§ 24-60-4702 — Compact approved and ratified

The general assembly
approves and ratifies, and the governor shall enter into, a compact on behalf of the
state of Colorado and any of the United States or other jurisdictions legally joining
the compact in the form substantially as follows:

Section 1.

Purpose

In order to strengthen access to Medical Services, and in recognition of
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 CFR
20.3 (d), from the State's criminal history record repository as defined in 28 CFR
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 means 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 National
Commission on Certification of Physician Assistants Physician Assistant National
Certifying Examination as a requirement for PA licensure;

8. 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 National Commission on Certification of Physician Assistants
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 of this section 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
Subsections B.1 and B.2 of this section, the Licensee must meet the requirements of
Subsection A of this section 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. 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 evidence or witnesses are located.

3. Notwithstanding Subsection A.2 of this section, 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
of this Compact.

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 of any 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 D.1 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 of this Compact.

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 enforcement 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 by
or on behalf of or for use of the Commission or other committee charged with
responsibility of investigation or determination of compliance issues pursuant to
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 Subsection
D, 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 the Licensee 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 (7) voting members who are elected by the Commission from the
current membership of the Commission;

b. One (1) ex officio, nonvoting member from a recognized national PA
professional association; and

c. One (1) 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 meetings 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 Subsection D.3 of this Section and shall announce the closed meeting as
the Commission is required to under Subsection D.4 of this Section and keep
minutes of the closed meeting as the Commission is required to under Subsection
D.5 of this Section.

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 herein 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
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 information, Adverse Action information, 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 no 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;

2. To persons who have requested 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 of this section, 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 Subsection L, 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 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 United States District Court for the District of
Columbia or the federal district where the Commission has its principal offices. The
prevailing party 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 United States 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 this Compact, the Commission shall
convene and review the enactment of each of the States that enacted this 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 of this Compact.

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 of
this Compact 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 this Compact subsequent to the seven initial
Charter Participating States shall be subject to the process set forth in Section
7.C.21 of this Compact 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 this Compact prior to the effective date of this
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 this Compact. Provisions of this 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 this 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 of this section, the Commission may deny a
State's participation in the Compact or, in accordance with the requirements of
Section 10.B of this Compact, 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 this Compact, a
material departure from the Compact. Otherwise, if this Compact shall be held to be
contrary to the constitution of any Participating State, this 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.

Legislative History

Source: L. 2024: Entire part added, (SB 24-018), ch. 194, p. 1162, � 1, effective August 7.