§ 147L.1 — Respiratory care interstate compact

Iowa § 147L.1

• Jurisdiction: Iowa
• Title IV: PUBLIC HEALTH
• Ch. 147L: RESPIRATORY CARE INTERSTATE COMPACT

Text

1. Title and purpose.
a. The purpose of this compact is to facilitate the interstate practice of respiratory
therapy with the goal of improving public access to respiratory therapy services by providing
respiratory therapists licensed in a member state the ability to practice in other member
states. The compact preserves the regulatory authority of states to protect public health and
safety through the current system of state licensure.
b. This compact is designed to achieve the following objectives:
(1) Increase public access to respiratory therapy services by creating a responsible,
streamlined pathway for licensees to practice in member states with the goal of improving
outcomes for patients.
(2) Enhance states’ ability to protect the public’s health and safety.
(3) Promote the cooperation of member states in regulating the practice of respiratory
therapy within those member states.
(4) Ease administrative burdens on states by encouraging the cooperation of member
states in regulating multistate respiratory therapy practice.
(5) Support relocating active military members and their spouses.
(6) Promote mobility and address workforce shortages.
2. Definitions. As used in this compact, unless the context otherwise requires, the
following definitions shall apply:
a. “Active military member” means a person with a full-time duty status in the armed
forces of the United States, including a member of the national guard and reserve.
b. “Adverse action” means an administrative, civil, equitable, or criminal action permitted
by a state’s laws which is imposed by a state authority with regulatory authority over
respiratory therapists, such as license denial, censure, revocation, suspension, probation,
monitoring of a licensee, or restriction on a licensee’s practice, not including participation
in an alternative program.
c. “Alternative program” means a nondisciplinary monitoring or practice remediation
process applicable to a respiratory therapist approved by a state authority with regulatory
authority over respiratory therapists. This includes but is not limited to programs to which
licensees with substance abuse or addiction issues are referred in lieu of adverse action.
d. “Charter member states” means those member states that were the first seven states to
enact the compact into the laws of their state.
e. “Commission” or “respiratory care interstate compact commission” means the
government instrumentality and body politic whose membership consists of all member
states that have enacted the compact.
f. “Commissioner” means the individual appointed by a member state to serve as the
member of the commission for that member state.
g. “Compact” means the respiratory care interstate compact.
h. “Compact privilege” means the authorization granted by a remote state to allow a
licensee from another member state to practice as a respiratory therapist in the remote state
under the remote state’s laws and rules. The practice of respiratory therapy occurs in the
member state where the patient is located at the time of the patient encounter.
i. “Criminalbackgroundcheck”meansthesubmissionbythememberstateoffingerprints
or other biometric-based information on license applicants at the time of initial licensing for
the purpose of obtaining that applicant’s criminal history record information, as defined in 28
C.F.R.§20.3(d)orsuccessorprovision, fromthefederalbureauofinvestigationandthestate’s
criminal history record repository, as defined in 28 C.F.R. §20.3(f) or successor provision.
§147L.1, RESPIRATORY CARE INTERSTATE COMPACT 2
j. “Data system” means the commission’s repository of information about licensees as
further set forth in subsection 8.
k. “Domicile” means the jurisdiction which is the licensee’s principal home for legal
purposes.
l. “Encumbered license” means a license that a state’s respiratory therapy licensing
authority has limited in any way.
m. “Executivecommittee”meansagroupofdirectorselectedorappointedtoactonbehalf
of, and within the powers granted to the directors by, the commission.
n. “Home state” means the member that is the licensee’s primary domicile, except as set
forth in subsection 5.
o. “Home state license” means an active license to practice respiratory therapy in a home
state that is not an encumbered license.
p. “Jurisprudence requirement” means an assessment of an individual’s knowledge of the
state laws and regulations governing the practice of respiratory therapy in such state.
q. “Licensee” means an individual who currently holds an authorization from the state to
practice as a respiratory therapist.
r. “Member state” means a state that has enacted the compact and been admitted to the
commission in accordance with the provisions of this compact and commission rules.
s. “Model compact” means the model for the respiratory care interstate compact on file
with the council of state governments or other entity as designated by the commission.
t. “Remote state” means a member state where a licensee is exercising or seeking to
exercise the compact privilege.
u. “Respiratorytherapist”or“respiratorycarepractitioner”meansanindividualwhoholds
a credential issued by the national board for respiratory care or its successor and holds a
license in a state to practice respiratory therapy. For purposes of this compact, any other title
or status adopted by a state to replace the term “respiratory therapist” or “respiratory care
practitioner” shall be deemed synonymous with “respiratory therapist” and shall confer the
same rights and responsibilities to the licensee under the provisions of this compact at the
time of its enactment.
v. “Respiratory therapy”, “respiratory therapy practice”, “respiratory care”, “the practice
of respiratory care”, and “the practice of respiratory therapy” mean the care and services
provided by or under the direction and supervision of a respiratory therapist or respiratory
care practitioner.
w. “Respiratory therapy licensing authority” means the agency, board, or other body of a
state that is responsible for licensing and regulation of respiratory therapists.
x. “Rule” means a regulation promulgated by an entity that has the force and effect of law.
y. “Scope of practice” means the procedures, actions, and processes a respiratory
therapist licensed in a state or practicing under a compact privilege in a state is permitted
to undertake in that state and the circumstances under which the respiratory therapist
is permitted to undertake those procedures, actions, and processes. Such procedures,
actions, and processes, and the circumstances under which they may be undertaken, may
be established through means including but not limited to statute, regulations, case law,
and other processes available to the state respiratory therapy licensing authority or other
government agency.
z. “Significant investigative information” means information, records, and documents
received or generated by a state respiratory licensing authority pursuant to an investigation
for which a determination has been made that there is probable cause to believe that the
licensee has violated a statute or regulation that is considered more than a minor infraction
for which the state respiratory therapy licensing authority could pursue adverse action
against the licensee.
aa. “State” means a state, commonwealth, district, or territory of the United States.
3. State participation in this compact.
a. In order to participate in this compact and thereafter continue as a member state, a
member state shall do all of the following:
(1) Enact a compact that is not materially different from the model compact.
(2) License respiratory therapists.
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(3) Participate in the commission’s data system.
(4) Have a mechanism in place for receiving and investigating complaints against
licensees and compact privilege holders.
(5) Notify the commission, in compliance with the terms of this compact and commission
rules, of any adverse action against a licensee, a compact privilege holder, or a license
applicant.
(6) Notify the commission, in compliance with the terms of this compact and commission
rules, of the existence of significant investigative information.
(7) Comply with the rules of the commission.
(8) Grant the compact privilege to a holder of an active home state license and otherwise
meet the applicable requirements of subsection 4 in a member state.
(9) Complete a criminal background check for each new licensee at the time of initial
licensure. Where expressly authorized or permitted by federal law, whether such federal
law is in effect prior to, at, or after the time of a member state’s enactment of this compact,
a member state’s enactment of this compact shall hereby authorize the member state’s
respiratory therapy licensing authority to perform criminal background checks as defined
in this compact. The absence of such a federal law as described in this subsection shall not
prevent or preclude such authorization where it may be derived or granted through means
other than the enactment of this compact.
b. Nothing in this compact prohibits a member state from charging a fee for granting and
renewing the compact privilege.
4. Compact privilege.
a. To exercise the compact privilege under the terms and provisions of the compact, the
licensee shall meet all of the following requirements:
(1) Hold and maintain an active home state license as a respiratory therapist.
(2) Hold and maintain an active credential from the national board for respiratory care
or its successor that would qualify the licensee for licensure in the remote state in which the
licensee is seeking the privilege.
(3) Have not had any adverse action against a license within the previous two years.
(4) Notify the commission that the licensee is seeking the compact privilege within a
remote state.
(5) Pay any applicable fee, including any state and commission fees and renewal fees, for
the compact privilege.
(6) Meet any jurisprudence requirement established by the remote state in which the
licensee is seeking a compact privilege.
(7) Report to the commission adverse action taken by a nonmember state within thirty
days from the date that adverse action is taken.
(8) Report to the commission, when applying for a compact privilege, the address of
the licensee’s domicile and thereafter promptly report to the commission any change in the
address of the licensee’s domicile within thirty days of the effective date of the change in
address.
(9) Consent to accept service of process by mail at the licensee’s domicile on record with
the commission with respect to any action brought against the licensee by the commission or
amemberstate, andconsenttoacceptserviceofasubpoenabymailatthelicensee’sdomicile
on record with the commission with respect to any action brought or investigation conducted
by the commission or a member state.
b. The compact privilege is valid until the expiration date or revocation of the home
state license unless terminated pursuant to adverse action. The licensee must comply with
all the requirements of paragraph “a” to maintain the compact privilege in a remote state.
If those requirements are met, no adverse actions are taken, and the licensee has paid any
applicable compact privilege renewal fees, then the licensee will maintain the licensee’s
compact privilege.
c. A licensee providing respiratory therapy in a remote state under the compact privilege
shall function within the scope of practice authorized by the remote state for the type of
respiratory therapist license the licensee holds. Such procedures, actions, processes, and
the circumstances under which they may be undertaken, may be established through means
§147L.1, RESPIRATORY CARE INTERSTATE COMPACT 4
including but not limited to statute, regulations, case law, and other processes available to
the state respiratory therapy licensing authority or other government agency.
d. If a licensee’s compact privilege in a remote state is removed by the remote state, the
individual shall lose or be ineligible for the compact privilege in that remote state until the
compact privilege is no longer limited or restricted by that state.
e. If a home state license is encumbered, the licensee shall lose the compact privilege in
all remote states until all of the following occur:
(1) The home state license is no longer encumbered.
(2) Two years have elapsed from the date on which the license is no longer encumbered
due to the adverse action.
f. Once a licensee with a restricted or limited license meets the requirements of paragraph
“e”, the licensee must also meet the requirements of paragraph “a” to obtain a compact
privilege in a remote state.
5. Active military members and spouses.
a. An active military member or a spouse of an active military member shall designate a
home state where the individual has a current license in good standing. The individual may
retain the home state designation during the period the service member is on active duty.
b. An active military member or a spouse of an active military member shall not be
required to pay to the commission for a compact privilege any fee that may otherwise be
charged by the commission. If a remote state chooses to charge a fee for a compact privilege,
it may choose to charge a reduced fee or no fee to an active military member or a spouse of
an active military member for a compact privilege.
6. Adverse actions.
a. A member state in which a licensee is licensed shall have authority to impose adverse
action against the license issued by that member state.
b. A member state may take adverse action based on significant investigative information
of a remote state or the home state, so long as the member state follows its own procedures
for imposing adverse action.
c. Nothing in this compact shall override a member state’s decision that participation in
an alternative program may be used in lieu of adverse action and that such participation shall
remain nonpublic if required by the member state’s laws.
d. A remote state shall have the authority to do all of the following:
(1) Takeadverseactionsassetforthinthiscompactagainstalicensee’scompactprivilege
in that state.
(2) Issue subpoenas for both hearings and investigations that require the attendance and
testimony of witnesses and the production of evidence.
(a) Subpoenas may be issued by a respiratory therapy licensing authority in a member
state for the attendance and testimony of witnesses and the production of evidence.
(b) Subpoenas issued by a respiratory therapy licensing authority in a member state for
the attendance and testimony of witnesses shall be enforced in the latter state by any court
of competent jurisdiction in the latter state, according to the practice and procedure of that
court applicable to subpoenas issued by the proceedings pending before it.
(c) Subpoenas issued by a respiratory therapy licensing authority in a member state
for production of evidence from another member state shall be enforced in the latter state,
according to the practice and procedure of that court applicable to subpoenas issued in the
proceedings pending before it.
(d) The issuing authority shall pay witness fees, travel expenses, mileage, and other fees
required by the service statutes of the state where the witness or evidence is located.
(3) Unless otherwise prohibited by state law, recover from the licensee the costs of
investigations and disposition of cases resulting from any adverse action taken against that
licensee.
(4) Notwithstanding paragraph “d”, subparagraph (2), a member state shall not issue a
subpoena to gather evidence of conduct in another member state that is lawful in such other
member state for the purpose of taking adverse action against a licensee’s compact privilege
or application for a compact privilege in that member state.
(5) Nothing in this compact authorizes a member state to impose discipline against a
5 RESPIRATORY CARE INTERSTATE COMPACT, §147L.1
respiratory therapist’s compact privilege in that member state for the individual’s otherwise
lawful practice in another state.
e. Joint investigations.
(1) In addition to the authority granted to a member state by its respective respiratory
therapy practice act or other applicable state law, a member state may participate with other
member states in joint investigations of licensees, provided, however, that a member state
receiving such a request has no obligation to respond to any subpoena issued regarding an
investigation of conduct or practice that was lawful in a member state at the time it was
undertaken.
(2) Member states shall share any significant investigative information, litigation, or
compliance materials in furtherance of any joint or individual investigation initiated under
the compact. In sharing such information between member state respiratory therapy
licensing authorities, all information obtained shall be kept confidential, except as otherwise
mutually agreed upon by the sharing and receiving member states.
f. Nothing in this compact permits a member state to take any adverse action against
a licensee or holder of a compact privilege for conduct or a practice that was legal in the
member state at the time it was undertaken.
g. Nothing in this compact permits a member state to take disciplinary action against
a licensee or holder of a compact privilege for conduct or a practice that was legal in the
member state at the time it was undertaken.
7. Establishment of the respiratory care interstate compact commission.
a. The compact member states hereby create and establish a joint government agency
whose membership consists of all member states that have enacted the compact, known as
the respiratory care interstate compact commission. The commission is an instrumentality
of the compact member 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 subsection 11.
b. Membership, voting, and meetings.
(1) Each member state shall have and be limited to one commissioner, selected by that
member state’s respiratory therapy licensing authority.
(2) The commissioner shall be an administrator of the member state’s respiratory therapy
licensing authority or a staff member designated by the administrator.
(3) The commission shall by rule or bylaw establish a term of office for commissioners
and may by rule or bylaw establish term limits.
(4) The commission may recommend to a member state the removal or suspension of a
commissioner from office.
(5) A member state’s respiratory therapy licensing authority shall fill any vacancy of its
commissioner occurring on the commission within sixty days of the vacancy.
(6) Each commissioner shall be entitled to one vote on all matters before the commission
requiring a vote by commissioners.
(7) Acommissionershallvoteinpersonorbysuchothermeansasprovidedinthebylaws.
The bylaws may provide for commissioners to meet by telecommunication, videoconference,
or other means of communication.
(8) The commission shall meet at least once during each calendar year. Additional
meetings may be held as set forth in the bylaws.
c. The commission shall have all of the following powers:
(1) Establish and amend the fiscal year of the commission.
(2) Establish and amend bylaws and policies, including but not limited to a code of
conduct and conflict of interest.
(3) Establish and amend rules, which shall be binding in all member states.
(4) Maintain its financial records in accordance with the bylaws.
(5) Meet and take such actions as are consistent with the provisions of this compact, the
commission’s rules, and the bylaws.
(6) Initiate and conduct legal proceedings or actions in the name of the commission,
provided that the standing of any respiratory therapy licensing authority to sue or be sued
under applicable law shall not be affected.
§147L.1, RESPIRATORY CARE INTERSTATE COMPACT 6
(7) Maintain and certify records and information provided to a member state as the
authenticated business records of the commission, and designate an agent to do so on the
commission’s behalf.
(8) Purchase and maintain insurance and bonds.
(9) Accept or contract for services of personnel, including but not limited to employees of
a member state.
(10) Conduct an annual financial review.
(11) Hire employees, elect or appoint officers, fix compensation, define duties, grant such
individuals appropriate authority to carry out the purposes of the compact, and establish the
commission’s personnel policies and programs relating to conflicts of interest, qualifications
of personnel, and other related personnel matters.
(12) Assess and collect fees.
(13) Accept any and all appropriate gifts, donations, grants of money, other sources of
revenue, equipment, supplies, materials, and services, and receive, utilize, and dispose of the
same, provided that at all times the commission does all of the following:
(a) Avoid any appearance of impropriety.
(b) Avoid any appearance of conflict of interest.
(14) Lease, purchase, retain, own, hold, improve, or use any property, real, personal, or
mixed, or any undivided interest therein.
(15) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
any property, real, personal, or mixed.
(16) Establish a budget and make expenditures.
(17) Borrow money in a fiscally responsible manner.
(18) Appoint committees, including standing committees, composed of commissioners,
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.
(19) Provide and receive information from, and cooperate with, law enforcement
agencies.
(20) Establish and elect an executive committee, including a chair, vice chair, secretary,
treasurer, and such other offices as the commission shall establish by rule or bylaw.
(21) Enter into contracts or arrangements for the management of the affairs of the
commission.
(22) Determine whether a state’s adopted language is materially different from the model
compact language such that the state would not qualify for participation in the compact.
(23) Perform such other functions as may be necessary or appropriate to achieve the
purposes of this compact.
d. 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. The powers, duties, and responsibilities of the
executive committee shall include all of the following:
(a) Overseeing the day-to-day activities of the administration of the compact, including
enforcement and compliance with the provisions of the compact, its rules and bylaws, and
other such duties as deemed necessary.
(b) Recommending to the commission changes to the rules or bylaws, changes to this
compact legislation, fees charged to compact member states, fees charged to licensees, and
other fees.
(c) Ensuring compact administration services are appropriately provided, including by
contract.
(d) Preparing and recommending the budget.
(e) Maintaining financial records on behalf of the commission.
(f) Monitoring compact compliance of member states and providing compliance reports
to the commission.
(g) Establishing additional committees as necessary.
(h) Exercising the powers and duties of the commission during the interim between
commission meetings, except for adopting or amending rules, adopting or amending bylaws,
7 RESPIRATORY CARE INTERSTATE COMPACT, §147L.1
and exercising any other powers and duties expressly reserved to the commission by rule
or bylaw.
(i) Performing other duties as provided in the rules or bylaws of the commission.
(2) The executive committee shall be composed of up to nine of the following members,
as further set forth in the bylaws of the commission:
(a) Seven voting members who are elected by the commission from the current
membership of the commission.
(b) Two ex officio, nonvoting members.
(3) The commission may remove any member of the executive committee as provided in
the commission’s bylaws.
(4) The executive committee shall meet at least annually.
(a) Executive committee meetings shall be open to the public, except that the executive
committee may meet in a closed, nonpublic meeting as provided in paragraph “f”,
subparagraph (4).
(b) The executive committee shall give advance notice of its meetings, posted on its
internet site and as determined to provide notice to persons with an interest in the business
of the commission.
(c) The executive committee may hold a special meeting in accordance with paragraph
“f”, subparagraph (2).
e. The commission shall adopt and provide to the member states an annual report.
f. Meetings of the commission.
(1) All meetings of the commission that are not closed pursuant to subparagraph (4) shall
be open to the public. Notice of public meetings shall be posted on the commission’s internet
site at least thirty days prior to the public meeting.
(2) Notwithstanding subparagraph (1), the commission may convene an emergency
public meeting by providing at least twenty-four hours’ prior notice on the commission’s
internet site, 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 subsection 9, paragraph
“g”. The commission’s legal counsel shall certify that one of the reasons justifying an
emergency public meeting has been met.
(3) Notice of all commission meetings shall provide the time, date, and location
of the meeting, and if the meeting is to be held or accessible via telecommunication,
videoconference, or other electronic means, the notice shall include the mechanism for
access to the meeting.
(4) The commission or the executive committee may convene in a closed, nonpublic
meeting for the commission or executive committee to receive or solicit legal advice or to
discuss any of the following:
(a) Noncompliance of a member state with its obligations under the compact.
(b) The employment, compensation, discipline, or other matters, practices, or procedures
related to specific employees.
(c) Current or threatened discipline of a licensee or compact privilege holder by the
commission or by a member state’s respiratory therapy licensing authority.
(d) Current, threatened, or reasonably anticipated litigation.
(e) Negotiation of contracts for the purchase, lease, or sale of goods, services, or real
estate.
(f) Accusing any person of a crime or formally censuring any person.
(g) Trade secrets or commercial or financial information that is privileged or confidential.
(h) Information of a personal nature where disclosure would constitute a clearly
unwarranted invasion of personal privacy.
(i) Investigative records compiled for law enforcement purposes.
(j) 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.
(k) Legal advice.
(l) Matters specifically exempted from disclosure by federal or member state law.
(m) Other matters as promulgated by the commission by rule.
§147L.1, RESPIRATORY CARE INTERSTATE COMPACT 8
(5) If a meeting or portion of a meeting is closed, the presiding officer shall state that the
meeting will be closed and reference each relevant exempting provision, and such reference
shall be recorded in the minutes.
(6) The commission shall keep minutes in accordance with commission rules and bylaws.
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
only by a majority vote of the commission or order of a court of competent jurisdiction.
g. Financing 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 as provided in
this compact.
(3) The commission may levy on and collect an annual assessment from each member
state and impose fees on licensees of member states to whom it grants a compact privilege to
cover the cost of the operations and activities of the commission and its staff. The aggregate
annual assessment amount for member states, if any, shall be allocated based upon a formula
that the commission shall promulgate by rule.
(4) The commission shall not incur obligations of any kind prior to securing the funds or
a loan adequate to meet the same; nor shall the commission pledge the credit of any of the
member states, except by and with the authority of the member state.
(5) The commission shall keep accurate accounts of all receipts and disbursements.
The receipts and disbursements of the commission shall be subject to the financial review
and accounting procedures established under its bylaws. However, 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.
h. Qualified immunity, defense, and indemnification.
(1) Nothing in this paragraph 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.
(2) The member states, commissioners, officers, executive directors, employees, and
agents 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 subparagraph 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 in this
subparagraph.
(3) The commission shall defend any commissioner, officer, executive director, employee,
or agent 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 in this
subparagraph shall be construed to prohibit that person from retaining counsel at that
person’s 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.
(4) The commission shall indemnify and hold harmless any commissioner, member,
officer, executive director, employee, and agent 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
9 RESPIRATORY CARE INTERSTATE COMPACT, §147L.1
or alleged act, error, or omission did not result from the intentional or willful or wanton
misconduct of that person.
(5) Nothing in this compact shall be interpreted to waive or otherwise abrogate a
member 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.
(6) Nothing in this compact shall be construed to be a waiver of sovereign immunity by
the member states or by the commission.
8. Data system.
a. The commission shall provide for the development, maintenance, operation, and
utilization of a coordinated database and reporting system containing licensure, adverse
action, and the presence of significant investigative information.
b. Notwithstanding any other provision of state law to the contrary, a member state shall
submit a uniform data set to the data system as required by the rules of the commission,
including but not limited to all of the following:
(1) Identifying information.
(2) Licensure data.
(3) Adverse actions against a licensee, license applicant, or compact privilege holder and
information related thereto.
(4) Nonconfidential information related to alternative program participation, the
beginning and ending dates of such participation, and other information related to such
participation not made confidential under member state law.
(5) Any denial of application for licensure, and the reason for such denial.
(6) The presence of current significant investigative information.
(7) Other information that may facilitate the administration of this compact or the
protection of the public, as determined by the rules of the commission.
c. No member state shall submit any information which constitutes criminal history
record information, as defined by applicable federal law, to the data system established in
this subsection.
d. The records and information provided to a member 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 member state.
e. Significant investigative information pertaining to a licensee in any member state will
only be available to other member states.
f. It is the responsibility of the member states to report any adverse action against a
licensee and to monitor the database to determine whether adverse action has been taken
against a licensee. Adverse action information pertaining to a licensee in any member state
will be available to any other member state.
g. Member states contributing information to the data system may designate information
that may not be shared with the public without the express permission of the contributing
state.
h. Any information submitted to the data system that is subsequently expunged pursuant
to federal law or the laws of the member state contributing the information shall be removed
from the data system.
9. Rulemaking.
a. Thecommissionshallpromulgatereasonablerulesinordertoeffectivelyandefficiently
implementandadministerthepurposesandprovisionsofthecompact. Aruleshallbeinvalid
and have no force and effect only if a court of competent jurisdiction holds that the rule is
invalidbecausethecommissionexerciseditsrulemakingauthorityinamannerthatisbeyond
thescopeandpurposesofthecompact, orthepowersgrantedunderthissubsection, orbased
upon another applicable standard of review.
b. For purposes of the compact, the rules of the commission shall have the force of law in
each member state.
c. The commission shall exercise its rulemaking powers pursuant to the criteria set forth
§147L.1, RESPIRATORY CARE INTERSTATE COMPACT 10
in this subsection and the rules adopted pursuant to this subsection. Rules shall become
binding as of the date specified in each rule.
d. If a majority of the legislatures of the member states rejects a rule or portion of a rule,
by enactment of a statute or resolution in the same manner used to adopt the compact, within
four years of the date of application of the rule, then such rule shall have no further force and
effect in any member state.
e. Rules shall be adopted at a regular or special meeting of the commission.
f. Prior to adoption of a proposed rule, the commission shall hold a public hearing and
allow persons to provide oral and written comments, data, facts, opinions, and arguments.
g. Prior to adoption of a proposed rule by the commission, and at least thirty days in
advance of the meeting at which the commission will hold a public hearing on the proposed
rule, the commission shall provide a notice of proposed rulemaking by all of the following
methods:
(1) On the internet site of the commission or other publicly accessible platform.
(2) To persons who have requested notice of the commission’s notices of proposed
rulemaking.
(3) In such other way as the commission may by rule specify.
h. The notice of proposed rulemaking shall include all of the following:
(1) The time, date, and location of the public hearing at which the commission will hear
public comments on the proposed rule and, if different, the time, date, and location of the
meeting where the commission will consider and vote on the proposed rule.
(2) If the hearing is held via telecommunication, videoconference, or other electronic
means, the commission shall include the mechanism for access to the hearing in the notice
of proposed rulemaking.
(3) The text of the proposed rule and the reason therefor.
(4) A request for comments on the proposed rule from any interested person.
(5) The manner in which interested persons may submit written comments.
i. All hearings shall be recorded. A copy of the recording and all written comments and
documents received by the commission in response to the proposed rule shall be available to
the public.
j. Nothing in this subsection shall be construed as requiring a separate hearing on each
rule. Rules may be grouped for the convenience of the commission at hearings required by
this subsection.
k. The commission shall, by majority vote of all commissioners, take final action on the
proposed rule based on the rulemaking record and the full text of the rule.
(1) The commission may adopt changes to the proposed rule, provided that the changes
are consistent with the original purpose of the proposed rule.
(2) The commission shall provide 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.
(3) The commission shall determine a reasonable effective date for the rule. Except for
an emergency as provided in paragraph “l”, the effective date of the rule shall be no sooner
than thirty days after issuing the notice that it adopted or amended the rule.
l. Upon determination that an emergency exists, the commission may consider and
adopt an emergency rule with twenty-four hours’ notice, and with opportunity to comment,
providedthattheusualrulemakingproceduresprovidedinthecompactandinthissubsection
shall be retroactively applied to the rule as soon as reasonably possible, in no event later
than ninety days after the effective date of the rule. For the purposes of this provision, an
emergency rule is one that must be adopted immediately in order to do one of the following:
(1) Meet an imminent threat to public health, safety, or welfare.
(2) Prevent a loss of commission or member state funds.
(3) Meetadeadlineforthepromulgationofarulethatisestablishedbyfederallaworrule.
(4) Protect public health and safety.
m. The commission or an authorized committee of the commission may direct revisions
to a previously adopted 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
11 RESPIRATORY CARE INTERSTATE COMPACT, §147L.1
the internet site of the commission. The revision shall be subject to challenge by any person
for a period of thirty days after posting. The revision may be challenged only on grounds that
the revision results in a material change to a rule. A challenge shall be made in writing and
delivered to the 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 member state’s rulemaking process or procedural requirements shall apply to the
commission. The commission shall have no authority over any member state’s rulemaking
process or procedural requirements that do not pertain to the compact.
o. Nothing in this compact, nor any rule or regulation of the commission, shall be
construed to limit, restrict, or in any way reduce the ability of a member state to enact and
enforce laws, regulations, or other rules related to the practice of respiratory therapy in that
state where those laws, regulations, or other rules are not inconsistent with the provisions
of this compact.
10. Oversight, dispute resolution, and enforcement.
a. Oversight.
(1) The executive and judicial branches of state government in each member 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 in this subparagraph shall affect or limit the selection or propriety of venue in any
actionagainstalicenseeforprofessionalmalpractice, misconduct, oranysuchsimilarmatter.
(3) The commission shall be entitled to receive service of process in any proceeding
regarding the enforcement or interpretation of the compact and shall have standing to
intervene in such a proceeding for all purposes. Failure to provide the commission service
of process shall render a judgment or order void as to the commission, this compact, or
promulgated rules.
b. Default, technical assistance, and termination.
(1) If the commission determines that a member state has defaulted in the performance
of its obligations or responsibilities under this compact or the promulgated rules, the
commission shall provide written notice to the defaulting state. The notice of default shall
describe the default, the proposed means of curing the default, and any other action that the
commission may take, and shall offer training and specific technical assistance regarding
the default.
(2) The commission shall provide a copy of the notice of default to the other member
states.
c. If a state in default fails to cure the default, the defaulting state may be terminated
from the compact upon an affirmative vote of a majority of the commissioners of the member
states, and all rights, privileges, and benefits conferred on that state by this compact may be
terminated on the effective date of termination. A cure of the default does not relieve the
offending state of obligations or liabilities incurred during the period of default.
d. Termination of membership in the compact shall be imposed only after all other means
ofsecuringcompliancehavebeenexhausted. Noticeofintenttosuspendorterminateshallbe
given by the commission to the governor, the majority and minority leaders of the defaulting
state’s legislature, the defaulting state’s respiratory therapy licensing authority, and each of
the member states’ respiratory therapy licensing authorities.
e. A state that has been terminated is responsible for all assessments, obligations, and
liabilitiesincurredthroughtheeffectivedateoftermination, includingobligationsthatextend
beyond the effective date of termination, if necessary.
f. Upon termination of a state’s membership from this compact, that state shall
immediately provide notice to all licensees and compact privilege holders of which the
commission has a record within that state of such termination. The terminated state shall
§147L.1, RESPIRATORY CARE INTERSTATE COMPACT 12
continue to recognize all licenses granted pursuant to this compact for a minimum of one
hundred eighty days after the date of said notice of termination.
g. The commission shall not bear any costs related to a state that is found to be in default
or that has been terminated from the compact, unless agreed upon in writing between the
commission and the defaulting state.
h. The defaulting state may appeal the action of 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 fees.
i. Dispute resolution.
(1) Upon request by a member state, the commission shall attempt to resolve disputes
relatedtothecompactthatariseamongmemberstatesandbetweenmemberandnonmember
states.
(2) The commission shall promulgate a rule providing for both mediation and binding
dispute resolution for disputes, as appropriate.
j. Enforcement.
(1) By majority vote, as may be further provided by rule, the commission may initiate
legal action against a member state in default 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 promulgated rules. A member
state by enactment of this compact consents to venue and jurisdiction in such court for the
purposes set forth in this subparagraph. 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 fees. The remedies in this
subparagraph shall not be the exclusive remedies of the commission. The commission may
pursue other remedies available under federal or the defaulting member state’s law.
(2) A member 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
promulgated 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 fees.
(3) No person other than a member state shall enforce this compact against the
commission.
11. Effective date, withdrawal, and amendment.
a. The compact shall come into effect on the date on which the compact statute is enacted
into law in the seventh member state.
(1) Onoraftertheeffectivedateofthecompact, thecommissionshallconveneandreview
the enactment of each of the first seven member states to determine if the statute enacted by
each such charter member state is materially different than the model compact.
(a) A charter member state whose enactment is found to be materially different from the
model compact shall be entitled to the default process set forth in subsection 10.
(b) If any member state is later found to be in default or is terminated or withdraws from
the compact, the commission shall remain in existence and the compact shall remain in effect
even if the number of member states should be less than seven.
(2) Member states enacting the compact subsequent to the seven initial charter member
states shall be subject to the process set forth herein and commission rule 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 the actions of the commission
unless specifically repudiated by the commission. The commission shall own and have all
rights to any intellectual property developed on behalf or in furtherance of the commission
by individuals or entities involved in organizing or establishing the commission, as may be
further set forth in rules of the commission.
13 RESPIRATORY CARE INTERSTATE COMPACT, §147L.1
(4) Any state that joins the compact subsequent to the commission’s initial adoption of
the rules and bylaws shall be subject to the rules and bylaws as they exist on the date on
which the compact becomes law in that state. Any rule that has been previously adopted by
the commission shall have the full force and effect of law on the date the compact becomes
law in that state.
b. Any member state may withdraw from this compact by enacting a statute repealing the
same.
(1) A member state’s withdrawal shall not take effect until one hundred eighty days after
enactment of the repealing statute.
(2) Withdrawal shall not affect the continuing requirements of the withdrawing state’s
respiratory therapy licensing authority 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 from this compact, a state shall
immediately provide notice of such withdrawal to all licensees and compact privilege holders
of which the commission has a record within that state. Notwithstanding any subsequent
statutory enactment to the contrary, such withdrawing state shall continue to recognize all
licenses granted pursuant to this compact for a minimum of one hundred eighty days after
the date of such notice of withdrawal.
c. Nothing contained in this compact shall be construed to invalidate or prevent any
licensure agreement or other cooperative arrangement between a member state and a
nonmember state that does not conflict with the provisions of this compact.
d. This compact may be amended by the member states. No amendment to this compact
shall become effective and binding upon any member state until it is enacted into the laws of
all member states.
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
constitutionofanymemberstate,astateseekingparticipationinthecompact,oroftheUnited
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 paragraph “b”, the commission may deny a state’s participation in the
compactor,inaccordancewiththerequirementsofsubsection10,terminateamemberstate’s
participation in the compact if it determines that a constitutional requirement of a member
state is a material departure from the compact. Otherwise, if this compact shall be held to be
contrary to the constitution of any member state, the compact shall remain in full force and
effect as to the remaining member states and in full force and effect as to the member state
affected as to all severable matters.
13. Consistent effect and conflict with other state laws.
a. Nothing in this subsection shall prevent or inhibit the enforcement of any other law of
a member state that is not inconsistent with the compact.
b. Anylaws,statutes,regulations,orotherlegalrequirementsinamemberstateinconflict
with the compact are superseded to the extent of the conflict, including any subsequently
enacted state laws.
c. Allpermissibleagreementsbetweenthecommissionandthememberstatesarebinding
in accordance with their terms.
d. Other than as expressly set forth herein, nothing in this compact impacts initial
licensure.