ENROLLED HOUSE
BILL NO. 3781 By: Duel of the House
and
Pugh of
the Senate
An Act relating to physician assistants; creating the PA Licensure
Compact; stating purpose; defining terms; providing requirements for state
participation in the Compact; providing for Compact privilege; providing for
state designation; providing for adverse actions; establishing the PA Licensure
Compact Commission; providing for data and reporting system; providing for
rulemaking; providing for oversight, dispute resolution, and enforcement;
providing for implementation of the Commission; providing for construction and
severability; providing for binding effect of Compact; providing for
codification; and providing an effective date.
SUBJECT: Physician assistants
BE IT
ENACTED BY THE PEOPLE OF THE STATE OF
SECTION 1.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.1 of Title 59, unless there
is created a duplication in numbering, reads as follows:
In order to strengthen access to medical
services and in recognition of the advances in the delivery of medical services,
the participating states of the PA Licensure Compact have allied in common
purpose to develop a comprehensive process that complements the existing
authority of state licensing boards to license and discipline physician
assistants, or PAs, and seeks to enhance the portability of a license to
practice as a PA while safeguarding the safety of patients. The Compact allows medical services to be
provided by PAs via the mutual recognition of the licensee's qualifying license
by other Compact participating states. The
Compact also adopts the prevailing standard for PA licensure and affirms that
the practice and delivery of medical services by the PA occurs where the
patient is located at the time of the patient encounter and therefore requires
the PA to be under the jurisdiction of the state licensing board where the patient
is located. State licensing boards that
participate in the Compact retain the jurisdiction to impose adverse action
against a Compact privilege in that state issued to a PA through the procedures
of the Compact. The PA Licensure Compact
will alleviate burdens for military families by allowing active duty military
personnel and their spouses to obtain a Compact privilege based on having an
unrestricted license in good standing from a participating state.
SECTION 2.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.2 of Title 59, unless
there is created a duplication in numbering, reads as follows:
As used in the Compact:
1.
"Adverse action" means any administrative, civil, equitable,
or criminal action permitted by a state's laws which is imposed by a licensing board
or other authority against a PA license or license application or Compact privilege
such as license denial, censure, revocation, suspension, probation, monitoring
of the licensee, or restriction on the licensee's practice;
2.
"Compact privilege" means the authorization granted by a remote
state to allow a licensee from another participating state to practice as a PA
to provide medical services and other licensed activity to a patient located in
the remote state under the remote state's laws and regulations;
3.
"Conviction" means a finding by a court that an individual is
guilty of a felony or misdemeanor offense through adjudication or entry of a
plea of guilt or no contest to the charge by the offender;
4.
"Criminal background check" means the submission of
fingerprints or other biometric-based information for a license applicant for
the purpose of obtaining that applicant's criminal history record information,
as defined in 28 C.F.R., Section 20.3(d), from the state's criminal history
record repository as defined in 28 C.F.R., Section 20.3(f);
5.
"Data system" means the repository of information about licensees,
including, but not limited to, license status and adverse actions, which is
created and administered under the terms of the Compact;
6.
"Executive committee" means a group of directors and ex officio
individuals elected or appointed pursuant to paragraph 2 of subsection F of Section
7 of this Compact;
7.
"Impaired practitioner" means a PA whose practice is adversely
affected by health-related conditions that impact his or her ability to
practice;
8.
"Investigative information" means information, records, or
documents received or generated by a licensing board pursuant to an
investigation;
9.
"Jurisprudence requirement" means the assessment of an
individual's knowledge of the laws and rules governing the practice of a PA in
a state;
10.
"License" means current authorization by a state, other than
authorization pursuant to a Compact privilege, for a PA to provide medical services,
which would be unlawful without current authorization;
11.
"Licensee" means an individual who holds a license from a state
to provide medical services as a PA;
12.
"Licensing board" means any state entity authorized to license
and otherwise regulate PAs;
13.
"Medical services" means health care services provided for the
diagnosis, prevention, treatment, cure, or relief of a health condition,
injury, or disease, as defined by a state's laws and regulations;
14.
"Model Compact" means the model for the PA Licensure Compact
on file with The Council of State Governments or other entity as designated by
the Commission;
15.
"Participating state" means a state that has enacted the Compact;
16.
"PA" means an individual who is licensed as a physician
assistant in a state. For purposes of the
Compact, any other title or status adopted by a state to replace the term "physician
assistant" shall be deemed synonymous with "physician assistant"
and shall confer the same rights and responsibilities to the licensee under the
provisions of the Compact at the time of its enactment;
17.
"PA Licensure Compact Commission", "Compact Commission",
or "Commission" means the national administrative body created
pursuant to subsection A of Section 7 of this Compact;
18.
"Qualifying license" means an unrestricted license issued by a
participating state to provide medical services as a PA;
19.
"Remote state" means a participating state where a licensee
who is not licensed as a PA is exercising or seeking to exercise the Compact privilege;
20.
"Rule" means a regulation promulgated by an entity that has
the force and effect of law;
21.
"Significant investigative information" means investigative information
that a licensing board, after an inquiry or investigation that includes
notification and an opportunity for the PA to respond if required by state law,
has reason to believe is not groundless and, if proven true, would indicate
more than a minor infraction; and
22.
"State" means any state, commonwealth, district, or territory
of the United States.
SECTION 3.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.3 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
To participate in the Compact, a participating state shall:
1.
License PAs;
2.
Participate in the Compact Commission's data system;
3.
Have a mechanism in place for receiving and investigating complaints
against licensees and license applicants;
4.
Notify the Commission, in compliance with the terms of the Compact and
Commission rules, of any adverse action against a licensee or license applicant
and the existence of significant investigative information regarding a licensee
or license applicant;
5.
Fully implement a criminal background check requirement within a time
frame established by Commission rule, by its licensing board receiving the
results of a criminal background check, and reporting to the Commission whether
the license applicant has been granted a license;
6.
Comply with the rules of the Compact Commission;
7.
Utilize passage of a recognized national exam such as the NCCPA PANCE as
a requirement for PA licensure; and
8.
Grant the Compact privilege to a holder of a qualifying license in a
participating state.
B.
Nothing in the Compact prohibits a participating state from charging a
fee for granting the Compact privilege.
SECTION 4.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.4 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A. To exercise the Compact
privilege, a licensee shall:
1.
Have graduated from a PA program accredited by the Accreditation Review
Commission on Education for the Physician Assistant, Inc., or other programs
authorized by Commission rule;
2.
Hold current NCCPA certification;
3.
Have no felony or misdemeanor conviction;
4.
Have never had a controlled substance license, permit, or registration
suspended or revoked by a state or by the United States Drug Enforcement
Administration;
5.
Have a unique identifier as determined by Commission rule;
6.
Hold a qualifying license;
7.
Have had no revocation of a license or limitation or restriction on any license
currently held due to an adverse action;
8.
If a licensee has had a limitation or restriction on a license or Compact
privilege due to an adverse action, two (2) years must have elapsed from the
date on which the license or Compact privilege is no longer limited or
restricted due to the adverse action;
9.
If a Compact privilege has been revoked or is limited or restricted in a
participating state for conduct that would not be a basis for disciplinary
action in a participating state in which the licensee is practicing or applying
to practice under a Compact privilege, that participating state shall have the
discretion not to consider such action as an adverse action requiring the
denial or removal of a Compact privilege in that state;
10.
Notify the Compact Commission that the licensee is seeking the Compact privilege
in a remote state;
11.
Meet any jurisprudence requirement of a remote state in which the licensee
is seeking to practice under the Compact privilege and pay any fees applicable
to satisfying the jurisprudence requirement; and
12.
Report to the Commission any adverse action taken by a nonparticipating state
within thirty (30) days after the action is taken.
B.
The Compact privilege is valid until the expiration or revocation of the
qualifying license unless terminated pursuant to an adverse action. The licensee must also comply with all of the
requirements of subsection A of this section to maintain the Compact privilege
in a remote state. If the participating state
takes adverse action against a qualifying license, the licensee shall lose the Compact
privilege in any remote state in which the licensee has a Compact privilege
until all of the following occur:
1.
The license is no longer limited or restricted; and
2.
Two (2) years have elapsed from the date on which the license is no
longer limited or restricted due to the adverse action.
C.
Once a restricted or limited license satisfies the requirements of paragraphs
1 and 2 of subsection B of this section, the licensee must meet the
requirements of subsection A of this section to obtain a Compact privilege in
any remote state.
D.
For each remote state in which a PA seeks authority to prescribe
controlled substances, the PA shall satisfy all requirements imposed by such state
in granting or renewing such authority.
SECTION 5.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.5 of Title 59, unless
there is created a duplication in numbering, reads as follows:
Upon a licensee's application for a Compact
privilege, the licensee shall identify to the Commission the participating
state from which the licensee is applying, in accordance with applicable rules
adopted by the Commission, and subject to the following requirements:
1.
When applying for a Compact privilege, the licensee shall provide the
Commission with the address of the licensee's primary residence and thereafter
shall immediately report to the Commission any change in the address of the
licensee's primary residence; and
2.
When applying for a Compact privilege, the licensee is required to
consent to accept service of process by mail at the licensee's primary
residence on file with the Commission with respect to any action brought
against the licensee by the Commission or a participating state, including a
subpoena, with respect to any action brought or investigation conducted by the
Commission or a participating state.
SECTION 6.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.6 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
A participating state in which a licensee is licensed shall have
exclusive power to impose adverse action against the qualifying license issued
by that participating state.
B.
In addition to the other powers conferred by state law, a remote state
shall have the authority, in accordance with existing state due process law, to
do all of the following:
1.
Take adverse action against a PA's Compact privilege within that state
to remove a licensee's Compact privilege or take other action necessary under
applicable law to protect the health and safety of its citizens;
2.
Issue subpoenas for both hearings and investigations that require the
attendance and testimony of witnesses, as well as the production of evidence. Subpoenas issued by a licensing board in a
participating state for the attendance and testimony of witnesses or the
production of evidence from another participating state shall be enforced in
the latter state by any court of competent jurisdiction, according to the
practice and procedure of that court applicable to subpoenas issued in proceedings
pending before it. The issuing authority
shall pay any witness fees, travel expenses, mileage, and other fees required
by the service statutes of the state in which the witnesses or evidence are
located;
3.
Notwithstanding paragraph 2 of this subsection, subpoenas may not be
issued by a participating state to gather evidence of conduct in another state
that is lawful in that other state for the purpose of taking adverse action
against a licensee's Compact privilege or application for a Compact privilege
in that participating state; and
4.
Nothing in the Compact authorizes a participating state to impose
discipline against a PA's Compact privilege or to deny an application for a Compact
privilege in that participating state for the individual's otherwise lawful
practice in another state.
C.
For purposes of taking adverse action, the participating state which
issued the qualifying license shall give the same priority and effect to
reported conduct received from any other participating state as it would if the
conduct had occurred within the participating state which issued the qualifying
license. In so doing, that participating
state shall apply its own state laws to determine appropriate action.
D.
A participating state, if otherwise permitted by state law, may recover
from the affected PA the costs of investigations and disposition of cases
resulting from any adverse action taken against that PA.
E.
A participating state may take adverse action based on the factual
findings of a remote state, provided that the participating state follows its
own procedures for taking the adverse action.
F.
Joint investigations:
1.
In addition to the authority granted to a participating state by its
respective state PA laws and regulations or other applicable state law, any
participating state may participate with other participating states in joint
investigations of licensees; and
2.
Participating states shall share any investigative, litigation, or
compliance materials in furtherance of any joint or individual investigation
initiated under the Compact.
G.
If an adverse action is taken against a PA's qualifying license, the PA's
Compact privilege in all remote states shall be deactivated until two (2) years
have elapsed after all restrictions have been removed from the state license. All disciplinary orders by the participating
state which issued the qualifying license that impose adverse action against a
PA's license shall include a statement that the PA's Compact privilege is
deactivated in all participating states during the pendency of the order.
H.
If any participating state takes adverse action, it promptly shall
notify the administrator of the data system.
SECTION 7.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.7 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
The participating states hereby create and establish a joint government
agency and national administrative body known as the PA Licensure Compact
Commission. The Commission is an
instrumentality of the Compact states acting jointly and not an instrumentality
of any one state. The Commission shall
come into existence on or after the effective date of the Compact as set forth
in subsection A of Section 11.
B.
Membership, voting, and meetings:
1.
Each participating state shall have and be limited to one delegate
selected by that participating state's licensing board or, if the state has
more than one licensing board, selected collectively by the participating state's
licensing boards;
2.
The delegate shall be either:
a. a
current PA, physician, or public member of a licensing board or PA council/committee,
or
b. an
administrator of a licensing board;
3.
Any delegate may be removed or suspended from office as provided by the
laws of the state from which the delegate is appointed;
4.
The participating state licensing board shall fill any vacancy occurring
in the Commission within sixty (60) days;
5.
Each delegate shall be entitled to one vote on all matters voted on by
the Commission and shall otherwise have an opportunity to participate in the
business and affairs of the Commission. A delegate shall vote in person or by such
other means as provided in the bylaws. The
bylaws may provide for delegates' participation in meetings by
telecommunications, video conference, or other means of communication;
6.
The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth
in the Compact and the bylaws; and
7.
The Commission shall establish by rule a term of office for delegates.
C.
The Commission shall have the following powers and duties:
1.
Establish a code of ethics for the Commission;
2.
Establish the fiscal year of the Commission;
3.
Establish fees;
4.
Establish bylaws;
5.
Maintain its financial records in accordance with the bylaws;
6.
Meet and take such actions as are consistent with the provisions of the Compact
and the bylaws;
7.
Promulgate rules to facilitate and coordinate implementation and
administration of the Compact. The rules
shall have the force and effect of law and shall be binding in all participating
states;
8.
Bring and prosecute legal proceedings or actions in the name of the
Commission, provided that the standing of any state licensing board to sue or
be sued under applicable law shall not be affected;
9.
Purchase and maintain insurance and bonds;
10.
Borrow, accept, or contract for services of personnel, including, but
not limited to, employees of a participating state;
11.
Hire employees and engage contractors, elect or appoint officers, fix
compensation, define duties, grant such individuals appropriate authority to
carry out the purposes of 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.
Accept any and all appropriate donations and grants of money, equipment,
supplies, materials, and services, and receive, utilize, and dispose of the
same, provided that at all times the Commission shall avoid any appearance of
impropriety or conflict of interest;
13.
Lease, purchase, accept appropriate gifts or donations of, or otherwise
own, hold, improve, or use, any property, real, personal or mixed, provided
that at all times the Commission shall avoid any appearance of impropriety;
14.
Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise
dispose of any property, real, personal, or mixed;
15.
Establish a budget and make expenditures;
16.
Borrow money;
17.
Appoint committees, including standing committees, composed of members, state
regulators, state legislators or their representatives, and consumer
representatives and such other interested persons as may be designated in the Compact
and the bylaws;
18.
Provide and receive information from, and cooperate with, law
enforcement agencies;
19. Elect a chair, vice-chair, secretary and
treasurer, and such other officers of the Commission as provided in the
Commission's bylaws;
20. Reserve for itself, in addition to those
reserved exclusively to the Commission under the Compact, powers that the executive
committee may not exercise;
21. Approve or disapprove a state's participation
in the Compact based upon its determination as to whether the state's Compact
legislation departs in a material manner from the model Compact language;
22. Prepare and provide to the participating states
an annual report; and
23. Perform such other functions as may be
necessary or appropriate to achieve the purposes of the Compact consistent with
the state regulation of PA licensure and practice.
D.
Meetings of the Commission:
1.
All meetings of the Commission that are not closed pursuant to this
subsection shall be open to the public.
Notice of public meetings shall be posted on the Commission's website at
least thirty (30) days prior to the public meeting;
2.
Notwithstanding paragraph 1 of this subsection, the Commission may
convene a public meeting by providing at least twenty-four (24) hours prior
notice on the Commission's website, and any other means as provided in the
Commission's rules, for any of the reasons it may dispense with notice of
proposed rulemaking under subsection L of Section 9 of this Compact;
3.
The Commission may convene in a closed, nonpublic meeting or nonpublic
part of a public meeting to receive legal advice or to discuss:
a. noncompliance
of a participating state with its obligations under the Compact,
b. the
employment, compensation, discipline, or other matters, practices, or
procedures, related to specific employees or other matters related to the
Commission's internal personnel practices and procedures,
c. current,
threatened, or reasonably anticipated litigation,
d. negotiation
of contracts for the purchase, lease, or sale of goods, services, or real
estate,
e. accusing
any person of a crime or formally censuring any person,
f. disclosure
of trade secrets or commercial or financial information that is privileged or
confidential,
g. disclosure
of information of a personal nature where disclosure would constitute a clearly
unwarranted invasion of personal privacy,
h. disclosure
of investigative records compiled for law enforcement purposes,
i. disclosure
of information related to any investigative reports prepared 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 the Compact,
j. legal
advice, or
k. matters
specifically exempted from disclosure by federal or participating states'
statutes;
4.
If a meeting, or portion of a meeting, is closed pursuant to this subsection,
the chair of the meeting or the chair's designee shall certify that the meeting
or portion of the meeting may be closed and shall reference each relevant
exempting provision; and
5.
The Commission shall keep minutes that fully and clearly describe all
matters discussed in a meeting and shall provide a full and accurate summary of
actions taken, including a description of the views expressed. All documents considered in connection with an
action shall be identified in such minutes. All minutes and documents of a closed meeting
shall remain under seal, subject to release by a majority vote of the
Commission or order of a court of competent jurisdiction.
E.
Financing of the Commission:
1.
The Commission shall pay, or provide for the payment of, the reasonable
expenses of its establishment, organization, and ongoing activities;
2.
The Commission may accept any and all appropriate revenue sources,
donations, and grants of money, equipment, supplies, materials, and services;
and
3.
The Commission may levy on and collect an annual assessment from each
participating state and may impose Compact privilege fees on licensees of
participating states to whom a Compact privilege is granted to cover the cost
of the operations and activities of the Commission and its staff, which must be
in a total amount sufficient to cover its annual budget as approved by the Commission
each year for which revenue is not provided by other sources. The aggregate annual assessment amount levied
on participating states shall be allocated based upon a formula to be
determined by Commission rule.
a. a
Compact privilege expires when the licensee's qualifying license in the
participating state from which the licensee applied for the Compact privilege
expires, and
b. if
the licensee terminates the qualifying license through which the licensee
applied for the Compact privilege before its scheduled expiration, and the
licensee has a qualifying license in another participating state, the licensee
shall inform the Commission that it is changing to that participating state the
participating state through which it applies for a Compact privilege and pay to
the Commission any Compact privilege fee required by Commission rule;
4.
The Commission shall not incur obligations of any kind prior to securing
the funds adequate to meet the same, nor shall the Commission pledge the credit
of any of the participating states, except by and with the authority of the
participating state;
5.
The Commission shall keep accurate accounts of all receipts and
disbursements. The receipts and
disbursements of the Commission shall be subject to the financial review and
accounting procedures established under its bylaws. All receipts and disbursements of funds
handled by the Commission shall be subject to an annual financial review by a
certified or licensed public accountant, and the report of the financial review
shall be included in and become part of the annual report of the Commission.
F.
The executive committee:
1.
The executive committee shall have the power to act on behalf of the
Commission according to the terms of the Compact and Commission rules;
2.
The executive committee shall be composed of nine (9) members:
a. seven
voting members who are elected by the Commission from the current membership of
the Commission,
b. one
ex officio, nonvoting member from a recognized national PA professional association,
and
c. one
ex officio, nonvoting member from a recognized national PA certification
organization;
3.
The ex officio members will be selected by their respective
organizations;
4.
The Commission may remove any member of the executive committee as
provided in its bylaws;
5.
The executive committee shall meet at least annually;
6.
The executive committee shall have the following duties and
responsibilities:
a. recommend
to the Commission changes to the Commission's rules or bylaws, changes to the Compact
legislation, fees to be paid by Compact participating states such as annual
dues, and any Commission Compact fee charged to licensees for the Compact
privilege,
b. ensure
Compact administration services are appropriately provided, contractual or
otherwise,
c. prepare
and recommend the budget,
d. maintain
financial records on behalf of the Commission,
e. monitor
Compact compliance of participating states and provide compliance reports to
the Commission,
f. establish
additional committees as necessary,
g. exercise
the powers and duties of the Commission during the interim between Commission
meetings, except for issuing proposed rulemaking or adopting Commission rules
or bylaws, or exercising any other powers and duties exclusively reserved to
the Commission by the Commission's rules, and
h. perform
other duties as provided in the Commission's rules or bylaws;
7.
All meetings of the executive committee at which it votes or plans to
vote on matters in exercising the powers and duties of the Commission shall be
open to the public, and public notice of such meetings shall be given as public
meetings of the Commission are given; and
8.
The executive committee may convene in a closed, nonpublic meeting for
the same reasons that the Commission may convene in a nonpublic meeting as set
forth in paragraph 3 of subsection D of this section and shall announce the
closed meeting as the Commission is required to under paragraph 4 of subsection
D of this section and keep minutes of the closed meeting as the Commission is
required to under paragraph 5 of subsection D of this section.
G.
Qualified immunity, defense, and indemnification:
1.
The members, officers, executive director, employees, and
representatives of the Commission shall be immune from suit and liability, both
personally and in their official capacity, for any claim for damage to or loss
of property or personal injury or other civil liability caused by or arising
out of any actual or alleged act, error, or omission that occurred, or that the
person against whom the claim is made had a reasonable basis for believing it occurred
within the scope of Commission employment, duties, or responsibilities,
provided that nothing in this paragraph shall be construed to protect any such
person from suit or liability for any damage, loss, injury, or liability caused
by the intentional or willful or wanton misconduct of that person. The procurement of insurance of any type by
the Commission shall not in any way compromise or limit the immunity granted
hereunder;
2.
The Commission shall defend any member, officer, executive director,
employee, and representative of the Commission in any civil action seeking to
impose liability arising out of any actual or alleged act, error, or omission
that occurred within the scope of Commission employment, duties, or
responsibilities, or as determined by the Commission that the person against
whom the claim is made had a reasonable basis for believing occurred within the
scope of Commission employment, duties, or responsibilities, provided that
nothing herein shall be construed to prohibit that person from retaining their
own counsel at their own expense, and provided further, that the actual or
alleged act, error, or omission did not result from that person's intentional
or willful or wanton misconduct;
3.
The Commission shall indemnify and hold harmless any member, officer,
executive director, employee, and representative of the Commission for the
amount of any settlement or judgment obtained against that person arising out
of any actual or alleged act, error, or omission that occurred within the scope
of Commission employment, duties, or responsibilities, or that such person had
a reasonable basis for believing occurred within the scope of Commission
employment, duties, or responsibilities, provided that the actual or alleged
act, error, or omission did not result from the intentional or willful or
wanton misconduct of that person;
4.
Venue is proper and judicial proceedings by or against the Commission
shall be brought solely and exclusively in a court of competent jurisdiction
where the principal office of the Commission is located. The Commission may waive venue and
jurisdictional defenses in any proceedings as authorized by Commission rules;
5.
Nothing herein shall be construed as a limitation on the liability of
any licensee for professional malpractice or misconduct, which shall be
governed solely by any other applicable state laws;
6.
Nothing herein shall be construed to designate the venue or jurisdiction
to bring actions for alleged acts of malpractice, professional misconduct,
negligence, or other such civil action pertaining to the practice of a PA. All such matters shall be determined
exclusively by state law other than the Compact;
7.
Nothing in the Compact shall be interpreted to waive or otherwise
abrogate a participating state's state action immunity or state action
affirmative defense with respect to antitrust claims under the Sherman Act,
Clayton Act, or any other state or federal antitrust or anticompetitive law or
regulation; and
8.
Nothing in the Compact shall be construed to be a waiver of sovereign
immunity by the participating states or by the Commission.
SECTION 8.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.8 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
The Commission shall provide for the development, maintenance,
operation, and utilization of a coordinated data and reporting system
containing licensure, adverse action, and the reporting of the existence of significant
investigative information on all licensed PAs and applicants denied a license
in participating states.
B.
Notwithstanding any other state law to the contrary, a participating
state shall submit a uniform data set to the data system on all PAs to whom the
Compact is applicable (utilizing a unique identifier) as required by the rules
of the Commission, including:
1.
Identifying information;
2.
Licensure data;
3.
Adverse actions against a license or Compact privilege; and
4.
Any denial of application for licensure and the reason for such denial, excluding
the reporting of any criminal history record information where prohibited by
law;
5.
The existence of significant investigative information; and
6.
Other information that may facilitate the administration of the Compact,
as determined by the rules of the Commission.
C.
Significant investigative information pertaining to a licensee in any
participating state shall only be available to other participating states.
D.
The Commission shall promptly notify all participating states of any
adverse action taken against a licensee or an individual applying for a license
that has been reported to it. This adverse
action information shall be available to any other participating state.
E.
Participating states contributing information to the data system may, in
accordance with state or federal law, designate information that may not be
shared with the public without the express permission of the contributing state.
Notwithstanding any such designation,
such information shall be reported to the Commission through the data system.
F.
Any information submitted to the data system that is subsequently
expunged pursuant to federal law or the laws of the participating state
contributing the information shall be removed from the data system upon
reporting of such by the participating state to the Commission.
G.
The records and information provided to a participating state pursuant
to the Compact or through the data system, when certified by the Commission or
an agent thereof, shall constitute the authenticated business records of the
Commission and shall be entitled to any associated hearsay exception in any
relevant judicial, quasi-judicial, or administrative proceedings in a participating
state.
SECTION 9.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.9 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
The Commission shall exercise its rulemaking powers pursuant to the
criteria set forth in this section and the rules adopted thereunder. Commission rules shall become binding as of
the date specified by the Commission for each rule.
B.
The Commission shall promulgate reasonable rules in order to effectively
and efficiently implement and administer the Compact and achieve its purposes. A Commission rule shall be invalid and have no
force or effect only if a court of competent jurisdiction holds that the rule
is invalid because the Commission exercised its rulemaking authority in a
manner that is beyond the scope of the purposes of the Compact, or the powers
granted hereunder, or based upon another applicable standard of review.
C.
The rules of the Commission shall have the force of law in each participating
state; provided, however, that where the rules of the Commission conflict with
the laws of the participating state that establish the medical services a PA
may perform in the participating state, as held by a court of competent
jurisdiction, the rules of the Commission shall be ineffective in that state to
the extent of the conflict.
D.
If a majority of the legislatures of the participating states rejects a
Commission rule, by enactment of a statute or resolution in the same manner
used to adopt the Compact within four (4) years of the date of adoption of the
rule, then such rule shall have no further force and effect in any
participating state or to any state applying to participate in the Compact.
E.
Commission rules shall be adopted at a regular or special meeting of the
Commission.
F.
Prior to promulgation and adoption of a final rule or rules by the
Commission, and at least thirty (30) days in advance of the meeting at which
the rule will be considered and voted upon, the Commission shall file a notice
of proposed rulemaking:
1.
On the website of the Commission or other publicly accessible platform;
2.
To persons who have requested notice of the Commission's notices of
proposed rulemaking; and
3.
In such other way(s) as the Commission may by rule specify.
G.
The notice of proposed rulemaking shall include:
1.
The time, date, and location of the public hearing on the proposed rule
and the proposed time, date, and location of the meeting in which the proposed
rule will be considered and voted upon;
2.
The text of the proposed rule and the reason for the proposed rule;
3.
A request for comments on the proposed rule from any interested person
and the date by which written comments must be received; and
4.
The manner in which interested persons may submit notice to the
Commission of their intention to attend the public hearing or provide any
written comments.
H.
Prior to adoption of a proposed rule, the Commission shall allow persons
to submit written data, facts, opinions, and arguments, which shall be made
available to the public.
I.
If the hearing is to be held via electronic means, the Commission shall
publish the mechanism for access to the electronic hearing.
1.
All persons wishing to be heard at the hearing shall, as directed in the
notice of proposed rulemaking, not less than five (5) business days before the
scheduled date of the hearing, notify the Commission of their desire to appear
and testify at the hearing.
2.
Hearings shall be conducted in a manner providing each person who wishes
to comment a fair and reasonable opportunity to comment orally or in writing.
3.
All hearings shall be recorded. A
copy of the recording and the written comments, data, facts, opinions, and
arguments received in response to the proposed rulemaking shall be made
available to a person upon request.
4.
Nothing in this section shall be construed as requiring a separate
hearing on each proposed rule. Proposed rules
may be grouped for the convenience of the Commission at hearings required by
this section.
J.
Following the public hearing, the Commission shall consider all written
and oral comments timely received.
K.
The Commission shall, by majority vote of all delegates, take final
action on the proposed rule and shall determine the effective date of the rule,
if adopted, based on the rulemaking record and the full text of the rule.
1.
If adopted, the rule shall be posted on the Commission's website.
2.
The Commission may adopt changes to the proposed rule provided the
changes do not enlarge the original purpose of the proposed rule.
3.
The Commission shall provide on its website an explanation of the
reasons for substantive changes made to the proposed rule, as well as reasons
for substantive changes not made that were recommended by commenters.
4.
The Commission shall determine a reasonable effective date for the rule.
Except for an emergency as provided in
subsection L of this section, the effective date of the rule shall be no sooner
than thirty (30) days after the Commission issued the notice that it adopted
the rule.
L.
Upon determination that an emergency exists, the Commission may consider
and adopt an emergency rule with twenty-four (24) hours prior notice, without
the opportunity for comment or hearing, provided that the usual rulemaking
procedures provided in the Compact and in this section shall be retroactively
applied to the rule as soon as reasonably possible, in no event later than
ninety (90) days after the effective date of the rule. For the purposes of this subsection, an
emergency rule is one that must be adopted immediately by the Commission in
order to:
1.
Meet an imminent threat to public health, safety, or welfare;
2.
Prevent a loss of Commission or participating state funds;
3.
Meet a deadline for the promulgation of a Commission rule that is
established by federal law or rule; or
4.
Protect public health and safety.
M.
The Commission or an authorized committee of the Commission may direct
revisions to a previously adopted Commission rule for purposes of correcting
typographical errors, errors in format, errors in consistency, or grammatical
errors. Public notice of any revisions
shall be posted on the website of the Commission. The revision shall be subject to challenge by
any person for a period of thirty (30) days after posting. The revision may be challenged only on grounds
that the revision results in a material change to a rule. A challenge shall be made as set forth in the
notice of revisions and delivered to the Commission prior to the end of the
notice period. If no challenge is made,
the revision will take effect without further action. If the revision is challenged, the revision
may not take effect without the approval of the Commission.
N.
No participating state's rulemaking requirements shall apply under the Compact.
SECTION 10.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.10 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
Oversight:
1.
The executive and judicial branches of state government in each
participating state shall enforce the Compact and take all actions necessary
and appropriate to implement the Compact;
2.
Venue is proper and judicial proceedings by or against the Commission
shall be brought solely and exclusively in a court of competent jurisdiction
where the principal office of the Commission is located. The Commission may waive venue and
jurisdictional defenses to the extent it adopts or consents to participate in
alternative dispute resolution proceedings. Nothing herein shall affect or limit the
selection or propriety of venue in any action against a licensee for
professional malpractice, misconduct, or any such similar matter; and
3.
The Commission shall be entitled to receive service of process in any
proceeding regarding the enforcement or interpretation of the Compact or the
Commission's rules and shall have standing to intervene in such a proceeding
for all purposes. Failure to provide the
Commission with service of process shall render a judgment or order in such
proceeding void as to the Commission, the Compact, or Commission rules.
B.
Default, technical assistance, and termination:
1.
If the Commission determines that a participating state has defaulted in
the performance of its obligations or responsibilities under the Compact or the
Commission rules, the Commission shall provide written notice to the defaulting
state and other participating states. The
notice shall describe the default, the proposed means of curing the default,
and any other action that the Commission may take and shall offer remedial
training and specific technical assistance regarding the default;
2.
If a state in default fails to cure the default, the defaulting state
may be terminated from the Compact upon an affirmative vote of a majority of
the delegates of the participating states, and all rights, privileges, and
benefits conferred by the Compact upon such state may be terminated on the
effective date of termination. A cure of
the default does not relieve the offending state of obligations or liabilities
incurred during the period of default;
3.
Termination of participation in the Compact shall be imposed only after
all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall
be given by the Commission to the governor, the majority and minority leaders
of the defaulting state's legislature, and to the licensing boards of each of
the participating states;
4.
A state that has been terminated is responsible for all assessments,
obligations, and liabilities incurred through the effective date of
termination, including obligations that extend beyond the effective date of
termination;
5.
The Commission shall not bear any costs related to a state that is found
to be in default or that has been terminated from the Compact, unless agreed
upon in writing between the Commission and the defaulting state;
6.
The defaulting state may appeal its termination from the Compact by the
Commission by petitioning the U.S. District Court for the District of Columbia
or the federal district where the Commission has its principal offices. The prevailing member shall be awarded all
costs of such litigation, including reasonable attorney fees; and
7.
Upon the termination of a state's participation in the Compact, the state
shall immediately provide notice to all licensees within that state of such
termination:
a. licensees
who have been granted a Compact privilege in that state shall retain the Compact
privilege for one hundred eighty (180) days following the effective date of
such termination, and
b. licensees
who are licensed in that state who have been granted a Compact privilege in a
participating state shall retain the Compact privilege for one hundred eighty
(180) days unless the licensee also has a qualifying license in a participating
state or obtains a qualifying license in a participating state before the one-hundred-eighty-day
period ends, in which case the Compact privilege shall continue.
C.
Dispute resolution:
1.
Upon request by a participating state, the Commission shall attempt to
resolve disputes related to the Compact that arise among participating states
and between participating and nonparticipating states; and
2.
The Commission shall promulgate a rule providing for both mediation and
binding dispute resolution for disputes as appropriate.
D.
Enforcement:
1.
The Commission, in the reasonable exercise of its discretion, shall
enforce the provisions of the Compact and rules of the Commission;
2.
If compliance is not secured after all means to secure compliance have
been exhausted, by majority vote, the Commission may initiate legal action in
the U.S. District Court for the District of Columbia or the federal district
where the Commission has its principal offices against a participating state in
default to enforce compliance with the provisions of the Compact and the
Commission's promulgated rules and bylaws. The relief sought may include both injunctive
relief and damages. In the event
judicial enforcement is necessary, the prevailing party shall be awarded all
costs of such litigation, including reasonable attorney fees; and
3.
The remedies herein shall not be the exclusive remedies of the
Commission. The Commission may pursue
any other remedies available under federal or state law.
E.
Legal action against the Commission:
1.
A participating state may initiate legal action against the Commission
in the U.S. District Court for the District of Columbia or the federal district
where the Commission has its principal offices to enforce compliance with the
provisions of the Compact and its rules. The relief sought may include both injunctive
relief and damages. In the event
judicial enforcement is necessary, the prevailing party shall be awarded all
costs of such litigation, including reasonable attorney fees.
2.
No person other than a participating state shall enforce the Compact
against the Commission.
SECTION 11.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.11 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
The Compact shall come into effect on the date on which the Compact
statute is enacted into law in the seventh participating state.
1.
On or after the effective date of the Compact, the Commission shall
convene and review the enactment of each of the states that enacted the Compact
prior to the Commission convening "Charter Participating States" to
determine if the statute enacted by each such Charter Participating State is
materially different than the model Compact:
a. A
Charter Participating State whose enactment is found to be materially different
from the model Compact shall be entitled to the default process set forth in subsection
B of Section 10 of this Compact, and
b. If
any participating state later withdraws from the Compact or its participation
is terminated, the Commission shall remain in existence and the Compact shall
remain in effect even if the number of participating states should be less than
seven. Participating states enacting the Compact subsequent to the Commission
convening shall be subject to the process set forth in paragraph 21 of
subsection C of Section 7 of this Compact to determine if their enactments are
materially different from the model Compact and whether they qualify for
participation in the Compact;
2.
Participating states enacting the Compact subsequent to the seven
initial Charter Participating States shall be subject to the process set forth
in paragraph 21 of subsection C of Section 7 of this Compact to determine if
their enactments are materially different from the model Compact and whether
they qualify for participation in the Compact; and
3.
All actions taken for the benefit of the Commission or in furtherance of
the purposes of the administration of the Compact prior to the effective date
of the Compact or the Commission coming into existence shall be considered to
be actions of the Commission unless specifically repudiated by the Commission.
B.
Any state that joins the Compact shall be subject to the Commission's 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
day the Compact becomes law in that state.
C.
Any participating state may withdraw from the Compact by enacting a
statute repealing the same.
1.
A participating state's withdrawal shall not take effect until one
hundred eighty (180) days after enactment of the repealing statute. During this one-hundred-eighty-day period, all
Compact privileges that were in effect in the withdrawing state and were
granted to licensees licensed in the withdrawing state shall remain in effect. If any licensee licensed in the withdrawing
state is also licensed in another participating state or obtains a license in
another participating state within the one hundred eighty (180) days, the
licensee's Compact privileges in other participating states shall not be
affected by the passage of the one hundred eighty (180) days.
2.
Withdrawal shall not affect the continuing requirement of the state
licensing boards of the withdrawing state to comply with the investigative and
adverse action reporting requirements of the Compact prior to the effective
date of withdrawal.
3.
Upon the enactment of a statute withdrawing a state from the Compact,
the state shall immediately provide notice of such withdrawal to all licensees
within that state. Such withdrawing state
shall continue to recognize all licenses granted pursuant to the Compact for a
minimum of one hundred eighty (180) days after the date of such notice of
withdrawal.
D.
Nothing contained in the Compact shall be construed to invalidate or
prevent any PA licensure agreement or other cooperative arrangement between
participating states and between a participating state and nonparticipating
state that does not conflict with the provisions of the Compact.
E.
The Compact may be amended by the participating states. No amendment to the Compact shall become
effective and binding upon any participating state until it is enacted
materially in the same manner into the laws of all participating states as determined
by the Commission.
SECTION 12.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.12 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
The 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 the Compact shall be severable, and if any phrase,
clause, sentence, or provision of the Compact is held by a court of competent
jurisdiction to be contrary to the constitution of any participating state, a
state seeking participation in the Compact, or of the United States, or the
applicability thereof to any government, agency, person, or circumstance is
held to be unconstitutional by a court of competent jurisdiction, the validity
of the remainder of the Compact and the applicability thereof to any other
government, agency, person, or circumstance shall not be affected thereby.
C.
Notwithstanding subsection B of this section, the Commission may deny a
state's participation in the Compact or, in accordance with the requirements of
subsection B of Section 10 of this Compact, terminate a participating state's
participation in the Compact, if it determines that a constitutional
requirement of a participating state is, or would be with respect to a state
seeking to participate in the Compact, a material departure from the Compact. Otherwise, if the Compact shall be held to be
contrary to the constitution of any participating state, the Compact shall
remain in full force and effect as to the remaining participating states and in
full force and effect as to the participating state affected as to all
severable matters.
SECTION 13.
NEW LAW A new section of law
to be codified in the Oklahoma Statutes as Section 545.13 of Title 59, unless
there is created a duplication in numbering, reads as follows:
A.
Nothing herein prevents the enforcement of any other law of a
participating state that is not inconsistent with the Compact.
B.
Any laws in a participating state in conflict with the Compact are superseded
to the extent of the conflict.
C.
All agreements between the Commission and the participating states are
binding in accordance with their terms.
SECTION 14.
This act shall become effective November 1, 2024.
Passed the
House of Representatives the 4th day of March, 2024.
Presiding
Officer of the House
of
Representatives
Passed the Senate the 15th day of
April, 2024.
Presiding
Officer of the Senate
OFFICE OF THE GOVERNOR
Received by the Office
of the Governor this ____________________ day of ___________________,
20_______, at _______ o'clock _______ M.
By:
_________________________________
Approved by the
Governor of the State of Oklahoma this _________ day of ___________________,
20_______, at _______ o'clock _______ M.
_________________________________
Governor of
the State of Oklahoma
OFFICE
OF THE SECRETARY OF STATE
Received by the Office
of the Secretary of State this __________ day of ___________________,
20_______, at _______ o'clock _______ M.
By:
_________________________________