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(b) “Adverse action” means any administrative, civil, equitable, or criminal
6action permitted by a state's laws that may be imposed against licensed emergency
7medical services personnel by a state EMS authority or state court, including, but
8not limited to, actions against an individual's license such as revocation, suspension,
9probation, consent agreement, monitoring or other limitation or encumbrance on the
10individual's practice, letters of reprimand or admonition, fines, criminal convictions,
11and state court judgments enforcing adverse actions by the state EMS authority.
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(c) “Alternative program” means a voluntary, nondisciplinary substance abuse
13recovery program approved by a state EMS authority.
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(d) “Certification” means the successful verification of entry-level cognitive
15and psychomotor competency using a reliable, validated, and legally defensible
16examination.
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(e) “Commission” means the national administrative body of which all states
18that have enacted the compact are members.
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(f) “Emergency medical technician” or “EMT” means an individual licensed
20with cognitive knowledge and a scope of practice that corresponds to that level in the
21National Emergency Medical Services Education Standards and National
22Emergency Medical Services Scope of Practice Model.
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(g) “Home state” means a member state where an individual is licensed to
24practice emergency medical services.
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1(h) “License” means the authorization by a state for an individual to practice
2as an EMT, AEMT, paramedic, or a level in between EMT and paramedic.
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(i) “Medical director” means a physician licensed in a member state who is
4accountable for the care delivered by emergency medical services personnel.
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(j) “Member state” means a state that has enacted this compact.
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(k) “Paramedic” means an individual licensed with cognitive knowledge and a
7scope of practice that corresponds to that level in the National Emergency Medical
8Services Education Standards and National Emergency Medical Services Scope of
9Practice Model.
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(L) “Privilege to practice” means an individual's authority to deliver emergency
11medical services in remote states as authorized under this compact.
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(m) “Remote state” means a member state in which an individual is not
13licensed.
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(n) “Restricted” means the outcome of an adverse action that limits a license
15or the privilege to practice.
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(o) “Rule” means a written statement by the interstate commission
17promulgated pursuant to sub. (12) that is of general applicability; implements,
18interprets, or prescribes a policy or provision of the compact; or is an organizational,
19procedural, or practice requirement of the commission and has the force and effect
20of statutory law in a member state and includes the amendment, repeal, or
21suspension of an existing rule.
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(p) “Scope of practice” means defined parameters of various duties or services
23that may be provided by an individual with specific credentials. Whether regulated
24by rule, statute, or court decision, it tends to represent the limits of services an
25individual may perform.
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1(q) “Significant investigatory information” means any of the following:
SB736,18,52
1. Investigative information that a state EMS authority, after a preliminary
3inquiry that includes notification and an opportunity to respond if required by state
4law, has reason to believe, if proven true, would result in the imposition of an adverse
5action on a license or privilege to practice.
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2. Investigative information that indicates that the individual represents an
7immediate threat to public health and safety regardless of whether the individual
8has been notified and had an opportunity to respond.
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(r) “State” means any state, commonwealth, district, or territory of the United
10States.
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(s) “State EMS authority” means the board, office, or other agency with the
12legislative mandate to license emergency medical services personnel.
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13(3) Home state licensure. (a) Any member state in which an individual holds
14a current license shall be deemed a home state for purposes of this compact.
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(b) Any member state may require an individual to obtain and retain a license
16to be authorized to practice in the member state under circumstances not authorized
17by the privilege to practice under the terms of this compact.
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(c) A home state's license authorizes an individual to practice in a remote state
19under the privilege to practice only if the home state does all of the following:
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1. Currently requires the use of the National Registry of Emergency Medical
21Technicians examination as a condition of issuing initial licenses at the EMT and
22paramedic levels.
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2. Has a mechanism in place for receiving and investigating complaints about
24individuals.
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13. Notifies the commission, in compliance with the terms herein, of any adverse
2action or significant investigatory information regarding an individual.
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4. No later than 5 years after activation of the compact, requires a criminal
4background check of all applicants for initial licensure, including the use of the
5results of fingerprint or other biometric data checks compliant with the
6requirements of the federal bureau of investigation with the exception of federal
7employees who have suitability determination in accordance with
5 CFR 731.202 8and submit documentation of such as promulgated in the rules of the commission.
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5. Complies with the rules of the commission.
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10(4) Compact privilege to practice. (a) Member states shall recognize the
11privilege to practice of an individual licensed in another member state that is in
12conformance with sub. (3).
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(b) To exercise the privilege to practice under the terms and provisions of this
14compact, an individual must satisfy all of the following requirements:
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1. Be at least 18 years of age.
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2. Possess a current unrestricted license in a member state as an EMT, AEMT,
17paramedic, or state recognized and licensed level with a scope of practice and
18authority between EMT and paramedic.
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3. Practice under the supervision of a medical director.
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(c) An individual providing patient care in a remote state under the privilege
21to practice shall function within the scope of practice authorized by the home state
22unless and until modified by an appropriate authority in the remote state as may be
23defined in the rules of the commission.
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(d) Except as provided in par. (c), an individual practicing in a remote state will
25be subject to the remote state's authority and laws. A remote state may, in
1accordance with due process and that state's laws, restrict, suspend, or revoke an
2individual's privilege to practice in the remote state and may take any other
3necessary actions to protect the health and safety of its citizens. If a remote state
4takes action, it shall promptly notify the home state and the commission.
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(e) If an individual's license in any home state is restricted or suspended, the
6individual shall not be eligible to practice in a remote state under the privilege to
7practice until the individual's home state license is restored.
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(f) If an individual's privilege to practice in any remote state is restricted,
9suspended, or revoked, the individual shall not be eligible to practice in any remote
10state until the individual's privilege to practice is restored.
SB736,20,15
11(5) Conditions of practice in a remote state. An individual may practice in
12a remote state under a privilege to practice only in the performance of the
13individual's emergency medical services duties as assigned by an appropriate
14authority, as defined in the rules of the commission, and under all of the following
15circumstances:
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(a) The individual originates in the home state and transports the patient to
17a remote state.
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(b) The individual originates in the home state and enters a remote state to pick
19up a patient and provide care and transport of the patient to the home state.
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(c) The individual enters a remote state to provide patient care or transport
21within that remote state.
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(d) The individual enters a remote state to pick up a patient and provide care
23and transport to a 3rd member state.
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(e) Other conditions as determined by rules promulgated by the commission.
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1(6) Relationship to emergency management assistance compact. Upon a
2member state's governor's declaration of a state of emergency or disaster that
3activates the Emergency Management Assistance Compact, all relevant terms and
4provisions of the Emergency Management Assistance Compact shall apply and to the
5extent any terms or provisions of this compact conflicts with the Emergency
6Management Assistance Compact, the terms of the Emergency Management
7Assistance Compact shall prevail with respect to any individual practicing in the
8remote state in response to such declaration.
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9(7) Veterans, service members separating from active duty military, and their
10spouses. (a) Member states shall consider a veteran, active military service member,
11and member of the National Guard and Reserves separating from an active duty
12tour, and a spouse thereof, who holds a current valid and unrestricted certification
13by the National Registry of Emergency Medical Technicians at or above the level of
14the state license being sought as satisfying the minimum training and examination
15requirements for such licensure.
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(b) Member states shall expedite the processing of licensure applications
17submitted by veterans, active military service members, and members of the
18National Guard and Reserves separating from an active duty tour, and their spouses.
SB736,21,2019
(c) All individuals functioning with a privilege to practice under this subsection
20remain subject to the adverse actions provisions in sub. (8).
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21(8) Adverse actions. (a) A home state shall have exclusive power to impose
22adverse action against an individual's license issued by the home state.
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(b) 1. If an individual's license in any home state is restricted or suspended, the
24individual shall not be eligible to practice in a remote state under the privilege to
25practice until the individual's home state license is restored.
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12. All home state adverse action orders shall include a statement that the
2individual's compact privileges are inactive. The order may allow the individual to
3practice in remote states with prior authorization from the state EMS authority of
4both the home state and the remote state.
SB736,22,75
3. An individual currently subject to adverse action in the home state shall not
6practice in any remote state without prior written authorization from the state EMS
7authority of both the home state and the remote state.
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(c) A member state shall report adverse actions and any occurrences that the
9individual's compact privileges are restricted, suspended, or revoked to the
10commission in accordance with the rules of the commission.
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(d) A remote state may take adverse action on an individual's privilege to
12practice within that state.
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(e) Any member state may take adverse action against an individual's privilege
14to practice in that state based on the factual findings of another member state, so long
15as each state follows its own procedures for imposing such adverse action.
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(f) The state EMS authority of a home state shall investigate and take
17appropriate action with respect to reported conduct in a remote state as it would if
18such conduct had occurred within the home state. In such cases, the home state's law
19shall control in determining the appropriate adverse action.
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(g) Nothing in this compact shall override a member state's decision that
21participation in an alternative program may be used in lieu of adverse action and
22that such participation shall remain nonpublic if required by the member state's
23laws. Member states must require individuals who enter any alternative programs
24to agree not to practice in any other member state during the term of the alternative
25program without prior authorization from such other member state.
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1(9) Additional powers invested in a state EMS authority of a member state. 2The state EMS authority of a member state, in addition to any other powers granted
3under state law, is authorized under this compact to do any of the following:
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(a) Issue subpoenas for both hearings and investigations that require the
5attendance and testimony of witnesses and the production of evidence. Subpoenas
6issued by the state EMS authority of a member state for the attendance and
7testimony of witnesses, or the production of evidence from another member state,
8shall be enforced in the remote state by any court of competent jurisdiction, according
9to that court's practice and procedure in considering subpoenas issued in its own
10proceedings. The issuing state EMS authority shall pay any witness fees, travel
11expenses, mileage, and other fees required by the service statutes of the state where
12the witnesses or evidence are located.
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(b) Issue cease and desist orders to restrict, suspend, or revoke an individual's
14privilege to practice in the state.
SB736,23,19
15(10) Establishment of the Interstate Commission for Emergency Medical
16Services Personnel Practice. (a)
Interstate Commission for Emergency Medical
17Services Personnel Practice. The compact states hereby create and establish a joint
18public agency known as the Interstate Commission for Emergency Medical Services
19Personnel Practice.
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1. The commission is a body politic and an instrumentality of the compact
21states.
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2. Venue is proper and judicial proceedings by or against the commission shall
23be brought solely and exclusively in a court of competent jurisdiction where the
24principal office of the commission is located.
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13. Nothing in this compact shall be construed to be a waiver of sovereign
2immunity.
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(b)
Membership, voting, and meetings. 1. Each member state shall have and
4be limited to one delegate. The responsible official of the state EMS authority or his
5or her designee shall be the delegate to this compact for each member state. Any
6delegate may be removed or suspended from office as provided by the law of the state
7from which the delegate is appointed. Any vacancy occurring in the commission shall
8be filled in accordance with the laws of the member state in which the vacancy exists.
9In the event that more than one board, office, or other agency with the legislative
10mandate to license emergency medical services personnel at and above the level of
11EMT exists, the governor of the state will determine which entity will be responsible
12for assigning the delegate.
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2. Each delegate shall be entitled to one vote with regard to the promulgation
14of rules and creation of bylaws and shall otherwise have an opportunity to participate
15in the business and affairs of the commission. A delegate shall vote in person or by
16such other means as provided in the bylaws. The bylaws may provide for delegates'
17participation in meetings by telephone or other means of communication.
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3. The commission shall meet at least once during each calendar year.
19Additional meetings shall be held as set forth in the bylaws.
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4. All meetings shall be open to the public, and public notice of meetings shall
21be given in the same manner as required under the rule-making provisions in sub.
22(12).
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5. The commission may convene in a closed, nonpublic meeting if the
24commission must discuss any of the following:
SB736,24,2525
a. Noncompliance of a member state with its obligations under the compact.
SB736,25,3
1b. The employment, compensation, discipline, or other personnel matters,
2practices, or procedures related to specific employees, or other matters related to the
3commission's internal personnel practices and procedures.
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c. Current, threatened, or reasonably anticipated litigation.
SB736,25,65
d. Negotiation of contracts for the purchase or sale of goods, services, or real
6estate.
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e. Accusing any person of a crime or formally censuring any person.
SB736,25,98
f. Disclosure of trade secrets or commercial or financial information that is
9privileged or confidential.
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g. Disclosure of information of a personal nature where disclosure would
11constitute a clearly unwarranted invasion of personal privacy.
SB736,25,1212
h. Disclosure of investigatory records compiled for law enforcement purposes.
SB736,25,1613
i. Disclosure of information related to any investigatory reports prepared by or
14on behalf of or for use of the commission or other committee charged with
15responsibility of investigation or determination of compliance issues pursuant to the
16compact.
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j. Matters specifically exempted from disclosure by federal or member state
18statute.
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6. If a meeting, or portion of a meeting, is closed pursuant to this provision, the
20commission's legal counsel or designee shall certify that the meeting may be closed
21and shall reference each relevant exempting provision. The commission shall keep
22minutes that fully and clearly describe all matters discussed in a meeting and shall
23provide a full and accurate summary of actions taken, and the reasons therefore,
24including a description of the views expressed. All documents considered in
25connection with an action shall be identified in such minutes. All minutes and
1documents of a closed meeting shall remain under seal, subject to release by a
2majority vote of the commission or order of a court of competent jurisdiction.
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(c)
Rules and bylaws. The commission shall, by a majority vote of the delegates,
4prescribe bylaws and rules to govern its conduct as may be necessary or appropriate
5to carry out the purposes and exercise the powers of the compact, including all of the
6following:
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1. Establishing the fiscal year of the commission.
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2. Providing reasonable standards and procedures for all of the following:
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a. The establishment and meetings of other committees.
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b. Governing any general or specific delegation of any authority or function of
11the commission.
SB736,26,2012
3. Providing reasonable procedures for calling and conducting meetings of the
13commission, ensuring reasonable advance notice of all meetings, and providing an
14opportunity for attendance of such meetings by interested parties, with enumerated
15exceptions designed to protect the public's interest, the privacy of individuals, and
16proprietary information, including trade secrets. The commission may meet in
17closed session only after a majority of the membership votes to close a meeting in
18whole or in part. As soon as practicable, the commission must make public a copy
19of the vote to close the meeting revealing the vote of each member with no proxy votes
20allowed.
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4. Establishing the titles, duties, and authority, and reasonable procedures for
22the election of the officers of the commission.
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5. Providing reasonable standards and procedures for the establishment of the
24personnel policies and programs of the commission. Notwithstanding any civil
1service or other similar laws of any member state, the bylaws shall exclusively
2govern the personnel policies and programs of the commission.
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6. Promulgating a code of ethics to address permissible and prohibited
4activities of commission members and employees.
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7. Providing a mechanism for winding up the operations of the commission and
6the equitable disposition of any surplus funds that may exist after the termination
7of the compact after the payment or reserving of all of its debts and obligations.