AB193: Bill Text

AB193,18,19 SUBCHAPTER XIV

AB193,18,21 RESPIRATORY CARE INTERSTATE COMPACT

AB193,19,3 448.9886 Respiratory care interstate compact. (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.

AB193,19,4 (b) This compact is designed to achieve the following objectives:

AB193,19,7 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;

AB193,19,8 2. Enhance states’ ability to protect the public’s health and safety;

AB193,19,10 3. Promote the cooperation of member states in regulating the practice of respiratory therapy within those member states;

AB193,19,12 4. Ease administrative burdens on states by encouraging the cooperation of member states in regulating multi-state respiratory therapy practice;

AB193,19,13 5. Support relocating active military members and their spouses; and

AB193,19,14 6. Promote mobility and address workforce shortages.

AB193,19,16 (2) Definitions. As used in this compact, unless the context requires otherwise, the following definitions shall apply:

AB193,19,19 (a) “Active military member” means any person with a full-time duty status in the armed forces of the United States, including members of the national guard and reserve.

AB193,19,24 (b) “Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state’s laws which is imposed by any state authority with regulatory authority over respiratory therapists, such as license denial, censure, revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee’s practice, not including participation in an alternative program.

AB193,20,5 (c) “Alternative program” means a nondisciplinary monitoring or practice remediation process applicable to a respiratory therapist approved by any 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.

AB193,20,7 (d) “Charter member states” means those member states who were the first 7 states to enact the compact into the laws of their state.

AB193,20,10 (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.

AB193,20,12 (f) “Commissioner” means the individual appointed by a member state to serve as the member of the commission for that member state.

AB193,20,13 (g) “Compact” means the respiratory care interstate compact.

AB193,20,18 (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.

AB193,20,24 (i) “Criminal background check” means the submission by the member state of fingerprints 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 CFR 20.3 (d) or successor provision, from the federal bureau of investigation and the state’s criminal history record repository, as defined in 28 CFR 20.3 (f) or successor provision.

AB193,21,2 (j) “Data system” means the commission’s repository of information about licensees as further set forth in sub. (8).

AB193,21,4 (k) “Domicile” means the jurisdiction which is the licensee’s principal home for legal purposes.

AB193,21,6 (L) “Encumbered license” means a license that a state’s respiratory therapy licensing authority has limited in any way.

AB193,21,8 (m) “Executive committee” means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by the commission.

AB193,21,10 (n) “Home state” except as set forth in sub. (5), means the member state that is the licensee’s primary domicile.

AB193,21,12 (o) “Home state license” means an active license to practice respiratory therapy in a home state that is not an encumbered license.

AB193,21,15 (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.

AB193,21,17 (q) “Licensee” means an individual who currently holds an authorization from the state to practice as a respiratory therapist.

AB193,21,20 (r) “Member state” means a state that has enacted the compact and been admitted to the commission in accordance with the provisions herein and commission rules.

AB193,21,23 (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.

AB193,22,2 (t) “Remote state” means a member state where a licensee is exercising or seeking to exercise the compact privilege.

AB193,22,10 (u) “Respiratory therapist” or “respiratory care practitioner” means an individual who holds 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.

AB193,22,14 (v) “Respiratory therapy,” “respiratory therapy practice,” “respiratory care,” “the practice of respiratory care,” and “the practice of respiratory therapy” means the care and services provided by or under the direction and supervision of a respiratory therapist or respiratory care practitioner.

AB193,22,17 (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.

AB193,22,19 (x) “Rule” means a regulation promulgated by an entity that has the force and effect of law.

AB193,23,3 (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.

AB193,23,9 (z) “Significant investigative information” means information, records, and documents received or generated by a state respiratory therapy 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.

AB193,23,11 (zm) “State” means any state, commonwealth, district, or territory of the United States.

AB193,23,13 (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:

AB193,23,14 1. Enact a compact that is not materially different from the model compact;

AB193,23,15 2. License respiratory therapists;

AB193,23,16 3. Participate in the commission’s data system;

AB193,23,18 4. Have a mechanism in place for receiving and investigating complaints against licensees and compact privilege holders;

AB193,23,21 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;

AB193,23,23 6. Notify the commission, in compliance with the terms of this compact and commission rules, of the existence of significant investigative information;

AB193,23,24 7. Comply with the rules of the commission;

AB193,24,2 8. Grant the compact privilege to a holder of an active home state license and otherwise meet the applicable requirements of sub. (4) in a member state; and

AB193,24,4 9. Complete a criminal background check for each new licensee at the time of initial licensure.

AB193,24,12 a. 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 herein. The absence of such a federal law as described in this subd. 9. a. shall not prevent or preclude such authorization where it may be derived or granted through means other than the enactment of this compact.

AB193,24,14 (b) Nothing in this compact prohibits a member state from charging a fee for granting and renewing the compact privilege.

AB193,24,16 (4) Compact privilege. (a) To exercise the compact privilege under the terms and provisions of the compact, the licensee shall:

AB193,24,17 1. Hold and maintain an active home state license as a respiratory therapist;

AB193,24,20 2. Hold and maintain an active credential from the National Board for Respiratory Care (or its successor) that would qualify them for licensure in the remote state in which they are seeking the privilege;

AB193,24,22 3. Have not had any adverse action against a license within the previous 2 years;

AB193,24,24 4. Notify the commission that the licensee is seeking the compact privilege within a remote state(s);

AB193,25,2 5. Pay any applicable fees, including any state and commission fees and renewal fees, for the compact privilege;

AB193,25,4 6. Meet any jurisprudence requirements established by the remote state in which the licensee is seeking a compact privilege;

AB193,25,6 7. Report to the commission adverse action taken by any nonmember state within 30 days from the date the adverse action is taken;

AB193,25,10 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 30 days of the effective date of the change in address; and

AB193,25,15 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 a member state, and consent to accept service of a subpoena by mail at the licensee’s domicile on record with the commission with respect to any action brought or investigation conducted by the commission or a member state.

AB193,25,21 (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 of the requirements of par. (a), above, 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.

AB193,26,4 (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, including, but not limited to, statute, regulations, case law, and other processes available to the state respiratory therapy licensing authority or other government agency.

AB193,26,8 (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.

AB193,26,10 (e) If a home state license is encumbered, the licensee shall lose the compact privilege in all remote states until the following occur:

AB193,26,11 1. The home state license is no longer encumbered; and

AB193,26,13 2. Two years have elapsed from the date on which the license is no longer encumbered due to the adverse action.

AB193,26,16 (f) Once a licensee with a restricted or limited license meets the requirements of par. (e) 1. and 2., the licensee must also meet the requirements of par. (a) to obtain a compact privilege in a remote state.

AB193,26,20 (5) Active military member or their spouse. (a) An active military member, or their spouse, 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.

AB193,27,2 (b) An active military member and their spouse 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 and their spouse for a compact privilege.

AB193,27,5 (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.

AB193,27,8 (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.

AB193,27,12 (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.

AB193,27,13 (d) A remote state shall have the authority to:

AB193,27,15 1. Take adverse actions as set forth herein against a licensee’s compact privilege in that state;

AB193,27,17 2. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence.

AB193,27,20 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.

AB193,28,2 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 in proceedings pending before it.

AB193,28,6 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.

AB193,28,9 d. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses or evidence are located;

AB193,28,12 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;

AB193,28,16 4. Notwithstanding subd. 2., a member state may 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; and

AB193,28,19 5. Nothing in this compact authorizes a member state to impose discipline against a respiratory therapist’s compact privilege in that member state for the individual’s otherwise lawful practice in another state.

AB193,29,2 (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.

AB193,29,8 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 state(s).

AB193,29,11 (f) Nothing in this compact may permit a member state to take any adverse action against a licensee or holder of a compact privilege for conduct or practice that was legal in the member state at the time it was undertaken.

AB193,29,14 (g) Nothing in this compact may permit a member state to take disciplinary action against a licensee or holder of a compact privilege for conduct or practice that was legal in the member state at the time it was undertaken.

AB193,29,21 (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 sub. (11).

AB193,29,24 (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.

AB193,30,2 2. The commissioner shall be an administrator or their designated staff member of the member state’s respiratory therapy licensing authority.