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A BILL TO BE ENTITLED
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AN ACT
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relating to the physician assistant licensure compact; authorizing |
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a fee. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 204, Occupations Code, is amended by |
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adding Subchapter I to read as follows: |
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SUBCHAPTER I. PHYSICIAN ASSISTANT LICENSURE COMPACT |
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Sec. 204.401. PHYSICIAN ASSISTANT LICENSURE COMPACT. The |
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Physician Assistant Licensure Compact is enacted and entered into |
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with all other jurisdictions that legally join in the compact, |
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which reads as follows: |
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PA LICENSURE COMPACT |
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Section 1. Purpose |
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In order to strengthen access to Medical Services, and in |
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recognition of the advances in the delivery of Medical Services, |
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the Participating States of the PA Licensure Compact have allied in |
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common purpose to develop a comprehensive process that complements |
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the existing authority of State Licensing Boards to license and |
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discipline PAs and seeks to enhance the portability of a License to |
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practice as a PA while safeguarding the safety of patients. This |
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Compact allows Medical Services to be provided by PAs, via the |
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mutual recognition of the Licensee's Qualifying License by other |
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Compact Participating States. This Compact also adopts the |
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prevailing standard for PA licensure and affirms that the practice |
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and delivery of Medical Services by the PA occurs where the patient |
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is located at the time of the patient encounter, and therefore |
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requires the PA to be under the jurisdiction of the State Licensing |
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Board where the patient is located. State Licensing Boards that |
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participate in this Compact retain the jurisdiction to impose |
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Adverse Action against a Compact Privilege in that State issued to a |
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PA through the procedures of this Compact. The PA Licensure Compact |
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will alleviate burdens for military families by allowing active |
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duty military personnel and their spouses to obtain a Compact |
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Privilege based on having an unrestricted License in good standing |
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from a Participating State. |
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Section 2. Definitions |
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In this Compact: |
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A. "Adverse Action" means any administrative, civil, |
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equitable, or criminal action permitted by a State's laws which is |
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imposed by a Licensing Board or other authority against a PA License |
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or License application or Compact Privilege such as License denial, |
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censure, revocation, suspension, probation, monitoring of the |
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Licensee, or restriction on the Licensee's practice. |
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B. "Compact Privilege" means the authorization granted by a |
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Remote State to allow a Licensee from another Participating State |
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to practice as a PA to provide Medical Services and other licensed |
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activity to a patient located in the Remote State under the Remote |
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State's laws and regulations. |
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C. "Conviction" means a finding by a court that an |
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individual is guilty of a felony or misdemeanor offense through |
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adjudication or entry of a plea of guilt or no contest to the charge |
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by the offender |
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D. "Criminal Background Check" means the submission of |
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fingerprints or other biometric-based information for a License |
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applicant for the purpose of obtaining that applicant's criminal |
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history record information, as defined in 28 C.F.R. § 20.3(d), from |
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the State's criminal history record repository as defined in 28 |
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C.F.R. § 20.3(f). |
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E. "Data System" means the repository of information about |
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Licensees, including but not limited to License status and Adverse |
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Actions, which is created and administered under the terms of this |
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Compact. |
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F. "Executive Committee" means a group of directors and |
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ex-officio individuals elected or appointed pursuant to Section |
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7.F.2. |
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G. "Impaired Practitioner" means a PA whose practice is |
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adversely affected by health-related condition(s) that impact |
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their ability to practice. |
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H. "Investigative Information" means information, records, |
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or documents received or generated by a Licensing Board pursuant to |
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an investigation. |
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I. "Jurisprudence Requirement" means the assessment of an |
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individual's knowledge of the laws and Rules governing the practice |
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of a PA in a State. |
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J. "License" means current authorization by a State, other |
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than authorization pursuant to a Compact Privilege, for a PA to |
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provide Medical Services, which would be unlawful without current |
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authorization. |
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K. "Licensee" means an individual who holds a License from a |
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State to provide Medical Services as a PA. |
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L. "Licensing Board" means any State entity authorized to |
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license and otherwise regulate PAs. |
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M. "Medical Services" means health care services provided |
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for the diagnosis, prevention, treatment, cure or relief of a |
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health condition, injury, or disease, as defined by a State's laws |
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and regulations. |
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N. "Model Compact" means the model for the PA Licensure |
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Compact on file with The Council of State Governments or other |
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entity as designated by the Commission. |
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O. "Participating State" means a State that has enacted this |
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Compact. |
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P. "PA" means an individual who is licensed as a physician |
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assistant in a State. For purposes of this Compact, any other title |
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or status adopted by a State to replace the term "physician |
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assistant" shall be deemed synonymous with "physician assistant" |
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and shall confer the same rights and responsibilities to the |
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Licensee under the provisions of this Compact at the time of its |
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enactment. |
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Q. "PA Licensure Compact Commission," "Compact Commission," |
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or "Commission" mean the national administrative body created |
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pursuant to Section 7.A of this Compact. |
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R. "Qualifying License" means an unrestricted License |
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issued by a Participating State to provide Medical Services as a PA. |
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S. "Remote State" means a Participating State where a |
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Licensee who is not licensed as a PA is exercising or seeking to |
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exercise the Compact Privilege. |
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T. "Rule" means a regulation promulgated by an entity that |
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has the force and effect of law. |
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U. "Significant Investigative Information" means |
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Investigative Information that a Licensing Board, after an inquiry |
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or investigation that includes notification and an opportunity for |
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the PA to respond if required by State law, has reason to believe is |
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not groundless and, if proven true, would indicate more than a minor |
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infraction. |
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V. "State" means any state, commonwealth, district, or |
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territory of the United States. |
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Section 3. State Participation in this Compact |
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A. To participate in this Compact, a Participating State |
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shall: |
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1. License PAs. |
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2. Participate in the Compact Commission's Data |
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System. |
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3. Have a mechanism in place for receiving and |
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investigating complaints against Licensees and License applicants. |
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4. Notify the Commission, in compliance with the terms |
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of this Compact and Commission Rules, of any Adverse Action against |
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a Licensee or License applicant and the existence of Significant |
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Investigative Information regarding a Licensee or License |
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applicant. |
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5. Fully implement a Criminal Background Check |
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requirement, within a time frame established by Commission Rule, by |
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its Licensing Board receiving the results of a Criminal Background |
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Check and reporting to the Commission whether the License applicant |
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has been granted a License. |
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6. Comply with the Rules of the Compact Commission. |
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7. Utilize passage of a recognized national exam such |
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as the NCCPA PANCE as a requirement for PA licensure. |
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8. Require continuing education for License renewal. |
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9. Grant the Compact Privilege to a holder of a |
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Qualifying License in a Participating State. |
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B. Nothing in this Compact prohibits a Participating State |
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from charging a fee for granting the Compact Privilege. |
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Section 4. Compact Privilege |
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A. To exercise the Compact Privilege, a Licensee must: |
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1. Have graduated from a PA program accredited by the |
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Accreditation Review Commission on Education for the Physician |
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Assistant, Inc. or other programs authorized by Commission Rule. |
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2. Hold current NCCPA certification. |
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3. Have no felony or misdemeanor Conviction |
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4. Have never had a controlled substance license, |
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permit, or registration suspended or revoked by a State or by the |
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United States Drug Enforcement Administration. |
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5. Have a unique identifier as determined by |
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Commission Rule. |
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6. Hold a Qualifying License. |
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7. Have had no revocation of a License or limitation or |
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restriction on any License currently held due to an adverse action. |
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8. If a Licensee has had a limitation or restriction on |
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a License or Compact Privilege due to an Adverse Action, two years |
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must have elapsed from the date on which the License or Compact |
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Privilege is no longer limited or restricted due to the Adverse |
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Action. |
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9. If a Compact Privilege has been revoked or is |
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limited or restricted in a Participating State for conduct that |
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would not be a basis for disciplinary action in a Participating |
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State in which the Licensee is practicing or applying to practice |
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under a Compact Privilege, that Participating State shall have the |
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discretion not to consider such action as an Adverse Action |
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requiring the denial or removal of a Compact Privilege in that |
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State. |
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10. Notify the Compact Commission that the Licensee is |
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seeking the Compact Privilege in a Remote State. |
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11. Meet any Jurisprudence Requirement of a Remote |
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State in which the Licensee is seeking to practice under the Compact |
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Privilege and pay any fees applicable to satisfying the |
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Jurisprudence Requirement. |
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12. Report to the Commission any Adverse Action taken |
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by a non-participating State within thirty (30) days after the |
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action is taken. |
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B. The Compact Privilege is valid until the expiration or |
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revocation of the Qualifying License unless terminated pursuant to |
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an Adverse Action. The Licensee must also comply with all of the |
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requirements of Subsection A above to maintain the Compact |
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Privilege in a Remote State. If the Participating State takes |
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Adverse Action against a Qualifying License, the Licensee shall |
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lose the Compact Privilege in any Remote State in which the Licensee |
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has a Compact Privilege until all of the following occur: |
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1. The License is no longer limited or restricted; and |
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2. Two (2) years have elapsed from the date on which |
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the License is no longer limited or restricted due to the Adverse |
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Action. |
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C. Once a restricted or limited License satisfies the |
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requirements of Subsection B.1 and 2, the Licensee must meet the |
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requirements of Subsection A to obtain a Compact Privilege in any |
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Remote State. |
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D. For each Remote State in which a PA seeks authority to |
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prescribe controlled substances, the PA shall satisfy all |
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requirements imposed by such State in granting or renewing such |
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authority. |
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Section 5. Designation of the State from Which Licensee is |
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Applying for a Compact Privilege |
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A. Upon a Licensee's application for a Compact Privilege, |
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the Licensee shall identify to the Commission the Participating |
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State from which the Licensee is applying, in accordance with |
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applicable Rules adopted by the Commission, and subject to the |
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following requirements: |
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1. When applying for a Compact Privilege, the Licensee |
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shall provide the Commission with the address of the Licensee's |
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primary residence and thereafter shall immediately report to the |
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Commission any change in the address of the Licensee's primary |
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residence. |
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2. When applying for a Compact Privilege, the Licensee |
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is required to consent to accept service of process by mail at the |
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Licensee's primary residence on file with the Commission with |
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respect to any action brought against the Licensee by the |
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Commission or a Participating State, including a subpoena, with |
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respect to any action brought or investigation conducted by the |
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Commission or a Participating State. |
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Section 6. Adverse Actions |
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A. Participating State in which a Licensee is licensed shall |
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have exclusive power to impose Adverse Action against the |
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Qualifying License issued by that Participating State. |
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B. In addition to the other powers conferred by State law, a |
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Remote State shall have the authority, in accordance with existing |
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State due process law, to do all of the following: |
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1. Take Adverse Action against a PA's Compact |
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Privilege within that State to remove a Licensee's Compact |
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Privilege or take other action necessary under applicable law to |
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protect the health and safety of its citizens. |
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2. Issue subpoenas for both hearings and |
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investigations that require the attendance and testimony of |
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witnesses as well as the production of evidence. Subpoenas issued |
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by a Licensing Board in a Participating State for the attendance and |
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testimony of witnesses or the production of evidence from another |
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Participating State shall be enforced in the latter State by any |
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court of competent jurisdiction, according to the practice and |
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procedure of that court applicable to subpoenas issued in |
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proceedings pending before it. The issuing authority shall pay any |
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witness fees, travel expenses, mileage and other fees required by |
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the service statutes of the State in which the witnesses or evidence |
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are located. |
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3. Notwithstanding paragraph 1, subpoenas may not be |
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issued by a Participating State to gather evidence of conduct in |
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another State that is lawful in that other State for the purpose of |
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taking Adverse Action against a Licensee's Compact Privilege or |
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application for a Compact Privilege in that Participating State. |
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4. Nothing in this Compact authorizes a Participating |
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State to impose discipline against a PA's Compact Privilege or to |
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deny an application for a Compact Privilege in that Participating |
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State for the individual's otherwise lawful practice in another |
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State. |
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C. For purposes of taking Adverse Action, the Participating |
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State which issued the Qualifying License shall give the same |
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priority and effect to reported conduct received from any other |
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Participating State as it would if the conduct had occurred within |
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the Participating State which issued the Qualifying License. In so |
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doing, that Participating State shall apply its own State laws to |
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determine appropriate action. |
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D. A Participating State, if otherwise permitted by State |
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law, may recover from the affected PA the costs of investigations |
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and disposition of cases resulting from any Adverse Action taken |
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against that PA. |
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E. A Participating State may take Adverse Action based on |
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the factual findings of a Remote State, provided that the |
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Participating State follows its own procedures for taking the |
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Adverse Action. |
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F. Joint Investigations |
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1. In addition to the authority granted to a |
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Participating State by its respective State PA laws and regulations |
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or other applicable State law, any Participating State may |
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participate with other Participating States in joint |
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investigations of Licensees. |
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2. Participating States shall share any |
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investigative, litigation, or compliance materials in furtherance |
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of any joint or individual investigation initiated under this |
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Compact. |
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G. If an Adverse Action is taken against a PA's Qualifying |
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License, the PA's Compact Privilege in all Remote States shall be |
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deactivated until two (2) years have elapsed after all restrictions |
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have been removed from the State License. All disciplinary orders |
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by the Participating State which issued the Qualifying License that |
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impose Adverse Action against a PA's License shall include a |
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Statement that the PA's Compact Privilege is deactivated in all |
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Participating States during the pendency of the order. |
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H. If any Participating State takes Adverse Action, it |
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promptly shall notify the administrator of the Data System. |
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Section 7. Establishment of the PA Licensure Compact Commission |
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A. The Participating States hereby create and establish a |
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joint government agency and national administrative body known as |
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the PA Licensure Compact Commission. The Commission is an |
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instrumentality of the Compact States acting jointly and not an |
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instrumentality of any one State. The Commission shall come into |
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existence on or after the effective date of the Compact as set forth |
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in Section 11.A. |
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B. Membership, Voting, and Meetings |
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1. Each Participating State shall have and be limited |
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to one (1) delegate selected by that Participating State's |
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Licensing Board or, if the State has more than one Licensing Board, |
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selected collectively by the Participating State's Licensing |
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Boards. |
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2. The delegate shall be either: |
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a. A current PA, physician or public member of a |
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Licensing Board or PA Council/Committee; or |
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b. An administrator of a Licensing Board. |
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3. Any delegate may be removed or suspended from |
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office as provided by the laws of the State from which the delegate |
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is appointed. |
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4. The Participating State Licensing Board shall fill |
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any vacancy occurring in the Commission within sixty (60) days. |
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5. Each delegate shall be entitled to one (1) vote on |
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all matters voted on by the Commission and shall otherwise have an |
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opportunity to participate in the business and affairs of the |
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Commission. A delegate shall vote in person or by such other means |
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as provided in the bylaws. The bylaws may provide for delegates' |
|
participation in meetings by telecommunications, video conference, |
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or other means of communication. |
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6. The Commission shall meet at least once during each |
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calendar year. Additional meetings shall be held as set forth in |
|
this Compact and the bylaws. |
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7. The Commission shall establish by Rule a term of |
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office for delegates. |
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C. The Commission shall have the following powers and |
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duties: |
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1. Establish a code of ethics for the Commission; |
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2. Establish the fiscal year of the Commission; |
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3. Establish fees; |
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4. Establish bylaws; |
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5. Maintain its financial records in accordance with |
|
the bylaws; |
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6. Meet and take such actions as are consistent with |
|
the provisions of this Compact and the bylaws; |
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7. Promulgate Rules to facilitate and coordinate |
|
implementation and administration of this Compact. The Rules shall |
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have the force and effect of law and shall be binding in all |
|
Participating States; |
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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 |
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affected; |
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9. Purchase and maintain insurance and bonds; |
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10. Borrow, accept, or contract for services of |
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personnel, including, but not limited to, employees of a |
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Participating State; |
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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 |
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personnel, and other related personnel matters; |
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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; |
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13. Lease, purchase, accept appropriate gifts or |
|
donations of, or otherwise own, hold, improve or use, any property, |
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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 |
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mixed; |
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15. Establish a budget and make expenditures; |
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16. Borrow money; |
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17. Appoint committees, including standing committees |
|
composed of members, State regulators, State legislators or their |
|
representatives, and consumer representatives, and such other |
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interested persons as may be designated in this Compact and the |
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bylaws; |
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18. Provide and receive information from, and |
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cooperate with, law enforcement agencies; |
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19. Elect a Chair, Vice Chair, Secretary and Treasurer |
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and such other officers of the Commission as provided in the |
|
Commission's bylaws. |
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20. Reserve for itself, in addition to those reserved |
|
exclusively to the Commission under the Compact, powers that the |
|
Executive Committee may not exercise; |
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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; |
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22. Prepare and provide to the Participating States an |
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annual report; and |
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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. |
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D. Meetings of the Commission |
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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 |
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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. |
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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 |
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severable matters. |
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Section 13. Binding Effect of Compact |
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A. Nothing herein prevents the enforcement of any other law |
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of a Participating State that is not inconsistent with this |
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Compact. |
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B. Any laws in a Participating State in conflict with this |
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Compact are superseded to the extent of the conflict. |
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C. All agreements between the Commission and the |
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Participating States are binding in accordance with their terms. |
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Sec. 204.402. ADMINISTRATION OF COMPACT. The physician |
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assistant board is the Physician Assistant Licensure Compact |
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administrator for this state. |
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Sec. 204.403. RULES. The physician assistant board may |
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adopt rules necessary to implement this subchapter. |
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SECTION 2. This Act takes effect September 1, 2023. |