88R20123 SCP-D
 
  By: Campos, Raymond, Morales of Maverick, H.B. No. 2544
      Garcia
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the physician assistant licensure compact; authorizing
  a fee.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 204, Occupations Code, is amended by
  adding Subchapter I to read as follows:
  SUBCHAPTER I. PHYSICIAN ASSISTANT LICENSURE COMPACT
         Sec. 204.401.  PHYSICIAN ASSISTANT LICENSURE COMPACT. The
  Physician Assistant Licensure Compact is enacted and entered into
  with all other jurisdictions that legally join in the compact,
  which reads as follows:
  PA LICENSURE COMPACT
  Section 1.  Purpose
  In order to strengthen access to Medical Services, and in
  recognition of the advances in the delivery of Medical Services,
  the Participating States of the PA Licensure Compact have allied in
  common purpose to develop a comprehensive process that complements
  the existing authority of State Licensing Boards to license and
  discipline PAs and seeks to enhance the portability of a License to
  practice as a PA while safeguarding the safety of patients. This
  Compact allows Medical Services to be provided by PAs, via the
  mutual recognition of the Licensee's Qualifying License by other
  Compact Participating States. This Compact also adopts the
  prevailing standard for PA licensure and affirms that the practice
  and delivery of Medical Services by the PA occurs where the patient
  is located at the time of the patient encounter, and therefore
  requires the PA to be under the jurisdiction of the State Licensing
  Board where the patient is located. State Licensing Boards that
  participate in this Compact retain the jurisdiction to impose
  Adverse Action against a Compact Privilege in that State issued to a
  PA through the procedures of this Compact. The PA Licensure Compact
  will alleviate burdens for military families by allowing active
  duty military personnel and their spouses to obtain a Compact
  Privilege based on having an unrestricted License in good standing
  from a Participating State.
  Section 2.  Definitions
  In this Compact:
         A.  "Adverse Action" means any administrative, civil,
  equitable, or criminal action permitted by a State's laws which is
  imposed by a Licensing Board or other authority against a PA License
  or License application or Compact Privilege such as License denial,
  censure, revocation, suspension, probation, monitoring of the
  Licensee, or restriction on the Licensee's practice.
         B.  "Compact Privilege" means the authorization granted by a
  Remote State to allow a Licensee from another Participating State
  to practice as a PA to provide Medical Services and other licensed
  activity to a patient located in the Remote State under the Remote
  State's laws and regulations.
         C.  "Conviction" means a finding by a court that an
  individual is guilty of a felony or misdemeanor offense through
  adjudication or entry of a plea of guilt or no contest to the charge
  by the offender
         D.  "Criminal Background Check" means the submission of
  fingerprints or other biometric-based information for a License
  applicant for the purpose of obtaining that applicant's criminal
  history record information, as defined in 28 C.F.R. § 20.3(d), from
  the State's criminal history record repository as defined in 28
  C.F.R. § 20.3(f).
         E.  "Data System" means the repository of information about
  Licensees, including but not limited to License status and Adverse
  Actions, which is created and administered under the terms of this
  Compact.
         F.  "Executive Committee" means a group of directors and
  ex-officio individuals elected or appointed pursuant to Section
  7.F.2.
         G.  "Impaired Practitioner" means a PA whose practice is
  adversely affected by health-related condition(s) that impact
  their ability to practice.
         H.  "Investigative Information" means information, records,
  or documents received or generated by a Licensing Board pursuant to
  an investigation.
         I.  "Jurisprudence Requirement" means the assessment of an
  individual's knowledge of the laws and Rules governing the practice
  of a PA in a State.
         J.  "License" means current authorization by a State, other
  than authorization pursuant to a Compact Privilege, for a PA to
  provide Medical Services, which would be unlawful without current
  authorization.
         K.  "Licensee" means an individual who holds a License from a
  State to provide Medical Services as a PA.
         L.  "Licensing Board" means any State entity authorized to
  license and otherwise regulate PAs.
         M.  "Medical Services" means health care services provided
  for the diagnosis, prevention, treatment, cure or relief of a
  health condition, injury, or disease, as defined by a State's laws
  and regulations.
         N.  "Model Compact" means the model for the PA Licensure
  Compact on file with The Council of State Governments or other
  entity as designated by the Commission. 
         O.  "Participating State" means a State that has enacted this
  Compact.
         P.  "PA" means an individual who is licensed as a physician
  assistant in a State. For purposes of this Compact, any other title
  or status adopted by a State to replace the term "physician
  assistant" shall be deemed synonymous with "physician assistant"
  and shall confer the same rights and responsibilities to the
  Licensee under the provisions of this Compact at the time of its
  enactment.
         Q.  "PA Licensure Compact Commission," "Compact Commission,"
  or "Commission" mean the national administrative body created
  pursuant to Section 7.A of this Compact.
         R.  "Qualifying License" means an unrestricted License
  issued by a Participating State to provide Medical Services as a PA.
         S.  "Remote State" means a Participating State where a
  Licensee who is not licensed as a PA is exercising or seeking to
  exercise the Compact Privilege.
         T.  "Rule" means a regulation promulgated by an entity that
  has the force and effect of law.
         U.  "Significant Investigative Information" means
  Investigative Information that a Licensing Board, after an inquiry
  or investigation that includes notification and an opportunity for
  the PA to respond if required by State law, has reason to believe is
  not groundless and, if proven true, would indicate more than a minor
  infraction.
         V.  "State" means any state, commonwealth, district, or
  territory of the United States.
  Section 3.  State Participation in this Compact
         A.  To participate in this Compact, a Participating State
  shall:
               1.  License PAs.
               2.  Participate in the Compact Commission's Data
  System.
               3.  Have a mechanism in place for receiving and
  investigating complaints against Licensees and License applicants.
               4.  Notify the Commission, in compliance with the terms
  of this Compact and Commission Rules, of any Adverse Action against
  a Licensee or License applicant and the existence of Significant
  Investigative Information regarding a Licensee or License
  applicant.
               5.  Fully implement a Criminal Background Check
  requirement, within a time frame established by Commission Rule, by
  its Licensing Board receiving the results of a Criminal Background
  Check and reporting to the Commission whether the License applicant
  has been granted a License.
               6.  Comply with the Rules of the Compact Commission.
               7.  Utilize passage of a recognized national exam such
  as the NCCPA PANCE as a requirement for PA licensure.
               8.  Require continuing education for License renewal.
               9.  Grant the Compact Privilege to a holder of a
  Qualifying License in a Participating State.
         B.  Nothing in this Compact prohibits a Participating State
  from charging a fee for granting the Compact Privilege.
  Section 4.  Compact Privilege
         A.  To exercise the Compact Privilege, a Licensee must:
               1.  Have graduated from a PA program accredited by the
  Accreditation Review Commission on Education for the Physician
  Assistant, Inc. or other programs authorized by Commission Rule.
               2.  Hold current NCCPA certification.
               3.  Have no felony or misdemeanor Conviction
               4.  Have never had a controlled substance license,
  permit, or registration suspended or revoked by a State or by the
  United States Drug Enforcement Administration.
               5.  Have a unique identifier as determined by
  Commission Rule.
               6.  Hold a Qualifying License.
               7.  Have had no revocation of a License or limitation or
  restriction on any License currently held due to an adverse action.
               8.  If a Licensee has had a limitation or restriction on
  a License or Compact Privilege due to an Adverse Action, two years
  must have elapsed from the date on which the License or Compact
  Privilege is no longer limited or restricted due to the Adverse
  Action.
               9.  If a Compact Privilege has been revoked or is
  limited or restricted in a Participating State for conduct that
  would not be a basis for disciplinary action in a Participating
  State in which the Licensee is practicing or applying to practice
  under a Compact Privilege, that Participating State shall have the
  discretion not to consider such action as an Adverse Action
  requiring the denial or removal of a Compact Privilege in that
  State.
               10.  Notify the Compact Commission that the Licensee is
  seeking the Compact Privilege in a Remote State.
               11.  Meet any Jurisprudence Requirement of a Remote
  State in which the Licensee is seeking to practice under the Compact
  Privilege and pay any fees applicable to satisfying the
  Jurisprudence Requirement.
               12.  Report to the Commission any Adverse Action taken
  by a non-participating State within thirty (30) days after the
  action is taken.
         B.  The Compact Privilege is valid until the expiration or
  revocation of the Qualifying License unless terminated pursuant to
  an Adverse Action. The Licensee must also comply with all of the
  requirements of Subsection A above to maintain the Compact
  Privilege in a Remote State. If the Participating State takes
  Adverse Action against a Qualifying License, the Licensee shall
  lose the Compact Privilege in any Remote State in which the Licensee
  has a Compact Privilege until all of the following occur:
               1.  The License is no longer limited or restricted; and
               2.  Two (2) years have elapsed from the date on which
  the License is no longer limited or restricted due to the Adverse
  Action.
         C.  Once a restricted or limited License satisfies the
  requirements of Subsection B.1 and 2, the Licensee must meet the
  requirements of Subsection A to obtain a Compact Privilege in any
  Remote State.
         D.  For each Remote State in which a PA seeks authority to
  prescribe controlled substances, the PA shall satisfy all
  requirements imposed by such State in granting or renewing such
  authority.
  Section 5.  Designation of the State from Which Licensee is
  Applying for a Compact Privilege
         A.  Upon a Licensee's application for a Compact Privilege,
  the Licensee shall identify to the Commission the Participating
  State from which the Licensee is applying, in accordance with
  applicable Rules adopted by the Commission, and subject to the
  following requirements:
               1.  When applying for a Compact Privilege, the Licensee
  shall provide the Commission with the address of the Licensee's
  primary residence and thereafter shall immediately report to the
  Commission any change in the address of the Licensee's primary
  residence.
               2.  When applying for a Compact Privilege, the Licensee
  is required to consent to accept service of process by mail at the
  Licensee's primary residence on file with the Commission with
  respect to any action brought against the Licensee by the
  Commission or a Participating State, including a subpoena, with
  respect to any action brought or investigation conducted by the
  Commission or a Participating State.
  Section 6.  Adverse Actions
         A.  Participating State in which a Licensee is licensed shall
  have exclusive power to impose Adverse Action against the
  Qualifying License issued by that Participating State.
         B.  In addition to the other powers conferred by State law, a
  Remote State shall have the authority, in accordance with existing
  State due process law, to do all of the following:
               1.  Take Adverse Action against a PA's Compact
  Privilege within that State to remove a Licensee's Compact
  Privilege or take other action necessary under applicable law to
  protect the health and safety of its citizens.
               2.  Issue subpoenas for both hearings and
  investigations that require the attendance and testimony of
  witnesses as well as the production of evidence. Subpoenas issued
  by a Licensing Board in a Participating State for the attendance and
  testimony of witnesses or the production of evidence from another
  Participating State shall be enforced in the latter State by any
  court of competent jurisdiction, according to the practice and
  procedure of that court applicable to subpoenas issued in
  proceedings pending before it. The issuing authority shall pay any
  witness fees, travel expenses, mileage and other fees required by
  the service statutes of the State in which the witnesses or evidence
  are located.
               3.  Notwithstanding paragraph 1, subpoenas may not be
  issued by a Participating State to gather evidence of conduct in
  another State that is lawful in that other State for the purpose of
  taking Adverse Action against a Licensee's Compact Privilege or
  application for a Compact Privilege in that Participating State.
               4.  Nothing in this Compact authorizes a Participating
  State to impose discipline against a PA's Compact Privilege or to
  deny an application for a Compact Privilege in that Participating
  State for the individual's otherwise lawful practice in another
  State.
         C.  For purposes of taking Adverse Action, the Participating
  State which issued the Qualifying License shall give the same
  priority and effect to reported conduct received from any other
  Participating State as it would if the conduct had occurred within
  the Participating State which issued the Qualifying License. In so
  doing, that Participating State shall apply its own State laws to
  determine appropriate action.
         D.  A Participating State, if otherwise permitted by State
  law, may recover from the affected PA the costs of investigations
  and disposition of cases resulting from any Adverse Action taken
  against that PA.
         E.  A Participating State may take Adverse Action based on
  the factual findings of a Remote State, provided that the
  Participating State follows its own procedures for taking the
  Adverse Action.
         F.  Joint Investigations
               1.  In addition to the authority granted to a
  Participating State by its respective State PA laws and regulations
  or other applicable State law, any Participating State may
  participate with other Participating States in joint
  investigations of Licensees.
               2.  Participating States shall share any
  investigative, litigation, or compliance materials in furtherance
  of any joint or individual investigation initiated under this
  Compact.
         G.  If an Adverse Action is taken against a PA's Qualifying
  License, the PA's Compact Privilege in all Remote States shall be
  deactivated until two (2) years have elapsed after all restrictions
  have been removed from the State License. All disciplinary orders
  by the Participating State which issued the Qualifying License that
  impose Adverse Action against a PA's License shall include a
  Statement that the PA's Compact Privilege is deactivated in all
  Participating States during the pendency of the order.
         H.  If any Participating State takes Adverse Action, it
  promptly shall notify the administrator of the Data System.
  Section 7.  Establishment of the PA Licensure Compact Commission
         A.  The Participating States hereby create and establish a
  joint government agency and national administrative body known as
  the PA Licensure Compact Commission. The Commission is an
  instrumentality of the Compact States acting jointly and not an
  instrumentality of any one State. The Commission shall come into
  existence on or after the effective date of the Compact as set forth
  in Section 11.A.
         B.  Membership, Voting, and Meetings
               1.  Each Participating State shall have and be limited
  to one (1) delegate selected by that Participating State's
  Licensing Board or, if the State has more than one Licensing Board,
  selected collectively by the Participating State's Licensing
  Boards.
               2.  The delegate shall be either:
                     a.  A current PA, physician or public member of a
  Licensing Board or PA Council/Committee; or
                     b.  An administrator of a Licensing Board.
               3.  Any delegate may be removed or suspended from
  office as provided by the laws of the State from which the delegate
  is appointed.
               4.  The Participating State Licensing Board shall fill
  any vacancy occurring in the Commission within sixty (60) days.
               5.  Each delegate shall be entitled to one (1) vote on
  all matters voted on by the Commission 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 telecommunications, video conference,
  or other means of communication.
               6.  The Commission shall meet at least once during each
  calendar year. Additional meetings shall be held as set forth in
  this Compact and the bylaws.
               7.  The Commission shall establish by Rule a term of
  office for delegates.
         C.  The Commission shall have the following powers and
  duties:
               1.  Establish a code of ethics for the Commission;
               2.  Establish the fiscal year of the Commission;
               3.  Establish fees;
               4.  Establish bylaws;
               5.  Maintain its financial records in accordance with
  the bylaws;
               6.  Meet and take such actions as are consistent with
  the provisions of this Compact and the bylaws;
               7.  Promulgate 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
  Participating States;
               8.  Bring and prosecute legal proceedings or actions in
  the name of the Commission, provided that the standing of any State
  Licensing Board to sue or be sued under applicable law shall not be
  affected;
               9.  Purchase and maintain insurance and bonds;
               10.  Borrow, accept, or contract for services of
  personnel, including, but not limited to, employees of a
  Participating State;
               11.  Hire employees and engage contractors, elect or
  appoint officers, fix compensation, define duties, grant such
  individuals appropriate authority to carry out the purposes of this
  Compact, and establish the Commission's personnel policies and
  programs relating to conflicts of interest, qualifications of
  personnel, and other related personnel matters;
               12.  Accept any and all appropriate donations and
  grants of money, equipment, supplies, materials and services, and
  receive, utilize and dispose of the same; provided that at all times
  the Commission shall avoid any appearance of impropriety or
  conflict of interest;
               13.  Lease, purchase, accept appropriate gifts or
  donations of, or otherwise own, hold, improve or use, any property,
  real, personal or mixed; provided that at all times the Commission
  shall avoid any appearance of impropriety;
               14.  Sell, convey, mortgage, pledge, lease, exchange,
  abandon, or otherwise dispose ofany property real, personal, or
  mixed;
               15.  Establish a budget and make expenditures;
               16.  Borrow money;
               17.  Appoint committees, including standing committees
  composed 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;
               18.  Provide and receive information from, and
  cooperate with, law enforcement agencies;
               19.  Elect a Chair, Vice Chair, Secretary and Treasurer
  and such other officers of the Commission as provided in the
  Commission's bylaws.
               20.  Reserve for itself, in addition to those reserved
  exclusively to the Commission under the Compact, powers that the
  Executive Committee may not exercise;
               21.  Approve or disapprove a State's participation in
  the Compact based upon its determination as to whether the State's
  Compact legislation departs in a material manner from the Model
  Compact language;
               22.  Prepare and provide to the Participating States an
  annual report; and
               23.  Perform such other functions as may be necessary
  or appropriate to achieve the purposes of this Compact consistent
  with the State regulation of PA licensure and practice.
         D.  Meetings of the Commission
               1.  All meetings of the Commission that are not closed
  pursuant to this subsection shall be open to the public. Notice of
  public meetings shall be posted on the Commission's website at
  least thirty (30) days prior to the public meeting.
               2.  Notwithstanding subsection D.1 of this section, the
  Commission may convene a public meeting by providing at least
  twenty-four (24) hours prior notice on the Commission's website,
  and any other means as provided in the Commission's Rules, for any
  of the reasons it may dispense with notice of proposed rulemaking
  under Section 9.L.
               3.  The Commission may convene in a closed, non-public
  meeting or non-public part of a public meeting to receive legal
  advice or to discuss:
                     a.  Non-compliance of a Participating State with
  its obligations under this Compact;
                     b.  The employment, compensation, discipline or
  other matters, practices or procedures related to specific
  employees or other matters related to the Commission's internal
  personnel practices and procedures;
                     c.  Current, threatened, or reasonably
  anticipated litigation;
                     d.  Negotiation of contracts for the purchase,
  lease, 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 investigative records compiled
  for law enforcement purposes;
                     i.  Disclosure of information related to any
  investigative reports prepared byor on behalf of or for use of the
  Commission or other committee charged with responsibility of
  investigation or determination of compliance issues pursuant to
  this Compact;
                     j.  Legal advice; or
                     k.  Matters specifically exempted from disclosure
  by federal or Participating States' statutes
               4.  If a meeting, or portion of a meeting, is closed
  pursuant to this provision, the chair of the meeting or the chair's
  designee shall certify that the meeting or portion of the meeting
  may be closed and shall reference each relevant exempting
  provision.
               5.  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, 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.
         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 Participating State and may impose Compact
  Privilege fees on Licensees of Participating States to whom a
  Compact Privilege is granted to cover the cost of the operations and
  activities of the Commission and its staff, which must be in a total
  amount sufficient to cover its annual budget as approved by the
  Commission each year for which revenue is not provided by other
  sources. The aggregate annual assessment amount levied on
  Participating States shall be allocated based upon a formula to be
  determined by Commission Rule.
                     a.  A Compact Privilege expires when the
  Licensee's Qualifying License in the Participating State from which
  the Licensee applied for the Compact Privilege expires.
                     b.  If the Licensee terminates the Qualifying
  License through which the Licensee applied for the Compact
  Privilege before its scheduled expiration, and the Licensee has a
  Qualifying License in another Participating State, the Licensee
  shall inform the Commission that it is changing to that
  Participating State the Participating State through which it
  applies for a Compact Privilege and pay to the Commission any
  Compact Privilege fee required by Commission Rule.
               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 Participating
  States, except by and with the authority of the Participating
  State.
               5.  The Commission shall keep accurate accounts of all
  receipts and disbursements. The receipts and disbursements of the
  Commission shall be subject to the financial review and accounting
  procedures established under its bylaws. All receipts and
  disbursements of funds handled by the Commission shall be subject
  to an annual financial review by a certified or licensed public
  accountant, and the report of the financial review shall be
  included in and become part of the annual report of the Commission.
         F.  The Executive Committee
               1.  The Executive Committee shall have the power to act
  on behalf of the Commission according to the terms of this Compact
  and Commission Rules.
               2.  The Executive Committee shall be composed of nine
  (9) members:
                     a.  Seven voting members who are elected by the
  Commission from the current membership of the Commission;
                     b.  One ex-officio, nonvoting member from a
  recognized national PA professional association; and
                     c.  One ex-officio, nonvoting member from a
  recognized national PA certification organization.
               3.  The ex-officio members will be selected by their
  respective organizations.
               4.  The Commission may remove any member of the
  Executive Committee as provided in its bylaws.
               5.  The Executive Committee shall meet at least
  annually.
               6.  The Executive Committee shall have the following
  duties and responsibilities:
                     a.  Recommend to the Commission changes to the
  Commission's Rules or bylaws, changes to this Compact legislation,
  fees to be paid by Compact Participating States such as annual dues,
  and any Commission Compact fee charged to Licensees for the Compact
  Privilege;
                     b.  Ensure Compact administration services are
  appropriately provided, contractual or otherwise;
                     c.  Prepare and recommend the budget;
                     d.  Maintain financial records on behalf of the
  Commission;
                     e.  Monitor Compact compliance of Participating
  States and provide compliance reports to the Commission;
                     f.  Establish additional committees as necessary;
                     g.  Exercise the powers and duties of the
  Commission during the interim between Commission meetings, except
  for issuing proposed rulemaking or adopting Commission Rules or
  bylaws, or exercising any other powers and duties exclusively
  reserved to the Commission by the Commission's Rules; and
                     h.  Perform other duties as provided in the
  Commission's Rules or bylaws.
               7.  All meeting of the Executive Committee at which it
  votes or plans to vote on matters in exercising the powers and
  duties of the Commission shall be open to the public and public
  notice of such meetings shall be given as public meetings of the
  Commission are given.
               8.  The Executive Committee may convene in a closed,
  non-public meeting for the same reasons that the Commission may
  convene in a non-public meeting as set forth in Section 7.D 3 and
  shall announce the closed meeting as the Commission is required to
  under Section 7.D.4 and keep minutes of the closed meeting as the
  Commission is required to under Section 7.D.5.
         G.  Qualified Immunity, Defense, and Indemnification
               1.  The members, officers, executive director,
  employees and representatives of the Commission shall be immune
  from suit and liability, both personally and in their official
  capacity, for any claim for damage to or loss of property or
  personal injury or other civil liability caused by or arising out of
  any actual or alleged act, error, or omission that occurred, or that
  the person against whom the claim is made had a reasonable basis for
  believing occurred within the scope of Commission employment,
  duties or responsibilities; provided that nothing in this paragraph
  shall be construed to protect any such person from suit or liability
  for any damage, loss, injury, or liability caused by the
  intentional or willful or wanton misconduct of that person. The
  procurement of insurance of any type by the Commission shall not in
  any way compromise or limit the immunity granted hereunder.
               2.  The Commission shall defend any member, officer,
  executive director, employee, and 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 as
  determined by the commission that the person against whom the claim
  is made had a reasonable basis for believing occurred within the
  scope of Commission employment, duties, or responsibilities;
  provided that nothing herein shall be construed to prohibit that
  person from retaining their own counsel at their own expense; and
  provided further, that the actual or alleged act, error, or
  omission did not result from that person's intentional or willful
  or wanton misconduct.
               3.  The Commission shall indemnify and hold harmless
  any member, officer, executive director, employee, and
  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.
               4.  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 in any proceedings as authorized by
  Commission Rules.
               5.  Nothing herein shall be construed as a limitation
  on the liability of any Licensee for professional malpractice or
  misconduct, which shall be governed solely by any other applicable
  State laws.
               6.  Nothing herein shall be construed to designate the
  venue or jurisdiction to bring actions for alleged acts of
  malpractice, professional misconduct, negligence, or other such
  civil action pertaining to the practice of a PA. All such matters
  shall be determined exclusively by State law other than this
  Compact.
               7.  Nothing in this Compact shall be interpreted to
  waive or otherwise person's intentional or willful or wanton
  misconduct.abrogate a Participating State's state action immunity
  or state action affirmative defense with respect to antitrust
  claims under the Sherman Act, Clayton Act, or any other State or
  federal antitrust or anticompetitive law or regulation.
               8.  Nothing in this Compact shall be construed to be a
  waiver of sovereign immunity by the Participating States or by the
  Commission.
  Section 8.  Data System
         A.  The Commission shall provide for the development,
  maintenance, operation, and utilization of a coordinated data and
  reporting system containing licensure, Adverse Action, and the
  reporting of the existence of Significant Investigative
  Information on all licensed PAs and applicants denied a License in
  Participating States.
         B.  Notwithstanding any other State law to the contrary, a
  Participating State shall submit a uniform data set to the Data
  System on all PAs to whom this Compact is applicable (utilizing a
  unique identifier) as required by the Rules of the Commission,
  including:
               1.  Identifying information;
               2.  Licensure data;
               3.  Adverse Actions against a License or Compact
  Privilege;
               4.  Any denial of application for licensure, and the
  reason(s) for such denial (excluding the reporting of any Criminal
  history record information where prohibited by law);
               5.  The existence of Significant Investigative
  Information; and
               6.  Other information that may facilitate the
  administration of this Compact, as determined by the Rules of the
  Commission.
         C.  Significant Investigative Information pertaining to a
  Licensee in any Participating State shall only be available to
  other Participating States.
         D.  The Commission shall promptly notify all Participating
  States of any Adverse Action taken against a Licensee or an
  individual applying for a License that has been reported to it. This
  Adverse Action information shall be available to any other
  Participating State.
         E.  Participating States contributing information to the
  Data System may, in accordance with State or federal law, designate
  information that may not be shared with the public without the
  express permission of the contributing State. Notwithstanding any
  such designation, such information shall be reported to the
  Commission through the Data System.
         F.  Any information submitted to the Data System that is
  subsequently expunged pursuant to federal law or the laws of the
  Participating State contributing the information shall be removed
  from the Data System upon reporting of such by the Participating
  State to the Commission.
         G.  The records and information provided to a Participating
  State pursuant to this Compact or through the Data System, when
  certified by the Commission or an agent thereof, shall constitute
  the authenticated business records of the Commission, and shall be
  entitled to any associated hearsay exception in any relevant
  judicial, quasi-judicial or administrative proceedings in a
  Participating State.
  Section 9.  Rulemaking
         A.  The Commission shall exercise its Rulemaking powers
  pursuant to the criteria set forth in this Section and the Rules
  adopted thereunder. Commission Rules shall become binding as of the
  date specified by the Commission for each Rule.
         B.  The Commission shall promulgate reasonable Rules in
  order to effectively and efficiently implement and administer this
  Compact and achieve its purposes. A Commission Rule shall be
  invalid and have not force or effect only if a court of competent
  jurisdiction holds that the Rule is invalid because the Commission
  exercised its rulemaking authority in a manner that is beyond the
  scope of the purposes of this Compact, or the powers granted
  hereunder, or based upon another applicable standard of review.
         C.  The Rules of the Commission shall have the force of law in
  each Participating State, provided however that where the Rules of
  the Commission conflict with the laws of the Participating State
  that establish the medical services a PA may perform in the
  Participating State, as held by a court of competent jurisdiction,
  the Rules of the Commission shall be ineffective in that State to
  the extent of the conflict.
         D.  If a majority of the legislatures of the Participating
  States rejects a Commission Rule, by enactment of a statute or
  resolution in the same manner used to adopt this Compact within four
  (4) years of the date of adoption of the Rule, then such Rule shall
  have no further force and effect in any Participating State or to
  any State applying to participate in the Compact.
         E.  Commission Rules shall be adopted at a regular or special
  meeting of the Commission.
         F.  Prior to promulgation and adoption of a final Rule or
  Rules by the Commission, and at least thirty (30) 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 or other publicly
  accessible platform; and
               2.  To persons who have requested notice of the
  Commission's notices of proposed rulemaking, and
               3.  In such other way(s) as the Commission may by Rule
  specify
         G.  The Notice of Proposed Rulemaking shall include:
               1.  The time, date, and location of the public hearing
  on the proposed Rule and the proposed time, date and location of the
  meeting in which the proposed Rule will be considered and voted
  upon;
               2.  The text of the proposed Rule and the reason for the
  proposed Rule;
               3.  A request for comments on the proposed Rule from any
  interested person and the date by which written comments must be
  received; and
               4.  The manner in which interested persons may submit
  notice to the Commission of their intention to attend the public
  hearing or provide any written comments.
         H.  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.
         I.  If the hearing is to be held via electronic means, the
  Commission shall publish the mechanism for access to the electronic
  hearing.
               1.  All persons wishing to be heard at the hearing shall
  as directed in the Notice of Proposed Rulemaking, not less than five
  (5) business days before the scheduled date of the hearing, notify
  the Commission of their desire to appear and testify at 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.  All hearings shall be recorded. A copy of the
  recording and the written comments, data, facts, opinions, and
  arguments received in response to the proposed rulemaking shall be
  made available to a person upon request.
               4.  Nothing in this section shall be construed as
  requiring a separate hearing on each proposed Rule. Proposed Rules
  may be grouped for the convenience of the Commission at hearings
  required by this section.
         J.  Following the public hearing the Commission shall
  consider all written and oral comments timely received.
         K.  The Commission shall, by majority vote of all delegates,
  take final action on the proposed Rule and shall determine the
  effective date of the Rule, if adopted, based on the Rulemaking
  record and the full text of the Rule.
               1.  If adopted, the Rule shall be posted on the
  Commission's website.
               2.  The Commission may adopt changes to the proposed
  Rule provided the changes do not enlarge the original purpose of the
  proposed Rule.
               3.  The Commission shall provide on its website an
  explanation of the reasons for substantive changes made to the
  proposed Rule as well as reasons for substantive changes not made
  that were recommended by commenters.
               4.  The Commission shall determine a reasonable
  effective date for the Rule. Except for an emergency as provided in
  subsection L, the effective date of the Rule shall be no sooner than
  thirty (30) days after the Commission issued the notice that it
  adopted the Rule.
         L.  Upon determination that an emergency exists, the
  Commission may consider and adopt an emergency Rule with
  twenty-four (24) hours prior notice, without the opportunity for
  comment, or hearing, provided that the usual rulemaking procedures
  provided in this Compact and in this section shall be retroactively
  applied to the Rule as soon as reasonably possible, in no event
  later than ninety (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 by the Commission in order to:
               1.  Meet an imminent threat to public health, safety,
  or welfare;
               2.  Prevent a loss of Commission or Participating State
  funds;
               3.  Meet a deadline for the promulgation of a
  Commission 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 Commission
  Rule for purposes of correcting typographical errors, errors in
  format, errors in consistency, or grammatical errors. Public notice
  of any revisions shall be posted on the website of the Commission.
  The revision shall be subject to challenge by any person for a
  period of thirty (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 as set forth in the
  notice of revisions and delivered to the Commission prior to the end
  of the notice period. If no challenge is made, the revision will
  take effect without further action. If the revision is challenged,
  the revision may not take effect without the approval of the
  Commission.
         N.  No Participating State's rulemaking requirements shall
  apply under this Compact.
  Section 10.  Oversight, Dispute Resolution, and Enforcement
         A. Oversight
               1.  The executive and judicial branches of State
  government in each Participating State shall enforce this Compact
  and take all actions necessary and appropriate to implement the
  Compact.
               2.  Venue is proper and judicial proceedings by or
  against the Commission shall be brought solely and exclusively in a
  court of competent jurisdiction where the principal office of the
  Commission is located. The Commission may waive venue and
  jurisdictional defenses to the extent it adopts or consents to
  participate in alternative dispute resolution proceedings. Nothing
  herein shall affect or limit the selection or propriety of venue in
  any action against a licensee for professional malpractice,
  misconduct or any such similar matter.
               3.  The Commission shall be entitled to receive service
  of process in any proceeding regarding the enforcement or
  interpretation of the Compact or the Commission's Rules and shall
  have standing to intervene in such a proceeding for all purposes.
  Failure to provide the Commission with service of process shall
  render a judgment or order in such proceeding void as to the
  Commission, this Compact, or Commission Rules.
         B.  Default, Technical Assistance, and Termination
               1.  If the Commission determines that a Participating
  State has defaulted in the performance of its obligations or
  responsibilities under this Compact or the Commission Rules, the
  Commission shall provide written notice to the defaulting State and
  other Participating States. The notice shall describe the default,
  the proposed means of curing the default and any other action that
  the Commission may take and shall offer 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 this Compact upon an
  affirmative vote of a majority of the delegates of the
  Participating States, and all rights, privileges and benefits
  conferred by this Compact upon such State 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 participation in this 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 to the Licensing
  Board(s) of each of the Participating 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 this Compact, unless agreed upon in writing between the
  Commission and the defaulting State.
               6.  The defaulting State may appeal its termination
  from the Compact by 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.
               7.  Upon the termination of a State's participation in
  the Compact, the State shall immediately provide notice to all
  Licensees within that State of such termination:
                     a.  Licensees who have been granted a Compact
  Privilege in that State shall retain the Compact Privilege for one
  hundred eighty (180) days following the effective date of such
  termination.
                     b.  Licensees who are licensed in that State who
  have been granted a Compact Privilege in a Participating State
  shall retain the Compact Privilege for one hundred eighty (180)
  days unless the Licensee also has a Qualifying License in a
  Participating State or obtains a Qualifying License in a
  Participating State before the one hundred eighty (180)-day period
  ends, in which case the Compact Privilege shall continue.
         C.  Dispute Resolution
               1.  Upon request by a Participating State, the
  Commission shall attempt to resolve disputes related to this
  Compact that arise among Participating States and between
  participating and non-Participating 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 of this Compact and Rules
  of the Commission.
               2.  If compliance is not secured after all means to
  secure compliance have been exhausted, 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 Participating State
  in default to enforce compliance with the provisions of this
  Compact and the Commission's promulgated Rules and bylaws. The
  relief sought may include both injunctive relief and damages. In
  the event judicial enforcement is necessary, the prevailing party
  shall be awarded all costs of such litigation, including reasonable
  attorney's fees.
               3.  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.
         E.  Legal Action Against the Commission
               1.  A Participating State may initiate legal action
  against the Commission in the U.S. District Court for the District
  of Columbia or the federal district where the Commission has its
  principal offices to enforce compliance with the provisions of the
  Compact and its Rules. The relief sought may include both
  injunctive relief and damages. In the event judicial enforcement is
  necessary, the prevailing party shall be awarded all costs of such
  litigation, including reasonable attorney's fees.
               2.  No person other than a Participating State shall
  enforce this Compact against the Commission.
  Section 11.  Date of Implementation of the PA Licensure Compact
  Commission
         A.  This Compact shall come into effect on the date on which
  this Compact statute is enacted into law in the seventh
  Participating State.
               1.  On or after the effective date of the Compact, the
  Commission shall convene and review the enactment of each of the
  States that enacted the Compact prior to the Commission convening
  ("Charter Participating States") to determine if the statute
  enacted by each such Charter Participating State is materially
  different than the Model Compact.
                     a.  A Charter Participating State whose enactment
  is found to be materially different from the Model Compact shall be
  entitled to the default process set forth in Section 10.B.
                     b.  If any Participating State later withdraws
  from the Compact or its participation is terminated, the Commission
  shall remain in existence and the Compact shall remain in effect
  even if the number of Participating States should be less than
  seven. Participating States enacting the Compact subsequent to the
  Commission convening shall be subject to the process set forth in
  Section 7.C.21 to determine if their enactments are materially
  different from the Model Compact and whether they qualify for
  participation in the Compact.
               2.  Participating States enacting the Compact
  subsequent to the seven initial Charter Participating States shall
  be subject to the process set forth in Section 7.C.21 to determine
  if their enactments are materially different from the Model Compact
  and whether they qualify for participation in the Compact.
               3.  All actions taken for the benefit of the Commission
  or in furtherance of the purposes of the administration of the
  Compact prior to the effective date of the Compact or the Commission
  coming into existence shall be considered to be actions of the
  Commission unless specifically repudiated by the Commission.
         B.  Any State that joins this Compact shall be subject to the
  Commission's Rules and bylaws as they exist on the date on which
  this 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 this Compact becomes law in that State.
         C.  Any Participating State may withdraw from this Compact by
  enacting a statute repealing the same.
               1.  A Participating State's withdrawal shall not take
  effect until one hundred eighty (180) days after enactment of the
  repealing statute. During this one hundred eighty (180) day-period,
  all Compact Privileges that were in effect in the withdrawing State
  and were granted to Licensees licensed in the withdrawing State
  shall remain in effect. If any Licensee licensed in the withdrawing
  State is also licensed in another Participating State or obtains a
  license in another Participating State within the one hundred
  eighty (180) days, the Licensee's Compact Privileges in other
  Participating States shall not be affected by the passage of the one
  hundred eighty (180) days.
               2.  Withdrawal shall not affect the continuing
  requirement of the State Licensing Board(s) of the withdrawing
  State to comply with the investigative, and Adverse Action
  reporting requirements of this Compact prior to the effective date
  of withdrawal.
               3.  Upon the enactment of a statute withdrawing a State
  from this Compact, the State shall immediately provide notice of
  such withdrawal to all Licensees within that State. Such
  withdrawing State shall continue to recognize all licenses granted
  pursuant to this Compact for a minimum of one hundred eighty (180)
  days after the date of such notice of withdrawal.
         D.  Nothing contained in this Compact shall be construed to
  invalidate or prevent any PA licensure agreement or other
  cooperative arrangement between Participating States and between a
  Participating State and non-Participating State that does not
  conflict with the provisions of this Compact.
         E.  This Compact may be amended by the Participating States.
  No amendment to this Compact shall become effective and binding
  upon any Participating State until it is enacted materially in the
  same manner into the laws of all Participating States as determined
  by the Commission.
  Section 12.  Construction and Severability
         A.  This Compact and the Commission's rulemaking authority
  shall be liberally construed so as to effectuate the purposes, and
  the implementation and administration of the Compact. Provisions of
  the Compact expressly authorizing or requiring the promulgation of
  Rules shall not be construed to limit the Commission's rulemaking
  authority solely for those purposes.
         B.  The provisions of this Compact shall be severable and if
  any phrase, clause, sentence or provision of this Compact is held by
  a court of competent jurisdiction to be contrary to the
  constitution of any Participating State, a State seeking
  participation in the Compact, or of the United States, or the
  applicability thereof to any government, agency, person or
  circumstance is held to be unconstitutional by a court of competent
  jurisdiction, the validity of the remainder of this Compact and the
  applicability thereof to any other government, agency, person or
  circumstance shall not be affected thereby.
         C.  Notwithstanding subsection B or this section, the
  Commission may deny a State's participation in the Compact or, in
  accordance with the requirements of Section10.B, terminate a
  Participating State's participation in the Compact, if it
  determines that a constitutional requirement of a Participating
  State is, or would be with respect to a State seeking to participate
  in the Compact, a material departure from the Compact. Otherwise,
  if this Compact shall be held to be contrary to the constitution of
  any Participating State, the Compact shall remain in full force and
  effect as to the remaining Participating States and in full force
  and effect as to the Participating State affected as to all
  severable matters.
  Section 13.  Binding Effect of Compact
         A.  Nothing herein prevents the enforcement of any other law
  of a Participating State that is not inconsistent with this
  Compact.
         B.  Any laws in a Participating State in conflict with this
  Compact are superseded to the extent of the conflict.
         C.  All agreements between the Commission and the
  Participating States are binding in accordance with their terms.
         Sec. 204.402.  ADMINISTRATION OF COMPACT. The physician
  assistant board is the Physician Assistant Licensure Compact
  administrator for this state.
         Sec. 204.403.  RULES. The physician assistant board may
  adopt rules necessary to implement this subchapter.
         SECTION 2.  This Act takes effect September 1, 2023.