so chooses.
               4.  Nothing in this section shall be construed as
  requiring a separate hearing on each rule. Rules may be grouped for
  the convenience of the commission at hearings required by this
  section.
         I.  Following the scheduled hearing date, or by the close of
  business on the scheduled hearing date if the hearing was not held,
  the commission shall consider all written and oral comments
  received.
         J.  The commission shall, by majority vote of all members,
  take final action on the proposed rule and shall determine the
  effective date of the rule, if any, based on the rulemaking record
  and the full text of the rule.
         K.  If no written notice of intent to attend the public
  hearing by interested parties is received, the commission may
  proceed with promulgation of the proposed rule without a public
  hearing.
         L.  Upon determination that an emergency exists, the
  commission may consider and adopt an emergency rule without prior
  notice, opportunity for comment, or hearing, provided that the
  usual rulemaking procedures provided in the compact and in this
  section shall be retroactively applied to the rule as soon as
  reasonably possible, in no event later than 90 days after the
  effective date of the rule. For the purposes of this provision, an
  emergency rule is one that must be adopted immediately in order to:
               1.  meet an imminent threat to public health, safety,
  or welfare;
               2.  prevent a loss of commission or member state funds;
               3.  meet a deadline for the promulgation of an
  administrative rule that is established by federal law or rule; or
               4.  protect public health and safety.
         M.  The commission or an authorized committee of the
  commission may direct revisions to a previously adopted rule or
  amendment for purposes of correcting typographical errors, errors
  in format, errors in consistency, or grammatical errors. Public
  notice of any revisions shall be posted on the website of the
  commission. The revision shall be subject to challenge by any
  person for a period of 30 days after posting. The revision may be
  challenged only on grounds that the revision results in a material
  change to a rule. A challenge shall be made in writing, and
  delivered to the chair of the commission prior to the end of the
  notice period. If no challenge is made, the revision will take
  effect without further action. If the revision is challenged, the
  revision may not take effect without the approval of the
  commission.
         Section 13.  OVERSIGHT, DISPUTE RESOLUTION, AND
  ENFORCEMENT.  A. Oversight.
               1.  The executive, legislative, and judicial branches
  of state government in each member state shall enforce this compact
  and take all actions necessary and appropriate to effectuate the
  compact's purposes and intent. The provisions of this compact and
  the rules promulgated hereunder shall have standing as statutory
  law.
               2.  All courts shall take judicial notice of the
  compact and the rules in any judicial or administrative proceeding
  in a member state pertaining to the subject matter of this compact
  which may affect the powers, responsibilities or actions of the
  commission.
               3.  The commission shall be entitled to receive service
  of process in any such proceeding, and shall have standing to
  intervene in such a proceeding for all purposes. Failure to provide
  service of process to the commission shall render a judgment or
  order void as to the commission, this compact, or promulgated
  rules.
         B.  Default, Technical Assistance, and Termination.  1. If
  the commission determines that a member state has defaulted in the
  performance of its obligations or responsibilities under this
  compact or the promulgated rules, the commission shall:
                     a.  provide written notice to the defaulting state
  and other member states of the nature of the default, the proposed
  means of curing the default and/or any other action to be taken by
  the commission; and
                     b.  provide remedial training and specific
  technical assistance regarding the default.
               2.  If a state in default fails to cure the default, the
  defaulting state may be terminated from the compact upon an
  affirmative vote of a majority of the member states, and all rights,
  privileges and benefits conferred by this compact may be terminated
  on the effective date of termination. A cure of the default does not
  relieve the offending state of obligations or liabilities incurred
  during the period of default.
               3.  Termination of membership in the compact shall be
  imposed only after all other means of securing compliance have been
  exhausted. Notice of intent to suspend or terminate shall be given
  by the commission to the governor, the majority and minority
  leaders of the defaulting state's legislature, and each of the
  member states.
               4.  A state that has been terminated is responsible for
  all assessments, obligations, and liabilities incurred through the
  effective date of termination, including obligations that extend
  beyond the effective date of termination.
               5.  The commission shall not bear any costs related to a
  state that is found to be in default or that has been terminated
  from the compact, unless agreed upon in writing between the
  commission and the defaulting state.
               6.  The defaulting state may appeal the action of the
  commission by petitioning the U.S. District Court for the District
  of Columbia or the federal district where the commission has its
  principal offices. The prevailing member shall be awarded all costs
  of such litigation, including reasonable attorney's fees.
         C.  Dispute Resolution.  1. Upon request by a member state,
  the commission shall attempt to resolve disputes related to the
  compact that arise among member states and between member and
  non-member states.
               2.  The commission shall promulgate a rule providing
  for both mediation and binding dispute resolution for disputes as
  appropriate.
         D.  Enforcement.  1.  The commission, in the reasonable
  exercise of its discretion, shall enforce the provisions and rules
  of this compact.
               2.  By majority vote, the commission may initiate legal
  action in the United States District Court for the District of
  Columbia or the federal district where the commission has its
  principal offices against a member state in default to enforce
  compliance with the provisions of the compact and its promulgated
  rules and bylaws. The relief sought may include both injunctive
  relief and damages. In the event judicial enforcement is necessary,
  the prevailing member shall be awarded all costs of such
  litigation, including reasonable attorney's fees.
               3.  The remedies herein shall not be the exclusive
  remedies of the commission. The commission may pursue any other
  remedies available under federal or state law.
         Section 14.  DATE OF IMPLEMENTATION OF THE INTERSTATE
  COMMISSION FOR EMS PERSONNEL PRACTICE AND ASSOCIATED RULES,
  WITHDRAWAL, AND AMENDMENT.  A. The compact shall come into effect
  on the date on which the compact statute is enacted into law in the
  tenth member state. The provisions, which become effective at that
  time, shall be limited to the powers granted to the commission
  relating to assembly and the promulgation of rules. Thereafter, the
  commission shall meet and exercise rulemaking powers necessary to
  the implementation and administration of the compact.
         B.  Any state that joins the compact subsequent to the
  commission's initial adoption of the rules shall be subject to the
  rules as they exist on the date on which the compact becomes law in
  that state. Any rule that has been previously adopted by the
  commission shall have the full force and effect of law on the day
  the compact becomes law in that state.
         C.  Any member state may withdraw from this compact by
  enacting a statute repealing the same.
               1.  A member state's withdrawal shall not take effect
  until six months after enactment of the repealing statute.
               2.  Withdrawal shall not affect the continuing
  requirement of the withdrawing state's EMS authority to comply with
  the investigative and adverse action reporting requirements of this
  compact prior to the effective date of withdrawal.
         D.  Nothing contained in this compact shall be construed to
  invalidate or prevent any EMS personnel licensure agreement or
  other cooperative arrangement between a member state and a
  non-member state that does not conflict with the provisions of this
  compact.
         E.  This compact may be amended by the member states. No
  amendment to this compact shall become effective and binding upon
  any member state until it is enacted into the laws of all member
  states.
         Section 15.  CONSTRUCTION AND SEVERABILITY. This compact
  shall be liberally construed so as to effectuate the purposes
  thereof. If this compact shall be held contrary to the constitution
  of any state member thereto, the compact shall remain in full force
  and effect as to the remaining member states. Nothing in this
  compact supersedes state law or rules related to licensure of EMS
  agencies.
         SECTION 2.  This Act takes effect September 1, 2015.